Today one of my favorite lecturers gave an assignment.
Frankly, I failed a pass/fail course. Every Monday a case would be released. And, every Friday a case report and quiz is due
I missed 2 of 12. The first, the week I got sick with a lengthy, but ultimately, treatable diagnosis. The second, the final quiz before exams.
So to pass the class she’s made a supplementary assignment for those like me.
“So this assignment is about drilling down to the root cause of a problem. Defining and redefining the problem is something that Spine cases aim to work on regularly, and you will be studying a case specifically about root cause analysis in veterinary practice in 4th year. But in the meantime, let’s take your skills at defining a clinical veterinary problem and apply them to your own work life.
One method for getting to the root cause of a problem is the “Five Whys” method, popularized by the Toyota corporation. Google it if you would like more information, but the main idea is that when faced with a problem, you ask yourself “why” a series of times to uncover the underlying cause of the problem. Usually 5 times is enough, but you may have to go further. The idea is to dig down deep enough to uncover the root cause of a problem.”
Because I didnt complete the tasks as required.
Why did you not complete the tasks?
Because I got overwhelmed and missed them.
Why did you get overwhelmed?
I got sick and fell behind, then I felt rushed and unprepared in other areas, distracting me from this one.
Why did you get sick/why did you fall behind?
Apparently it’s common in women. I fell behind in all my classes because I was exhausted and spent too much time sleeping. In trying to catch up, I panicked and things slid through the cracks.
Why did you panic?
Because I didn’t follow my coping strategies and routines well enough. I panicked and tried to recreate them on the fly to get more done in some areas, leading me to fall further behind in other areas (like spine). Thus my checks weren’t thorough when I went back to see that my work was completed as I wasn’t focused on the task at hand but busy worrying about others.
Why didnt you follow your coping strategies?
Because of lots of reasons. They’re newly acquired and I reverted to old, poorer habits under pressure. In trying to catch up, I did not work methodically, but grasped at straws trying to prioritize.
“Predictably, the next part of this assignment is to make a plan to prevent the problem from reoccurring.
What I’m looking for is evidence that you have thought this through. In 4th year Spine you are often asked to justify treatment plans in terms of why the treatment should work, how it will work, and how success can be measured. You should take a similar approach when designing a “treatment” plan for your problem.”
- Therapy: Thankfully finished
- Medication: changed and going well now
- Anxiety: learned coping methods at therapy and on medication
- Exercise – health stuff got in the way but working it back in
- stim tools – still working on this, as I’m an adult and the majority of stim tools seem to be designed for children. But grounding is just as important for adults as it is for kids. My noise cancelling headphones work great for separating from busy atmospheres.
- Help: ask for it. Ask to review exams. Ask to discuss questions. Work with friends. Get help when something is not right. Get medication, get tested, if it doesn’t feel right, it probably isn’t, trust your body and ask for help.
- Organization: Bullet journaling – it’s infinitely customizable and well suited to the business of vet school. When used correctly, it does help me immensely with staying organized. I use excel to track my lectures and labs.
- Executive function: Falls to organization to help with. I used to rely on the anxiety, but therapy was to teach me to favor routine. If I mess up the morning portion, there is still the afternoon, the evening. But to get up and take that first step every day.
- Make lists – especially checklists
- Set alarms
- Sticky notes – on my laptop, on the wall where I look when I first wake up, on the door to my room, in my study space.
- Calendar events
- Excel sheets semester calendars with important lectures/labs/assignments made important
- Timer – work I love I stop doing, and work I don’t love, I keep doing.
- Routines – are easier to enforce than individual actions. I lose my keys every day, but I tend to lose in them in 1 of about 10 spots. My routine means I put things in odd places, but I’ve made those places work for me.
- Make a morning routine – ie up at 6am, coffee and take care of dog. at home lectures or attend lectures during lecture hours…. ect ect. Have marked times for things to happen so when something falls apart, the next can fall into place. This works pretty well. Not so well in the case of the anemia had me asleep more than it didn’t and I missed too many points to catch up and it snowballed. Thankfully I had notes and stuff already done or it would have been worse than only two missed assignments.
- Next time, I have talked with a few friends in my class to organize a better support system between ourselves. If I miss listening/attending a lecture, one of us wont have. If there is something due, we will check on each other. Basically, if all my organization comes to naught, and I still screw up, hopefully a human check will catch whatever I miss.
- I am always going to have issues in this area. It is always going to require editing and work, steps forward and steps backwards.
How is success measured? This last year I measured it in check boxes checked, exam marks returned, lectures attended, assignments completed on my schedule and others. It worked. I saw a steady increase in my grades until the anemia, when it started to slip away again. My lectures attended increased dramatically from the start of therapy to its conclusion, as the mental health stuff became better controlled. Assignments were completed well within my personal schedule and overall I felt much better.
But the uptick and positives ran flat. I think, if this was last year, when I dropped the ball, I dropped it far more spectacularly than I did this year. So while in the end I didnt achieve every grade I wanted on every exam. Even during my worst this year, I performed better than last year or the year prior to that. Getting my memory and focus back with the b12 deficiency diagnosis, and my energy back with the anemia diagnosis. Stabilizing on the new anxiety meds and following the therapist’s recommendations for “moving forward” everyday. Despite having screwed up and not completing my work for spine, I am relieved to know my head works well enough under pressure to still allow me to pass my exams. Moving forward, I can rely on the support systems I have built to prevent me from missing important tasks as well.
So next year, my success will be measured much the same, with greater expectations. There isn’t an excuse for missing clearly outlined work, as there is not an excuse for not learning clearly defined material. I really look forward to what my future holds now that I have spent a year fully coming to terms with all the aspects of myself. Executive function issues, prior traumas, anxiety, obsessive interests… and everything in between make me what will be a strong veterinarian, someday soon, hopefully.