Logs
There's a recent thread on the DR-ED mailing list about student logs. One administrator talked of how they took their student logs so seriously that made the submission of logs required for graduation.
As a student I have to say, I find these logs a rather odd thing. Most students I know (and I'm including multiple schools here) fill these logs out just before they're due and forge whatever requirements they don't recall actually accomplishing.
Logbooks started on ships in the days of celestial navigation. They used the speed of the boat, which they determined by dropping a log in the water, tied to a rope with knots. The log would float and the number of knots that landing in the water in one minute would be recorded in a book. The logbook. In the days of celestial navigation beyond sight of land, it was vitally necessary to keep track of every compass heading, every rudder and sail order the officer of the deck gave, along with the time of each of the ship's clocks (which varied quite a bit more then than now) in order to make an educated guess about where to start your celnav calculations. This became the deck log. Even after the advent of mechanical measures of speed, the deck logbook stuck around.
Having been an officer of the deck at sea, I signed the deck log for orders I gave at the end of every watch. I reviewed the deck log to ensure all routine entries were made (like soundings, etc). I reviewed the Captain's standing orders in the back of the logbook every month, but I didn't review logs for learning, I don't know anyone who did.
The deck log proved to be quite useful, not only for navigation, but for reconstructing battles, resolving admiralty claims (collisions, piracy, and other legal affairs of the high seas), and, once steam was introduced, maintenance on engines.
When I was the engineering officer on duty on my ship, I logged the state of the ship's plant routinely, logged my changes, and signed my orders at the end of each watch.
Logbooks came to be used to record the vital signs of other machines, including machines on land, again, for maintenance. It was a short step for early aviators to appreciate the value of recording flight hours and cycles, along with their navigation numbers, in logbooks.
The aviators took their logbooks into space in the 60s.
I don't know who introduced logbooks to surgery residencies, but we can still appreciate how the number of cases a surgical resident does still has can have a life-or-death impact, and so those numbers should be closely tracked. If I had to guess, they were probably introduced by some military surgeon after WWII, like DeBakey.
Logs are now kept by computer. Not only in the Navy, but, as a sysadmin, my computers keep automated logs of network traffic and reports from applications. I review them for unauthorized access attempts (china is the most common attacker, about twice a week), recurring system errors that suggest I need to tweak something, who's accessing the system, from where, etc. I review debugging logs if a new application doesn't work right. On navyhpsp.net, I review the recent activity log for wiki spam and implement security to combat it.
Once I redesigned the Draft Log of the USS Wadsworth. The ship's Oil King recorded the level of every single water, fuel, and oil tank, every day. He gave that to me as the repair officer, to calculate the ship's displacement, pitch (bow up, bow down), and hog (bow and stern down, light in the middle, or bow and stern up, heavy in the middle). I put all the calculations in his spreadsheet and from then on, the Draft Log printed itself. Saved me two hours a day at sea.
Logbooks were never intended as learning tools. They were intended to protect life and property. If some old salt recounted how reviewing a log was a powerful learning experience, then they were surely cherry picking their anecdotes, for example, appreciating the value of the standard practice of taking more frequent soundings after crossing the line of demarcation inland if, on some occasion, they forgot and found themselves in shoal water. Reviewing the log while the tug was hauling him back to the channel, might cue have cued him in on where things went wrong. But that was never the log book's primary function, and that sort of in-the-incident learning will never be captured in a medical student's procedure log.
It seems to me that, at best, these student logs are intended for some sort of survey database purpose that has not materialized in any meaningful form. I'm sure you can find some students who will happily tell their professors that their logbooks were wonderful ideas and changed the way they experienced medical school. This is like Clarence Thomas asking Anita Hill if he treats her fairly. "Yes, sir, absolutely, sir." The most functional answer I've heard, and I'd been hoping to hear something better in this thread, is "LCME wants these numbers." One of the more laughable reasons I've heard is "It's important for you to learn how to code". Based on what I've seen from faculty and residents at work, these student logs, even those that do require ICD-9 codes, are not the same as coding. In fact, I've found Google to be the best way to find accurate codes for things I haven't memorized.
So what life and property are these student logs protecting? What analysis are you doing with these logs, which are so often taken on paper? How are those analyses getting back to the students? What thought, what sentence do you believe these logs would spark in a student's mind that would constitute learning? Threats of expulsion seem to me to be good only for promoting a culture of gundecking, the forging of logs. And gundecking has sunk many a ship.
