DISCUSSION TOPIC:

Imprinting & Graduate Medical Education

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Imprinting is a psychological term for “the process by which an organism develops a tendency to remain in proximity with the first stimuli to which it is exposed.”  Imprinting stimuli are more or less constant during a very critical period of early development, and unlike associative learning, are not induced by consequences (either rewards or negative feedback). Imprinting is early, immersive, and innately comfortable. We have argued that there are educational imprinting effects that occur in medical education, focusing on the formative clinical experiences. This educational imprinting likely impacts health care cost behaviors and our support for training programs as the imprinting can yield both positive and negative effects on value and overall care provided to patients. The science of understanding which outcomes are imprinted, how to modify them in the training environment, and how to modify them in practice, is new but growing. To paraphrase Hafferty, “reform initiatives must be undertaken with an eye to what residents learn, instead of what they are taught.”