Unteachable Things Hard To Teach, Study Suggests

A JAMA RCT found that 30 hours of state-of-the-art communication-skills training for ~500 doctors produced NO improvement in patient-rated care (and patients of trained doctors got more depressed about their illness). Scott 'called this,' and the NYT agrees -- rote empathy scripts can mute authentic voices. His illustration: a 5-star attending, after diagnosing a woman with metastatic lung cancer, launched into the dull anatomy of the bronchial tree -- deliberate 'white noise' giving her permission to tune out and collect herself rather than perform a reaction on demand. The kind of tacit skill a course can't teach. Closes with James Miller's earning-to-give career advice and a riff on the varieties of weak social skills (the rhinoceros-in-a-china-shop type should become a pathologist).

Quality 68 · Strong. Strong (68). Lifted by a genuinely insightful, memorable observation -- the bronchial-tree 'white noise' as unteachable tacit clinical skill -- atop a clean 'training doesn't work' finding. Held mid-Strong: loosely structured (study + anecdote + career aside) and explicitly moral-free. Scored on merit (2014).

Claude’s paradigm shift 46 · Moderate. Moderate (46). The 'communication skill is tacit/illegible, not teachable' framing plus the white-noise insight are mildly fresh; the underlying RCT is others'.

Real-world impact 2 · Minor. 2 -- minor/within-blog. A medicine/tacit-skill reflection; within-discourse, no material footprint.