Understanding Pimping as a Rite of Passage: An Enduring Cultural Practice in Medical Education (Published 2015)
Apr 06, 2016
Meza J and Provenzano A
Few studies have attempted to understand the contrasting experiences between students and faculty or the cultural context in which pimping occurs. The aim of this study is to examine the practice of “pimping” within an educational curriculum evaluation.
Background: Frederick Brancati provides a description of the quintessential experience of “pimping” in his famous article titled The Art of Pimping and although the practice of “pimping” is ubiquitous in medical education, few studies have attempted to understand the contrasting experiences between students and faculty or the cultural context in which pimping occurs.
Purpose: To examine the practice of “pimping” within an educational curriculum evaluation as it relates to the experiences of students, residents, and faculty physicians.
Methods: We elicited attitudes about pimping in the curriculum by providing a standardized prompt that consisted solely of Brancati’s article in JAMA 1989. We collected a combination data set from three groups: medical students responded via email; resident physicians and faculty responded through open ended group discussions during regularly scheduled curricular evaluations, which were then recorded and transcribed verbatim. The data was analyzed using four codes derived from midrange social science theory.
Results: Response rates were 75% of students, 70% of residents, and 100% of faculty. We report qualitative exemplars of four themes, separating faculty comments from learner comments in order to highlight the contrasting responses. Our data confirms the understanding of pimping through four fundamental constructs: hierarchy, competence, cultural replication, and relationship centered learning. We also expand the extant data that is used to understand pimping.
Conclusions: We understand “pimping” as a cultural phenomenon using the theory of liminality from Victor Turner. Power relationships within medical practice are re-established as medical students cope with their emerging physicianhood. This study suggests that “pimping” can be understood as cultural replication and liminality (rites of passage) even though medical education typically does not recognize the cultural components of establishing competence.
I was quite fascinated by this paper but found its structure and poor flow caused me a lot of confusion, especially in understanding the terminology used. The use of the word pimping is not one I have come across much in the medical education literature; the use of the word has very different meanings within a European culture. I felt that the authors were talking really about the concept of psychological bullying or abuse. I continue to be interested in this subject and believe it is an important issue that needs airing but I fail to take anything away from this paper that I could usefully use in my everyday practice.