{"id":136101,"date":"2022-02-15T14:42:47","date_gmt":"2022-02-15T13:42:47","guid":{"rendered":"https:\/\/www.erasmusmagazine.nl\/en\/?p=136101"},"modified":"2025-12-19T11:26:07","modified_gmt":"2025-12-19T10:26:07","slug":"first-year-medical-students-learn-what-a-meal-at-an-italian-restaurant-does-to-your-kidneys","status":"publish","type":"post","link":"https:\/\/www.erasmusmagazine.nl\/en\/2022\/02\/15\/first-year-medical-students-learn-what-a-meal-at-an-italian-restaurant-does-to-your-kidneys\/","title":{"rendered":"First-year medical students learn what a meal at an Italian restaurant does to your kidneys"},"content":{"rendered":"

What stage is a patient\u2019s kidney disease in? These are the kinds of questions first-year medical students learn to answer during their skill-based learning seminar. \u201cYou\u2019re not allowed to guess the patient\u2019s urine volume.\u201d<\/p>\n

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Professor Bob Zietse has been in the lecture theatre for fifteen minutes by the time his students arrive. In addition to the thirty students who are attending the lecture in person, he will also teach students who are attending the lecture remotely, by means of an iPad installed on his desk. A pile of paper sits on the long table next to the door.<\/p>\n\t

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Lecture<\/strong>: Skill-based learning seminar (Wednesdays, 1pm, in Erasmus MC lecture room 39).<\/p>\n

Lecturer<\/strong>: Bob Zietse, also a well-known Youtuber amongst medical students because of his Bob\u2019s Brain Breaker videos<\/a>.<\/p>\n

Subject<\/strong>: How kidneys behave and how they are communicating with us through the urine.<\/p>\n

Audience<\/strong>: First-year medical students. Some students are attending remotely, but the majority come to the in-person seminar because they find it important and enjoyable.<\/p>\n

Reason to follow<\/strong>: It gives students in-depth knowledge, teaches them how to work with others and how best to treat patients. It\u2019s a small taste of what the students will be doing once they are doctors.<\/p>\n\n\t<\/div>\n

\u201cWelcome, all of you!\u201d shouts Zietse at exactly 11am. The chatter in the lecture theatre falls silent. The lecturer then positions himself in front of his iPad and waves. \u201cHello, viewers at home!\u201d This is not the kind of lecture where a lecturer explains everything to listening students. Today, the students work in small groups and try to solve cases together. The subjects discussed range from impaired kidney function to diarrhoea, loss of strength and cardiac arrhythmia. The lecturer puts the students to work at once. \u201cYou\u2019ve received the questions digitally, but if you\u2019d rather work on paper, there are printed versions over there.\u201d He points at the sheets of paper on the long table.<\/p>\n

Serum and plasma<\/h2>

Students Jeremy, Fabienne and Willemijn, who are seated at the back of the lecture theatre, decide to collaborate. Their first case study focuses on a 34-year-old man who has been taken to the emergency room due to impaired kidney function. He has no history of kidney disease, but he\u2019s had a fever for several days now. He sweats a lot and is not drinking much. \u201cOK, let\u2019s look at the first question,\u201d says Jeremy after the three students have read the case details thoroughly and have discussed the patient\u2019s condition at length. \u201cWhat is the difference between serum and plasma?\u201d<\/p>\n

\u201cThere\u2019s no protein in plasma, right?\u201d says Willemijn. Fabienne tries to find a note on her laptop. \u201cYes, that\u2019s right. Serum and plasma are in your blood, but serum is plasma plus coagulation factors, which means serum contains proteins, while plasma doesn\u2019t.\u201d<\/p>\n

Don\u2019t guess<\/h2>
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\n\t\n\n<\/svg>\n<\/span>\n\tImage by:<\/span>\n\n\t\t\t\n\t\t\t\t\t\t\tPauline Wiersema<\/a>\t\t\t\t\t<\/span>\n\t<\/p>\n<\/figcaption><\/figure><\/div>

The three struggle a bit to answer the second question: What is the patient\u2019s GFR? \u2018GFR\u2019 stands for \u2018Glomerular Filtration Rate\u2019 and indicates how much blood the kidneys can filter each minute, which is to say it indicates how well the kidneys function. You can use the rate to determine the stage of the patient\u2019s kidney disease. \u201cI honestly have no idea,\u201d says Jeremy. Fabienne writes down a formula in her notebook. \u201cMaybe we can use this formula. We can calculate his creatinine clearance, right?\u201d Only for Willemijn to say: \u201cBut we don\u2019t know his urine volume.\u201d<\/p>\n

The three are joined by the lecturer, who listens to their discussion. \u201cSo we have all the information we need to answer the question, except volume,\u201d he says when the students get stuck. \u201cYou\u2019re not allowed to guess the patient\u2019s urine volume. So in this situation the correct answer is: \u2018We don\u2019t know.\u2019\u201d \u201cOh, so we\u2019re allowed to say, \u2018We have no idea\u2019?\u201d asks Jeremy.<\/p>\n

The lecturer then explains what students must focus on in these kinds of situations and which substances must be measured in the patient\u2019s body. \u201cMy advice for the upcoming exam is to read the question very attentively. However, my advice for the rest of your life is to listen well to your patients.\u201d<\/p>\n\n\t

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\n\t\t\u2018My advice for the upcoming exam is to read the question very attentively.\u2019\n\t<\/blockquote>\n\n\t\t\t
\n\t\t\t\t\t\t\t–<\/span>\n\t\t\t\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\tBob Zietse\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/figcaption>\n\t<\/figure>\n\t\t<\/div>\n\t<\/div>\n
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\n\t\n\n<\/svg>\n<\/span>\n\tImage by:<\/span>\n\n\t\t\t\n\t\t\t\t\t\t\tPauline Wiersema<\/a>\t\t\t\t\t<\/span>\n\t<\/p>\n<\/figcaption><\/figure>

Nice work environment<\/h2>

Zietse walks around the lecture theatre, visiting one group, then another. His students seem to like the seminar. \u201cIt\u2019s a lot of fun, and at the same time it\u2019s quite difficult. The questions are complicated, but once the lecturer has explained how it\u2019s done, it all makes complete sense,\u201d says student Zoe. \u201cI think it\u2019s good that we\u2019re given enough time to think it over, rather than being presented with the answer straight away. When the lecturer explains the whole process, you understand the rationale behind it.\u201d<\/p>\n\n\t

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\n\t\t\u2018The lecturer is approachable. We\u2019re always allowed to ask him questions, whenever we get stuck.\u2019\n\t<\/blockquote>\n\n\t\t\t
\n\t\t\t\t\t\t\t–<\/span>\n\t\t\t\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\tStudent Gelno\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/figcaption>\n\t<\/figure>\n\t\t<\/div>\n\t<\/div>\n

Student Linda says, \u201cWe\u2019re really given a chance to apply the subject matter. When you attend a lecture, you listen to what the lecturer says, but here we actually work. You\u2019re less likely to be presented with case studies in a lecture.\u201d Her fellow student Veerle agrees. \u201cWe dig deeper into the subject matter and it\u2019s a nice work environment. It\u2019s very easy to collaborate with your fellow students.\u201d A third student, Gelno, adds: \u201cThe lecturer is approachable. We\u2019re always allowed to ask him questions, whenever we get stuck.\u201d<\/p>\n

Clear explanations <\/h2>
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\n\t\n\n<\/svg>\n<\/span>\n\tImage by:<\/span>\n\n\t\t\t\n\t\t\t\t\t\t\tPauline Wiersema<\/a>\t\t\t\t\t<\/span>\n\t<\/p>\n<\/figcaption><\/figure><\/div>

The groups go on discussing the questions, while Zietse walks to his iPad. He puts in his ear buds and asks how the students who are attending the seminar remotely are doing. One student asks a question. \u201cFunnily enough, that\u2019s the question I\u2019ve been asked the most,\u201d says the lecturer. \u201cI\u2019m about to discuss the two case studies with the entire group. If I don\u2019t answer your question while doing that, shall we discuss it in Teams afterwards?\u201d The remote student nods. \u201cOK, I\u2019ll take you all back to the theatre now.\u201d<\/p>\n

Zietse interrupts the discussions the students are having and explains things to the entire group, making a few jokes along the way. \u201cSo let\u2019s look at the abnormal acid-base values here. First, let\u2019s look at the bicarbonate, because bicarbonate means\u2026?\u201d No one in the theatre answers. \u201cPerhaps I should first explain the concept of interactive teaching to you once more?\u201d Zietse asks jokingly. The students laugh and answer his question, in unison: \u201cMetabolic acidosis.\u201d The lecturer nods with satisfaction and continues explaining things. Ten minutes later he concludes his explanation by stating: \u201cSo the only question you should really be asking, time and again, is: what would you do if you were a kidney?\u201d<\/p>\n\n\t

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\n\t\t\u2018So the only question you should really be asking, time and again, is: what would you do if you were a kidney?\u2019\n\t<\/blockquote>\n\n\t\t\t
\n\t\t\t\t\t\t\t–<\/span>\n\t\t\t\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\tBob Zietse\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/figcaption>\n\t<\/figure>\n\t\t<\/div>\n\t<\/div>\n

\u201cHe\u2019s very enthusiastic when he tells his stories,\u201d says student Marley. Another student, Wenjia, thinks he\u2019s funny, too. \u201cHe makes puns and has certain catchphrases that he\u2019ll use over and over during all the seminars.\u201d<\/p>\n

But the main thing is that his explanations are clear and easy to understand. As student Marc says: \u201cFor instance, he\u2019ll tell us not only that sodium levels depend on what you eat, but he\u2019ll illustrate that by saying that he went to an Italian restaurant last night because it was his wife\u2019s birthday, and so he consumed more sodium than usual, and then he\u2019ll explain the consequences this will have for his kidney function. I\u2019m not sure if it actually was his wife\u2019s birthday [it was \u2013 ed.], but thanks to stories like that, you\u2019ll remember his explanations.\u201d<\/p>\n\t

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Editor Feba Sukmana and illustrator Pauline Wiersema follow a lecture every month. Together they describe and depict how education is given, what happens in the lecture hall and what students think of the lecture.<\/em><\/p>\n

EM is looking for the best, funniest or most interesting lectures at the EUR. Do you want us to visit your lecturer? Tip us at\u00a0sukmana@em.eur.nl\u00a0<\/a><\/em><\/p>\n\n\t<\/div>\n\n\t

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Also a nice lecture<\/h2>\n\t\t\t\n\t\t\t