Trick of the Trade: Increasing students responses to the differential diagnosis

By |Aug 25, 2010|Categories: Medical Education, Tricks of the Trade|2 Comments

Anyone who teaches medicine asks students to list their differential diagnosis when discussing a new clinical case. It’s also part of several models for education including the One-Minute Preceptor and SNAPPS. For the most part, students are good at coming up with answers to the differential, but what do you do when they strike out? Or what if the answer is always the same, i.e. chest pain = myocardial infarction? […]

  • 3D Character and Question Mark

Article Review: Use of Effective Questioning

By |Aug 23, 2010|Categories: Education Articles, Medical Education|5 Comments

Asking effective questions is a valuable skill for any teacher. As a junior faculty member working to improve my teaching, I’m often in awe of my more experienced colleagues when I have the chance to watch them teach. At times, it’s quite easy to pick out the skills that they put into action but occasionally, their expertise is much more subtle. Effective questioning falls into this category. […]

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Incorporating debriefing into clinical practice

By |Aug 19, 2010|Categories: Medical Education|1 Comment

I’m in the middle of an intense weeklong course on debriefing for medical simulation here in Cambridge, MA. One of the goals many of the participants share is our desire to improve our skills in the art of debriefing after clinical simulations. Although the course focuses on “Debriefing with Good Judgement” 1 today the faculty also offered a simple tool to structure a brief debrief when time is very limited. […]

  • Closed Door

Article Review: Premature diagnostic closure

By |Jul 26, 2010|Categories: Education Articles, Medical Education|0 Comments

You are taking care of a patient, who frequently presents to the ED for polysubstance use. You are pretty sure his altered mental status is from polysubstance use again. He was found in his home next to drug paraphernalia. He intermittently becomes severely agitated, and so you give him sedatives. He has a low-grade fever, but you attribute that to his psychomotor agitation and likely stimulant use. Because he remains confused and lethargic after 8 hours, you admit him to an inpatient team to await further metabolism of his recreational drugs and your sedation medications.  The next day, you learn [...]

How to teach procedures in the Emergency Department

By |Jul 15, 2010|Categories: Medical Education|Tags: |0 Comments

As I was going through the free EM-RAP Educator’s Edition podcasts, somehow missed the March 2010 podcast on how to teach procedures in the Emergency Department. In the 36-minute podcast, Dr. Mak Moayedi (Univ of Maryland) discusses a framework to teaching procedures. Check it out. More specifically, Dr. Moayedi talks about how teaching procedures has moved beyond the antiquated “see one, do one, teach one” philosophy. Instead, we should follow principles based on accepted adult learning theories. […]

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Video: Caution about patient hand-offs in the ED

By |Jul 1, 2010|Categories: Medical Education|Tags: |0 Comments

Kudos to Dr. Vineet Arora (Univ of Chicago) on creating a great video on the importance of clear, concise, and updated hand-off information on patients. This is especially important in the Emergency Department where patients are constantly being “signed out” to other residents for continued acute care. Whatever hand-off process you are using now, we can always do better. […]

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Article Review: Evaluating students using RIME method

By |Jun 28, 2010|Categories: Education Articles, Medical Education|Tags: |1 Comment

How do evaluate medical students and residents, who are rotating through your Emergency Department? Do you have a structured framework for assessing their competencies? Have you heard of the RIME method of evaluating learners on their clinical rotation? Dr. Lou Pangaro (Vice Chair for Educational Programs in the Dept of Medicine at the Uniformed Services University) published a landmark article in 1999 on his simple yet effective approach in evaluating medical students and residents. I had the pleasure of briefly meeting Dr. Pangaro when he gave CDEM’s keynote speech in 2008.  […]