Article review: Importance of first clinical clerkship

What was your first clinical clerkship rotation?

Oddly, I started my third year with a sub-internship rotation on the Burn/Plastics service as my first rotation. Not sure how that happened… I managed my own patients like a 4th year student, did lots of wound care, and even got to harvest a few skin grafts. It was trial by fire.

In a recent JAMA article, 3rd year medical students who started their clinical experiences in an Internal Medicine rotation overall did better on overall clerkship grades, when compared those who started their rotations on the Ob/Gyn, Psychiatry, or Family Medicine service.

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By Michelle Lin, MD|2016-11-11T19:00:25-08:00Oct 4, 2010|Education Articles, Medical Education|

Paucis Verbis card: C1-C2 injuries

$Cervical spine C1-C2 fracture$

I’m starting to work on co-authoring the next edition of my chapter on “Spine and Spinal Cord Injury” within the textbook “Emergency Medicine” by Dr. Jim Adams (Northwestern EM Chair). There are some useful tables that I created that I thought you might find helpful. This is the first installment covering C1-C2 fractures. The next PV card will cover the lower cervical fractures.

I always forget which are stable and unstable. For instance, the above extension teardrop fracture looks innocuous but is an unstable fracture because the anterior longitudinal ligament is ruptured.

PV Card: C1 and C2 Fractures and Injuries

Go to ALiEM (PV) Cards for more resources.

By Michelle Lin, MD|2021-10-18T10:02:37-07:00Oct 1, 2010|ALiEM Cards, Orthopedic|

Tips to building authenticity into your talk

For lecturers, much focus is placed on improving the visual display and factual content of your talk.

Keep slides simple
Add relevant, non-extraneous images
Avoid cramming too much information into your talk

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By Michelle Lin, MD|2016-11-11T19:00:26-08:00Sep 28, 2010|Medical Education|

5 rules for creating great Powerpoint presentations

As much as people talk about “Death by Powerpoint”, many of us still use Powerpoint despite its many shortcomings. So how can we make our Powerpoint talks better?

This video reviews 5 great rules to live by. Interestingly, this dynamic video was built using Powerpoint by Nancy Duarte from Duarte Design. Of note, Duarte Design was the company behind the stunning slides which Al Gore used to present his compelling talk on An Inconvenient Truth.

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By Michelle Lin, MD|2019-01-28T23:21:57-08:00Sep 23, 2010|Medical Education|

What is "contextualizing" patient care?

Medicine is as much about Science as it is about Art. This is no better illustrated than an educational intervention study about “contextualizing” patient care, published in JAMA.

What is contextualization?

It is the “process of identifying individual patient circumstances (their context) and, if necessary, modifying the plan of care to accommodate those circumstances”. In other words, this is care beyond the evidence-based guidelines, beyond standardized quality measures, and beyond the checklists.

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By Michelle Lin, MD|2016-11-11T19:00:27-08:00Sep 20, 2010|Education Articles, Medical Education|

Paucis Verbis card: When murmurs need echo evaluation

Have you been in a situation where you are the first to detect a cardiac murmur in a patient? If you are hearing it in a busy, loud Emergency Department, I find that it’s at least a grade III.

Should you order an echocardiogram for further outpatient evaluation? It depends on the grade and characteristic of the murmur, in addition to the patient’s symptoms. For instance, all diastolic murmurs require an echo. There is a useful ACC/AHA algorithm which helps you decide.

PV Card: When Murmurs Need Echocardiography Evaluation

Adapted from [1]
Go to ALiEM (PV) Cards for more resources.

Thanks to Amy Kinard, an Emergency RN and aspiring Family Nurse Practitioner, for drafting this useful Paucis Verbis card for me during her studies. Keep the great ideas coming, everyone!

Reference

Bonow RO, Carabello BA, Chatterjee K, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2008;118(15):e523-e661. doi: 10.1161/circulationaha.108.190748

By Michelle Lin, MD|2021-10-18T10:05:29-07:00Sep 17, 2010|ALiEM Cards, Cardiovascular|

Trick of the trade: I got ultrasound gel in my eye!

Bedside ultrasonography is increasingly being used in the ED to examine the eye. For instance, it can be used to detect a retinal detachment, vitreous hemorrhage, and high intracranial pressure. The technique involves applying ultrasound gel on the patient’s closed eyelid. A generous amount of gel should be used to minimize the amount of direct pressure applied on the patient’s eye by the ultrasound probe.