Getting a subpoena: What is an expert witness?

Well, it’s an inevitable part of working in an Emergency Department. I got a subpoena recently and now have to go in to testify on a trauma patient. I’ve gotten a few subpoenas before on trauma patients, but fortunately most cases were settled out of court.

First of all, I think it’s an ethical responsibility of emergency physicians to describe what we saw and did in the care of the injured patient in the legal system. However, I have found that the few lawyers I have interacted with slowly expand their scope of questions to cover things NOT in the medical chart. Has this happened to anyone else? They essentially start to ask me things which an “expert witness” should answer. Expert witnesses receive expert witness fees. (more…)

By Michelle Lin, MD|2019-02-19T18:53:03-08:00Aug 31, 2010|Medical Education|

Article Review: Rethinking the premed requirements

Think back to your college years. Remember those premed courses that you had to take? Biology, chemistry, physics… oh my. How helpful were these in your preparation for medical school and clinical practice?

In 1981, the Association of American Medical Colleges assembled a group, the General Professional Education of the Physician and College Preparation for Medicine (GPEP) to relook at these premed requirements. In 1984, the published a report “Physicians for the Twenty-First Century”. They advocated that the intensive premed requirements overly skews students’ education towards a “narrow objective of medical school admission”. Education is not balanced to include broader liberal arts learning, which may teach students more about humanistic values and communication skills.

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By Michelle Lin, MD|2016-11-11T19:00:31-08:00Aug 30, 2010|Education Articles, Medical Education|

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

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?

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By Robert Cooney, MD MSMedEd|2016-11-20T11:17:15-08:00Aug 25, 2010|Medical Education, Tricks of the Trade|

Article Review: Use of Effective Questioning

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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By Robert Cooney, MD MSMedEd|2016-11-18T10:05:48-08:00Aug 23, 2010|Education Articles, Medical Education|

Incorporating debriefing into clinical practice

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.

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By Demian Szyld, MD EdM|2016-11-11T19:02:23-08:00Aug 19, 2010|Medical Education|

Article Review: Premature diagnostic closure

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 that had meningoencephalitis.

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By Michelle Lin, MD|2016-11-11T19:00:36-08:00Jul 26, 2010|Education Articles, Medical Education|

How to teach procedures in the Emergency Department

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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By Michelle Lin, MD|2016-12-20T10:04:41-08:00Jul 15, 2010|Medical Education|

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