Diagnostic reasoning is one of the most complex, analytical, and intuitive processes to develop in the medical profession. Even seasoned physicians spend a lot of time fine tuning this skill. Although charged with teaching others, some excellent diagnosticians find it difficult to explain in detail how they arrived at a diagnosis or a differential diagnosis. Some might even find themselves in a position in which they have to assess someone else’s diagnostic reasoning. This task is even more daunting since we are not all taught much about this process, even less how to teach it to others.
Reiter et al 1 just published a review on Individual Interactive Instruction also known as asynchronous learning in the Annals of Emergency Medicine.
They chronicled the events in 2008 that led CORD (Council of Emergency Medicine Residency Directors) to recommend integration of individual interactive instruction into the residency curriculum. The summary recommendations by Sadosty et al 2 discuss components, strengths, and weakness of both asynchronous and synchronous learning paradigms along with background about Malcolm Knowles and andragogy.
I have been frustrated (in a good way) by the recent social media discussions (see BoringEM.com) about how social media content is viewed with a skeptical eye by medical educators, academicians, and professionals because of the lack of formal quality-control mechanisms.
Doing well on your Emergency Medicine rotation, whether you are a medical student or resident, will depend in large part on your ability to deliver a coherently concise presentation to the senior resident or attending physician. It’s about telling a story that fits into the construct of how the expert physician thinks.
Mentorship is one of the professional relationships that fascinates me the most. We’ve all had those people in our lives that help us advance our careers, gain more insight to our practice, guide us to a more work/life balance. Some might call these people mentors, while other call them coaches or guides. Even after completion of training or schooling, people make use of these coaches/mentors as is the case in sports or medicine. For example Atul Gawande writes how a mentor helped him improve his practice as a surgeon years after completing his training.
You’ve seen this word on the agenda at the most recent Emergency Medicine conference that you attended. It sounded interesting… but you ended up going to a happy hour and missed out on the event. And so you are left with the burning question, what is SimWars?
I have now heard Dr. Haru Okuda (Director of VA SIMLEARN) introduce SimWars a few times at the start of competitions at conferences. He usually has a photo of two cute little kittens with great big sweet eyes juxtaposed with a photo of two warring tigers fighting each other. He uses this comedic relief to illustrate the difference between a standard simulation session and SimWars competition.
“The worst thing about busy shifts is that I never learn anything.”
– anonymous resident
A junior resident and I were contemplating the many difficulties of residency, especially when working at a busy urban ED where patients are plenty, but teaching during shifts may be harder to come by. We discussed the importance of coming up with at least one learning point or clinical question during each shift, and making a point of following through and reading up on it after. (That shift we both learned about fat emboli s/p extremity fracture.)