I wanted to share some of our experiences, and discuss some challenges to educating internationally. More importantly, I want to engage you, the readers to share some of your experiences when educating internationally as well.
“So there’s a patient, and umm… they are in the hallway, they came to the ED today for breathing problems, I mean dyspnea. They also don’t speak any English. So, uh the respiratory rate is normal, and they had a blood clot, er… I mean PE, in the past, but not on coumadin anymore. Shoot, I forgot to tell you my exam…they had pitting edema for 3 months. By the way, the labs came back on that other anemic patient in the other hallway, and they are really anemic…” – Anonymous medical student
Sounds familiar? Imagine working in a hectic ED while listening to this chaotic presentation.
What’s the secret to presenting patients?
Andragogy refers to learning strategies which help adults to learn more effectively.
It is a term that was first used by Alexander Kapp in 1833 and later expanded by Malcolm Knowles to fit the needs of adult education. The concept is contrasted with pedagogy in which the child is lead through the learning process by the teacher. In andragogy most of the learning is self-directed and the teacher is a facilitator in the learning process. (more…)
Expert physicians: These are the ones who effortlessly handle a busy Emergency Department while juggling patient load, learners and consultants.
- How do they make decisions?
- How do they get there?
This article 1 studied macrocognition differences between novices and experts in the Emergency Department. (more…)
Medical education high-fidelity simulation allows for deliberate practice in a safe environment. We are able to miss the intubation repeatedly or botch up the management of aspirin overdose without the demise of the patient. At the end of each session, we gather in a pow wow and debrief….
I have been involved with debriefings, and often wonder what residents are thinking:
- Do they understand what debriefing means?
- Do they think this is the time where they are scolded for mistakes?
- Do they think it is a valuable part of the simulation?
What does debriefing even mean?
Seth Godin, a marketing guru, discusses his opinion about “what school is for” in this above video. Although this talk or Seth Godin are not directly related to medical education, this is still related to education and can still be applied to today’s medical education curriculum in many aspects.
Mr. Godin goes on to explain that school was modeled in the industrial age and has changed little ever since. The video covers such concepts as:
- Standardized exams in the industrial age were used as a tool to sort students. The person who created the standardized exams later on came to believe that the standardized exams were too crude, but due to his new conclusions he was excluded from his field.
- Teachers in the industrial age believed that school was about teaching obedience and respect.
- The industrial revolution created products en mass, but also needed people who were educated on consuming these products in order to survive. Therefore, schools were also created to educate people (or make replicas of people) about these products.
One day back in 2005 during my PGY-1 pharmacy practice residency, I remember a conversation with my residency director. He was a Surgical/Trauma ICU pharmacist. There had been a recent article published (I think it may have been one linking ‘tight’ glucose control to decreased mortality in ICU patients). Funny how times change…
Anyway, he mentioned all of the ‘discussion’ surrounding the article in terms of comments submitted to the journal. It was my first introduction to the idea that published literature could be challenged through an avenue provided by the journal.
Just this past week during EM residency journal club, we were discussing the recent Etomidate/Sepsis Meta-Analysis published in Critical Care Medicine (more to come on that soon in another post). I mentioned to my group how one could search for submitted comments. Most seem surprised to learn this trick of the trade.