What makes a good clinical educator?
In this constantly evolving world of learner competencies, assessments, and milestones often is forgotten the important role of clinical teachers. We can all remember clinical instructors that stand out despite the grueling years of medical school and residency training. We admired them for various reasons and remember the insights and teaching pearls they bestowed upon us. But what exactly were the qualities that they possessed that other instructors did not have? What exactly did they have that made them a good clinical teacher in medicine? [+]
Geriatric Emergency Departments: Coming to a Hospital Near You?
We are all familiar with the concept of pediatric EDs. We see them as medical students, we train in them as residents, and we work alongside pediatric EM fellows. It is generally clear what pediatric EDs have to offer: smaller sized beds and equipment, nurses trained in pediatric triage and assessment who know how to put IVs in babies and calm crying kids, and physicians with training in pediatric Emergency Medicine. But what about the other end of the age spectrum? Over the last 10 years geriatric EDs, also called Senior EDs, have been popping up around the country. You [+]
MEdIC Series: Case of the Unexpected Outcome
Cry By Clala1220 Emergency medicine is a specialty that requires a level of comfort with uncertainty. No matter how good of a clinician you are, at the end of the day there will be patients that, despite solid medical care, will have an unexpected outcome. In addition to being potentially emotionally devastating, a serious miss can make us question our competence and shift our practice patterns from evidence- to anecdote-based. Dealing with these issues productively will be the topic of discussion in this months MEdIC. [+]
Deep Vein Thrombosis (DVT): Wells criteria and D-dimers happy together
You are evaluating a 45-year-old male who is complaining of calf pain. He has a history of cancer however he has never had a clot in the past. The leg is neither swollen nor warm but he notes a cramping sensation in the posterior portion of his calf. You are concerned for a deep vein thrombosis (DVT) and consider the multiple means to reliable exclude the diagnosis: Wells score, D-dimers, ultrasound? What works? [+]
Atypical Antipsychotic Medication Re-initiation in the ED
The acute episode of intoxication and agitation has subsided and your patient is calm. She has been medically cleared and is ready to be moved to a less acute, less monitored portion of the ED to await further assessment and treatment for her underlying psychiatric conditions. As a well-intentioned emergency medicine practitioner, you wish to give your patient the tools she needs to maintain this calm status by restarting her home atypical antipsychotic medication. What is the best way to go about doing this? While the atypical antipsychotics have generally been considered safer than the first generation agents due [+]
Self-Regulated Learning and Forgetting
We go through school without realizing if our learning strategies are inefficient even more so when some assessments support these practices as opposed to discourage it. Unfortunately, exams and graduation run the risk of giving us a sense that learning is over, that what we have learned does not change, or that there are not more effective ways of learning. There is no way of unlearning what we have learned in the past, so it’s always a sensible practice to reassess our knowledge on a constant basis. [+]
Trick of the Trade: Making your own homemade ultrasound gel
You are spending a month in rural Kenya, doing an ultrasound teaching course. Your enthusiastic participants have been ultrasounding every chance they get. Unfortunately, this has caused your ultrasound gel supplies to dwindle. It will be a month before a new shipment of gel arrives from Nairobi. This gel will cost about $5 per bottle, which is a considerable expense for the local hospital’s budget. [+]
Understanding Phenytoin Equivalents
Sometimes, in an effort to make things simpler, we actually make them more confusing. Such is the case with phenytoin equivalents. Fosphenytoin is a water-soluble prodrug of phenytoin. After IV administration, much of the fosphenytoin is metabolized to phenytoin within 15 minutes. Advantages over phenytoin include the option for IM administration and less cardiotoxicity allowing for faster infusion rates. Even the potential for hyperphosphatemia from the release of phosphate is generally inconsequential. [+]
Neuraminidase Inhibitors for Influenza – The Truth, The Whole Truth, and Nothing But the Truth Finally
Over the last 5 years, the use of neuraminidase inhibitors for the treatment of influenza has skyrocketed. Emergency physicians have been pushed to prescribe these medications under the belief that they reduced symptoms, the risk of complications, hospitalizations, and transmission. However, the recommendation for the use of these drugs has never sat on firm evidence-based ground. So what did we know then, and what do we know now? [+]
Behaviorism: Is punishment or reward more effective in education?
Every person involved in teaching and learning has a philosophy on how people learn. Implicitly, explicitly, legitimate or not this mental construct of learning affects the way they impart instruction and assess learning. One of the oldest and most commonly used educational theory of learning is behaviorism. [+]
