Darren B. Taichman, MD, PhD
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From the Editors of Annals of Internal Medicine and Education Guest Editor, Gretchen Diemer, MD, FACP, Associate Dean of Graduate Medical Education and Affiliations, Thomas Jefferson University.
Taichman DB. Annals for Educators - 15 November 2016. Ann Intern Med. 2016;165:ED10. doi: 10.7326/AFED201611150
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Published: Ann Intern Med. 2016;165(10):ED10.
Start a teaching session with a multiple-choice question. We've provided one below.
Ask your learners to list possible reasons for increases in opioid abuse, addiction, and overdose. What factors have contributed to the increase in the provision of opioids to patients? The demand for them? Use the first paper to help frame your discussion.
What roles should physicians play in addressing nonmedical societal problems (e.g., deficiencies in social support systems) that impact medical care and disease?
Do your learners routinely screen each of their patients for substance abuse disorders? How do they do it?
What criteria did the authors use to evaluate a novel screening tool's performance? Can your learners explain sensitivity, specificity, and the tradeoff between them in developing a diagnostic test?
What criteria must be met for a screening tool to be worthwhile?
Use freely available and comprehensive teaching resources to plan educational activities about the science of screening. These resources include teaching slides, handouts, worksheets with sample cases to work through with residents, and more. They are part of a host of freely available resources for medical educators available from the ACP's High Value Care Curriculum.
Ask your learners whether they have ever been asked by a patient if they would provide them with assistance to end his or her life. How did they respond? How would they respond to such an inquiry?
Is PAS legal where you practice? What are the requirements for PAS in jurisdictions where it is legal?
Ask your learners to list the potential benefits, and potential dangers of, permitting PAS.
Do your learners believe that professional medical societies have an obligation to “actively engage” in providing guidance to care for patients who actively seek assistance in dying?
Teach at the bedside! Ask patients with terminal illnesses if they would be amenable to discussing their thoughts about dying with your team. What questions will your team want to ask?
Invite a palliative care specialist to discuss with your team how she/he would approach a request from a patient for assistance in dying. What would she/he want to know? What would she/he offer?
Find a quiet spot to listen to audio recordings of these essays with your team, read by Dr. Michael LaCombe.
Sit quietly afterward to allow your team members to reflect and react. Don't ask questions at first, or perhaps at all. These essays describe joyful, painful, and uplifting experiences of our profession.
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