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.
Watch this short video in which Dr. Faith Fitzgerald shares a lesson of empathy.
Do you or other physicians at your center recall the early days of the HIV epidemic, when AIDS patients were feared and even shunned by the public and even health care providers? Share these memories with your learners.
How have things changed?
Ask your learners if certain patients seem to have been abandoned or less loved than others. Why? Do we fear them? Do we blame them for their illness? What might it say about us if we lack compassion for certain patients? What can we do?
Can empathy be taught?
Start a teaching session with a multiple choice question. We've provided two below.
Ask your learners to list the criteria required for screening to be appropriate for a condition.
Why might improvements in the effectiveness of treatment for later-stage disease alter the benefit of a screening program? How might the balance of benefits and harms change?
This study found that advances in systemic therapies for breast cancer have not substantively reduced the relative benefits of screening but have likely reduced the absolute benefits because of their positive effect on breast cancer survival. Why is it important to try to update assessments of whether screening remains beneficial in the setting of modern therapies?
Assign 5 groups to each succinctly summarize the findings of just one report. Tell your learners to briefly list the benefits and harms reported and how confident the data are.
As each group summarizes its paper, list the key findings on the board, with emphasis on reported benefits and harms according to patients' ages as well as the quality of the available information.
Ask your learners what overdiagnosis and overtreatment are.
After summarizing, ask each group to formulate its own recommendations regarding screening mammography for average-risk women in each of several age groups.
Have your learners read the clinical practice guideline.
Ask them if they agree with the Task Force's recommendations. In what ways do they agree or disagree with the recommendations your learners made after hearing summaries of the evidence in the activity above?
Have your learners role-play “shared decision making” with women aged 40 to 49 years. What questions might they ask a 40-year-old average-risk woman who wonders if she should undergo mammography screening? How would your learners explain the potential risks and benefits?
Ask your learners why breast cancer screening is so contentious. What role do they think lawmakers should play in regulating what screening services are covered by insurance? Use the accompanying editorials by Siu et al and Laine et al to help frame your discussion.
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Taichman DB. Annals for Educators - 16 February 2016. Ann Intern Med. ;164:ED4. doi: 10.7326/AFED201602160
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Published: Ann Intern Med. 2016;164(4):ED4.
Breast Cancer, Cancer Screening/Prevention, Hematology/Oncology, Prevention/Screening.
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