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.
Review the evaluation of knee pain. What questions should be asked? What is the differential diagnosis of osteoarthritis of the knee? Use the information in In the Clinic: Osteoarthritis to help prepare a teaching session.
Teach at the bedside! Have your learners practice examining each other's knees and then examine patients with osteoarthritis and other causes of knee discomfort. There are likely several on your service in the hospital, even if not the reason for admission.
Ask a radiologist if she or he would assemble a few teaching images of key radiographic findings of the knee to review with your team.
Ask a physical therapist to join your discussion of this paper's results and explain what a patient referred to therapy for knee osteoarthritis will be provided.
Start a teaching session with a multiple-choice question. We've provided one below.
Ask your learners how they evaluate a patient who reports insomnia. What is the differential diagnosis? Are any tests indicated? Use the information in In the Clinic: Insomnia .
Ask your learners how one refers a patient for cognitive behavioral therapy (CBT). What are the barriers? Is it readily available? Use the accompanying editorial to help frame your discussion. Invite an expert in CBT tell your group what is involved and to demonstrate its practice with your learners.
The guideline recommends CBT as initial therapy for insomnia. How would your learners explain this to a patient, who may want a “pill to help me sleep”? CBT involves more “effort” by the patient than taking a pill. How will your learners explain this, and will they be able to convince a patient to try?
Review the pharmacologic treatments available for insomnia. Note the potential advantages, as well as the harms, of each. Use the guideline's figure to help. Ask your learners when pharmacologic therapy would be appropriate, and how they would choose the appropriate agents for their patients.
Ask your learners why access to organ donation has historically been severely limited for HIV-positive individuals. Why has thinking in this area changed?
What are the potential risks to an HIV-positive patient specifically to undergo organ transplantation? What additional risks are there to receipt of an organ from an HIV-positive donor?
Do your learners think it is “fair” to provide HIV-positive organs to HIV-positive recipients as a means of increasing their access to treatment? Why or why not?
Watch the brief video with your learners.
Ask when an evaluation of VPCs is necessary. What testing should be performed?
Is suppressive therapy ever needed for VPCs?
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Taichman DB. Annals for Educators - 19 July 2016. Ann Intern Med. ;165:ED2. doi: 10.7326/AFED201607190
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Published: Ann Intern Med. 2016;165(2):ED2.
Hospital Medicine, Pulmonary/Critical Care, Sleep Disorders.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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