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.
Ask your learners what the physical examination of a patient who has had an opioid overdose might reveal.
How should opioid overdose be managed? What needs to be done first? How is response evaluated, and for how long should patients be monitored? Which patients require intubation?
The authors of the review and the editorialists note substantial deficiencies in evidence for the optimal dose and route of administration of naloxone and the need for transportation to the hospital after out-of-hospital administration. What might be the barriers to performing randomized trials to address these issues?
How should patients who have had an opioid overdose be assisted after emergency care? What is the role of pharmacologic agents, such as methadone or buprenorphine? How are they initiated, and what are the regulations related to their use? How are patients followed? Invite a specialist in the use of these agents to join your discussion.
Start a teaching session with a multiple-choice question. We've provided one below!
Ask your learners how they approach the evaluation of a patient presenting with nasal congestion and/or rhinitis. What should they ask? What should they look for on examination?
What interventions do your learners consider for patients with allergic rhinitis? Is allergen avoidance sufficient?
Do your learners ever prescribe leukotriene inhibitors? When? What does this guideline conclude about their use for allergic rhinitis? What if the patient has a concomitant diagnosis of mild persistent asthma?
Are your learners able to recognize nasal polyps? If present, how do they affect management? Should referral for removal be considered?
Start a teaching session by reading one of the brief case presentations with your learners. You can do one in a few minutes at the beginning of each of several sessions.
Discuss the possible answers with your team and then review the answer critique together. Did you get it right?
Ask what “illness scripts,” “diagnostic momentum,” and “diagnostic timeouts” are.
Claim CME and MOC credit for yourself.
Listen to an audio recording, read by Dr. Michael LaCombe.
Ask your learners whether Jane's behaviors would alarm them if a colleague displayed them or whether they would be seen as normal. Can you tell the difference?
What must we do if we suspect a colleague is struggling? What should we do if we're struggling ourselves?
How do we position ourselves physically to show others that we are really listening? Do we put away our cellphones? Do we come out from behind our computers? How does that help those in need of our ear? How does it help us?
Do your learners know what resources are available to them if they are struggling?
Do your learners know what to do when a colleague reaches out for help? What if your learners think the colleague needs assistance from others? What if the colleague refuses?
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Taichman DB. Annals for Educators - 19 December 2017. Ann Intern Med. ;167:ED12. doi: 10.7326/AFED201712190
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Published: Ann Intern Med. 2017;167(12):ED12.
Emergency Medicine, Endocrine and Metabolism, Hospital Medicine, Pulmonary/Critical Care, Tobacco, Alcohol, and Other Substance Abuse.
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