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.
Start a teaching session with a multiple-choice question. We've provided one below!
Ask your learners what risks might accompany kidney donation. What did this systematic review and meta-analysis find?
What medical and ethical issues must be considered and discussed with persons who are considering donating a kidney? How might the results of this review inform these discussions?
What limitations in the available data were identified in this study? Why is the follow-up time so important?
How should we counsel patients who inquire about donating a kidney? What questions do we need to ask? What do we need to tell them about the short- and long-term risks?
The authors assessed whether the nondonor comparison groups were as healthy as the donors in the studies included in this meta-analysis. Why is that important? The authors found that most comparison groups were likely not as healthy as the kidney donors. How might that affect the findings and conclusions?
Use the accompanying editorial to help frame your discussion of these questions, and invite a specialist in kidney transplantation to join your discussion.
Ask your learners what they know about CTE. How is it defined? Is it helpful to know about a disease entity that, at present, can only be diagnosed at autopsy? How?
What symptoms and signs have been reported in patients with CTE? What is the differential diagnosis for each?
Who is at risk for CTE? What is known (and not known) about the relationship between concussion and CTE?
How would your learners respond to a patient who is concerned about CTE? How would they discuss the risks and benefits of participating in sports that might involve head trauma? What would they recommend patients (or parents whose children participate in sports) do?
Ask your learners how they assess the risks for cardiac complications of noncardiac surgery. Who is at increased risk? Who requires testing, and how? Use In the Clinic: Preoperative Evaluation for Noncardiac Surgery to help prepare a teaching session.
Review the results of this study. What are its strengths and limitations? Use the accompanying editorial to help frame your discussion. Why does it matter whether a study was prespecified by the investigators?
Should your learners continue aspirin in noncardiac surgical patients who have had prior PCI?
Who requires antiplatelet therapy after PCI? For how long? Watch The Consult Guys - An MI, a Stent, Bleeding, and Surgery! What Do I Do? with your learners for a relaxed way to review antiplatelet therapy after coronary stent placement.
Ask your learners what threshold they use to diagnose hypertension. What do the guidelines from ACC/AHA and the American College of Physicians and American Academy of Family Physicians recommend? Why do they differ?
How do blood pressure measurements obtained in your learners' practices differ from those obtained in the clinical trials whose results are used to formulate hypertension guidelines? What other important differences are there between a clinical trial and your learners' practices?
The authors of this paper discuss how failure to recognize these differences might affect assessments of the quality of care provided by physicians. Do your learners think this is a problem? Can they suggest solutions?
Listen to an audio recording, read by Dr. Virginia Hood.
Ask your learners whether differences in political opinions have affected their interactions with coworkers. What about with patients? How? Should we refrain from discussing political topics at work?
Do your learners share the author's concern for civility in our society? What responsibilities does our profession have here?
Taichman DB. Annals for Educators - 20 February 2018. Ann Intern Med. 2018;168:ED4. doi: https://doi.org/10.7326/AFED201802200
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Published: Ann Intern Med. 2018;168(4):ED4.
Cardiology, Coronary Heart Disease, Emergency Medicine, Ethics, Nephrology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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