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 the clinical characteristics of hand osteoarthritis are. How should they be evaluated? What is the differential diagnosis? Use the information in In the Clinic: Osteoarthritis to help prepare for teaching.
What are the risk factors for osteoarthritis?
How do your learners treat patients with hand osteoarthritis? Do they use anti-inflammatory drugs? Which ones? Do they work?
Do the results of this randomized trial indicate that inflammation is not important in the pathophysiology of hand osteoarthritis? Why or why not? Use the accompanying editorial to help frame your discussion.
What are the potential causes of a “negative” trial? What factors need to be considered when evaluating whether negative findings indicate that a therapeutic approach should not be pursued?
Ask your learners whether they always review the drugs of pregnant patients to assess whether any are potentially teratogenic. Where do they look?
Do your learners know the FDA pregnancy categories? What do they mean? Which categories of drugs do they feel comfortable prescribing to pregnant patients? When should they consult an obstetrician?
How do your learners assess whether a drug is safe when a mother is breastfeeding?
Ask your learners how hyperthyroidism should be treated during pregnancy.
Ask your learners how CKD is classified. Use the figure in the paper's appendix to review.
What mineral and bone disorders are of particular concern among patients with CKD? Who is at risk?
Which patients with CKD should undergo dual-energy x-ray absorptiometry (DXA) testing?
How should serum phosphate and calcium levels be managed? When and how should phosphate levels be lowered?
What dietary recommendations should your learners make to their patients with CKD?
When and why should parathyroid hormone levels be measured?
How should osteoporosis be treated in patients with CKD?
Invite a nephrologist to join your discussion.
Listen to an audio recording, read by Dr. Virginia Hood.
Ask your learners whether the 3 lessons Dr. Trautner describes are “new.” If not, why do we seem to need constant reminders to practice them?
Ask a patient (or a few) whether they would be willing or even would enjoy talking with your team about the lessons they have learned since they became ill. Then, ask your patient to tell your team about these lessons during teaching rounds.
What did you learn? Can your learners draw inspiration from asking their patients about such lessons? Should we do so regularly? How might such questions be helpful to our patients?
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Taichman DB. Annals for Educators - 20 March 2018. Ann Intern Med. 2018;168:ED6. doi: https://doi.org/10.7326/AFED201803200
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Published: Ann Intern Med. 2018;168(6):ED6.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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