Darren B. Taichman, MD, PhD
Visit Annals Teaching Tools for more resources for educators from Annals and ACP.
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 steps are required immediately in the management of a patient with an opioid overdose. What interventions should be considered after management of acutely life-threatening issues?
Ask your learners what options are available for patients with opioid use disorder. How do methadone, buprenorphine, and naltrexone work? How are they prescribed? Who may prescribe them, and what monitoring is required? How effective are they at reducing risk for subsequent overdose and/or death?
How would your learners arrange for outpatient care of patients presenting with an opioid overdose? How often is this actually done at your center?
Why do your learners think MOUDs are underused? What are the legal barriers to their use? Should these be changed? Review a recent ACP position paper to help frame your discussion.
The editorialists believe that the persistent belief that MOUDs “substitute a new addiction for an old one” is part of the problem. What are reasonable concerns regarding MOUDs? Do the benefits outweigh the risks? Invite a specialist in substance abuse to join your discussion.
Start a teaching session with a multiple-choice question. We've provided one below!
Ask your learners how a diagnosis of diabetes is established. How do they do it? Do they confirm an abnormal glycemic test result on a separate sample? If not, why not?
Should the results of this study alter how we diagnose diabetes? Why or why not? What are the study's limitations?
What properties should we require of a diagnostic test?
Given that diagnosing diabetes with tests performed on a single blood sample would be easier for patients and clinicians, why not take this approach now? Use the accompanying editorial to help frame your discussion.
Ask your learners if they know how patients should dispose of unused opioids. How should this be done?
Do your learners ever talk about safe storage of opioids and what to do with the remaining supply after the drug is no longer needed for the reason it was prescribed? Have they ever discussed with their patients the potential for the drug's diversion and the role that might play in harming others?
How would your learners counsel their patients? What specific advice would they provide?
Watch the short video of the patient's interview.
Ask your learners what criteria should determine eligibility for antihypertensive treatment in persons aged 60 years or older. What should their target blood pressure be? Which antihypertensive agents are preferable?
Watch the grand rounds presentation with your learners. Now how would they answer these questions?
How would your learners discuss with a patient whether to initiate antihypertensive treatment?
Be sure to answer the multiple-choice questions to earn CME/MOC credit for yourself!
Ask your learners who is at risk for herpes zoster.
Who should be vaccinated against varicella zoster virus? How effective is the vaccine?
Is laboratory testing required to diagnose herpes zoster? What is the differential diagnosis?
When should an ophthalmologist or an otolaryngologist be consulted?
How is herpes zoster treated? When is intravenous treatment needed?
Use the multiple-choice questions to help introduce topics for discussion with your team, and log on to enter your answers to earn CME/MOC credit for yourself.
Listen to an audio recording, read by Dr. Michael LaCombe.
Ask what a “good death” is.
What is our role in a patient's death? How would your learners have responded when this patient indicated with a smile that he would die that day?
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Taichman DB. Annals for Educators - 7 August 2018. Ann Intern Med. ;169:ED3. doi: 10.7326/AFED201808070
Download citation file:
Published: Ann Intern Med. 2018;169(3):ED3.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism, Hypertension.
Results provided by:
Copyright © 2019 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use