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 how common urinary incontinence is among adult women. In what ways may it manifest? What are the possible causes, and how should incontinence be evaluated? Use the information in DynaMed Plus: Urinary Incontinence in Women, a benefit of your ACP membership.
Are women who are concerned about urinary incontinence hesitant to raise the issue with their physicians?
Review the findings of this systematic review. Do your learners recommend screening for urinary incontinence? What did the Women's Preventive Services Initiative recommend, and why?
What are the requirements for disease screening to be effective?
What potential challenges and problems are there with screening for urinary incontinence as recommended here? Use the accompanying editorial to help frame your discussion.
Ask your learners whether they believe marijuana is beneficial for any medical conditions. Are there any risks?
What is known about marijuana's benefits and harms? Look at the results of recent systematic reviews that evaluated its use for chronic pain and posttraumatic stress disorder and the risks to respiratory and cardiovascular health.
Ask your learners whether they ask patients about marijuana use. Should they?
Why do your learners think the public seems to have a favorable view of the benefits of marijuana despite the lack of evidence? Why might this matter?
Ask your learners what symptoms should prompt consideration of Parkinson disease. What questions should be asked? What should be looked for on physical examination?
How is the diagnosis made?
What is the differential diagnosis, and what testing should be considered?
When should drug therapy be started, and how? Should your learners do this, or should all patients see a specialist?
What drugs are used to treat Parkinson disease, and what are the potential side effects and adverse reactions?
What are the nonmotor symptoms of Parkinson disease? How should they be managed?
What is the prognosis of a patient with Parkinson disease? How would your learners discuss the prognosis with a patient and her or his family? What information should be provided, and what questions should be asked?
Listen to an audio recording of the testimonial, read by Dr. Michael LaCombe.
Ask your learners if they have ever talked to patients with terminal illnesses about their concerns regarding their eventual death. What did they learn?
Go to the bedside! Are there patients on your service who would be willing to discuss their thoughts about dying with your team, and perhaps would even appreciate it?
Do your learners believe that patients with terminal illnesses should have the option of determining when their lives will end?
Do your learners believe that physicians should be allowed to assist patients who wish to determine the timing of their death?
Why does the author emphasize in the opening paragraph that the word “option” is very important? Why might such an option be important to a patient even if she or he does not exercise it?
Listen to an audio recording, read by Dr. Virginia Hood.
Ask your learners whether they have sufficient time for patient appointments. If not, why not? Are all of the pressures external, or are we at fault as well?
How long are your learners' scheduled outpatient appointments? How long will they likely be after residency? Will your learners be able to negotiate the amount of time for patient appointments when discussing a job with a potential employer? What would your learners be willing to sacrifice to have more time at each patient appointment?
What can we do as individuals and as a profession to address the problems raised in this essay?
Taichman DB. Annals for Educators - 4 September 2018. Ann Intern Med. 2018;169:ED5. doi: https://doi.org/10.7326/AFED201809040
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Published: Ann Intern Med. 2018;169(5):ED5.
Nephrology, Urological Disorders.
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