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.
Listen to an audio recording of this essay with your team, read by Dr. Virginia Hood. Allow time for quiet after the reading.
Ask your learners whether they have experienced pressures similar to those Dr. Lapedis describes.
Why might we—as medical students, as residents, or after training—feel we are not good enough? What actions increase the stress? How do our own words regarding “success” or “competence” affect ourselves and those around us?
Do your learners know how to help themselves to stay well? Do they know how to recognize when they need help, or when others need help? How do they get it?
What does your program do to safeguard the mental health of your learners? Is it enough? Is this monitored? Is it discussed?
Share this essay with your colleagues. Do you think there is more you should be doing at your program to help prevent what happened to Sarah?
Ask your learners to list the potential complications of sickle cell disease.
In what ways can vaso-occlusive crisis present? How is it diagnosed and treated?
What is the differential diagnosis of hemolysis?
What might have happened to this patient had the findings on a blood smear been overlooked?
How is malaria treated?
Review the pathogenesis of malaria infection. Ask your learners how sickle cell disease and malaria are believed to be connected.
Start a teaching session with a multiple-choice question. We've provided one below!
Review the progression of lesions in the pathogenesis of colorectal cancer. What are the different histologic types of polyps? Which need to be removed, and why?
Ask your learners by what mechanism colonoscopy is believed to reduce mortality from colorectal cancer. Is it only in detecting lesions early?
What are the benefits and risks of attempting to remove all polyps during colonoscopy? How might the approach used in this study help? Invite an endoscopist to join your discussion. Would it be feasible for your team to observe a colonoscopy?
What does “generalizability” mean in relation to the results of a clinical research study? What might limit the generalizability of approaches such as the one used in this study to perform colonoscopy? How did the authors try to assess this issue? Use the accompanying editorial to help frame your discussion.
Invite a clinician who cared for HIV-positive patients in the 1980s and 1990s to describe to your learners what it was like.
Ask your learners what HIV treatment goals and targets are. How well are they achieved in your learners' patients? Identify as many patients with HIV as possible who are on your service or have been seen by your learners in the past few months. Had they achieved viral suppression? Alternatively, are such data available for the HIV specialty practice at your center?
What variables do your learners think influence whether patients achieve viral suppression? What was found in this study?
How might the findings of this study help further efforts toward achieving the United Nations' “90-90-90” targets (diagnosis, therapy, viral suppression)? Use the accompanying editorial to help frame your discussion.
Take a break with your team to watch this short episode of the consultative medicine talk show.
Pause the video after Geno reads the viewer's letter. What do your learners think?
Do your learners evaluate bone mineral density in their male patients?
What will they do in the future?
Answer the brief multiple-choice questions. Be sure to log on to claim CME/MOC credit for yourself!
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Taichman DB. Annals for Educators - 18 September 2018. Ann Intern Med. ;169:ED6. doi: 10.7326/AFED201809180
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Published: Ann Intern Med. 2018;169(6):ED6.
Colonoscopy/Sigmoidoscopy, Gastroenterology/Hepatology, HIV, Infectious Disease.
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