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!
What are the signs and symptoms of measles? What are the potential complications? Use the information at DynaMed Plus: Measles, a benefit of your ACP membership.
Ask your learners what they know about claims that vaccines cause autism. Have they heard this opinion expressed by patients or others? How have they responded?
Why do you think these concerns persist despite numerous studies refuting such a link and the retraction of the fraudulent “scientific” paper that claimed this association?
How might such misconceptions cause harm?
Do your learners believe that medical professionals have a responsibility to speak up when they hear such concerns expressed? What knowledge do we need to be effective?
Ask your learners to practice explaining, in lay language, why the MMR vaccine is recommended and the reasons why the concerns about its causing autism are unfounded. They can use the patient summary to help consider what they might say. What else should be communicated?
What do your learners know about the current outbreaks of measles in the United States and immunization rates among the affected communities?
Ask your learners whether they are aware of acute harms from cannabis use. Do the potential harms differ according to whether the cannabis is inhalable or edible?
What cannabis-attributable conditions were identified in the emergency department visits evaluated in this study?
Why might the adverse effects of inhalable and edible cannabis differ? This is discussed in the accompanying editorial.
How should hyperemesis syndrome be managed?
What acute psychiatric symptoms were reported? How would your learners manage these patients?
When might patients with cannabis-related adverse effects require hospitalization?
Ask whether your learners order mammograms for their patients. Which patients? How often? Why?
Ask your learners what potential harms may result from breast cancer screening.
What is overdiagnosis?
Do your learners perform clinical breast examinations? What does this guidance statement recommend?
This guidance statement is intended for women at average risk for breast cancer. How is that defined? How do your learners determine whether a patient is at average risk? Use the accompanying editorial to help frame your discussion.
How would your learners counsel a 45-year-old woman at average risk for breast cancer who is unsure about whether to undergo screening?
Ask your learners whether they feel confident in their clinical skills.
Does it differ from day to day? From hour to hour?
Are they ever overconfident?
What shakes their confidence? Are they too hard on themselves?
Is there a proper balance? Is sharing their experiences helpful?
Listen to an audio recording, read by Dr. Virginia Hood.
Ask your learners whether any specific experience Dr. Pyzer describes hit them particularly hard. If necessary, prompt your learners by telling what was most powerful to you (for example, the taste of acid in one's throat with hypercarbia or the experience of being “bagged”).
How does hearing about these experiences help us to be better physicians? What commonly observed patient experience do your learners fear most?
Teach at the bedside! Ask patients who have experienced one of these things to discuss their memories.
Listen to an audio recording, read by Dr. Michael LaCombe.
Ask your learners whether they have an urge to make others aware that they are physicians when they find themselves on the “other side” of patient care.
What might motivate us to do this?
Should we do this? Do we really want to be treated differently than nonphysician patients? Are there dangers to that? Are there benefits?
Is being aware of these concerns and desires useful when we serve as physicians to other physicians? How should we behave?
Taichman DB. Annals for Educators - 16 April 2019. Ann Intern Med. 2019;170:ED8. doi: https://doi.org/10.7326/AWED201904160
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Published: Ann Intern Med. 2019;170(8):ED8.
Infectious Disease, Prevention/Screening, Vaccines/Immunization.
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