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 symptoms and signs should prompt consideration of malaria.
What tests should be sent when there is concern about malaria? Ask a hematologist or infectious disease specialist to review the thick smear findings of malaria with your team.
What interventions should be started, and when? Does your health system have plans in place to obtain therapy for an acutely ill patient with severe malaria? If not, what should be done, and can your learners play a role in ensuring it is done?
Ask your learners to name risk factors for suicide. What do your learners do when they see patients with these risk factors?
Do your learners know how to ask a patient about suicidal ideation? Do they worry they might introduce the idea? Why is that incorrect? Invite a mental health expert to join your discussion and provide advice.
What should your learners do if they are concerned about a patient's risk for suicide? Review the algorithms presented in the figures in the guideline synopsis.
What questions should your learners ask? Should they inquire about firearms? What should they do if firearms are available? What about other lethal means?
Do your learners know how to arrange for the care of a patient at risk for suicide? To whom should they turn for assistance, and how? How should they manage the patient until this assistance is available?
In assessing the available literature on the prevention and management of suicide, the editorialist comments that “one is challenged by the use of ‘evidence’ as a definitive term.” What does this mean?
Ask your learners what the indications are for the placement of a permanent pacemaker. What about for an implantable cardioverter-defibrillator?
What are the potential complications associated with each of these CIEDs?
What patient-specific variables should be considered when assessing who will benefit and who might be harmed by placement of a CIED?
Invite an interventional cardiologist to join your discussion. Ask how your institution monitors its rates of complications. Are rates above or below the average reported for institutions included in this study? What are potential explanations for the differences?
How would your learners propose to evaluate the rate of certain complications of CIEDs at your institution? How would they develop and implement potential solutions for improvement and to monitor their effects?
Ask what is known about the effectiveness of interventions to prevent the onset or progression of cognitive decline. What do your learners advise patients and their families?
Should we screen for dementia? Why or why not?
What studies should be considered when evaluating a patient with cognitive deficits?
Should medications be used for AD? Should your learners discuss ineffective therapies with patients and families? Why?
What should your learners ask about a patient's sleep, and why?
When and how should your learners discuss end-of-life care with patients with dementia and their families?
Use the provided multiple-choice questions to introduce topics for discussion. Be sure to log on and enter your answers to earn CME/MOC credit for yourself!
Listen to an audio recording, read by Dr. Virginia Hood.
Ask your learners whether they have experienced patients or others making racist or other inappropriate remarks in the health care setting. What was the reaction of others? How was the situation handled?
How should we react if a patient is verbally abusive? To whom should your learners turn for help?
How do we set boundaries regarding unacceptable behavior by patients while still providing appropriate care? What happens if the patient continues to cross the boundaries?
Listen to an audio recording, read by Dr. Michael LaCombe.
Is it appropriate to “close” one's practice to new patients? Why or why not? Is it OK for exceptions to be made? When they are made, are some patients being provided special treatment? Is this right?
How do your learners manage the guilt that accompanies being late for outpatient appointments and making patients wait? What can they do to avoid this? What can they do when it happens despite their best efforts?
Taichman DB. Annals for Educators - 3 September 2019. Ann Intern Med. 2019;171:ED5. doi: https://doi.org/10.7326/AWED201909030
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Published: Ann Intern Med. 2019;171(5):ED5.
Dementia, Infectious Disease, Neurology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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