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 whether they have heard of Candida auris. What kinds of infections have been reported to be caused by this fungus?
In what key ways does Candida auris differ from other, more commonly known Candida species?
What antimicrobial agents are commonly effective for Candida infections? What about for Candida auris?
How do most invasive Candida infections occur? What is different about Candida auris? What is known about its transmission in the health care setting?
What implications does this have for prevention efforts? Invite your hospital epidemiologist to discuss your center's preventive efforts. What are the challenges?
Ask your learners what they know about the risks and benefits of hormone replacement therapy.
What did the WHI study show? What does the U.S. Preventive Services Task Force recommend regarding both combined estrogen–progestin and unopposed estrogen use to prevent chronic conditions?
Why did the investigators of this study evaluate women according to whether they had undergone bilateral oophorectomy? What did they find?
Do your learners think women who have undergone hysterectomy should be treated with estrogen?
Ask your learners what regimen of blood glucose monitoring they prescribe to their patients with diabetes. What are the options, and what are their advantages and disadvantages?
In whom should continuous glucose monitoring be considered? What about automated insulin delivery systems? Invite an expert in diabetes management to join your discussion.
What factors limit the accuracy of glucose monitors?
How do your learners arrange for patient education?
Review the mechanisms of loop diuretics and aldosterone antagonists.
Have your learners heard of “diuretic resistance”?
Listen to the Annals On Call podcast, “Diuretic Resistance.”
What do your learners do when patients with fluid overload do not respond to furosemide?
Do your learners think the results of this study are sufficiently definitive to influence patient care? Why or why not? What are the study's limitations? How are preliminary studies such as these useful, and what more needs to be done to guide care?
Listen to an audio recording, read by Dr. Michael LaCombe.
Ask your learners whether health care providers scorn patients who struggle with obesity.
Do we ever make inappropriate remarks among ourselves when we think no one is listening? Does it matter?
Do we perform equally thorough examinations of patients who are obese and those who are not? Does it make a difference? Do we think patients notice the difference? How does it make them feel?
Do your learners think their obese patients feel judged by them? How can we address this?
Are we too quick to ascribe a patient's symptoms to their weight? Are we as empathic of patients' struggles with their weight as we are of their struggles with other health challenges?
Ask your learners whether they “give up” on talking to patients with dementia. Why?
Why do patients' families continue to whisper into the ears of their comatose loved ones? Do we ever do this as clinicians? Why or why not? Do we feel silly doing so?
Ask your learners if they have ever witnessed a sudden expression of clairvoyance from a patient previously assumed to have lost all ability for organized or coherent thought.
At such a moment, Dr. Pyzer remarks, “We rejoiced, failing to appreciate how this revelation was a contradiction to our previous consolation; its implications for his continuing suffering; and how it ultimately highlighted the ever-present struggle to reconcile what we want for our patients, and for those left behind.” What does she mean? How does believing the “person” is no longer present console us as doctors? As family members? Might knowing there is still a “person inside” also make our jobs easier or more rewarding?
Taichman DB. Annals for Educators - 17 September 2019. Ann Intern Med. 2019;171:ED6. doi: https://doi.org/10.7326/AWED201909170
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Published: Ann Intern Med. 2019;171(6):ED6.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism, Infectious Disease.
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