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 causes hemophilia. What is the difference between hemophilia A and B?
What are the clinical manifestations? At what sites does bleeding most often occur? What determines the severity of bleeding and whether it occurs spontaneously?
How is hemophilia managed? Use the information in DynaMed Plus: Hemophilia A and Hemophilia B, a benefit of your ACP membership.
In addition to the medical burdens, what are the potential psychosocial burdens faced by patients with hemophilia? Invite an expert in the care of these patients to join your discussion. Might a patient with hemophilia be willing to talk with your learners about her or his experiences living with the disease?
Review the results of this study. Is hemophilia more common than your learners thought?
Why is an assessment of the global burden of hemophilia important? Use the accompanying editorial to help frame your discussion.
Ask your learners why prompt administration of antibiotics to patients with sepsis is important. Use the accompanying editorial to quickly refresh your memory of key survival data.
In what ways are blood cultures useful in caring for patients with sepsis?
What did this study find regarding cultures drawn before and after administration of antibiotics? Use the provided visual abstract to help quickly summarize the findings for your learners.
What do your learners propose is an appropriate balance between the need to obtain blood cultures before administration of antibiotics and the need for prompt administration to patients with sepsis?
Who draws blood cultures at your center? What is the proper technique for obtaining them? How quickly are they obtained? What are potential causes of delays, and when they occur, is the administration of antibiotics delayed? Who decides?
How would your learners propose to study whether blood cultures are obtained promptly at your center in patients with sepsis? How would they study whether antibiotics are administered promptly? Review the timing for patients with sepsis on your service. What did you find?
Ask your learners why aspirin might be useful for the prevention of cardiovascular disease.
What are the potential harms?
Watch the Consult Guys video.
Discuss the key findings of this research study. How would your learners discuss the potential use of aspirin to prevent cardiovascular disease with a patient? How would they explain the balance of harms and benefits, and what specific information about the patient would they want to guide the discussion? How is cardiovascular risk assessed?
Show the cartoon (yes, a cartoon in Annals!) to your learners.
Do they often feel this way?
Is this dangerous? Why?
How might this situation be remedied? How much of the “chaos” is within our control?
Listen to an audio recording, read by Dr. Michael LaCombe.
Do your learners think publicly sanctioned, safe consumption spaces (“supervised injection facilities”) are a good idea? What are the arguments in favor of and against them?
Do your learners think that prejudice plays a role in the public policy discussion about safe consumption spaces? Are we guilty of prejudice ourselves regarding patients with substance abuse disorders? What elements of this essay help break down such prejudices?
Have your learners ever felt frustrated, as Dr. Chatterjee describes feeling here? How do we deal with this?
Listen to an audio recording, read by Dr. Virginia Hood.
Ask your learners whether they believe the words “fighter” or “fighting” are useful or appropriate when referring to patients as they deal with their conditions. Might this language be helpful to some patients? Might it be problematic for others?
In what ways might our own experiences with illness alter our approach to providing care to others?
How might providing care to others help us deal with our own illnesses?
Taichman DB. Annals for Educators - 15 October 2019. Ann Intern Med. 2019;171:ED8. doi: https://doi.org/10.7326/AWED201910150
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Published: Ann Intern Med. 2019;171(8):ED8.
Coagulopathies, Hematology/Oncology, Multi-Organ Failure and Sepsis, Prevention/Screening, Pulmonary/Critical Care.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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