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.
Ask your learners whether they ask dying patients or their families about their wishes and hopes. What sort of answers have they heard?
Describe what the 3 Wishes Project entailed. Look at Table 1 to provide examples of the wishes involved in this study. Use the visual abstract to help explain the study to your learners.
Watch the 7-minute author insight video with your team.
Do your learners think an initiative to elicit and fulfill wishes like this one could be implemented at your center? Would they like to try? Does it have to be in the ICU only?
Ask them how they could start. Is an organized project required, or could your learners try this one patient at a time?
With whom could your learners speak to discuss implementing 3 Wishes at your center? What other team members should be involved in planning? Ask your learners to read the paper to be sure they know how much (or how little) was required in terms of commitment and investment by the centers involved in this study.
Ask your learners if they know how VAPI is currently defined.
In what settings should they consider VAPI in the differential diagnosis?
What other causes of respiratory failure need to be considered? How should they be evaluated?
Why would establishing a diagnosis of VAPI be useful if “supportive care” is all we currently have to offer?
Do your learners talk to their patients about vaping? Should they? What should they discuss?
Start a teaching session with a multiple-choice question. We've provided one below!
For which patients is the HPV vaccine recommended? Look at the most recent recommendations from the Advisory Committee on Immunization Practices.
Ask how cost-effectiveness analyses can be useful. How is “cost-effective” defined? What is the meaning of an incremental cost-effectiveness ratio (ICER) per quality-adjusted life-years gained? What ICER is often used as a benchmark for making health policy decisions? Invite an expert in cost-effectiveness studies or health policy to join your discussion.
Ask your learners what symptoms or signs should prompt consideration of celiac disease. See the boxes on pages 4 and 5. What are the potential gastrointestinal and extraintestinal manifestations? What autoimmune disorders are associated with celiac disease?
What is dermatitis herpetiformis? Use Figure 1 to show your learners. Why might this physical finding be helpful?
When should serum IgA and tissue transglutaminase testing be considered?
What is the role of intestinal biopsy?
What do your learners know about a gluten-free diet? How difficult is it to follow? Invite a nutritionist to join your discussion.
Can a patient with celiac disease safely reintroduce gluten into his or her diet after initial control of their symptoms? Why or why not?
Use the provided multiple-choice questions to help introduce topics in a teaching session. And, log on to enter your answers and earn CME/MOC credit for yourself.
Listen to an audio recording, read by Dr. Virginia Hood.
Ask your learners what the common causes of death from AIDS were in the 1990s. Invite a physician who cared for patients during that time to join your discussion. How commonly were patients with “end-stage” HIV infection admitted? What has changed? Why?
What prevents some patients from receiving care for HIV infection? Does the social stigma of HIV infection continue to present a barrier to care? What can we as health care professionals do to combat it?
Taichman DB. Annals for Educators - 7 January 2020. Ann Intern Med. 2020;172:ED1. doi: https://doi.org/10.7326/AWED202001070
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Published: Ann Intern Med. 2020;172(1):ED1.
Infectious Disease, Prevention/Screening, Pulmonary/Critical Care, Vaccines/Immunization.
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