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 the donor and recipient risk factors for CMV infection after solid organ transplant are. Use the information in DynaMed: CMV Infection in Solid-organ Transplant Recipients, a benefit of your ACP membership.
What symptoms and signs should raise concerns about CMV disease?
How is a diagnosis established? How is the disease treated?
Can CMV infection be prevented?
What are the potential long-term complications of CMV infection among transplant recipients?
Ask your learners how big a problem falls are among inpatients at your hospital.
How common are falls among hospitalized patients nationally? What are the personal and health system costs? What are the implications for your hospital of the Centers for Medicare & Medicaid Services deeming a fall a “never event”? Use the editorial to help frame your discussion.
What strategies are used at your hospital to identify patients at risk for falling? Who is responsible for identifying patients at risk?
What strategies are used to prevent falls? Are they effective? How do you know? What did this study find?
Do you use “sitters” at your institution? How about restraints? What are the potential benefits and complications with each approach? Invite a leader from your hospital's nursing department to join your discussion.
What is the value of a systematic review that finds that the evidence base for a commonly used intervention is not great? In what ways might that be helpful?
Review the immunization recommendations with your learners.
Is there a system in place to ensure identification of patients in need of immunizations in your practice? For which immunizations? What is the approach to others?
Ask your learners what has changed since last year's recommendations.
What is different in the recommendations for pneumococcal vaccination? Are PCV13 and PPSV23 both routinely recommended? Why the change? How would your learners discuss whether to use PCV13 with their patients?
Ask your learners whether they ask patients about insomnia. Should they?
What questions do your learners ask when a patient reports problems sleeping? What evaluation should be performed?
What should be the approach to management of insomnia? Is cognitive behavioral therapy useful? How do you arrange for it? When is pharmacologic therapy appropriate? Which drugs should be considered, and what are the benefits and risks?
Do all patients with possible sleep apnea require an in-laboratory polysomnogram?
Ask your learners what they consider when patients complain of chronic, widespread pain.
Should “screening” rheumatologic blood markers be tested?
How is a diagnosis of fibromyalgia made?
What is the role of cognitive behavioral therapy? What about sleep hygiene?
Is referral to a specialist required for diagnosis or management?
What is the prognosis?
Use the provided multiple-choice questions to help introduce topics for discussion. And, sign on to enter your answers to earn CME/MOC credit for yourself!
Listen to an audio recording, read by Dr. Michael LaCombe.
Ask your learners whether they believe too much emphasis is put on the importance of physical examination.
Is there value to examining a patient even when it does not lead to a diagnosis or altered management?
How might physical examination be harmful? Can it be “therapeutic”?
Taichman DB. Annals for Educators - 3 March 2020. Ann Intern Med. 2020;172:ED5. doi: https://doi.org/10.7326/AWED202003030
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Published: Ann Intern Med. 2020;172(5):ED5.
Chronic Fatigue Syndrome/Fibromyalgia, Hospital Medicine, Infectious Disease, Prevention/Screening, Pulmonary/Critical Care.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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