Discover and read the best of Twitter Threads about #MEDeD

Most recents (24)

@BenTritle presenting an Update on IR-guided central line access! #meded #foamed @CleClinicMD
Different central line access:
Dialysis catheters and Port catheters:
Read 10 tweets
A thread on Fellowship of the Royal College of Surgeons with information that I got from a classmate who is—or, to be more precise was a former—Fellow of the RCS of UK.

I hope it will be of use at least to South Asian doctors who aim to be Fellows.
This is the inside story for doctors, especially in India (and other South Asian countries) who have been fooled into believing that FRCS is one of the highest degrees.

#meded #FRCS #RCS #UK 🇮🇳
There are 4 Royal Colleges of Surgeons. RCS of England, RCS of Edinburgh, RCS of Glasgow and RCS of Ireland. All 4 are completely independent of each other. Of the 4 the most respected and popular among UK doctors are England and Ireland as they are the toughest to get into.
Read 15 tweets
Thom Yorke es un músico inglés mundialmente conocido por ser el vocalista de Radiohead, en donde además es el principal compositor y pianista

Si nos fijamos en su rostro, encontramos un signo importante de reconocer: La ptosis palpebral

Inicia #Hilo
#tweetorial #ENARM #MedEd
1/ Thom Yorke nació en el año 1968 y según algunas fuentes, nació con parálisis facial (sin especificar datos), para la cual fueron necesarias múltiples cirugías y el comenta que en la última de estas, le causaron una lesión que ocasionó la caída de su párpado (ptosis palpebral)
2/ Pregunta

¿Cuál es el nervio craneal encargado de la elevación del párpado?
Read 20 tweets
35F, from St. Louis, woke up w/ a mildly painful bruise L arm, the next day, +diffuse erythematous rash, fever, abdominal pain. Unremarkable VS/labs. Representative pics of rashes 👇.

Diagnosis? Differentials? @TxID_Edu @BradCutrellMD @Cortes_Penfield @DocWoc71
@TxID_Edu @BradCutrellMD @Cortes_Penfield @DocWoc71 1/9
Case continued:
Bruise evolved into an ulcer. On further questioning, reported seeing spider close to her bed prior

Acute generalized exanthematous pustulosis (AGEP) 2/2 spider bite

Pics in MCQ:……
The rash a/w AGEP is characteristic:

▪️ Diffuse erythema
▪️ Innumerable, pinhead-sized pustules

@TxID_Edu @rloganjonesmd @PVishnuRao1 @alxpenguin @npowah @dschless immediately suspected AGEP! Nice job!
Read 11 tweets
1/ So I got quite a bit of "pushback" when saying that I would probably/most likely/am considering no longer using the joined # of #hpm or #hapc ... when tweeting about #PalliativeCare exclusively...

I also said I would explain myself to those wondering why...
2/ Quick disclaimer: I will entertain thoughtful discussion and opinions in this thread...

I won't entertain one sided views that try to shut me down with that "I'm big & your small, I'm smart & your dumb..." talk

I am expressing MY thoughts, keep your gaslighting to yourself
3/ One of the #CAPCSeminar19 keynotes was on messaging and how we brand ourselves.

It was a great conversation with Diane Meier and Mark Ganz (intentionally not tagging them) with the sharing of ACTUAL CAPC data but also ACTUAL life stories involving Mark's parents.
Read 15 tweets
THREAD: Sunday, I tweeted re: trans folks' feelings seeking healthcare: anxious, humiliated; when it works, good. Here are some narratives that help explain. We'll do negative narratives today, and positives Tuesday.
Paul Farmer, public health advocate and a founder of Partners in Health (@PIH) says, “stories illustrate some of the mechanisms through which large-scale social forces crystallize into the sharp, hard surfaces of individual suffering.” #narrativematters #bioethics #meded
@PIH Of course, stories also remind us of the joy that folks can take in life even when suffering occurs. And trans joy is real.
But alas, today I'm going to tell you about how clinical encounters damage trans folks, how a source of help is too often a source of harm. 3/n
Read 37 tweets
@tavrkapadia delivering @CleClinicMD Grand Rounds. On #TAVR. Starts by showing how morbid and complex the open surgery is. Many elderly patients are not candidate. Hence #TAVR was developed. #meded
The team that ensures ZERO percent mortality in #TAVR for any patient coming to @ClevelandClinic with Aortic stenosis. #meded
Heart is NOT stopped! After #tavr can see immediate hemodynamics improvement!
Read 10 tweets
Welcome to my first #tweetorial! Inspired by @NnekaUfereMD's talk @AASLDtweets to give back as a trainee

There are many things to discuss with #cirrhosis patients.
Ascites, HE, varices, HCC, transplant, GOC, rehab: the list goes on.

#Nutrition needs to be part of that routine!
Why is this such a big deal?

Independent of severity of liver dysfxn, poor nutrition, sarcopenia leads to:
1⃣Lowers survival (HR 2.18)
2⃣Increased risk of infxn
3⃣Increased HE, ascites ➡️ lower QOL
4⃣Lower survival in post-transplant setting
But what’s so special about nutrition in #cirrhosis?

For that we have to do a VERY BRIEF return to med school and the 1953 Nobel Prize winning work on energy extraction (citric acid cycle) 3/
Read 9 tweets
ERYTHEMA MULTIFORME – a #dermatology #tweetorial/#medthread!

#MedEd #FOAMEd #dermatologia #dermtwitter #medtwitter #derm pc: @dermnetnz

Let's warm up with a question for all y'all tweeps out there!

What is the most common trigger for erythema multiforme (EM) in adults?
EM is an immunologic syndrome usually triggered by infection in adults. We usually consider HSV and mycoplasma. A simple history for cold sores or genital ulcers can be telling, but mycoplasma can go undetected symptomatically.

What primary lesions do you expect in EM?
EM is usually made up of papular (raised) targets. Pic1 is of EM; you can see the 3 zones in a typical target (red rim, then white, then red center). Versus SJS/TEN (pic2), where macular targetoid (2 zones of red rim, dusky center & flat).

2nd photo:…
Read 10 tweets
Herniación Cerebral en Traumatismo Craneoencefálico
#PedsICU #FOAMed #MedEd

Abro hilo, iniciamos y abiertos los comentarios👩‍⚕️👨‍⚕️
Último hilo del año sobre la serie de #TCE.
Antes de iniciar, te dejamos los 4 enlaces de la serie completa (#tweetorial):

1. Abordaje Prehospitalario e Inicial en el TCE
Todo empieza antes de llegar al Hospital, así se logra el mejor desenlace.

2. Cuidados basales en el #TCE Severo
Lo que todo paciente con Escala de Coma de Glasgow igual o menor de 8 debe recibir.

Read 31 tweets
A thread on #psychological safety at #aamc19

Not surprised 2hear that @AmyCEdmondson “stumbled into psychological safety while studying learning organizations.”

Perhaps that’s b/c psychosocial safety is a basic human need that must be satisfied to fully engage w/ learning
“I found that better teams were making more mistakes. Or maybe they were just better at talking about them” @AmyCEdmondson

But there are numerous barriers to doing so, which are called intrapersonal risks. These risks keep us quiet and disengaged and drive impression management
“We choose self-protection over growth.”

In medicine, why do we feel such pressure to protect our egos? B/c they are constantly under duress?

Read 14 tweets
It’s tough to be an intern!
As a resident, 1st priority is to provide quality care for our patients & 2nd our interns.
Here is a series of tweets on ways residents (and staff) can take care of our interns 💛
#medtwitter #loveourinterns
#HappyTuesday #tweetorial
1. Give credit where credit is due. When your intern does a good job it’s best to give them props in front of the team! But if you give them props just to the attending make sure you tell them that you told the attending what a great job they did and that you appreciate them👏
2. Fall on the sword. The flip side of this is if you make a mistake as a resident make sure it’s clear to the team that it was your mistake, not your interns. This keeps morale high, and it’s honest. Nobody wants to get blamed, especially for something they didn’t do. ⚔️
Read 12 tweets
This week, I taught the @UCSF IM residents about tools for cognitive assessment in hospitalized patients. For my very first #tweetorial – I’m sharing my pearls with #medtwitter! #FOAM #geriatrics #MedEd 1/
@UCSF Throughout my training, I was taught to use the MoCA (Montreal Cognitive Assessment). But after a few months seeing patients at @VABostonHC, I noticed that most of my patients were getting a score of 21-23. Everyone especially seemed to think this was a hippo. 2/
@UCSF @VABostonHC I wanted to know why! So I looked into the development and validation of the MoCA a bit. Turns out, a cognitive test developed in a mostly white, highly educated, bilingual population (aka the people of Montreal) hasn’t really panned out for use among other groups. 3/
Read 16 tweets
1/ Welcome to the Saturday Poster session at #KidneyWk. On behalf of Hector and Edgar, I’d like to welcome you to our tweet thread on • Gender disparities in #SoMe and #MedEd•. You can view our poster (&🗣w/us) live TODAY from 10-12 PM (#27) or learn more about our work below
2/ #SoMe is exploding in medicine & #Nephrology leads the way in many metrics & most certainly in #SoMe research. Many #SoMe *users* are becoming active #SoMe *educators* & share valuable educational information to the larger online community.…
3/ Concurrently, there is a greater push to equalize the way we share knowledge. Gender is an area in need of equalization. More men than women are offered presenting &/or moderating opportunities. This imbalance negatively effects both female *and* male learners. #KidneyWk
Read 19 tweets
Hi hi hi. We see lots of red flags on a daily basis when we review labs.

One thing we see commonly is #lymphopenia. Should we care? When can we dismiss it and when should we work it up?

Let’s find out.

#MedEd #MedTwitter #IDTwitter #Tweetorial #oncology
- Lymphopenia assc w/ ⬆️risk of sepsis
- More common in elderly and w/ co-morbidities
- lymphs account for 20-40% of WBC, may go unnoticed when WBC checked w/o diff
- Primary- recurrent infxns in kids, CVID in adults
- Secondary-⬇️production; ⬆️destruction; hiding in tissue
What is the most common cause of lymphopenia in hospitalized patients?
Read 14 tweets
Starting the morning with “The Sciece of Learning” with Peter C Brown at the new #MedEd Workshop #KidneyWk

3 Big Ideas:
Additional testing may be more effective than additional studying #MedEd #KidneyWk
Spaced practice allows time for consolidation, strengthens connections, updates learning...and sleep is important! 😴 #KidneyWk
Read 5 tweets
1/ A 46-year-old man with a history of #malaria presented to the @JohnsHopkinsDOM on 8/12/1923 with

-- 3 years of generalized arthralgia
-- intermittent joint swelling

-- 40 lbs weight loss

@CPSolvers @DxRxEdu #medtwitter #MedEd
2/ Exam

-- synovitis of the 2nd and 3rd MCPs

-- diffuse joint tenderness

-- lymphadenopathy

-- pyorrhea alveolaris* of the few remaining teeth.

What do you want to do next? What's your #DDX?

Remember: Sir William Osler died in 1919, so it's all you...
So far, we have #tuberculosis on the differential. “Consumption” or “#phthisis”, wasting away, as #Tb was often referred to, certainly could explain this patients weight loss and adenopathy.

But does it explain the rest?
Read 16 tweets
In preparation for #HMIchat this Wed 9 PM with @drlizaola "Transforming our Teaching for the Digital Age" here are a few concepts to brush up on:
- #RAT
How do these relate to
- #BloomsTaxonomy
- #Dewey
- #KolbsExperientialLearning?
1/n... @harvardmacy #HMIHCE
#TPACK is a model 4 educators 2 integrate Content, Pedagogy and Technology Knowledge to enhance learning
Misra & Kohler Extended Lee Shulman's framework of Pedagogical Concept Knowledge (…)
2/n... #HMIchat
Educators need 2 know:
a) content matter -> concepts most difficult 2 grasp & durable frameworks
b) principles of how students learn and how best to teach so learners get those concepts and build those frameworks
c) how best to leverage tech to enhance b)
Read 10 tweets
THREAD: #meded #medtwitter

I'm a #Psychiatrist. These are my most common activities:

* discussing stress & ways to handle it
* helping families find common ground
* talking about people's lives, and learning about them
* hearing & helping kids who have been hurt

Of course I do prescribe medication, and when I do, I do a damned good job of it. Informed consent (Risks, benefits, alternatives, start/stop issues). Many times, I remove medications that were inappropriately started, or change to safer ones.
Other activities that I do far more commonly than prescribe medication:

* teach medical students, patients, and families
* email and call patients or familes
* administrate a hospital unit
* MEETINGS (patient-centered, YAY!)
* SO MANY MEETINGS (policy-centered, zzzzz)
Read 5 tweets
1/ So, today was a big day for @DrJRMarcelin and I. We've been developing curricula on "Structural Challenges & Inequities in Healthcare Delivery" for the @UNMCCOM M1 students as part of the Health Systems Science coil.

Thread on this #MedEd project + today's capstone 👇🏾
2/ With inspiration from @JonathanMetzl & Dr. Helena Hanson's work on #StructuralCompetency, we wanted to assemble a pilot set of experiences that would give @UNMC students a glimpse into local health inequities, from historical & community perspectives:
3/ We gave the M1s several introductory lectures & assignments focused on big-picture issues like #SDoH & disparities, creating a "structural DDx" for patients, unconscious #bias & #microaggressions, developing structural humility, and #racism in medicine...
Read 11 tweets
BEFORE READING THIS THREAD, do you think this statement is TRUE or FALSE?

Despite being a documented #epidemic for decades, @HHSGov's #CenterForDiseaseControl(@CDCgov) intentionally obstructs its collecting #statistics on what causes at least 10% of deaths NEEDLESSLY every year.

HINT: You already know of these systemic #DataScams due to #PublicCorruption & #RegulatoryCapture:

🤥#UScensus is maliciously biased

Thread coming soon about #CauseOfDeath #DataFraud

#AmericanSwamp #MedicalControlFraud

ANOTHER HINT: My inability to escape intrahospital, interhospital & health/disability insurers’ #ConspiracyAgainstRights using #MedicalControlFrauds exposes motive of the right answer.

Watch this video later to understand #PublicCorruption by example📽️
Read 43 tweets

This week’s #MedEd #Tweetorial will focus on #LearningStyles. Courtesy of my @uicdme coursework with @mededdoc

What are learning styles?
Is there evidence to support them?
Should we tailor our teaching (or learning) to them?

Let’s get started.
@uicdme @mededdoc 2/

What are learning styles?

This article by Pashler et al (…) defines learning styles as

“the view that different people learn information in different ways”
@uicdme @mededdoc 3/

To most of us, the concept of learning styles makes intuitive sense.

One popular model (by Dunn and Dunn) includes the concept of “modality preferences” where individuals prefer that information appeals to one of the senses: auditory, visual, tactile, or kinaesthetic.
Read 16 tweets
1/ When I find myself #disappointed or frustrated with a student or trainee, I always go back to was I explicit in my #expectations?

Was I clear about my standard for pt care?

Particularly, to not make assumptions about pt’s health #literacy or understanding of their plan?
2/ Was I not clear about my expectation about their medical knowledge

And if they don’t know something, its okay

But to take a stab at looking it up themselves if they have time since that will stick a lot more #MedEd
3/ Was I clear about closed loop #communication with the interdisciplinary team

And not make assumptions that #orders does not = that it’s happening for the patient or others understand the reasoning or its importance
Read 7 tweets
Have I ever told y’all how much I loooove to give #feedback?

Here’s why:
1. It adds meaning to my work in #MedEd.
2. It honors the learners and the patients.
3. It informs my final evaluations.
4. It improves the learning climate.
5. It's necessary.

*Shout out to #2.
I know lots of experts have written and presented great stuff on this. But if #medtwitter has taught me nothing else, it's that we can always add new ways to look at stuff.


So with that, here’s my practical approach to feedback on the wards and in clinic. Ready?
Okay, so 1st, let’s quickly revisit how feedback was defined in Ende’s classic paper:

“an informed, nonevaluative, objective appraisal of performance intended to improve clinical skills”  

(Ende J. Feedback in clinical medical education. JAMA. 1983;250:777–781)

Cool? Cool.
Read 22 tweets

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