Discover and read the best of Twitter Threads about #MedEd

Most recents (24)

1/ #medtwitter if you care about #metoostem #meded #equity #burnout please follow along. Gender violence is pervasive in medical training.

bit.ly/2FBkNGG

#sciencetoo #meded #medtwitter #medtoo #timesup #beethical #heforshe #timesup
2/ “…we may hear and intimately know the experiences of gender violence, but we are unable to share. Our voices are trapped and silenced, exacerbated by the hierarchical and apprentice-based training environment.." bit.ly/2FBkNGG
3/ Over 50% of medical students experience sexual harassment from faculty and staff. The people who are entrusted to teach us how to be physicians.
Read 10 tweets
Are you still shaking off the holiday? I know I am!

How about a #cartooncausalinference #tweetorial about casual graphs to ease us into the new year?

#epitwitter #DAGsfordocs #FOAMed #MedEd #statstwitter #econtwitter
The most common type of causal graph (at least on #epitwitter) is the directed acyclic graph, or #DAG.

DAGs have two main components: variables (also called nodes), and arrows (also called edges).

In the DAG below, there are 3 variables: sleeping, Santa, and presents.
The variables are ordered based on time — you have to go to sleep before Santa can come to your house & then he’ll leave presents!

Causation and time both flow in the direction of the arrows.
Read 24 tweets
I’d like to talk about the finances - and potential financial conflict of interest - at the National Board of Medical Examiners.

This is gonna be a long one - but thanks for hearing me out.

(Thread)
Yesterday, I started a discussion about how our focus on #USMLE Step 1 was hurting both undergraduate and graduate medical education.

It’s gotten a lot of attention, probably because I highlighted a comment from the CEO of the NBME that touched a nerve for a lot of you.
Beyond that quote, when I read the article, what struck me was this:

The CEOs of the NBME and FSMB expressed numerous concerns about adverse effects of making USMLE Step 1 pass/fail...

...but loss of revenue to the @NBMEnow was not mentioned.
Read 37 tweets
A thread.
So the @US_FDA @SGottliebFDA issued a warning re: Fluoroquinolones (FLQ) and aortic dissection (AD) or aneurysm (AA). Do FLQs cause AD/AA? Not really. Is there an association? Maybe. Let’s go throw the evidence and you can decide for yourself.
#CardioTwitter #MedEd
1/ Why was this association even studied? FLQ are known to be associated with Achilles tendon rupture, tendinopathy, retinal detachment. How? 1)decrease collagen synthesis and increase MMP (especially 2, 9) activity (among others). Aorta is affected by these processes
2/First study was published in 2015 using a national database in Taiwan. 1477 cases (662 AD, 850 AA) matched to 147 700 controls. There was signal of the association of FLQ and AD; rate ratio ranging 1.37 - 2.11 with any FLQ use (tinyurl.com/ybhcpexz)
Read 13 tweets
THREAD: Differential diagnosis of tachycardias can be tricky business! Here are some strategies to help keep you between the ditches. Hope you will like and share. #FOAMed #FOAMems #MedEd #CardioTwitter
1/ First let's look at the 2015 AHA ECC Guidelines tachycardia algorithm. It's fairly straight forward but there are some important concepts here that deserve some elaboration.
2/ In the first place we're asked to consider appropriateness of tachycardia for the clinical condition. This is really important! We don't want to attack the heart rhythm if it's a compensatory tachycardia! The second part causes a lot of confusion. What is significance of 150?
Read 29 tweets
@schnitzr This is absolutely appalling. Research shows responsible transparent non-stigmatized conversations around sexual health information and behaviors are essential to sexual public health. Joe Gow should be being heralded as a hero for breaking the barrier to discussion. #healthysex
@schnitzr The Need to Promote Sexual Health in America: A New Vision for Public Health Action ncbi.nlm.nih.gov/pubmed/28876308 #healthysex
@schnitzr Sexual Health in America: Improving Patient Care and Public Health jamanetwork.com/journals/jama/… "3rd, cuz STIs...R highly stigmatized conditions, use of a broader, sex-positive, health-focused framework...2 reduce stigma, fear, & discrimination assoc w/ these conditions." #healthysex
Read 12 tweets
A great case of bicuspid-associated aortopathy.
How common is aortic dissection in BAV? To date, many surgeons operate on patients with dilated aortas in the 4.5-5.0 cm range without concomitant severe valve disease. But, how about the evidence so far?
#cardiotwitter #MedEd
1) IRAD had 1.9% BAV patients in a 2006 report (out of 303 type A dissections)
ncbi.nlm.nih.gov/pubmed/16820599
2) GenTAC registry had 2 dissections / 772 BAV (follow-up 3.6 years, outcome ascertained in 88%)
ncbi.nlm.nih.gov/pubmed/27282895
Read 8 tweets
1/
Necrosis = cell death (unlike apoptosis, it does not occur naturally and is not programmed)

This short #Tweetorial shows you some of the histologic flavors of necrosis. The stain in each of these pics is hematoxylin-eosin (H&E)

#pathology #pulmpath #pathtweetorial
2/
First a question to test your knowledge. Necrosis with large numbers of neutrophils is called:
3/
And now a few examples. Necrosis in colorectal carcinoma is often described as “dirty” because it contains nuclear debris. This makes it look purplish instead of pink.

#gipath #MedEd
Read 14 tweets
[THREAD] Our tips on small bore chest tube placement for pleural effusion! Performed by a resident @BostonCityEM supervised by fellows @BUPulmonary. We'd love your input! Not a comprehensive guide. Made with written patient authorization. #meded #FOAMcc #pulmcc
For new large unilateral effusions such as this, we place a chest tube if fluid pH <7.2, glucose <60. Without fluid studies, we place a tube empirically if effusion is large, loculated, infected, or likely to reaccumulate- except CHF/fluid overload.
First step: ultrasound. We position the probe with marker to the head, as lateral as possible. Intercostals tend to sag as you move towards the midline, so you could hit them when going above the rib. Lateral access is safest.
Read 24 tweets
@McLNeuro @statnews "In stark contrast, the NIH has done essentially nothing to address gender violence committed by NIH-funded scientists"–@statnews YET in 5 yrs it's paid out almost $2 million 2 settle #SexualHarassment cases brt by scientists in its own labs! buzzfeednews.com/article/petera… #TimesUpNIH
Read 19 tweets
1/ A long thread on LifeVest. I promise it will be entertaining. If you find any inaccuracies please let me know.

Paper of VEST published here - will discuss background to WCD and #VEST but not the trial itself nejm.org/doi/full/10.10…
2/ In 2001, FDA gave approval to Lifecor for the first WCD. Later Lifecor was acquired by Zoll (2004 agreement, 2006 acquisition). Zoll maintains a registry for prescribed LifeVests. But lets go back to the FDA approval process.
3/ Lifecor presented 2 separate prospective studies to the FDA; WEARIT and BIROAD. FDA asked for both to be combined into 1 study, and each study representing a subgroup. A total of 289 patients were included.
Read 18 tweets
I’ve traded away my privacy around my own deeply personal medical issues for the chance – the mere hope really – that maybe someone will listen, will learn.

This is what validation feels like:
I was being worked up in the ED one night for a small bowel obstruction, the imaging was _very_ concerning.

The surgical team came through, reviewed the EMR, peppered me with questions, felt my abdomen, and then left.

Except the surgical resident came back in a minute later.
She saw how scared I was, felt my unasked questions as her team treated me like a talking, anatomically interesting, mannequin that they were subjecting to a rapid-fire pit-stop...

And so she came back in to make sure I was ok. I wasn’t.
Read 5 tweets
Curious about how #POCUS is taught? This #Tweetorial is for U
#Preview for #ASEchoJC 🔜9/4 8pm EST

Point-of-Care Cardiac Ultrasound POCUS: State-of-the-Art in Medical School Education bit.ly/2wxD4PZ by @amerjohri

#POCUS not 🐇🎩, not short #TTE
2/ Current #goals #Cardiac #POCUS #MedEd

(1) introduce concepts of ultrasound- common imaging views, correlate with anatomy, & physical examination skills

(2) develop scanning techniques➡️ basic competence

(3) recognize & differentiate b/w normal anatomy & basic pathology
3/ When Do We Start? Prerequisite knowledge for #POCUS teaching

"priming effect" of preclinical education

Big machine 1st over handheld Martinez et al bit.ly/2wzCcJB @UMMC

Start 1st year @Hoppmann et al bit.ly/2Q4ECsO @UofSCSOM
Read 10 tweets
There are no winners in the senseless withdrawal of Saudi residents and fellows from Canadian teaching hospitals, by @picardonhealth theglobeandmail.com/opinion/articl… via @GlobeDebate
Withdrawal of Saudi trainees exposes vulnerability of Canadian health care cmaj.ca/content/early/… via @CMAJ @drstanbrook #MedEd
Saudi medical trainees' recall sparks a crisis in Canadian hospitals thelancet.com/journals/lance… via @DrIvyBourgeault @TheLancet @jocalynclark
Read 7 tweets
Why is your pt's ALT (or AST) >1000?
A #livertwitter #tweetorial

Take-homes:
1. Top 3 causes of acute liver injury
2. I always say it's ischemic hepatitis; 50% of the time, I'm right every time

Brought to u by:
@tonybreu et al. What causes severe ALI?
cghjournal.org/article/S1542-…
The liver is awesome.

Yet its vocabulary is ... limited.

We can all tell when it is upset - high ALT, AST.

But that could mean anything!

So what's your specific patient's specific reason for high ALT?
First - a poll:
What's the most common cause of severe acute liver injury
(ALT or AST > 10xULN)?
Read 11 tweets
#PregnancyCardiology Primer courtesy of a fantastic lecture by Dr. Sabrina Phillips from Mayo Clinic. Follow the thread #ACCFIT s for a good overview of considerations. #FelllowsFirst #MedEd

How does plasma volume and erythrocyte volume change during pregnancy? 1/12
#PregnancyCardiology Primer

Other important factors in the cycle of volume expansion and decreased SVR
2/12

#FellowsFirst #ACCFIT
#PregnancyCardiology

Cardiac Output changes in Pregnancy

3/12

#FellowsFirst #ACCFIT
Read 12 tweets
1/n #Tweetorial: As an Assistant PD for @OHSUIMRes focused on scholarship, #medtwitter, & #hcsm (health care social media), I’m often guide residents and colleagues on how to best use Twitter for academics, networking, learning, etc...
2/n recently, while welcoming newbies (esp students) and “onboarding” them to #medtwitter & #hcsm, I was asked to put together advice for IM applicants on how to best use social media during application/interview season. I think this advice is applicable beyond IM, too.
3/n First, tell me about yourself:
Read 28 tweets
1/ Thread: This morning I gave Dept of Medicine #GrandRounds @OHSUSOM @OHSUNews. In #medtwitter’s spirit of sharing & learning, here is my first #Tweetorial summarizing highlights & crediting #hcsm’s incredible contributors & source material
2/ 4 months ago EBM & cardiology expert Dr. Milton Packer published a blog post detailing how he found Twitter uninformative and emotion/opinion driven
Is this the reality of #medtwitter??
medpagetoday.com/blogs/revoluti…
3/ #SoMe is digitally based mediums that helps us
CREATE
SHARE
PARTICIPATE
60% of physicians say their most popular activity on #hcsm = Following what colleagues are sharing and discussing
Channel the “look at me” negative stereotype of #SoMe into “look at THIS” learning etc...
Read 28 tweets
Ryan's Rules of PowerPoint (abridged)
(1) Not using PowerPoint is the new PowerPoint. Just let the people talk and throw up key images. People want to talk. #MedEd
(2) You are the expert on the topic - you're the only one who read about this before your talk. Don't underestimate yourself. Be prepared and have minimal slides (have back-up slides if someone in the audience is contrary and insists on seeing slides).
(3) no cartoons or funny slides. People take in jokes or gifs are different speeds. So you end up with a staggered polite laugh. You can make jokes that sound spontaneous, but staged slides are never as funny to anyone else (fka the GaryLarson rule of PPT)
Read 11 tweets
1/ Content warning: sexual harassment and assault. The @theNASEM released a report on sexual harassment in medicine. Disturbing quotes by #womeinmedicine from the report are in this thread (17). #MeToo #MeTooSTEM #heforshe @womeninmedchat @physcianwomen bit.ly/2JzUunm
2/ Residency. "But, the thing is about residency training is everyone is having human rights violations. So, it’s just like tolerable sexual harassment." (Nontenure-track faculty) #believewomen #MeToo #MeTooSTEM #womeinmedicine #metoophd #metoomed #MedEd #sheforshe #heforshe
3/ Culture. "I still don’t think that the prospect of being sexually assaulted was as bad as watching the next generation of sexual harassers being formed. I think that was the worst part for me." (Nontenure-track faculty) #MeToo #MeTooSTEM #womeinmedicine #MedEd #heforshe
Read 19 tweets
1/This article highlights an urgent need for training faculty and administrators on issues related to gender violence and discrimination in #meded. We have five concerns with the article. #metoo #meded #womeninmedicine #sheforshe #heforshe @caroline_a_king @womeninmedchat
2/ Title IX. This article is missing information about federally mandated reporting processes and protections that legally protect medical students (and all students in the U.S.).
3/Anecdotal beliefs perpetuate harms. A physician expert states “the trainee must amass allies before lodging this complaint…” This is legally incorrect, a single report is enough to trigger Title IX and this reinforces the notion that single reports will not be believed.
Read 7 tweets
In commemoration of 3 years of emailing hundreds of papers/ resources to my @OHSUIMRes ward teams & thanks to the amazing educators here and on #medtwitter #meded

My 10 greatest hits based on learner feedback:
10/ AGC “Approach to abnormal LFT” guidelines - for all those times when it’s not acute liver failure, but those LFT’s look like they need some investigating - ht Dr Jou gi.org/guideline/eval…
9/ “Normotensive ischemic acute renal failure” - can’t tell you how many times this has come in handy where I’ve slipped this to my resident, antihypertensives were backed down and a mysterious AKI disappeared; ht Dr Chiovaro nejm.org/doi/full/10.10…
Read 11 tweets
How to make your
correlations correlate.
Even if they don't.
==============

A practical tweetorial for aspiring research fraudsters, cardiology fellows doing research, and others in need of a strong association when there isn't one.

#meded #foamed

Please retweet to fellows.
Thank you to @rallamee for loaning me the use of her garden and boating lake to do a few demonstrations in this weekend's tweetorial.
Thank you also to a colleague, for sending me this just now. It is enlightening and I am genuinely sorry.
Read 58 tweets

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