Discover and read the best of Twitter Threads about #Meded

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Hello everyone! I’ve been inspired by #MedEd colleague @JenniferSpicer4 to make my foray into #IDTwitter. I’m jumping right in with a #Tweetorial that combines my curiosity for the language of medicine and passion for powerful visuals and teaching about antibiotics!

I’ve always been intrigued by how we describe abx decisions – ‘narrow’, ‘broaden’, ‘expand’, ‘[de]escalate’, etc. For my UME micro course, I made a figure that captures this terminology and lets learners compare/contrast spectra of activity visually.

Let’s build it together.

Let’s start with a horizontal bar that represents the spectrum of clinically important bacteria. We will represent antibiotics above that spectrum with another horizontal bar.
Read 13 tweets
Finally, time to show some of my most used Powerpoint plugins, add-ins, and resources. All of them are free. Perfect for anyone in #MedEd who gives presentations. If anyone has anything they particularly love, please share! #FOAMed #Presentation #PowerPoint
First off, here’s how to add plugins from the office AppSource:…

PowerUser: The best “all in one” plugin. Templates, icons, diagrams, pics, & maps. You can automate formatting tasks (changing colors, font, charts or alignment) for your entire presentation automatically. Free, and premium free with a .edu email! Here:
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Today we learned about Lyme disease and it’s classic symptom: a bullseye rash (erythema migrans) formed around the area of a tick bite.

A classmate of mine asked, “How is this diagnosed for those with darker skin?”

Our professor struggled to give him a clear answer. 1/5
After class I decided to google what we learned to see what images came up. I wasn’t surprised by what I found: a homogenous representation of the bullseye rash on white skin.

It’s no wonder our professor didn’t have a good answer to answer my classmate’s question. 2/5
I’m learning more and more that medicine is taught in a way that is often times exclusionary and the treatment and manifestation of disease in those with melinated skin is treated as an afterthought, a “special case” of illness that students must do extra work to understand. 3/5
Read 5 tweets

For this week’s #MedEd #tweetorial, I’m going to share one evidence-based learning principle we can use to improve our teaching (and learning) by helping our students (and us) retain information (and do well on those pesky board exams).

Let’s get started.

Typical classroom instruction involves listening to a lecture, studying content at home, & taking a test to show knowledge.

The problem: The “testing” part actually results in the best learning, yet students often don’t get the opportunity to review/discuss their answers.

Tests force us to retrieve information from our brain. This process of retrieval builds connections making it easier to access the info again.

Think of it as pulling a file out of a file cabinet; the more you do it, the more easily you remember the info & where to find it.
Read 21 tweets
Syphilis! RMSF! Hand-foot mouth!

Slow down there, Tiger! Let's dive deeper into:

ACRAL RASHES - a #tweetorial/#medthread
(aka rashes on the "palms and soles" - kind of 😉).

#MedEd #FOAMEd #medtwitter #dermtwitter #dermatology #dermatologia pc:@dermnetnz
No where else on the body does a rash evoke more of a knee-jerk differential. That's not wrong per se, as we all learn this in med school, but it's more complicated then starting doxycycline and checking an RPR!

Let's start with a definition - what does "acral" actually mean?
Technically, "acral" just means our distal body parts. So while we often think of palms and soles, it's actually inclusive of the whole hand, the whole foot, ears, and some include even the nose!

I actually didn't learn this until #derm residency, which was shocking to me.
Read 20 tweets
Para otros países: es el exámen que realizamos en 🇲🇽 como médicos para poder hacer una Especialidad Médica.

Aplica también para el #MIR o el exámen que realicen en tu país 🌏🌎🌍

Abro hilo, iniciamos, y abierto los comentarios 👩‍⚕️👨‍⚕️
#MedEd #Edumed #SoMe
"¿Es un exámen difícil?"
No. No lo es.
"¿Pero me han dicho que es muy difícil?"
Esas respuestas, son de personas que no se prepararon lo suficiente.
Pero, vamos a platicar un poco de todo esto:
"Necesito un curso para pasarlo"
No. Pero si puede ser necesario, si necesitas mayor orientación, o no te ha dado resultados estudiar "sólo".

"No tengo dinero para pagarlo"
Es tu esfuerzo el que da resultados. Puedes pagar 5 cursos, pero ninguno de ellos hará por ti el examen.
Read 27 tweets
Did my fellows' curriculum lecture today, "Images in #Nephrology"
Thought of sharing the slides as a tweetorial. Goal is to present some 'classic' images that aid in kidney-related diagnoses. Not exhaustive; plan to make 2nd part as well.
#MedEd #FOAMed Not much POCUS involved!
1st question. Classic image but rarely encountered. Note the super high blood urea nitrogen and serum creatinine.
Here is the answer.....
Read 61 tweets
Let's go back to the basics today, and talk about some #morphology in the #dermatology exam.

Today's #tweetorial/#medthread will be about evaluating....


#MedEd #FOAMEd #dermtwitter #medtwitter #dermatologia pc:@dermnetnz
Before we get too far into it, how do we think about #scale? Meaning, which one of the following is it?
When we say "primary lesion," we mean the most basic element of a lesion/rash (papule, macule, patch, plaque etc).

SECONDARY CHANGE (which scale is) means the extra exam element that occurs on top of the primary lesion!

Tertiary/Quaternary isn't a thing. I'm just a jerk.
Read 15 tweets
Quick Tutorial Thread for Twitter

Psychiatric Cardiology 101: QTc

Wherein a psychiatrist tries to teach cardiology (and hopefully doesn't embarrass themselves)

#psychtwitter #medtwitter #MedEd #psychchat #somemed #somepsych

Warning: MATH
What is QT? (Yes yes, it can be your texting shorthand to get your groove on)

QT refers to the interval on the electrocardiocgram, in milliseconds, between the START of the QRS complex to the END of the T Wave
(as the graph shows, if you wanna be super fancy, we calculate the end of the T wave by intersecting the maximum slope with the isoelectric baseline)
Read 14 tweets
Unfortunately I can't be at #ICRE2019 but equity, diversity, and inclusion is kind of my thing. I'm watching tweets with great interest and have a jumble of thoughts #meded related that I'm going to share in this thread...
Can we discuss how those charged with addressing diversity in too many organizations are asked to do hard work for little or no pay...and expected to be grateful for the opportunity? /1
Can we discuss how little accountability exists for academic leaders on matters pertaining to equity, diversity, and inclusion? We don't embed equity related skills in our selection processes, and too often people with power are clueless about best practices. /2
Read 5 tweets
1/#Tweetorial! The @Aaimonline Collab on Learning & Working Environment Optimization released a conceptual model to guide LWE improvement.

But how do you actually USE the model?

We suggest 3 simple applications for #meded at the front lines:…
2/One quick question before explaining our three proposed approaches. In your opinion, is there a difference between a “Definition” of a thing, and a “Model”? Poll below and feel free to explain your answer:
3/Merriam Webster defines “Definition” as “A statement of the meaning of a word” or “A statement expressing the essential nature of something.”

A definition is, by definition (ha), reductionist. The goal of a definition is clarity, sharp lines, exactitude, immutability.
Read 16 tweets
Tomm we start a journey at @ZuckerSoM w/ 3rd yr #MedicalStudents to enhance #Awareness #Education #Skills #Comfort #Hope re: #OpioidCrisis

13.5 hours - "#OpioidEpidemic" themed week (3rd iteration)

Follow/RT as Students, Colleagues, & I tweet - #OURcrisis

#MEDeD #RecoveryMonth
1️⃣0️⃣0️⃣ MS3 #Students

6️⃣0️⃣ Faculty/Facilitators

3️⃣0️⃣ Clinical/Non-Clinical Depts

#OURcrisis @ZuckerSoM

@GIMaPreceptor @DrYili @MartinsWelchMD @JoeCMD @medicmin911 @ektrenchard @ethanfried @ginofarina @LindaWDeMasi @AFornari1 @joemd @DrAhuja @santhoshpaulus6 @TomMcGinn4
#Strategic Full Circle
1. from Health System (need)
2. to School of #Medicine (access)
3. to Health System (access/mission)

Our #OpioidEpidemic themed week is part of a 30+hour 4-yr longitudinal 'Addressing #SubstanceUse' curriculum
#OURcrisis #MEDeD
Read 28 tweets
For my 1st #MedEd #Tweetorial, I’m going to discuss cognitive load theory and its implications for our teaching in the classroom & clinical setting.

Here’s a great reference for anyone interested in learning more from @AMEE_Online & @MedTeachJournal:…
@AMEE_Online @MedTeachJournal 1st, a definition:

Cognitive load = the amount of mental energy that it takes to learn new information or perform a task.

Cognitive load theory proposes that we have a limited amount of mental energy available, and optimizing it makes it easier for us to function.
@AMEE_Online @MedTeachJournal Cognitive load theory identifies 3 components of cognitive load:

1. Intrinsic load
2. Extraneous load
3. Germane load

These components can be altered to make a task easier or harder to perform.
Read 17 tweets
I'm going to go outside of my regular comfort zone a bit today, and try out a #tweetorial/#medthread a bit more applicable to #medtwitter in general. So here goes....

A beginner's guide to the use of #PREDNISONE!

#MedEd #FOAMEd #dermtwitter #dermatology PC:@dermnetnz
Ah, prednisone. One of the most frequently used drugs in our specialty, and in many across the board in medicine. Useful for quick suppression of an overactive immune system, whether that be because of autoimmunity, or acute infection. But how does it work?
The point is that there are so many potential mechanisms, that it's hard to point at one particular enzyme or pathway to explain all its effects. This paper address many of them, but my main takeaway is that we don't know everything!…
Read 20 tweets

I've posted about this already, but "FIRST DO NO HARM" is:
* Not from the Hippocratic Oath
* Not accurately translated from Hippocrates
* Not actually a goal of medicine
(How could I say such a thing?!)
* Is very poorly understood.

#medtwitter #MedEd #hippocrates
If we did no harm, we would never do surgery. We would never give meds. We would never anaesthsitize patients, or attempt to replace lungs.

The actual goal (and oath!) is to BALANCE BENEFIT VS HARM so we endeavour to do more good than harm. We minimize harm when possible.
The Greek ὠφελέειν ή μὴ βλάπτειν (incorrectly translated to Latin as "primum non nocere") is a passage from the Hippocratic treatise on Epidemics "In illnesses one should keep two things in mind, to be useful rather than cause no harm".
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Not every day you get to speak to the Medical Deans of Australia and NZ on disruption and #MedEd #FOAMed & #SoMe in a plenary chaired by the indomitable @forrest_kirsty together with @LSchuwirth and Dr Joe Kolars from @umichmedicine 🙏🏽@forrest_kirsty for this opportunity.
Shout out my @MedEdStuffnN partners in disruption @GongGasGirl @hypoxicchicken including @char_durand @drlauraduggan & @MedEdUnicorn for their input. Plus thank you @aoglasserfor sharing & 🙏🏽@NEJM @tony_breu for impeccable timing ... why is a cow indeed?! Let’s embrace curiosity.
@MedEdStuffnN @GongGasGirl @hypoxicchicken @char_durand @drlauraduggan @MedEdUnicorn @NEJM @tony_breu A few people have asked for the talk so here you go a thread on disruption in #MedEd. Challenges facing medical education: medicine, social media and the digital age. Session moderated by @forrest_kirsty Prof KForrest Dean of Medicine @BondUniversity #MDANZ19 @MedicalDeans
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#TRIBECON begins #Pravara; felicitations to #AbhayBang @SearchGad & #sudarshan #VGKK for their inspiring work on #TribalHealth; @DrLahariya @whoindia among others felicitated
#abhayBang #healthsystem design for tribal communities need to be relooked for #UHC; strategies & schemes must adapt with local social & cultural context; recollects #Brainstorming with @DesirajuKeshav at @SearchGad leading to #ExpertCommittee #tribalhealth @TribalHealthIND
#TRIBECON #AbhayBang notes with happiness increasing interest in #tribalhealth research, yet this continues to be “off the beaten path”; congratulations to #pravara medical college in bringing this together; the proposed #Bandardhara declaration to improve #tribalhealth research
Read 81 tweets
Lots of discussion the past few days set off by the @WSJopinion piece about the role of social justice in medicine.

A brief thread for those who missed it or want a refresher:

Things started with an attention-grabbing op-ed with an even more cringe-worthy title, arguing that climate change, population health, and other similar areas of study have no place in medical school:…

One unforgettable bit:

"Why have medical schools become a target for inculcating social policy when the stated purpose of medical education since Hippocrates has been to develop individuals who know how to cure patients?"

Obviously, no one could be interested in 2 things.

Read 13 tweets
#MedTwitter has been discussing “Take Two Aspirin + Call Me By My Pronouns,” an op-ed claiming social justice is taking time from sci ed + decreasing the quality of #MedEd.

So here’s my take:
“Take Two Aspirin + Read a Curriculum”

#MedTwitter #SoMeDocs #DoubleDocs
As always, I start threads with my POV: #LatinasInMedicine #DoubleDocs student in year 2 of #medschool. I have interests in both #MedEd + #HealthJustice. I am about to finish my term as diversity rep on our med student govt. I care a lot about advocacy.
Let’s take a moment to learn about the author: Stanley Goldfarb is a nephrologist, *former* assoc dean of curriculum at UPenn Med. He graduated from med school in 1969. Ffolks who studied at UPenn have brought up negative experiences with Dr. Goldfarb.
Read 55 tweets
So a lot of people of dunked on this terrible op ed from Dr. Goldfarb in the @WSJ, so I’m not breaking any new ground. Most have focused on the false dichotomy of science versus policy/advocacy. But it’s really more than that. 1/11…
Dr. Goldfarb’s argument that progressive politics is preventing good science has it precisely backwards. There is undue political influence in the practice of medicine today, but it’s not from the left.…. 2/11
It’s not the left that wrote legislation that barred doctors from asking their patients about guns in the home or even discussing gun safety, despite the evidence supporting an impact on health outcomes. 3/11
Read 16 tweets
A #tweetorial/#medthread on…

CONSULT ETIQUETTE – for the consultant!

(This is the 2nd in a series on consult etiquette. See the end of this thread for a link to my other tweetorial for primary teams calling consults).

#MedEd #FOAMEd #dermtwitter #medtwitter #dermatology
So you just got paged for a consult…. What do you do?

Of course we all think #1, yes?! Realistically though, it can be stressful to get consults. They are unpredictable, can come at any time, & the primary team may or may not listen to what you have to say. Here are some tips I’ve come up with from my time on #dermconsults.
Read 12 tweets
Bit of a different #tweetorial today, on:


- TIPS for the PRIMARY TEAM calling the consult.

Caveat: Some examples are a little #dermconsult specific, but can be extrapolated to others!

#medthread #dermtwitter #medtwitter #meded #FOAMEd #tipsfornewdocs
As both a #dermatologist & a #hospitalist, I have the pleasure of being on both ends of the #consult game.

So, your team has decided to call a consult, and you are the intern or student who has been tasked with contacting the team. Don't be nervous! Try these tips!👇👇👇
First of all:

1)Have a consult question

Asking a consultant to see a pt w/o a ? is like having a pt see you w/o a chief complaint! The ? helps the consultant frame the note in a way that is most helpful for you & your team. Otherwise, I'm guessing at what you want to know.
Read 11 tweets
Derm/Rheum Consult 1: 82yoW w/ HTN, breast can, new annular rash. Skin bx eosinophilic lymphocytic infiltrate. Gave 1mg/kg steroids.
ANA+ with centromere pattern, CREST?
==>#UnmaskSx with Steroids when tapering steroids.
==>Deep perivascular infiltrate on bx = Derm IDK!

Derm/Rheum Case 2: 78yoF MGUS,HFpEF, rash on legs. ?purpura. w/u Cryocrit normal , RF+ skin bx C3 in vessel walls, LCV.
Dx: Type II Cryo
Learning Pearl: Retiform purpura "angular stellate rash" pic below and diagram -> VASCULITIS or VASCULOPATHY

#dermtwitter #rheumatology
Derm/Rheum 3: Bullous Rash? DDx: Bullous Lupus vs. Epidermal Bullous Acquisita (EBA) vs. Bullous Pemphigoid
Learning Pearl:
Minimal trauma w/ blisters = EBA, treat with dapsone +/- prednisone
Consult Derm!

Read 7 tweets
I completed medical school 4 years ago. So I would like to discuss how learning cultural competency and advocating for social justice are VERY relevant to my career. And I'm a dermatologist and aspiring physician scientist. THREAD #medtwitter #MedEd
First, this article erroneously assumes we no longer get basic science training. I assure you, we received plenty of basic science classes. I did have to memorize the Krebs cycle, after all. Learning cultural competency and advocacy did not replace basic science. #meded
1) Climate change is very relevant to healthcare. In #dermatology, endemic illnesses have expanded their geographic areas as the climate has changed. See @MishaRosenbach et al:
Read 11 tweets

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