Discover and read the best of Twitter Threads about #meded

Most recents (24)


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
This was a *CRAZY* busy week. I must have done 900 thoracenteses this week, so I had some questions about pleural effusions and their effect on dyspnea based on things I observed. Here are my take aways. #MedTwitter #MedEd #PulmCrit #FellowLife
1/ I felt like a hero - swooped in, did a thoracentesis, drained 1.5L... and her breathing didn't get better. I was like... 😕wtf. It turns out size of pleural effusion correlates poorly with dyspnea. This holds true for reduction in symptoms after thoracentesis.
2/ Did another thora, and his SpO2 was WORSE after. 😖I'm like... WHAT'S WRONG WITH ME? Things can actually worsen immediately after thoracentesis (even without mucking it up) for a few hours. Also, gas exchange issues DON'T correlate with the symptom of dyspnea!
Read 8 tweets
.@ammo_uw is kicking off the Educator’s Development PG course at #CHEST2019 with Mark Lavercombe (ML), @pkritek and @williamkellymd .. follow this thread for #CHESTMedEd updates from this day long session!
Also engaging us today will be Dr. Lisa Moore. Here are all the sessions for all you clinical educators at #CHEST2019 #CHESTMedEd
ML: is up next: Application of Adult Learning Principles

- Be aware of limitations of adult learners eg, limited time
- Be aware of limitations in environment: eg. Interruptions, clinical work, variety of learners

Read 41 tweets
“What does a surgeon look like?”

A story for all ages, written by @JJcolemanMD , illustrated by @gracie_leo

#ilooklikeasurgeon #womeninmedicine #medtwitter #meded #foamed #storytime
Story thread below...
She woke up one morning and asked the Mirror, “What does a surgeon look like?”

But the Mirror did not answer.

She asked the World and asked “What does a surgeon look like?”

And the World did answer.
The World said,

“He is TALL and NOT small.”
“He is not too young or too old.”
Read 10 tweets

I love to provide structure for my learners. A couple years ago I adopted a set of rules for rounds and ward teams. These continue to evolve.

I share them on day 1, and refer back to them frequently while on service.

#TeamRules #MedEd
What are your #teamrules?
Rule 1: We treat patients, not diseases or numbers.

Always always put the disease and number into context for that specific patient. And get to know the patient.

It’s good medicine, and makes the job so much more interesting.

#SDOH #IllnessInContext #EBM
Rule 2: Rounds are done by noon.

Come prepared and we will get the work done together

Stick with the 4 Ds - decompensated, discharges, diagnostic dilemmas, the C Diff patients last. Stop wherever we are at 11:30 and finish running the list.

HT @thecurbsiders ep157

Read 7 tweets

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:
Read 13 tweets
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".
Read 8 tweets
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
Read 33 tweets
#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

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