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Yesterday, I discussed a pt who had subacute chest pain and dyspnea w/a group of learners
A pivot point in the case gave me some insight into the process of teaching reasoning
I'd love to share my experience #medtwitter #teachdx 1/
A pivot point in the case gave me some insight into the process of teaching reasoning
I'd love to share my experience #medtwitter #teachdx 1/
The patient's pain was pleuritic. Dyspnea, exertional. Symptoms worsening. Other history, sparse. The exam yielded signal:
Tachycardic, tachypneic, hypoxic, speaking short sentences, quiet lung bases
A dx and rx path was forming 2/
Tachycardic, tachypneic, hypoxic, speaking short sentences, quiet lung bases
A dx and rx path was forming 2/
Heart and lungs were on the mind. The group wanted a CXR, so did I.
Pleural effusions, great
Atelectasis, yes
Enlarged cardiac silhouette...hmmm
'What do you think?', I asked.
'Echo!', 'CT thorax!', they replied.
Fantastic I said...but why? 3/
Pleural effusions, great
Atelectasis, yes
Enlarged cardiac silhouette...hmmm
'What do you think?', I asked.
'Echo!', 'CT thorax!', they replied.
Fantastic I said...but why? 3/
1/ “I’ve got a consult for you.”
A standard refrain for subspecialists, but one that often generates significant stress on both ends of the call.
Why?
Q: If you have ever felt anxiety about calling a consult, what was the cause of most of your stress?
A standard refrain for subspecialists, but one that often generates significant stress on both ends of the call.
Why?
Q: If you have ever felt anxiety about calling a consult, what was the cause of most of your stress?
2/ Consultation is an indispensable component of medical practice – the field is too vast and new science emerges too rapidly for any one specialty to stay current.
Thus, collegial and effective consultation is essential.
Thus, collegial and effective consultation is essential.
3/ Until recently, most ideas to improve ‘effectiveness’ of consultation focused on ‘mechanics’ & ‘culture’ – timeliness, communication, and professionalism – like the classic “10 Commandments of Effective Consultation”.
pubmed.ncbi.nlm.nih.gov/6615097/
This is the HOW of consultation.
pubmed.ncbi.nlm.nih.gov/6615097/
This is the HOW of consultation.
