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Jennifer Spicer, MD, MPH Profile picture
@JenniferSpicer4
May 12, 2020 • 6 tweets • 3 min read • Read on X
1/ This study documents patients who tested positive for SARS-CoV-2 after an initial negative test

Thx @EmoryMedicine MS3s @ariellevaldez & Eman Hijab (creators), @an_xiao_ & @cg_coleman (editors), &@EmoryDeptofMed ID fellow @DBhamidipatee (review)

#EducationInTheTimeOfCOVID Image
2/ It's unclear from this report if this is truly "reactivation." The authors mention that patients had symptoms, but it's unclear if these are new symptoms or persistent symptoms.

Is this really reactivation? Or just persistent infection? Or re-infection?
3/ It's all a little unclear, but it will be interesting to see more data

A positive PCR test just detects viral nucleic acid; it doesn't confirm actual live, replicating virus is still present. We don't know if these patients are still infectious (& they're likely not)
4/ I'm interested to know what others think about this paper. I'm not too impressed. I don't think we know much more than we previously did based on this data.
5/ Here's the link to the paper:
ncbi.nlm.nih.gov/pmc/articles/P…

And a link to our new webpage that hosts the literature summaries from our #EmoryID fellows and visuals from our medical students
med.emory.edu/departments/me…
And here's our revision. Thanks for everyone's suggestions! Image

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More from @JenniferSpicer4

Jennifer Spicer, MD, MPH Profile picture
Mar 17, 2023
Kicking off BST Mode ⁦@emoryimchiefs⁩ Grady campus on #MatchDay2023

⁦@gradydoctor⁩ Image
Do you want a 4-step process for questions to ask when you get a page next year when you’re alone on nightfloat or ICU call?

Check out this framework! Image
And now, do you wanna remember who the heck to order DEXA scans for in clinic?

Thankfully Miko De Bruyn comes to the rescue. Image
Read 16 tweets
Jennifer Spicer, MD, MPH Profile picture
Mar 7, 2023
1/ You're seeing a new consult with your team, and you want to teach the primary team too.

But WHEN is the best time to teach them?

On the phone?
At the bedside?
In their team room?

And in the morning?
Or maybe the afternoon?

This week: Image
2/ Last week @VarunPhadke2 described all of the individuals whom we can teach during the day.



But when should we teach them?

Often we default to teaching on the phone when receiving the consult or giving recommendations, but there are other options too.
3/ This week we will discuss the pros & cons of those options.

With one caveat.

Often the best time to teach is the one most convenient to your team & the primary team, which depends on your local institution's workflow.

But let's explore some general principles to consider.
Read 15 tweets
Jennifer Spicer, MD, MPH Profile picture
Feb 21, 2023
1/ You're finishing your last consult of the day.

It's late.
And it's been a long day.

You intended to find the primary team to teach them, but you have a million other things on your "to do" list.

Here are 8 reasons why you should still find time to teach the primary team. Image
2/ Reason #1: They want to learn

The primary team called with a question.
They are invested in the answer.

It's all about finding out what they want to know and targeting your teaching accordingly.
3/ Reason #2: It empowers them

Often the primary team has an idea of what to do but wants reinforcement that their plan is correct.

Teach them general rules that they can re-use. Image
Read 12 tweets
Jennifer Spicer, MD, MPH Profile picture
Jan 31, 2023
1/ Your team just saw a patient with syphilis, and you're ready to teach, but:

Resident #1: on week 2 of their rotation
👉 Has already seen 2 patients w/ syphilis

Resident #2: started today
👉 Hasn't seen a single patient with syphilis

What should you do now? Image
2/ Unfortunately, learners on our team may miss teaching that occurs during the rotation for multiple reasons. Image
3/ As @VarunPhadke2 previously pointed out, all learners on the team are usually not present all day, every day for the entire time we are on clinical services.

Image
Read 16 tweets
Jennifer Spicer, MD, MPH Profile picture
Jan 24, 2023
1/ A member of your consult team presents a patient w/ suspected neurosyphilis.

Your team:
⭐️ 3rd year medical student
⭐️ IM intern
⭐️ 2nd year IM resident
⭐️ 1st year ID fellow

How can you possibly provide valuable teaching to all of them?

This week: Multi-level teaching Image
2/ Teaching multi-level learners is hard.

Their range in baseline knowledge means a single teaching point is often not effective for everyone.

So how can you support everyone's learning without taking too long and/or boring others?
3/ A prior thread discussed the importance of clarifying learners' needs & interests at the beginning of the rotation.

This is one 🗝️ for effective multi-level teaching.

Know what materials is RELEVANT and INTERESTING for each learner level.

Read 14 tweets
Jennifer Spicer, MD, MPH Profile picture
Jan 10, 2023
1/ *Re-consult 📞*

You: What did the last consult note say?

Them: I don't know how to interpret it...

*reading the ✍️ yourself*
#Sepsis
- send tick serologies
- start broad-spectrum antibiotics
- we will follow up OSH data

You: 🤦 I feel you... We'll see the patient again. Image
2/ You wonder...

💭 What tick serologies were we referring to?
💭 What antibiotics were we wanting to start?
💭 And which OSH has prior records?

And you're not the only one wondering...

How can we ✍️ more effective notes?
3/ Clinical notes are used for many purposes, as previously highlighted by @YihanYangMD

Read 15 tweets

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