Geoff Stetson, MD Profile picture
Aug 26, 2020 10 tweets 6 min read Read on X
1/ Bias in Medicine – A 🧵

This week I was able to participate in a #BiasInMedicine curriculum @UCSFMedicine. Below are some of my favorite (paraphrased) quotes and insights.

CC: @gradydoctor @dereckwpaul @jbullockruns @ChaseTMAnderson @_HarryPaul_ @FutureDocs @Bob_Wachter
2/ Black Female MD:

“Me being present everyday is me advocating. Just being in this space is me speaking up.”

“Some identities that we have are out in the open. Others are hidden, such as certain disabilities. These can be sources of bias. This is important to remember.”
3/ Latinx Female Med Student:

“Don’t ever call the medical student ‘the medical student’”

“There are times when the #HierarchyInMedicine makes sense…graduated responsibility to keep patients safe. That doesn’t mean it has to translate into all aspects of training.”
4/ White Male MD who is legally blind:

“I am proud to be participating in these discussions of bias in medicine. #DocsWithDisabilities aren’t always included in these discussions, but there is a lot of bias. We also advocate for ourselves, and need #allyship from others.”
5/ Latinx Male MD:

“A research mentor once told me, ‘you’re so smart! Why would you waste your time on disparities research?’"

“A different white male mentor advised me to pursue disparities research. This person listened to me, and saw the unique perspective I provided"
6/ Personal Reflections:

🔑 “Small things” aren’t small.

“Small” slights or #microaggressions are #traumas to the people who experience them.

“Small” #AffirmationsOfBelonging for those who experience bias can mean a whole heck of a lot.
7/ “Small” demonstrations of inclusion, like learning names (with correct pronunciation), and using them, is important.
8/ Systems and Institutions need to implement major changes to achieve true equity and inclusion.

Those in leadership need to work hard, and feel pressure, to prioritize this.
9/ But, those with little power (medical students and residents) need not feel guilty about not trying to stage a coup. When you all hold the levers, you can pull them appropriately.

“Small” gestures of inclusion are not little things, and they are a great place to start.

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More from @GStetsonMD

May 17, 2022
1/ Attending: “Sam, what is the level of bilirubin at which scleral icterus is noticeable?”

Sam thinking: [1. I can make a guess, but 2. Who cares?]

Seem like a familiar scenario? Let’s help this attending ask a better question.
2/ Whether it is in the team room, or at the bedside, asking questions of learners is a skill that requires intention, preparation, and execution. These best practices were a topic I covered a while back, so this will be a refresher.
3/ These were all the topics that were covered in that series. Each individual thread can be found here:
twitter.com/i/events/13982…
Read 14 tweets
Apr 19, 2022
1/ You just admitted a patient with some really interesting pathology. You want to teach about it tomorrow on rounds. You know it is gonna be a busy day. What’s the plan?

Welcome back to #TweetorialTuesday from the @MedEdTwagTeam. Special S/O to our #MedEd & #MedTwitter friends!
2/ We are still in this “during rounds” section of our inpatient teaching block. Rounds are the CLASSIC time to drop pearls. But, doing it well takes thought and preparation.
3/ What does it mean to “drop pearls”? It refers to pearls of wisdom, and many of us think of some stately professor emeritus waxing poetic in a case conference.

But check out this definition here:
Read 11 tweets
Apr 5, 2022
1/ Welcome back to another edition of #TweetorialTuesday from the @MedEdTwagTeam. Special S/O to our #MedEd & #MedTwitter friends!

Over the last two weeks we have laid out the WHY and the WHAT of teaching communication. Today is the HOW. Let’s go!
2/ For refreshers on the WHY and WHAT, check out these previous threads from:
@JenniferSpicer4 (WHY) –
@GStetsonMD (WHAT) –
3/ And like the previous threads, much of this content comes from this book (Chapter 16 for this thread) by @DrCalvinChou & @LauraCooleyPhD of @ACHonline. It is a foundational book that is extremely readable and applicable. Well worth your time: CommunicationRx.org
Read 12 tweets
Mar 29, 2022
1/ We can’t always treat. We can’t always cure. But we can always support & care with good communication.

Welcome back to our #MedEd & #MedTwitter friends! Today we lay out some foundational skills of communication that you can help your learners to hone under your tutelage.
2/ As we continue to focus on inpatient teaching, we are still in the section that homes in on opportunities during rounds. Especially when rounds are done at the bedside this is a perfect time to practice communication skills.
3/ Last week, @JenniferSpicer4 helped us all to grasp WHY it is important to spend time teaching communication skills:
⬆️Health outcomes & patient experience
⬇️Cost of care
⬆️Clinician experience

Read 16 tweets
Nov 16, 2021
1/ It is near the end of your time on inpatient service and it has been BUSY!

Spirits are high, but folks are tired.
You want to make sure rounds are high-yield, but how to focus their energy?

Welcome back #MedTwitter & #MedEd for another #TweetorialTuesday from @MedEdTwagTeam!
2/ This week, I will share tips on how to use questions to get ”the wheels turning” for your learners before rounds.

In just a few minutes, this focuses energy, engages team members in the cases they may not be following, and enhances bedside learning for everyone.
3/ Today’s 🧵 harkens back to one I posted about ”prediction questions”.

Inspiration: #SmallLearning from @LangOnCourse. It is tremendous, with a lot of useful ideas that can be applied in the classroom or clinical setting. FYI - 2nd ed just came out.
Read 13 tweets
Sep 28, 2021
1/ Learning objectives? For serious?!? 🤔
Aren’t those for boring pre-clinical lectures?
Are they even necessary? I seem to get by just fine without them.

You may get by fine but knowing how to use learning objectives will take your game to a new level. Let's go!
2/ Welcome back, #MedEd and #MedTwitter friends, for another exciting week of learning from the @MedEdTwagTeam.

For orientation, we are still in our foundational skills section of #InpatientTeaching.
3/ Every resident who rotates with me leaves my team knowing why learning objectives (LOs) are important, how to make them, and how to apply them.

LOs provide structure to all didactic content, and IMHO, are the single most useful tool to power up your teaching.
Read 15 tweets

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