1/10 As someone who struggles with test-taking, I made a framework for tackling some common test-taking hurdles. I had the opportunity to go over this with all our @uclaimchiefs housestaff and decided to make it into a 🧵 #MedTwitter#MedStudentTwitter#FOAMed
2/ Test scores are important because they are what you need to become board-certified. Scores are often conflated with competency - that is quite a fallacy as so many other factors go into competency.
3/ Here is a non-comprehensive set of examples of test-taking hurdles. Let’s go through each of them systematically in a way that resonates with internists - problem listing! FYI, all of these end of overlapping a lot
4/ First we have impaired ⏲️ management. Opening up lab references will split your screen, so you don’t have to read the questions all the way across the monitor (this can help ⬇️ fatigue).
5/ Next up is getting stuck between choices. Finding a trusted individual is really important for your growth in this domain.
6/ Next is ⬇️ stamina. Steadily lengthening the block of practice questions can help.
7/ Finally we have ⬇️ focus, which overlaps greatly with ⬇️ stamina
8/ To mitigate these issues, create lots of SMART goal that are context-dependent (the rigors of your ICU rotations are different than those of your clinic rotations). Consider creating 🗓️ events to schedule time to study/take questions.
9/ Finally, it is worth keeping a log of reflections and learning points as your own reference to peruse at your leisure. Here is an example of my log from when I was studying for my boards.
10/10
In summary
✴️Invest time in diagnosing your test-taking issues
✴️Develop a #growthmindset when doing practice questions
✴️Keep a log of questions that helps inform and identify your test-taking issues
Would love to hear what others have to say!
And a big thank you to @rachelpbrookmd for allowing me to be involved in helping residents navigate these issues!
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1/12 The cognitive load on rounds can be high, so I like using daily e-mails as an adjunct to teaching on rounds. Here is a 🧵 on my approach! #MedTwitter#MedEd#FOAMEd
2/ I am of the opinion that you can form an outline of a lesson plan BEFORE you even start on service! My group attends for 14 days at a time, so this tells me how much “time” I have allotted to teach (more on this later).
3/ Make sure to include every learner who will rotate with you while you are on (I use amion to figure out which trainees are on with me). They might appreciate getting learning when they are off service and if there is an ongoing thread of teaching, they won’t miss out!
1/8 Medical education has evolved tremendously, and I am a HUGE fan of having a peripheral brain. An common question trainees ask me is “how do you cultivate references?” A 🧵 on my methodology for organizing information #MedTwitter#MedEd
2/8 Before we start, it is important to categorize the purpose of the info you are gathering:
1⃣ To teach others
2⃣To teach myself
I don’t organize my references this way, but I start here to remind myself that everyone learns best with different modalities!
3/8 Now that we’ve acknowledged that, you must create a list of modalities that you can consistently categorize information into. Here is my organizational system.
The primary focus of this thread is going to be on the history (a heads up - the flowchart at the end will go a little bit out of order)!
3/18 When taking a chest pain history, we ask lots of questions about associated symptoms and alleviating/aggravating factors, mostly because we were taught to obtain and report this history. But is there a more focused way to approach this?
Note: the original post was deleted due to a mathematical error
2/5 While the CHADSVASc is helpful for annual estimation of ischemic stroke risk (and other events), what is the risk of DAILY risk? Turns out we can do some math to derive it from the annual risk estimation!
3/5 The math here doesn't EXACTLY reflect the daily risk of for patients because there are countless variables that we cannot control. @JessieCurrier17 describes the rationale using probability quite nicely.
1/7 Considering how to manage community-acquired pneumonia (CAP)? Is it CURB-65 or should it be CARB-65? No idea what I am talking about? Let's talk about azotemia and uremia!
2/7 The CURB-65 score has been used for diagnosis and treatment of adults with community-acquired pneumonia (CAP). The most recent IDSA CAP guidelines in 2019 (pubmed.ncbi.nlm.nih.gov/31573350/) referenced the 2007 IDSA CAP criteria for defining severity
3/7 The original article that describes validation of the CURB scoring system (ncbi.nlm.nih.gov/pmc/articles/P…) does NOT use the word "uremia," but instead references an serum urea level cutoff.
2/9 The cornerstone of treatment is to treat the underlying cause. Everything else is just a 🩹. It can sometimes be very hard to treat the underlying cause immediately (assuming you can identify it).
3/9 Free water restriction is going to help (to a certain degree), but make sure that it’s feasible for the patient (they often need to do this beyond hospitalization). Consider restricting 500 cc below their 24-hour urine output: