IMreasoning - Clinical reasoning for Doctors and Students

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December 2017
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31

Syndication

In this episode we get tips on how to teach clinical reasoning from Bob Trowbridge, an expert clinical educator at Maine Medical Centre.

Go to our website www.imreasoning.com for links to Bob's new book, and other resources we discuss with Bob.

Visit us at https://www.facebook.com/IMreasoning to comment on the episode and to give us your thoughts on this topic.

Direct download: episode_17_-_Bob_trowbridge.mp3
Category:general -- posted at: 4:15am EST

We decided to call this episode an "in-between-isode", borrowing the term from the Tim Ferris show.  Its a short follow up continuing with our theme of feedback.  How do we provide an evaluation for a strong performer?  Does it help them to hear how great they are? Will it be a useful session? Will it help them improve even further?

Leave us your thoughts on our new Facebook page.

https://www.facebook.com/IMreasoning

 

Direct download: episode_15_-_feedback_2_-_Vic_eval_-_180516_6.11_AM.mp3
Category:general -- posted at: 2:26pm EST

In this episode we begin our foray into the topic of feedback.  You will hear us "worry out loud",  together with our guest Dr. Chris Watling from the University of Western Ontario, about the difficulties in giving effective feedback to our trainees.

Several themes arise from our conversation.  Feedback needs to be specific, credible, and not soul-destroying (although ironically, we each shared some of our most traumatic feedback experiences as the most memorable, and influential, course-correcting moments).  How we give and receive feedback is not only dependent on the individuals involved, but also importantly on the culture of the discipline; medical training culture is different from musical training, different from athletic training.

Also, keep an "ear" out for our new segment, the BOM (Bias of the Month). Enjoy!

Direct download: episode_15_-_feedback_1_-_90516_6.08_AM.mp3
Category:general -- posted at: 2:55pm EST

We're trying something new this week.  We go through a case of a diagnostic error with a fine tooth comb to try to find the cognitive pitfalls. We would love to hear your feedback about this episode.  Should we do this again?

Direct download: episode_14_-_Cognitive_autopsy_of_a_groin_lump_-_210316_3.07_PM.mp3
Category:general -- posted at: 10:38pm EST

Finally, our much awaited third try with Stump the Chumps.  This time one of our registrars Dr. Brian Grainger challenges us with a case of a young patient.  This is a longer episode, which I guess reflects the fact that sometimes, when the diagnosis is not obvious, you just have to take your time.  Enjoy!

Direct download: episode_13_-_STC_3_-_160216_3.32_PM.mp3
Category:general -- posted at: 9:59pm EST

What is compassion fatigue? Can you learn how to be more compassionate with your patients? We talk to Dr. Tony Fernando, psychiatrist, sleep specialist, educator and researcher, about compassion in healthcare, happiness, mindfulness, enlightenment, buddhist monks, and a bunch of other stuff. Enjoy!

Direct download: episode_12_compassion_fatigue_Tony_Fernando_-_171215_5.17_PM.mp3
Category:general -- posted at: 8:47pm EST

We bring you our second attempt at "stump the chumps".  Our friend and colleague Oliver Menzies brought an interesting case.  We think this case was not quite as enigmatic as our first one (episode 5) but we hope it illustrates sound clinical reasoning as we work our way through the clinical information.  Enjoy.

Direct download: episode_11_stump_the_chumps_take_2_-_91115_9.21_PM.mp3
Category:general -- posted at: 10:30pm EST

When we talk about medical errors, we need to remember that there are two victims; the patient who suffers harm as a result of the error, and the clinician who makes the error.  As long as the practice of medicine remains a human endeavour, medical errors are inevitable.  As a medical community we need to accept that errors will occur.  We need to talk about them openly and honestly, share our own stories, and support our colleagues when they share their stories with us. As members of society, we should better understand the fallibility of medical practitioners, and we need to understand the limits of their craft.

We had the opportunity to interview Brian Goldman, an ED doctor from Toronto, Canada, who is also a journalist, host of the CBC radio show "White Coat, Black Art", author of two books unveiling the secrets of medical culture, and a "TED-talker" with his presentation entitled "Doctors make mistakes - can we talk about that".

We also interviewed our friend and colleague, Dr. David Spriggs, a Brit who has lived in NZ for many years, an excellent general internist and geriatrician, who regularly teaches our trainees on the reality of making mistakes.

Direct download: episode_10_making_mistakes_-_21115_10.06_pm.mp3
Category:general -- posted at: 7:47pm EST

The future is coming.  In this episode we talk to Shantanu Nundy of the Human Diagnosis Project (HumanDx).  As Shantanu describes it, HumanDx is a worldwide effort to map any health problem to its possible diagnoses.  We have come across various projects that aim to create that elusive, high-fidelity, real-life, artificial intelligence of diagnosis.  HumanDx is building that AI by connecting the knowledge, experience, and real-life cases from all of us.  This is OUR project.  We think that HumanDx is the real thing.  Enjoy!

Direct download: episode_9_The_Human_Diagnosis_Project_-_81015_3.33_pm.mp3
Category:general -- posted at: 5:35pm EST

The Diagnostic Error in Medicine Conference 2015 has finally come!  We have been looking forward to attending this conference for a while now.  This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm.  These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard.

Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

Direct download: episode_8_DEM_conference_day_3_-_300915_12.30_am.mp3
Category:general -- posted at: 12:36am EST