Teaching the thought process – some thoughts

I often write about teaching the thought process.  Research that we (multiple clinician educators at UAB) have published documents clearly that learners value attending physicians who teach the thought process.  Learning this was a bit of a surprise to me, but many students and residents have reinforced this concept in conversations over recent years. These words are easy to type, but how does one learn to teach the thought process.  In thinking about this, I have an idea, and would love to read your comments about this suggestion. Two days ago in morning report we had a patient with possible syncope.  If you are teaching about syncope, how do you explain your evaluation process.  I teach syncope in a logical step-by-step fashion.  We first discuss orthostatic hypotension (with or without tachycardia), then we consider the cardiac causes (tachycardias, heart block, valvular disease), we then explore vasovagal causes, vertebral basilar insufficiency, etc. Using metacognition, I offer the possibility that it is easier to work through a differential diagnosis if you have learned a logical way of remembering the evaluation. When I teach anion gap acidosis, I eschew MUDPILES because it gives us a random list that does not enhance understanding.  Rather I developed KILU (ketoacidoses, ingestions, lactic acidoses, uremia) and thus teach increased anion gap acidosis one category at a time. Of course I teach the way I think about medicine.  As I study medicine (yes over 40 yea...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs