Tips for IM Attendings – Chapter 12 – Preparing teaching chunks

Many concepts recur often in medicine.  Patients get admitted for syncope, or chest pain, or edema.  Patients have anemia, or hyponatremia or hypokalemia.  We could make a long list of relatively common situations that we see repeatedly as attending physicians. Our learners need to develop a thoughtful approach to each of those situations.  As an educator you should develop a series of learning chunks for many situations.  For example, a patient gets admitted to our service with syncope.  Here is a rough outline of my approach, understanding that each number represents a chunk for teaching and learning: Is it really syncope?  In this chunk we discuss the difference between syncope and a seizure or just feeling week. Do they have orthostatic hypotension?  Did they measure it properly? How do we define orthostasis? If they have orthostasis do they have an appropriate pulse response? If no orthostasis then what is our biggest worry? Ways the heart can cause syncope – and thus what testing must we do? Can cerebrovascular disease cause syncope, and if so which vessels? What else causes syncope? What if we cannot find a cause? This list is not complete and experts might add a few more points.  But this outlines the chunks that I might use on rounds.  When we have time, we might discuss syncope for 20-30 minutes, but often we must truncate because the rounds do honor time constraints.  Having these chunks allows one to focus on a part of the discussion that has th...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs