#meded Archive

All ideas and resources tweeted alongside #meded are curated and collected here.

Thursday May 31, 2018
9:00 PM EDT

  • MedEdChat - Moderator May 31 @ 9:00 PM EDT
    Welcome to the Medical Education chat (US) I am your moderator for the next hour, @alliance4clined Big thanks to @TLMedEd for the topic tonight! #meded
  • MedEdChat - Moderator May 31 @ 9:01 PM EDT
    The topic & questions will be announced in a moment…for now, please introduce yourselves #meded
  • sood_lonika May 31 @ 9:01 PM EDT
    Happy to join in after a while... Lonika, hospitalist from Green Bay wi #meded
  • TLMedEd May 31 @ 9:01 PM EDT
    Happy to discuss and learn more about this important topic in #meded
    In reply to @MedEdChat, @Alliance4ClinEd
  • GLBDallaghan May 31 @ 9:01 PM EDT
    Gary joining tonight from Chapel Hill #meded
    In reply to @MedEdChat
  • MedEdChat - Moderator May 31 @ 9:02 PM EDT
    If you are tuning in to the #meded chat, remember to use the #meded hashtag and try to answer with the Topic numbers (T1, T2, T3)
  • MedEdDialogue May 31 @ 9:02 PM EDT
    Looking forward to the chat #MedEd
    In reply to @MedEdChat, @Alliance4ClinEd, @TLMedEd
  • sood_lonika May 31 @ 9:02 PM EDT
    Hey Gary! #meded
    In reply to @GLBDallaghan, @MedEdChat
  • MedEdChat - Moderator May 31 @ 9:03 PM EDT
    We will assume that all of your tweets are your own during this hour unless otherwise stated #meded
  • ThalamusGME May 31 @ 9:03 PM EDT
    NBA Finals = PhysicianWellness #NBAFinals #PhysicianWellness #MedEd #ThalamusGME
  • GLBDallaghan May 31 @ 9:04 PM EDT
    Hi! Glad to see you on tonight! #MedEd
    In reply to @sood_lonika, @MedEdChat
  • MedEdChat - Moderator May 31 @ 9:05 PM EDT
    Topic 1: What evidence suggests that patient care takes a hit in July-September, when new residents begin training? #meded
  • sood_lonika May 31 @ 9:06 PM EDT
    T1: experience based evidence :) #meded
  • GLBDallaghan May 31 @ 9:06 PM EDT
    #MedEd T1 Is there evidence? One would think faculty are more vigilant supervising during that timeframe.
  • sood_lonika May 31 @ 9:08 PM EDT
    But don’t faculty also typically start in july( new graduates)? #meded
    In reply to @GLBDallaghan
  • TLMedEd May 31 @ 9:09 PM EDT
    Wondering what the latest evidence is. It’s interesting to consider possible explanations yes or no. #meded
    In reply to @GLBDallaghan
  • sood_lonika May 31 @ 9:09 PM EDT
    T1: #MedEd Phillips, D.P. & Barker, G.E.C. J GEN INTERN MED (2010) 25: 774. https://t.co/Hqb4GP8Fxf
  • GLBDallaghan May 31 @ 9:10 PM EDT
    #meded T1 True. Overlooked them. Still, other than anecdotal perceptions is there any empirical data?
    In reply to @sood_lonika
  • JanelleRBlu May 31 @ 9:11 PM EDT
    T2: Is there even an ounce of evidence out there supporting this or just a bunch of us overworked, cynical, jaded folks spreading this myth? 🤦‍♀️ #MedEd
    In reply to @MedEdChat
  • TLMedEd May 31 @ 9:11 PM EDT
    But people used to use that evidence to claim the Earth was flat. 😉 #meded
    In reply to @sood_lonika
  • MedEdDialogue May 31 @ 9:13 PM EDT
    T1 - https://t.co/PXIxSr24AU A recent study published in 2016 found no evidence #meded
    In reply to @MedEdChat
  • MedEdChat - Moderator May 31 @ 9:14 PM EDT
    #meded T1 Maybe a good project for @acgme to investigate
    In reply to @TLMedEd, @GLBDallaghan, @acgme
  • VThornleyMD May 31 @ 9:15 PM EDT
    T1 #meded in #neurology, in one paper, at tertiary centers, there is less tPa given, less dysphagia screening but functional outcome and death rates remained the same during the months July and August with new interns and residents. https://t.co/dH7aARQP2w
    In reply to @MedEdChat
  • TLMedEd May 31 @ 9:15 PM EDT
    And if there is evidence to suggest a July effect, can it actually help to build explanations, approaches to promoting safety? Much of what is out there is a-theoretical. #meded
    In reply to @JanelleRBlu, @MedEdChat
  • sood_lonika May 31 @ 9:17 PM EDT
    Role to strengthen epa use for scheduling ? #meded
    In reply to @TLMedEd, @JanelleRBlu, @MedEdChat
  • TLMedEd May 31 @ 9:19 PM EDT
    Interesting. Can you explain further this idea? #meded
    In reply to @sood_lonika, @JanelleRBlu, @MedEdChat
  • GLBDallaghan May 31 @ 9:20 PM EDT
    #meded T1 I'm curious what you mean by this.
    In reply to @sood_lonika, @TLMedEd, @JanelleRBlu, @MedEdChat
  • TLMedEd May 31 @ 9:20 PM EDT
    Great idea! The truth is as far away as a close look. #meded
    In reply to @MedEdChat, @GLBDallaghan, @acgme
  • myheroistrane May 31 @ 9:22 PM EDT
    Not much experience in July, but lots of vigilance, IMO. Danger comes in September when complacency sets in. If I was going to check outcomes, I would study diagnostic error in July, sloppiness (handoffs, etc) in September #meded
  • MedEdChat - Moderator May 31 @ 9:23 PM EDT
    Topic 2: What are institutions doing to smooth the transition from medical school to residency? #meded
  • MedEdDialogue May 31 @ 9:24 PM EDT
    T1 - It would be interesting to investigate when the 'July effect' was noticed or where it stemmed from #meded
    In reply to @TLMedEd, @GLBDallaghan
  • GLBDallaghan May 31 @ 9:25 PM EDT
    #meded T2 We're creating bootcamps in most specialties to better prep #medstudents for training
    In reply to @MedEdChat
  • sood_lonika May 31 @ 9:25 PM EDT
    T2: not sure if ugme is as invested in this as residencies are.. but I may be wrong #meded
  • MedEdChat - Moderator May 31 @ 9:26 PM EDT
    T1 #MedEd Perhaps our colleagues in @SDRME_Meded could support an invited review on this topic
    • MedEdDialogue May 31 @ 9:24 PM EDT
      T1 - It would be interesting to investigate when the 'July effect' was noticed or where it stemmed from #meded
      In reply to @TLMedEd, @GLBDallaghan
  • raj_mehta May 31 @ 9:27 PM EDT
    We should ask @hswapnil and #nephjc. They have mastered the art of Twitter moments, blogs, online journal club, and more. Leaders in #meded on social media.
    In reply to @venkmurthy, @ADAlthousePhD, @EJSMD, @Doctor_V, @rwyeh, @ethanjweiss, @ProfDFrancis, @VinayPrasadMD, @Twitter, @hswapnil
  • TLMedEd May 31 @ 9:27 PM EDT
    @bobrien_15 recently published an article in @AcadMedJournal that informs this question. https://t.co/qNN7dXi1mT #meded
    In reply to @MedEdChat, @bobrien_15, @AcadMedJournal
  • myheroistrane May 31 @ 9:28 PM EDT
    Many residencies starting their interns in June with lots of supervision and extra staffing for the first two weeks. Good idea, but the dark side is that some programs do not start paying salary until July 1. #meded
  • GLBDallaghan May 31 @ 9:28 PM EDT
    #meded T2 I think med schools are more invested in this. The question is should we be following #neurosurgery who had a national bootcamp
    In reply to @sood_lonika
  • TLMedEd May 31 @ 9:29 PM EDT
    Maybe in this case it really is true that “little is known.” #meded
    In reply to @MedEdChat, @SDRME_Meded
  • VThornleyMD May 31 @ 9:31 PM EDT
    T2 #meded when I was a resident at UVA & UVM, med. students worked up patients from scratch, formed DDx, rounded and followed pts. They didn’t take call though which may be a shock when you suddenly enter internship. Perhaps more responsibility is needed
    In reply to @MedEdChat
  • TLMedEd May 31 @ 9:32 PM EDT
    Are the challenges of transition more technical in nature (learning curve) or organizational (relationships, culture, etc.)? #meded
    In reply to @GLBDallaghan, @sood_lonika
  • SDRME_Meded May 31 @ 9:32 PM EDT
    Excellent notion! Here is info on our invited reviews program: https://t.co/CDndRPTTYE ... watch for this year’s call for proposals, which should be out in September. #meded
    • MedEdChat - Moderator May 31 @ 9:26 PM EDT
      T1 #MedEd Perhaps our colleagues in @SDRME_Meded could support an invited review on this topic
      • MedEdDialogue May 31 @ 9:24 PM EDT
        T1 - It would be interesting to investigate when the 'July effect' was noticed or where it stemmed from #meded
        In reply to @TLMedEd, @GLBDallaghan
  • CarloRajMD May 31 @ 9:32 PM EDT
    Oncology Group Sues HHS Over Part B Payment Cuts #MedEd https://t.co/7GuaZnAcaC
  • DexterMendozaMD May 31 @ 9:32 PM EDT
    AMSER/ACER also has an extensive educational scholarship webinar series. Catered to jr faculty, but never too early for those interested in #MedEd. Any of these tracks require a VERY motivated, self-directed #radres
    In reply to @DarelHeitkamp, @RichDuszak, @sethmhardy, @PBalthazarMD, @Skepticscalpel, @Hopkins_Rad, @RadiologyACR, @RLI_ACR, @EmoryRadiology, @AlexDabrowiecki, @brainbanker, @theAPDR, @RSNA
  • MedEdDialogue May 31 @ 9:32 PM EDT
    T2 - Do institutions typically find a large gap in the competency levels of new incoming residents? Just curious #meded
  • DrJoannaT May 31 @ 9:33 PM EDT
    Interesting paper analysing medical residency recommendation letters for plagiarism: https://t.co/3YzYvgDPHs Makes me re-analyse my own letter writing! #meded #plagiarism
  • TLMedEd May 31 @ 9:34 PM EDT
    This is an interesting idea. Are we kicking the can further and further down the road wrt autonomy? #meded
    In reply to @VThornleyMD, @MedEdChat
  • sood_lonika May 31 @ 9:34 PM EDT
    I suspect organizational since sub-i typically will be exposed to these facets of patient care #Meded
    In reply to @TLMedEd, @GLBDallaghan
  • myheroistrane May 31 @ 9:34 PM EDT
    Probably a bit of both, eh? #meded
    • TLMedEd May 31 @ 9:32 PM EDT
      Are the challenges of transition more technical in nature (learning curve) or organizational (relationships, culture, etc.)? #meded
      In reply to @GLBDallaghan, @sood_lonika
  • MedEdDialogue May 31 @ 9:34 PM EDT
    #MedEd #MedEdResearch
  • Alliance4ClinEd May 31 @ 9:36 PM EDT
    #meded T2 They do, and there is a question about whether training programs will believe assessments of EPAs or milestones.
    In reply to @MedEdDialogue
  • TLMedEd May 31 @ 9:36 PM EDT
    Imagine so. And the latter probably exacerbates the former. #meded
    In reply to @myheroistrane
  • KhouryMD May 31 @ 9:37 PM EDT
    1) Rxns after direct challenges were rare & MILD. 2) Can't compare direct challenge study to one where challenges skipped due to +PCN SPT (n=11). Authors commended for this study and admitting prior fault and striving towards #evidencebased approach to #PCNallergy #MedEd #FOAMed
    • EricMacyMD May 30 @ 2:43 PM EDT
      More evidence for using direct oral challenges to confirm penicillin tolerance. Safety and Outcomes of Oral Graded Challenges to Amoxicillin without Prior Skin Testing. - PubMed - NCBI https://t.co/nE08wWFjtX
  • SAttspeech May 31 @ 9:37 PM EDT
    I'll be back later this pm as part of the panel to talk re my own journeying in #meded and theory. @Flinders Prideaux Centre for HPE. Ping @LSchuwirth
    • charlreessidhu May 31 @ 9:34 PM EDT
      Thank you @SAttspeech! What great questions and I very much enjoyed our discussions. Helpful for the development of @Monash_MCSHE education research strategy! #mededuc
      In reply to @SAttspeech, @Flinders, @SAttspeech, @Monash_MCSHE
  • TLMedEd May 31 @ 9:37 PM EDT
    Questions of organizational transition do seem less examined. #meded
    In reply to @sood_lonika, @GLBDallaghan
  • MMitzi11 May 31 @ 9:38 PM EDT
    When our PACKRAT 2 score is on point 🙌 #physicianassistantstudent #MedEd #gettingitdone
  • MedEdChat - Moderator May 31 @ 9:40 PM EDT
    Topic 3: Residents are particularly susceptible to toxic stress and burnout due to transition issues. How can we foster resident wellness and patient care with the same initiatives? #meded
  • TLMedEd May 31 @ 9:40 PM EDT
    Yikes! #meded
    In reply to @DrJoannaT
  • GLBDallaghan May 31 @ 9:40 PM EDT
    T2 #meded @Alliance4ClinEd put these recommendations together to prep #medstudents for residency https://t.co/uTEMv6pafV
  • MGH_MSUS May 31 @ 9:42 PM EDT
    Improve your #mskus skills: join top @harvardmed faculty, hands on scanning. Register now! https://t.co/MXjrTgR5z3 #POCUS #meded #foamed #physiatry #rheumatology #Orthopedics #Anesthesiology #IMpocus
  • sood_lonika May 31 @ 9:42 PM EDT
    T3: emphasize organizational commitment to wellness during orientation; call out the hidden curriculum #meded
  • GLBDallaghan May 31 @ 9:46 PM EDT
    T3 #meded Part of the stress is the rocky transition. That's why it may be better to have nationally developed bootcamp/preparatory training for interns.
    In reply to @MedEdChat
  • VThornleyMD May 31 @ 9:47 PM EDT
    T3 #meded residency working hours are already greatly reduced compared to when I was resident. Anything less than that leaves residents not as well-trained especially in procedural or interventional specialties. Perhaps quarterly retreats, we had those at U. of Roch. It was great
    In reply to @MedEdChat
  • TLMedEd May 31 @ 9:48 PM EDT
    If rockiness is due to organizational issues, national boot camp will help, but only partially address the problem. It’s interesting this is so little studied! #meded
    In reply to @GLBDallaghan, @MedEdChat
  • DrMeganConroy May 31 @ 9:48 PM EDT
    Registered and booked hotel for #chest2018 conference in San Antonio! #meded excited for October
  • Alliance4ClinEd May 31 @ 9:49 PM EDT
    T3 #meded This may be a project we could take on to better understand if individual med school prep is trusted or not
    In reply to @GLBDallaghan, @MedEdChat
  • StephRStarr May 31 @ 9:51 PM EDT
    T2: Transition to internship sim ‘boot camps’ and just-in-time #healthsystemsscience curricula (medicolegal topics, billing/coding, pain/opioid management), formative/summarize core EPA assessments #MedEd
  • jprunuske May 31 @ 9:52 PM EDT
    Lesson for #meded
    • onni_gust May 25 @ 3:19 PM EDT
      'Reliance on SET scores for evaluating teaching may contribute, paradoxically, to a culture of less rigorous education': Student Evaluations of Teaching are Not Valid | AAUP: https://t.co/MMbbOKUyqq
  • TLMedEd May 31 @ 9:53 PM EDT
    Excellent questions. #meded
    In reply to @Alliance4ClinEd, @GLBDallaghan, @MedEdChat
  • abhaydandekar May 31 @ 9:53 PM EDT
    T3- learner handoffs through self-directed and mentor guided and curated assessment can help address clinical skills as they synch with transition/life skills (time mgmt, fatigue mgmt). This must be a shared conversation : learner, Med school, residency #meded
  • StephRStarr May 31 @ 9:54 PM EDT
    Both? For example, triage and prioritization skills, given PGY1s less likely to have same/any cap on #of patients on service, relate to both types #MedEd
    • TLMedEd May 31 @ 9:32 PM EDT
      Are the challenges of transition more technical in nature (learning curve) or organizational (relationships, culture, etc.)? #meded
      In reply to @GLBDallaghan, @sood_lonika
  • MedEdChat - Moderator May 31 @ 9:55 PM EDT
    We have about 5 more minutes left in our discussion. Please feel free to give some final thoughts #meded
  • Kim_G_Williams May 31 @ 9:55 PM EDT
    So happy to be part of a project that works collaboratively to increase education about mential illness for medical students and graduate students in Tanzania @UCalgaryMed @para_ab @ResidentDoctors @CMA_Docs #meded
  • TLMedEd May 31 @ 9:55 PM EDT
    Are there any transition initiatives that place the onus on the organization, rather than just the resident? #meded
    In reply to @StephRStarr
  • Alliance4ClinEd May 31 @ 9:56 PM EDT
    T3 #MedEd These are skills we should be assessing, but it still begs the question if residency program x trusts what med school b says
    In reply to @abhaydandekar
  • abhaydandekar May 31 @ 9:56 PM EDT
    Does the boot camp method work as well as a boot “ramp” that may build skills at the end of UME and continue into GME? #MedEd
    In reply to @GLBDallaghan, @MedEdChat
  • GLBDallaghan May 31 @ 9:58 PM EDT
    T3 #meded Excellent question. I think some of the push for #CBME is trying to determine that.
    In reply to @abhaydandekar, @MedEdChat
  • StephRStarr May 31 @ 9:58 PM EDT
    Great question. IM residency at our institution has a boot camp on the receiving end of the UME GME transition, which is an example of systems approach @AmyOxentenkoMD #MedEd
    In reply to @TLMedEd, @AmyOxentenkoMD
  • TLMedEd May 31 @ 9:59 PM EDT
    As a closing thought, it’s interestingto see just how how many gaps there may be in this area. Great fodder for #MedEd research.