Podcasts about acad med

We are so thankful for help from our guests:Melissa (MJ) Sacco, MDAndrew Parsons, MDLearning Objective:By the end of this podcast, listeners should be able to develop an expert-guided approach to identifying and helping trainees improve deficits in diagnostic reasoning, complex decision-making, and effective communication of complicated clinical situations within the healthcare team.References:Parsons AS, Wijesekera TP, Rencic JJ. The Management Script: A Practical Tool for Teaching Management Reasoning. Acad Med. 2020 Aug;95(8):1179-1185. Peterson BD, Magee CD, Martindale JR, Dreicer JJ, Mutter MK, Young G, Sacco MJ, Parsons LC, Collins SR, Warburton KM, Parsons AS. REACT: Rapid Evaluation Assessment of Clinical Reasoning Tool. J Gen Intern Med. 2022 Jul;37(9):2224-2229. Citation:Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

We all know about the medical school curriculum. But what about the hidden curriculum, or how students learn about the unspoken culture of medicine through everyday, informal interactions? In this episode, Dr. Sandra Quezada and Dr. Sarah Dubbs explore the hidden curriculum with some examples, chat about whether the hidden curriculum can be positive or negative, and offer guidance on how students can best navigate the hidden curriculum and thrive within it.   References: Lawrence C, Mhlaba T, Stewart KA, et al. The Hidden Curricula of Medical Education: A Scoping Review. Acad Med. 2018 Apr;93(4):648-656. PMID: 29116981. Bandini J, Mitchell C, Epstein-Peterson ZD, et al. Student and Faculty Reflections of the Hidden Curriculum. Am J Hosp Palliat Care. 2017 Feb;34(1):57-63. Epub 2016 Jul 11. PMID: 26566929. Martimianakis MA, Michalec B, Lam J, et al. Humanism, the Hidden Curriculum, and Educational Reform: A Scoping Review and Thematic Analysis. Acad Med. 2015 Nov;90(11 Suppl):S5-S13. PMID: 26505101. Hopkins L, Saciragic L, Kim J, Posner G. The Hidden Curriculum: Exposing the Unintended Lessons of Medical Education. Cureus. 2016 Oct 25;8(10):e845. PMID: 27909633 Kalter L. Navigating the Hidden Curriculum in Medical School. AAMC News. Published July 13, 2019. Accessed December 10, 2024. Link.  Freedman D. The Hidden Curriculum. NYU Langone Health Hub. Accessed December 10, 2024. Link.   

In this episode of KeyLIME+, Adam and resident guest co-host Dr. Kim Vella, chat with Dr. Sarah Blissett about her recent paper on cognitive load theory in medical education. The conversation explores the development of the Workplace Cognitive Load Tool, which measures how various workplace characteristics impact cognitive load and learning for medical trainees. The discussion highlights the importance of understanding cognitive load in the chaotic environment of medical training, the factors that enhance or impede learning, and practical strategies for educators to optimize the learning experience in complex clinical settings.  Length of episode: 41:13  Article discussed:  Blissett S, Rodriguez S, Qasim A, O'Sullivan P. Beyond the Task: Developing a Tool to Measure Workplace Characteristics That Affect Cognitive Load and Learning. Acad Med. 2024 May 9. https://pubmed.ncbi.nlm.nih.gov/38722251/   Contact us: keylime@royalcollege.ca    Follow: Dr. Adam Szulewski https://x.com/Adam_Szulewski   

In this episode, Adam discusses the complexities of growth mindset in medical education with guests Milad Memari and Katie Gavinski. They explore the differences between growth and fixed mindsets, the dangers of misapplying mindset theory, and the trap of false growth mindset. The conversation emphasizes practical strategies for educators to promote a growth mindset among learners, the challenges of assessment in medical training, and the need for systemic changes informed by mindset theory to support learner development.    Length of Episode:   45:09 Resources to check out :    Memari M, Gavinski K, Norman MK. Beware False Growth Mindset: Building Growth Mindset in Medical Education Is Essential but Complicated. Acad Med. 2024 Mar 1;99(3):261-265.  https://pubmed.ncbi.nlm.nih.gov/37643577/   PISA 2018 Results (Volume I): https://www.oecd.org/en/publications/pisa-2018-results-volume-i_5f07c754-en/full-report.html   A national experiment reveals where a growth mindset improves achievement: https://pubmed.ncbi.nlm.nih.gov/31391586/   Yeager DS, Dweck CS. What can be learned from growth mindset controversies? Am Psychol. 2020 Dec;75(9):1269-1284. doi: 10.1037/amp0000794. PMID: 33382294; PMCID: PMC8299535. https://pmc.ncbi.nlm.nih.gov/articles/PMC8299535/  @MemariMD   @katiegavinski          Contact us: keylime@royalcollege.ca         Follow: Dr. Adam Szulewski https://x.com/Adam_Szulewski     

Adam and guest resident co-host, Dr. Victoria Turnbull, interview Dr. Michael Gottlieb about a recent paper of his that should be relevant to anyone who listens to podcasts for learning. The paper looked at immediate and delayed recall of podcast content of residents listening to podcasts during aerobic exercise and at rest. We also discuss multitasking, cognitive load, and the way our brains make decisions.   Length of Episode: 38 minutes   Resources to check out :  Gottlieb M, Cooney R, Haas MRC, King A, Fung CC, Riddell J. A Randomized Trial Assessing the Effect of Exercise on Residents' Podcast Knowledge Acquisition and Retention. Acad Med. 2024 May 1;99(5):575-581. doi: 10.1097/ACM.0000000000005592. Epub 2023 Dec 18. PMID: 38109353. https://pubmed.ncbi.nlm.nih.gov/38109353/  Perham, N., & Currie, H. (2014). Does listening to preferred music improve reading comprehension performance? Applied Cognitive Psychology, 28(2), 279–284. https://doi.org/10.1002/acp.2994 https://psycnet.apa.org/record/2014-08687-016  Contact us: keylime@royalcollege.ca   Follow: Dr. Adam Szulewski https://x.com/Adam_Szulewski 

Warning:  This content addresses mental health issues, including research and narratives on suicide. Please take care while engaging with it and only proceed if you feel safe doing so. If you, or someone you love, is having thoughts of suicide, please contact 988. Help is available. Interviewer Lisa Meeks   Interviewees John Ruddell Jennifer Ruddell Roja (friend of Jack Ruddell) Dr. Christine Moutier  Dr. Jessi Gold   Narrator Dr. Joseph Murray    Description In this deeply moving episode, host Lisa Meeks introduces a special series dedicated to exploring the mental health crisis among medical trainees, with a focus on the tragic story of Dr. Jack Ruddell. Joined by Jack's parents, John and Jennifer Ruddell, and his close friend Roja, we delve into Jack's life, his struggles with depression and anxiety, and the immense pressures faced by medical students. Dr. Joseph Murray, a psychiatrist at Weill Cornell Medical College, provides expert insights into the high rates of burnout, depression, and suicide in the medical field. We also hear from Dr. Christine Moutier, Chief Medical Officer of the American Foundation for Suicide Prevention, and Dr. Jessie Gold, a respected psychiatrist and author, who discuss the unique challenges and cultural issues within medical training that contribute to mental health struggles. This episode aims to reduce the stigma surrounding mental health issues, encourage medical learners to seek help, and advocate for systemic changes in medical education to foster a more supportive and compassionate environment. Description of Series  DWDI Special Series: Suicidality in Medical Training dives into the critical conversations around mental health, well-being, support systems, and the intense pressures faced during medical training. Through the power of storytelling, the series intertwines these broader themes with the deeply personal story of Dr. Jack Ruddell, a promising medical student who died by suicide. Jack's journey—his strengths, struggles, and the complexities leading to his untimely death—forms the emotional core of this five-part series, giving voice to the loved ones often excluded from these conversations. Alongside Jack's story, the series incorporates expert insights and data from the literature, offering a human perspective on burnout, depression, and suicide among medical trainees. With a commitment to improving mental health awareness and reducing the stigma around seeking help, the series presents a novel approach by centering personal narratives alongside expert analysis. It also explores actionable strategies for improving medical training environments and highlights the importance of institutional responses after a loss by suicide. Our mission is to reduce shame, encourage help-seeking among medical students struggling with depression, and ensure that every medical school is aware of the postvention resources offered by the American Foundation for Suicide Prevention (AFSP). Experts for the Series  Christine Moutier, MD – Chief Medical Officer, American Foundation for Suicide Prevention Jessi Gold, MD – Chief Wellness Officer, University of Tennessee System; Author of How Do You Feel? David Muller, MD – Director, Institute for Equity and Justice in Health Sciences Education; Dean Emeritus, Icahn School of Medicine at Mt. Sinai; Author of the NEJM essay, Kathryn Srijan Sen, MD, PhD – Director, Eisenberg Family Depression Center; PI of the Intern Health Study Justin Bullock, MD, MPH – Fellow, University of Washington; Author of the NEJM article, Suicide, Rewriting My Story Stuart Slavin, MD, MEd – Vice President for Well-Being, ACGME Episode Release Schedule: September 17: Episode 102 – Honoring Dr. Jack Ruddell: A Story of Joy, Compassion, and Mental Health in Medical Training. September 17: Episode 103 – Suicide and Suicidality in Medical Training: Understanding the Crisis and its Causes.  September 24: Episode 104 – Silent Struggles: Mental Health and Medical Education. September 26: Episode 105 – Repairing the System: How Do We Create Safe Environments? September 30: Episode 106 – Responding to Loss: Postvention and Support After a Suicide. Transcript Keywords: Suicide, Death, Mental health, Jack Ruddell, Medical training, Depression, Suicidality, Burnout, Anxiety, Medical trainees, American Foundation for Suicide Prevention, Tourette's, Disabilities, Medical education, Medical school, Discrimination, Academic pressure, Clinical practice, Imposter syndrome, Perfectionism, Shame, Mental disability, Learning challenges, Accommodations, High-stakes testing, Inclusivity, Stigma   Resources:  24/7 Suicide & Crisis Hotline, call or text 988 or chat 988lifeline.org. How are you? By Jessi Gold  National Office for Suicide Prevention: Language and suicide The American Foundation for Suicide Prevention   References    Johnson KM, Slavin SJ, Takahashi TA. Excellent vs Excessive: Helping Trainees Balance Performance and Perfectionism. J Grad Med Educ. 2023 Aug;15(4):424-427. doi: 10.4300/JGME-D-23-00003.1. PMID: 37637342; PMCID: PMC10449346.   Bynum WE 4th, W Teunissen P, Varpio L. In the "Shadow of Shame": A Phenomenological Exploration of the Nature of Shame Experiences in Medical Students. Acad Med. 2021 Nov 1;96(11S):S23-S30. doi: 10.1097/ACM.0000000000004261. PMID: 34348391.   Jain, Neera R. PhD, MS1; Stergiopoulos, Erene MD, MA2; Addams, Amy3; Moreland, Christopher J. MD, MPH4; Meeks, Lisa M. PhD, MA5. “We Need a Seismic Shift”: Disabled Student Perspectives on Disability Inclusion in U.S. Medical Education. Academic Medicine ():10.1097/ACM.0000000000005842, August 8, 2024. | DOI: 10.1097/ACM.0000000000005842   Meeks LM, Jain NR.  Accessibility, Inclusion, and Action in Medical Education: Lived Experiences of Learners and Physicians with Disabilities. Washington, DC: Association of American Medical Colleges; 2018. Retrieved on September 14, 2024 from: https://store.aamc.org/accessibility-inclusion-and-action-in-medical-education-lived-experiences-of-learners-and-physicians-with-disabilities.html.   Meeks, L. M., Pereira‐Lima, K., Plegue, M., Jain, N. R., Stergiopoulos, E., Stauffer, C., ... & Moreland, C. J. (2023). Disability, program access, empathy and burnout in US medical students: A national study. Medical education, 57(6), 523-534.   Recommended Readings:   Almutairi, H., Alsubaiei, A., Abduljawad, S., Alshatti, A., Fekih-Romdhane, F., Husni, M., & Jahrami, H. (2022). Prevalence of burnout in medical students: A systematic review and meta-analysis. International Journal of Social Psychiatry, 68(6), 1157-1170.   Enns MW & Cox B. (2002) The Nature and Assessment of Perfectionism: A Critical Analysis. In: Flett GL, Hewitt PL, eds. Perfectionism: Theory, Research, and Treatment. American Psychological Association, 33-62.   Goldman, M. L., Shah, R. N., & Bernstein, C. A. (2015). Depression and suicide among physician trainees: recommendations for a national response. JAMA psychiatry, 72(5), 411-412.   Johnson, K. M., Slavin, S. J., & Takahashi, T. A. (2023). Excellent vs excessive: helping trainees balance performance and perfectionism. Journal of Graduate Medical Education, 15(4), 424-427.   Meeks, L. M., Conrad, S. S., Nouri, Z., Moreland, C. J., Hu, X., & Dill, M. J. (2022). Patient And Coworker Mistreatment Of Physicians With Disabilities: Study examines mistreatment of physicians with disabilities. Health Affairs, 41(10), 1396-1402.   Mirza, A. A., Baig, M., Beyari, G. M., Halawani, M. A., & Mirza, A. A. (2021). Depression and anxiety among medical students: a brief overview. Advances in Medical Education and Practice, 393-398.   Pereira-Lima, K., Meeks, L. M., Ross, K. E., Marcelin, J. R., Smeltz, L., Frank, E., & Sen, S. (2023). Barriers to disclosure of disability and request for accommodations among first-year resident physicians in the US. JAMA Network Open, 6(5), e239981-e239981.    Meeks LM, Ramsey J, Lyons M, Spencer AL, Lee WW. Wellness and work: mixed messages in residency training. J Gen Intern Med. 2019;34(7):1352-1355. PMID: 30924087   Meeks LM, Stergiopoulos E, Petersen KH. Institutional Accountability for Students With Disabilities: A Call for Liaison Committee on Medical Education Action. Acad Med. 2021 Oct. PMID: 34670236    

Listen to Dr Rohan Mehra, RCP clinical education fellow, (Infectious diseases/microbiology SPR) and Dr Mumtaz Patel, as they shine a spotlight on female leadership in healthcare. They discuss many of the issues facing women in leadership position within healthcare and the challenges faced in reaching those positions. Inequality remains deeply engrained within the healthcare workforce and urgently needs addressed and Mumtaz and Rohan outline how this could be done.Dr Mumtaz Patel is a consultant in nephrology in Manchester as well as senior censor and vice president for education performing presidential duties including chair of council for the RCP. Mumtaz previously launched a global women leaders programme, on which she remains an active educator, which empowers female physicians to advance into leadership roles, which continues to be hugely successful to this day. This programme aims to narrow the gender leadership gap globally and is tailored to a local context to address these issues in smart sustainable targeted ways. It is also aligned to the Emerging women's leaders programme which focuses on the same issues within the UK which Mumtaz has also been instrumental in creating. Mumtaz also recently won the prestigious ‘Outstanding Leader award' at the Global women in Healthcare awards.Resources:https://www.rcp.ac.uk/events-and-education/education-and-learning/clinicians-as-leaders/emerging-women-leaders-programmehttps://www.rcp.ac.uk/news-and-media/news-and-opinion/celebrating-international-women-s-day-2024-global-women-leaders-programme/ References:Female global health leadership: data-driven approaches to close the gender gap. Lancet 2019; 393: 521-523.Downs JA, Reif LK, Hokororo A, Fitzgerald DW. Increasing women in leadership in global health. Acad Med 2014; 89: 1103–07.HRH Global Resource Center. Resource spotlight: gender and health workforce statistics. https://www.hrhresourcecenter.org/gender_stats (accessed Dec 25, 2020).Kwedi Nolna SK, Essama Mekongo PE, Leke RGF. Mentoring for early-career women in health research: the HIGHER Women Consortium approach. Glob Health Epidemiol Genom 2017; 2: e3.https://www.who.int/docs/default-source/health-workforce/en-exec-summ-delivered-by-women-led-by-men.pdf Linkage Inc, Intersectionality in the Workplace and the Advancement of Women Leaders, 2020Power, privilege and priorities Boylan J, Dacre J, Gordon, H. Addressing women's under-representation in medical leadership. Lancet, 2019, Volume 393: e14.Ferry G. Inspirational women in medicine. Lancet 2017; 390: 1825.RCP strategy 2022-24 RCP global strategyRCP - A 2020 VisionWorld Economic Forum. Global gender gap report, 2018.  Music: bensound.comThis episode was funded by Vertex Pharmaceuticals (Europe) Limited. Vertex had no involvement in the creation and elaboration of this episode and all views and opinions expressed by the presenter and guests are solely their own.

Much like going to the gym, CPD can be a hassle or an imposition, but it can also be fun and hugely rewarding.   Check out the paper mentioned Jeong D, Presseau J, ElChamaa R, Naumann DN, Mascaro C, Luconi F, Smith KM, Kitto S. Barriers and Facilitators to Self-Directed Learning in Continuing Professional Development for Physicians in Canada: A Scoping Review. Acad Med. 2018 Aug;93(8):1245-1254. https://pubmed.ncbi.nlm.nih.gov/29642101/    www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Dr. Melissa Klein interviews Doctors Sarah Lynn Hilgenberg and Su-Ting Li on the use of qualitative methods in educational research. This discussion is based on a recent publication by Goldstein et al “A Qualitative Exploration of Pediatric Resident Perceptions of Autonomy in the Era of Pediatric Hospital Medicine Fellowship.”  Read the article here: https://linkinghub.elsevier.com/retrieve/pii/S1876-2859(23)00332-7   Methods references:  Hanson JL, Balmer DF, Giardino AP. Qualitative research methods for medical educators. Acad Pediatr. 2011 Sep-Oct;11(5):375-86.  O'Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014 Sep;89(9):1245-51. Frambach JM, van der Vleuten CP, Durning SJ. AM last page. Quality criteria in qualitative and quantitative research. Acad Med. 2013 Apr;88(4):552. Frambach JM, van der Vleuten CP, Durning SJ. AM last page. Quality criteria in qualitative and quantitative research. Acad Med. 2013 Apr;88(4):552.

Episode length: 40:35 The purpose of this paper is 1) To describe interpretations of commonly used phrases in Letters of reference by PDs other than in pediatrics. 2) To identify areas of agreement or variation between pediatrics, surgery, and IM LORs.  Author  Saudek et. al. Publication  Pediatric, Surgery, and Internal Medicine Program Director Interpretations of Letters of Recommendation. Acad Med. 2019 Nov;94  Audience questions/comments start at: 24:52 36:30 Voting on Methodology and Educational Impact

During the 2022-2023 admission cycle, about 22,700 students enrolled in medical school in the United States. In this country alone, we have 154 medical schools offering an MD program. Many of these schools are actively working to incorporate modern learning principles into their structure. It's all a part of a larger goal to align the forces affecting the delivery of care with educational priorities. Over time, comprehensive care has become a widely accepted standard for modern medicine; it puts positive patient outcomes at the forefront. That's why creating those environmental opportunities are crucial to medical students as they prepare for a long career at the bedside. A Longitudinal Integrated Clerkship, or LIC, is a clinical curriculum in which students participate in the comprehensive care of patients over time. “LIC students have been found to experience lasting improvements in their patient centeredness, in their empathy, and also student satisfaction is higher,” says Amy Grover, MD, an assistant professor of pediatrics and pediatric hospital medicine.   Patient-student relationships are at the heart of LICs. We see these across the scope of medical education worldwide, but there is something unique about the LIC model here at Children's Hospital Colorado. Dr. Grover is a guest on today's episode, along with Meghan Treitz, MD, an associate professor of pediatrics and general pediatrics, and Margie Rodgers, an LIC coordinator. “One of the advantages of this model is students get exposure to the clinical world earlier and also at the end of their second year have had exposure to all of the core disciplines so planning for residency and career is actually made a little bit easier,” Dr. Treitz says.   Some highlights from this episode include: What an LIC is and how it works The advantages of an LIC curriculum compared to other medical education practices How students learn every discipline through an LIC in a pediatric hospital setting Stories about unique patient care experiences from students  Articles referenced in the podcast:  Hirsh DA, Ogur B, Thibault GE, Cox M. "Continuity" as an organizing principle for clinical education reform. N Engl J Med. 2007 Feb 22;356(8):858-66  Hirsh et al.  Better learning, better doctors, better delivery system: possibilities from a case study of longitudinal integrated clerkships.  Med Teach 2012;34(7):548-54.  Walters, et al. Outcomes of longitudinal integrated clinical placements for students, clinicians and society. Med Educ 2012; 46: 1028-1041   Poncelet, et al.  Development of a longitudinal integrated clerkship at an academic medical center. Med Educ Online 2011; 16: 5939.   Hirsh D, Gauberg E, Ogur B, et al. Educational outcomes of the Harvard Medical School—Cambridge integrated clerkship: a way forward for medical education. Acad Med. 2012;87:643-50  Teherani, et al. Outcomes of Different Clerkship Models: Longitudinal Integrated, Hybrid and Block.  Acad Med 2013; 88: 1-9   Gaufberg E, Hirsh D, Krupat E, et al. Into the future: patient-centeredness endures in longitudinal integrated clerkship graduates. Med Educ. 2014;48:572-82.  Flick RJ, Adams JE. Alliance, trust, and loss: experiences of patients cared for by students in a longitudinal integrated clerkship. Acad Med. 2019  Beard AS, Candy AE, Anderson TJ, Derrico NP, Ishani  KA, Gravely AA, Englander R, Ercan-Fang NG. Patient satisfaction with medical student participation in a longitudinal integrated clerkship: a controlled trial. Acad Med. 2020. 95(3):417-424.  McKenna et al. The missing link: connection is the key to resilience in medical education. Acad Med 2016  Wald, Hedy S. PhD Professional Identity (Trans)Formation in Medical Education, Academic Medicine, 2015  For more information on Children's Colorado, visit: childrenscolorado.org 

This paper, Smirnova et al, is a team of heavy hitting meded authors. The group set out to describe how CPIs, as measures of the activities, behaviours, and abilities of clinicians, can inform medical education and health care quality improvement.    Authors conclusions: 19:55 Jason's Spare Keys: 20:37 Voting for Methods = 2, N/A, N/A, 2. Voting for Impact = 5, 4, 5, 4. Authors: Smirnova A et. al., Publication details: Defining and Adopting Clinical Performance Measures in Graduate Medical Education: Where Are We Now and Where Are We Going? Acad Med. 2019 May;94(5):671-677 

Recently I read Tornado of Life: A Doctor's Journey Through Constraints and Creativity in the ER by Jay Baruch, MD. It's a collection of linked essays, so you can dip into the book in small, snatched moments without losing momentum. If you need an introduction to the always challenging, sometimes messy, but ultimately humanizing work that clinicians do at the acute end of care, this is a great start. Jay is a physician and writer who explores how creativity in medicine supports empathy, the cornerstone of clinical care. He is a practicing emergency room physician, Professor of Emergency Medicine at Brown University's Alpert Medical School, and the author of two award-winning short fiction collections. In his latest book, Jay interrogates the messy spaces of clinical practice and the art of caring for patients. Today we are talking about connections between writing, healing, and clinical care. We discussed Jay's experience of writing the book, the experiences that led to writing the book, and the ways that writing can help us figure out who we are and what we think and feel. Alan Bleakley, Emeritus Professor of Medical Education and Medical Humanities at the University of Plymouth calls Tornado of Life the best medical memoir he's read. I can only agree and encourage you to read the book, too. Why? Because it'll expand your concept of the healthcare team to include "the regular players already there, humanity scholars, writers, artists, and designers." And it'll expand your idea of what CME can do too. ResourcesBaruch J. Tornado of Life: A Doctor's Journey through Constraints and Creativity in the ER. Cambridge, MA: The MIT Press. 2022.   Baruch J, Springs S, Poterack A, Ganz Blythe S. What Cy Twombly's Art Can Teach Us About Patients' Stories. AMA J Ethics. 2020;22(5):E430-436. Baruch J. Doctors as Makers. Acad Med. 2017;92(1): 40-44.   Deavere Smith A. Talk to Me. Travels in Media and Politics. Anchor. 2001.  Scarry E. The Body in Pain. Oxford: OUP, 1987. Schulz K. Being Wrong: Adventures in the Margins of Error. Harper Collins. 2011. 

Guests Courtney Newman and Jaclyn Albin, MD, join host Toni Gallo to discuss culinary medicine and its role in teaching nutrition, nutrition counseling, and hands-on cooking skills to medical students. The conversation also covers how culinary medicine programs build connections and community and improve the well-being of students, faculty, and patients. A transcript of this episode is available at academicmedicineblog.org.  Read the article discussed in this episode: Newman C, Yan J, Messiah S, Albin J. Culinary medicine as innovative nutrition education for medical students: A scoping review. Acad Med. 2023;98:274-286.

Linda presents two papers in order to answer two questions... How Attending Physicians Negotiate Their Work Environment – “to generate an empiric, detailed, and updated view of the attending physician preceptor role and its interface with the complex work environment.” How evidence from observing attending physicians in the workplace links to a competency-based framework (CanMEDS competencies / Roles) Article 1) Authors: Bacchus M, Ward DR, de Grood J, Lemaire JB Publication details: How evidence from observing attending physicians links to a competency-based framework Med Educ. 2017 Jun; 51(6):633-644. Article 2) Authors: Lemaire JB, Wallace JE, Sargious PM, Bacchus M, Zarnke K, Ward DR, Ghali WA. Publication details: How Attending Physician Preceptors Negotiate Their Complex Work Environment: A Collective Ethnography. Acad Med. 2017 Jun 20. [Epub ahead of print] Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Want to learn more about KeyLIME?

      In this season 3 round up I reflect on the podcast journey to date  and celebrate the rich and growing community and content.  Leadership and leading change in clinician wellbeing were overarching themes this season. The Stanford WellMD conceptual model of professional fulfilment (https://wellmd.stanford.edu/about/model-external.html)   provides a good framework and lens to view this season's conversations relating to wider organisational and systems efficiency, high performing teams and building positive inclusive cultures of wellbeing, and individual tools, skills and supports.  Thank you to the incredible guests who have generously donated their time and expertise to contribute to the podcast and thanks for listening, sharing and helping to grow this community. My word for this year is POSSIBILITY and I see it everywhere. I look forward to joining you for Season 4 and more great guest content, conversations, collaboration and connection. Thanks Cheryl "Do the best you can until you know better. Then when you know better, do better." Maya Angelou "If I have seen further, it is by standing on the shoulders of giants" Isaac Newton Links/ references:Top episode downloaded in S3 Leading Organisational Change in Clinician Wellbeing with Dr Joanna Sinclair https://www.buzzsprout.com/1091279/10904210Wellness - centred leadership Shanafelt T, Trockel M, Rodriguez A, Logan D. Wellness-Centered Leadership: Equipping Health Care Leaders to Cultivate Physician Well-Being and Professional Fulfillment. Acad Med. 2021 May 1;96(5):641-651. doi: 10.1097/ACM.0000000000003907. PMID: 33394666; PMCID: PMC8078125.Podcast recommendations :The Revitalizing Doctor https://feeds.buzzsprout.com/1971016.rssBeing Better Together Podcast https://podcasts.apple.com/au/podcast/being-better-together/id1603984431The Emergency Mind Podcast https://www.emergencymind.com/podcastDoctor NOS https://feeds.buzzsprout.com/1834712.rssRate/Review and subscribe:https://apple.co/3uSoqkr The Mind Full Medic Podcast is proudly sponsored by the MBANSW Find out more about their service or donate today at www.mbansw.org.auDisclaimer: The content in this podcast is not intended to constitute or be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or other qualified health care professional. Moreover views expressed here are our own and do not necessarily reflect those of our employers or other official organisations.

Advancing Women in Urology: Sponsorship and It's Role in Career Advancement in Medicine Host: Jay D. Raman, MD, FACS Guest: Peggy Pearle, MD and Simone Thavaseelan, MD Outline: Segment #1 Defining Sponsorship Segment #2 Role in Career Advancement/Importance Segment #3 Identifying the Issue Segment #4 Key Characteristics of healthy/effective Sponsorship Segment #5 Opportunities for Action ACKNOWLEDGEMENT This educational series was made possible by support from Urovant Resources: Jain, S. Why Sponsorship in Medicine Matters. Wolters Kluwer Health, https://www.wolterskluwer.com/en/expert-insights/why-sponsorship-in-medicine-matters (2020). Ayyala, M.S., et al. Mentorship Is Not Enough: Exploring Sponsorship and Its Role in Career Advancement in Academic Medicine. Acad Med. 94, 94-100 (2019). Lewiss R.E., et al. Is Academic Medicine Making Mid-Career Women Physicians Invisible? J Womens Health (Larchmt). 29,187-192 (2020). Tesch, B.J., Wood, H.M., Helwig, A.L., Nattinger, A.B. Promotion of women physicians in academic medicine. Glass ceiling or sticky floor? JAMA. 273,1022-5 (1995). Silva, C. Study: Women Get Fewer Game Changing Leadership Roles. Harvard Business Review, https://hbr.org/2012/11/study-women-get-fewer-game-changing Hewlett, S.A., Peraino, K., Sherbin, L., Sumberg, K. The Sponsor Effect: Breaking Through the Last Glass Ceiling. Boston, Mass Harvard Business Review (2011). Richter, K.P., et al. Women Physicians and Promotion in Academic Medicine. N Engl J Med. 383, 2148-2157 (2020). Foust-Cummings H. Sponsoring Women to Success. Catalyst, http://www.catalyst.org/system/files/sponsoring_women_to_success.pdf. (2011) Velez, D., et al. Rising Tides: Challenges and Opportunities for Women in the Urologic Workforce. Urology. 150, 47-53 (2021). Harris, C. How to find the person who can help you get ahead at work. TEDWomen, https://www.youtube.com/watch?v=gpE_W50OTUc.(2018). Penaloza NG,, et al. Someone Like Me: An Examination of the Importance of Race-Concordant Mentorship in Urology. Urology. 22. (2022) Butler, P.D. When excellence is still not enough. Am J Surg. 220, 543-544 (2020)

Taking a minor break from ruffling the f*cking cages and feathers of what we call modern society these days and I wanted to talk about something a bit more conventional but important nevertheless and that is sleep. I have a multitude of studies for you to do your own research as I want to present this topic as clear cut as possible.   Time Stamps:   (0:28) Are You Enjoying the Podcast? (2:30) Going On a Journey With Sleep (6:40) Adverse Effects From Poor Sleep (16:30) Stress and the Blood-Brain Barrier (18:50) Naps ---------------------------- Resources: [i] Pilcher JJ, Walters AS. How sleep deprivation affects psychological variables related to college students' cognitive performance. J Am Coll Health. 1997 Nov;46(3):121-6. View Abstract [ii] Walker MP, et al. Practice with sleep makes perfect: sleep-dependent motor skill learning. Neuron. 2002 Jul 3;35(1):205-11. View Abstract [iii] Rosen IM, et al. Evolution of sleep quantity, sleep deprivation, mood disturbances, empathy, and burnout among interns. Acad Med. 2006 Jan;81(1):82-5. View Abstract [iv] Cohen S, et al. Sleep habits and susceptibility to the common cold. Arch Intern Med. 2009 Jan 12;169(1):62-7. View Full Paper [v] Patel SR, et al. Association between reduced sleep and weight gain in women. Am J Epidemiol. 2006 Nov 15;164(10):947-54. View Full Paper [vi] Donga E, et al. A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects. J Clin Endocrinol Metab. 2010 Jun;95(6):2963-8. View Abstract [vii] Williamson AM, Feyer AM. Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occup Environ Med. 2000 Oct;57(10):649-55. View Full Paper [viii] Kim TW, Jeong JH, Hong SC. The impact of sleep and circadian disturbance on hormones and metabolism. Int J Endocrinol. 2015;2015:591729. View Full Paper [ix] Vgontzas AN, et al. IL-6 and its circadian secretion in humans. Neuroimmunomodulation. 2005;12(3):131-40. View Abstract [x] Meier-Ewert HK, et al. Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects. Clin Chem. 2001 Mar;47(3):426-30. View Full Paper [xi] Meier-Ewert HK, et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol. 2004 Feb 18;43(4):678-83. View Abstract [xii] van Leeuwen WM, et al. Sleep restriction increases the risk of developing cardiovascular diseases by augmenting proinflammatory responses through IL-17 and CRP. PLoS One. 2009;4(2):e4589. View Full Paper [xiii] Chennaoui M, et al. Effect of one night of sleep loss on changes in tumor necrosis factor alpha (TNF-α) levels in healthy men. Cytokine. 2011 Nov;56(2):318-24. View Abstract [xiv] Vgontzas AN, et al. Chronic insomnia is associated with a shift of interleukin-6 and tumor necrosis factor secretion from nighttime to daytime. Metabolism. 2002 Jul;51(7):887-92. View Abstract [xv] He J, et al. Sleep restriction impairs blood-brain barrier function. J Neurosci. 2014 Oct 29;34(44):14697-706. View Full Paper [xvi] Zlokovic BV. The blood-brain barrier in health and chronic neurodegenerative disorders. Neuron. 2008 Jan 24;57(2):178-201. View Abstract [xvii] Hurtado-Alvarado G, et al. Blood-Brain Barrier Disruption Induced by Chronic Sleep Loss: Low-Grade Inflammation May Be the Link. J Immunol Res. 2016;2016:4576012. View Full Paper [xviii] Esposito P, et al. Corticotropin-releasing hormone and brain mast cells regulate blood-brain-barrier permeability induced by acute stress. J Pharmacol Exp Ther. 2002 Dec;303(3):1061-6. View Full Paper [xix] Steiger A. Sleep and the hypothalamo-pituitary-adrenocortical system. Sleep Med Rev. 2002 Apr;6(2):125-38. View Abstract [xx] Vgontzas AN, et al. Daytime napping after a night of sleep loss decreases sleepiness, improves performance, and causes beneficial changes in cortisol and interleukin-6 secretion. Am J Physiol Endocrinol Metab. 2007 Jan;292(1):E253-61. View Full Paper ---------------------------- Follow Me on Instagram! @tayloredwellbeing ---------------------------- Click Here to Apply to Work with Me or visit taylorsappington.com/application

Guest Heeyoung Han, PhD, joins hosts Toni Gallo and Research in Medical Education (RIME) Committee members Javeed Sukhera, MD, PhD, and Andres Fernandez, MD, MEd, to discuss new research into the different methodologies used in health professions education research and how rigorous, or not, the descriptions of these methodologies are in published studies. Also covered is advice for researchers who want to more creatively and rigorously conduct and write up their work.   A transcript of this episode is available at academicmedicineblog.org. Read the article discussed in this episode: Han H, Youm J, Tucker C, et al. Research methodologies in health professions education publications: Breadth and rigor. Acad Med. 2022;97:S54-S62. Read the complete collection of articles included in the 2022 RIME supplement.

Guests Luca Petrey and Laura Weingartner, PhD, MS, join hosts Toni Gallo and Research in Medical Education (RIME) Committee members Arianne Teherani, PhD, and Daniele Olveczky, MD, to discuss a new scoping review of the literature on the inclusion of standardized patient characters and actors with diverse gender identities in simulation cases. A transcript of this episode is available at academicmedicineblog.org. Read the articles discussed in this episode:  Petrey LN, Noonan EJ, Weingartner LA. Gender diverse representation in patient simulation: A scoping review [published online ahead of print August 09, 2022]. Acad Med. doi: 10.1097/ACM.0000000000004926. Weingartner L, Noonan EJ, Bohnert C, Potter J, Shaw MA, Holthouser A. Gender-affirming care with transgender and genderqueer patients: A standardized patient case. MedEdPORTAL. 2022;18:11249.  Read the complete collection of articles included in the 2022 RIME supplement at academicmedicine.org. 

Guests Addie McClintock, MD, and Joshua Jauregui, MD, join hosts Toni Gallo and Research in Medical Education (RIME) Committee members Andrea Leep, MD, and Paolo Martin, PhD, MS CHPR, MEd, to discuss clinical teachers' behaviors and how they support or harm students' sense of psychological safety in the clinical learning environment. This is the first episode in a 3-part series of discussions with RIME authors about their medical education research and its implications for the field. Read the article discussed in this episode:  McClintock AH, Fainstad TL, Jauregui J. Clinician teacher as leader: Creating psychological safety in the clinical learning environment for medical students [published online ahead of print August 9, 2022]. Acad Med. doi: 10.1097/ACM.0000000000004913. Read the complete collection of articles included in the 2022 RIME supplement at academicmedicine.org. A transcript of this episode is available at academicmedicineblog.org.

Welcome to the Summer of 2022 KeyLIME “re run” series! Over the summer months, we will be re-releasing some of our earliest episodes: Give some old favorites a listen or discover some episodes from our archive you may not have heard yet! This week, in summer re run #15...  Episode 261: Being While Becoming.  We discuss...when do you feel you ‘became' a doctor? Much of the literature on identity formation suggests that this happens sometime during early residency, when trainees are immersed in the workplace with some autonomy. In this article, the authors present the results of their analysis:  development of a conceptual framework and distinct identity formation themes. Jarvis-Selinger et. al. Understanding Professional Identity Formation in Early Clerkship: A Novel Framework. Acad Med. 2019; 94(10):1574-1580. View the episode abstract here. Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Lara Varpio: @LaraVarpio Lara Varpio's Disclaimer: The views expressed in this manuscript are solely those of the authors and do not necessarily reflect those of the Uniformed Services University of the Unites States Department of Defense.  Want to learn more about KeyLIME? Click here!

Guests Katherine Hoops, MD, MPH, Andra Blomkalns, MD, MBA, and Allison Augustus-Wallace, PhD, MS, MNS, join host Toni Gallo to talk about firearm safety and injury prevention education. They discuss the role of physicians in engaging patients and communities in firearm injury risk reduction, the current state of firearm injury prevention education, and where the academic medicine community needs to go from here.  Read the articles discussed in this episode:  Hoops K, Fahimi J, Khoeur L, et al. Consensus-driven priorities for firearm injury education among medical professionals. Acad Med. 2022;97:93-104. Mueller KL, Blomkalns AL, Ranney ML. Taking aim at the injury prevention curriculum: Educating residents on talking to patients about firearm injury [published online ahead of print April 19, 2022]. Acad Med. Read the complete collection of articles on firearm injury prevention published in Academic Medicine.  A transcript of this episode is available at academicmedicineblog.org. 

Welcome to the Summer of 2022 KeyLIME “re run” series! Over the summer months, we will be re-releasing some of our earliest episodes: Give some old favorites a listen or discover some episodes from our archive you may not have heard yet! This week, in summer re run #11...  Episode 158: Dear Author, Nope. - The Editors [Reasons for Rejecting a Manuscript]. The authors of this study looked to inform scholars about common reasons for internal editor review rejections, increase transparency of the process, and provide suggestions for improving submissions. Meyer HS et al. Making the First Cut: An Analysis of Academic Medicine Editors' Reasons for Not Sending Manuscripts Out for External Peer Review. Acad Med. 2018; 93(3):464-470. View the abstract here Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Lara Varpio: @LaraVarpio Lara Varpio's Disclaimer: The views expressed in this manuscript are solely those of the authors and do not necessarily reflect those of the Uniformed Services University of the Unites States Department of Defense.  Want to learn more about KeyLIME? Click here!

Welcome to the Summer of 2022 KeyLIME “re run” series! Over the summer months, we will be re-releasing some of our earliest episodes: Give some old favorites a listen or discover some episodes from our archive you may not have heard yet! This week, in summer re run #10, we play back Episode #154, where we discussed ITERs, (In-Training Evaluation Reports), a fundamental building block of health professions education.  They have been much maligned over the years; however, this article's "assessment supergroup" looks to show us the value of narrative comments in ITERs in a systematic review with "gold standard methods" (as per Jason, today's reviewer.) Hatala R et al.  Using In-Training Evaluation Report (ITER) Qualitative Comments to Assess Medical Students and Residents: A Systematic Review. Acad Med. 2017; 92(6):868-879. View the abstract here Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Lara Varpio: @LaraVarpio Lara Varpio's Disclaimer: The views expressed in this manuscript are solely those of the authors and do not necessarily reflect those of the Uniformed Services University of the Unites States Department of Defense.  Want to learn more about KeyLIME? Click here!

How do you find the right mentor? How should you prepare before meeting with your mentor? How is sponsorship key for success? How do we address inequities in how mentorship is offered? Check out the fourth part in this series with Dr. Harriet Hopf, Executive Director of Faculty Development and Academic Affairs in the Department of Anesthesiology and Co-Director of the Utah Coaching and Advancement Network. Additional Resources: UCAN: https://medicine.utah.edu/faculty-dev/programs/coaching-program Manuel SP, Poorsattar SP. Mentoring up: Twelve tips for successfully employing a mentee-driven approach to mentoring relationships. Med Teach. 2021; 43:384-387. Zerzan JT, Hess R, Schur E, Phillips RS, Rigotti N. Making the most of mentors: A guide for mentees. Acad Med. 2009;84(1):140-144. Kow CS et al. A systematic scoping review of ethical issues in mentoring in medical schools. BMC Medical Education (2020) 20:246. Straus SE, Johnson MO, Marquez C, Feldman MD. Characteristics of successful and failed mentoring relationships: A qualitative study across two academic health centers. Acad Med. 2013;88(1):82-89. Hastings LJ, Kane C. Distinguishing Mentoring, Coaching, and Advising for Leadership Development. New Directions for Student Leadership. 2018;158:9-22.

"Nutrition in medicine is a human factors issue" Dr Maryam Makowski In S3 E 7 I am delighted to welcome Dr Maryam S. Makowski, Ph.D., FACN, NBC-HWC to the podcast. Dr Makowski is a clinical assistant professor in the Stanford University Department of Psychiatry and Behavioral Sciences, the Associate Director of Scholarship and Health Promotion of the Stanford Medicine WellMD & WellPhD Center, and a nutrition and physician well-being coach at Stanford University.            Prior to joining Stanford, she served as a scientific associate at Toronto General Hospital-University Health Network in Toronto, and as an advisor to Air Canada rouge pilots and cabin crew on optimal nutrition for fatigue mitigation. Over the course of her career, she has authored many highly cited scientific papers on nutrition and well-being.    In this conversation we discuss her career and research trajectory particularly looking at how  nutrition, hydration and other lifestyle factors including how sleep  might influence cognitive performance initially in pilots and most recently applying this to doctors and in healthcare. We discuss in more details what Maryam refers to as the four pillars:  hydration, meal composition and timing and strategic use of caffeine and how we might optimise these and mitigate shift work related fatigue, We discuss the specific challenges and barriers to these that doctors encounter in their practice.  Maryam describes the complex interplay of nutrition and hydration with stress, sleep and mood/cognitive performance.       Whilst acknowledging the growing research evidence is increasingly substantive in this area it is not conclusive and no one size fits all.   Knowledge of circadian rhythms and individual thresholds is essential in tailoring interventions and strategies discussed.         I find Maryam's work fascinating, highly relevant and am impressed by the organisational change her team have been able to advocate for on the back of research.  I encourage you to think about you own approaches and how you might optimise these and also advocate for you colleagues in your own place of work. References / Links:Dr Maryam Makowski - research linkshttps://twitter.com/maryammakowski?lang=enhttps://pmj.bmj.com/content/92/1090/478.short Makowski MS, Trockel MT, Menon NK, Wang H, Katznelson L, Shanafelt TD. Performance Nutrition for Physician Trainees Working Overnight Shifts: A Randomized Controlled Trial. Acad Med. 2022 Mar 1;97(3):426-435. doi: 10.1097/ACM.0000000000004509. PMID: 34753859. Makowski MS, Shanafelt TD, Hausel A, Bohman BD, Roberts R, Trockel MT. Associations Between Dietary Patterns and Sleep-Related Impairment in a Cohort of Community Physicians: A Cross-sectional Study. Am J Lifestyle Med. 2019 Sep 10;15(6):644-652. doi: 10.1177/1559827619871923. PMID: 34916885; PMCID: PMC866989Recommended Reads: Feeling Great David D Burns MDhttps://www.amazon.com/stores/page/E0B7C5D5-CD14-405B-BD0A-253F8D94A3B4?channel=db-websiteBrain Changer Felice Jackahttps://www.panmacmillan.com.au/9781760556518/Disclaimer: The content in this podcast is not intended to constitute or be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or other qualified health care professional. Moreover views expressed here are our own and do not  necessarily reflect those of  our employers or other official organisations.  

Welcome to the Summer of 2022 KeyLIME “re run” series! Over the summer months, we will be re-releasing some of our earliest episodes: Give some old favorites a listen or discover some episodes from our archive you may not have heard yet!  **Please note: some listeners will find this a tough episode**   This week, in summer re run #7, we bring back episode #146, on an important, yet difficult, topic: The Mortality Rate of Residency Education. The stressors and impact of medical practice on physician health have been documented for decades and issues of the wellness of health care providers are an increasingly discussed topic in medical education. This study sets out to document the “mortality rate” of medical training by examining and characterizing US resident (postgraduate) trainee deaths from 2000-2014. Yaghmour NA, et al. Causes of Death of Residents in ACGME-Accredited Programs 2000 Through 2014: Implications for the Learning Environment. Acad Med. 2017 Jul;92(7):976-983. View the abstract here Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Lara Varpio: @LaraVarpio Lara Varpio's Disclaimer: The views expressed in this manuscript are solely those of the authors and do not necessarily reflect those of the Uniformed Services University of the Unites States Department of Defense.  Want to learn more about KeyLIME? Click here!

What skills and techniques are important for mentors, coaches, advisors, and sponsors when supporting mentees? What are coaching skills? What are the costs and benefits of being a mentor? Check out the third part in this series with Dr. Harriet Hopf, Executive Director of Faculty Development and Academic Affairs in the Department of Anesthesiology and Co-Director of the Utah Coaching and Advancement Network. Additional Resources: UCAN: https://medicine.utah.edu/faculty-dev/programs/coaching-program Manuel SP, Poorsattar SP. Mentoring up: Twelve tips for successfully employing a mentee-driven approach to mentoring relationships. Med Teach. 2021; 43:384-387. Zerzan JT, Hess R, Schur E, Phillips RS, Rigotti N. Making the most of mentors: A guide for mentees. Acad Med. 2009;84(1):140-144. Kow CS et al. A systematic scoping review of ethical issues in mentoring in medical schools. BMC Medical Education (2020) 20:246. Straus SE, Johnson MO, Marquez C, Feldman MD. Characteristics of successful and failed mentoring relationships: A qualitative study across two academic health centers. Acad Med. 2013;88(1):82-89. Hastings LJ, Kane C. Distinguishing Mentoring, Coaching, and Advising for Leadership Development. New Directions for Student Leadership. 2018;158:9-22.

Guests Chirag Bhat, MD, and Warren Cheung, MD, MMEd, join hosts Toni Gallo and associate editor Teresa Chan, MD, MHPE, to discuss their research into nurses' perspectives about giving feedback on residents' clinical performance. They share their findings regarding the unique perspective nurses can offer, the barriers nurses face in providing feedback, and some possible ways to overcome these barriers. Read the article discussed in this episode: Bhat C, LaDonna K, Dewhirst S, et al. Unobserved observers: Nurses' perspectives about sharing feedback on the performance of resident physicians. Acad Med. 2022;97:271-277. A transcript of this episode is available at academicmedicineblog.org. 

The grind of surgical training has been celebrated in the past, but to what end? With mounting evidence that supports a high prevalence of burnout in the surgical community, surgical educators and leaders are often called to develop initiatives to address the detrimental and potentially irreversible effects on trainees' wellness during surgical training. We invite Dr. David Rogers, who has personally experienced burnout, to share his insight and expertise in improving workplace wellness. Spoiler: it's not as easy as group yoga sessions and daily donuts. Hosts: Dr. David Rogers Dr. Jeremy Lipman Dr. Judith French Dr. Amy Han Learning Objectives 1.     Listeners will be able to define wellness in the context of surgical training. 2.     Listeners will be able to better characterize and recognize signs of burnout among surgeons and surgical trainees. 3.     Listeners will be able identify strategies for overcoming burnout.  4.     Listeners will be able to apply conceptual frameworks from workplace wellness outside of medicine that can guide developing effective programs that promote wellness in surgical education community. References: Torres-Landa S, Moreno K, Brasel KJ, Rogers DA. Identification of Leadership Behaviors that Impact General Surgery Junior Residents' Well-being: A Needs Assessment in a Single Academic Center. J Surg Educ. 2022;79(1):86-93. doi:10.1016/j.jsurg.2021.07.017 Coverdill JE, Bittner IV JG, Park MA, Pipkin WL, Mellinger JD. Fatigue as impairment or educational necessity? Insights into surgical culture. Acad Med. 2011;86:S69-72. Dyrbye LN, Thomas MR, Harper W, et al. The learning environment and medical student burnout: a multicentre study. Med Educ. 2009;43(3):274-282. doi:10.1111/j.1365-2923.2008.03282.x Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ. 2016;50(1):132-149. doi:10.1111/medu.12927 Bordage G. Conceptual frameworks to illuminate and magnify. Med Educ. 2009;43(4):312 319. doi:10.1111/j.1365-2923.2009.03295.x Bakker AB, de Vries JD. Job Demands–Resources theory and self-regulation: New explanations and remedies for job burnout. Anxiety, Stress, & Coping. 2021;34: 1-21. Georgiadis F. Author Dr Amit Sood: Rising Through Resilience; Five Things You Can Do To Become More Resilient. Medium. https://medium.com/authority-magazine/author-dr-amit-sood-rising-through-resilience-five-things-you-can-do-to-become-more-resilient-673b0a1e9f2a. Published 2020. Accessed May 10, 2022. Gino F. Are You Too Stressed to Be Productive? Or Not Stressed Enough? Harvard Business Review. Published October 5, 2017. https://hbr.org/2016/04/are-you-too-stressed-to-be-productive-or-not-stressed-enough Goleman D. Primal Leadership, with a New Preface by the Authors : Unleashing the Power of Emotional ... Intelligence.Harvard Bus Review Press; 2016. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

EPAs are coming in 2023. This isn't about your carbon emissions, but it will dramatically impact surgery training programs. Join Drs. Karen Brasel, Jeremy Lipman, Judith French, and Amy Han as they discuss Entrustable Professional Activities (EPAs) and how they will change the way we assess trainees. Learning Objectives 1.     Listeners will be able to define entrustable professional activities (EPAs) within the context of competency-based education during General Surgery residency training 2.     Listeners will be able to understand the impetus behind adopting EPA assessments for surgical trainees.  3.     Listeners will be able to interpret and apply EPA assessment data based on the discussion of the example scenarios. References: Brasel KJ, Klingensmith ME, Englander R, Grambau M, Buyske J, Sarosi G, Minter R. Entrustable professional activities in general surgery: development and implementation. Journal of surgical education. 2019 Sep 1;76(5):1174-86. Lindeman B, Brasel K, Minter RM, Buyske J, Grambau M, Sarosi G. A Phased Approach: The General Surgery Experience Adopting Entrustable Professional Activities in the United States. Acad Med. 2021;96(7S):S9-S13. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Episode length: 29:55 Author: O'Brien et. al. Publication: Perception of Medical Student Mistreatment: Does Specialty Matter? Acad Med. 2022 Feb 1;97(2):247-253 Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Lara Varpio: @LaraVarpio Lara Varpio's Disclaimer: The views expressed in this manuscript are solely those of the authors and do not necessarily reflect those of the Uniformed Services University of the Unites States Department of Defense.  Want to learn more about KeyLIME? Click here! Full transcript for this Episode is available upon request.  

Guests Will Bynum, MD, and Joe Jackson, MD, join host Toni Gallo to discuss new research into the nature of shame experiences in medical students and emerging work on the implications of premedical students' shame experiences for their professional development. They offer advice for educators and learners for naming, normalizing, and addressing the effects of shame and provide suggestions for fostering a safe, inclusive learning environment and a holistic admissions process that support learners and minimize opportunities for shame triggering experiences.  Read the article discussed in this episode: Bynum WE IV, Teunissen PW, Varpio L. In the “shadow of shame”: A phenomenological exploration of the nature of shame experiences in medical students. Acad Med. 2021;96:S23-S30.  A transcript of this episode is available at academicmedicineblorg.org. 

This episode was originally released in August 2019. Guests Will Bynum, MD, Lara Varpio, PhD, and Ashley Adams, MD, join Toni Gallo and former Academic Medicine editor-in-chief David Sklar, MD, to discuss shame in medicine and medical education, what it is and isn't, how it can be studied, and their research and other work in this area. Read the articles discussed in this episode:  Bynum WE IV, Adams AV, Edelman CE, Uijtdehaage S, Artino AR Jr, Fox JW. Addressing the elephant in the room: A shame resilience seminar for medical students. Acad Med. 2019;94:1132-1136. Bynum WE IV, Artino AR Jr, Uijtdehaage S, Webb AMB, Varpio L. Sentinel emotional events: The nature, triggers, and effects of shame experiences in medical residents. Acad Med. 2019;94:85-93.  Sklar DP. Recognizing and eliminating shame culture in health professions education. Acad Med. 2019;94:1061-1063. A transcript of this episode is available at academicmedicineblog.org. Disclaimer: The views expressed in this episode are the authors' own and do not necessarily represent those of the U.S. Department of Defense, the U.S. Government, or its agencies. 

During this episode of the Pursuit of Health Podcast we pick up on our topic of Infertility as a Health Concern with a remarkably accomplished guest physician, Dr. Chrissy Guidry. After years of medical and surgical training in Louisiana, Ohio and California, she is now the Medical Director of the Emergency General Surgery & Advanced Trauma Life Support Service at Tulane Medical Center and the Associate Program Director of General Surgery at Tulane University. As an Assistant Professor of Surgery at Tulane School of Medicine she serves as a mentor and advocate for many young student physicians. Amongst her many accomplishments and innumerable services on professional committees, she has recently added a focus on addressing Female Infertility Amongst Physicians. She explains that she has been carrying out this effort in collaboration with the American Medical Women's Association (AMWA) who has recently made a concerted effort to bring this issue out to the public and the medical profession. This began with an AMWA-sponsored Physician Fertility Summit at which Dr. Guidry was amongst the many guest physician leaders and speakers shedding light on this little discussed topic. During our visit with Dr. Guidry, she bravely shared with our audience her own personal issues regarding infertility so that others may know that they are not alone. She explains that Female Infertility amongst physicians is 3-4 times higher than the general population and that much research is needed to understand both the causes of this medical condition and how to best prevent and treat it. Dr. Guidry reveals many of the obstacles, biases and misconceptions regarding infertility and family planning amongst physicians. She stressed that this is an issue that can seriously affect women physicians and their families. She advocates for early awareness of this issue amongst those she mentors and her colleagues. Together, Dr. Fethke and Dr, Guidry agree that physicians wishing to have children are more well-rounded and healthy people when they are able to do so, thus improving their professional and personal lives. Through organizations like AMWA and RESOLVE, Dr Guidry is optimistic that the issue of Physician Infertility is now out in the open. She strongly believes that physicians have a unique platform to address this issue for themselves and the public at large in order to improve awareness and access to infertility-related medical care. She looks forward to a day when physicians can study and practice in environments that are supportive and proactive for all physicians who are in need of evaluating their fertility as a significant component of their physical and psychosocial health. Dr. Guidry poinantly finishes our fascinating and emotional discussion by emphasizing, “ It is time for this discussion to be out in the open so people know they are not alone.” Finally, Dr. Guidry wants everyone to be aware of the upcoming AMWA and RESOLVE sponsored three seminars occurring in February through April 2022 entitled Moving the Fertility Conversation Forward. We at the Pursuit of Health Podcast can be reached for audience feedback on this episode as well as past and future episodes. We can be reached at drfethkemd on Facebook and Instagram, as well as our website at drfethkemd.com. Refernces: 1. Marshall AL, Arora VM, Salles A. Acad Med, 2020;95(5):679. 2. Stentz NC et al. J Womens Health. 2016;25:1059.J Womens Health (Larchmt)2016 Oct;25(10):1059-1065. doi: 10.1089/jwh.2015.5638. 3. Chandra A et al. www.cdc.gov/nchs/ data/series/sr_23/sr23_025.pdf. 4. Kemkes-Grottenthaler A. J Biosoc Sci. 2003;35:213 5. https://www.nytimes.com/2021/09/13/health/women-doctors-infertility.html 6. JAMA Surg 2021 Oct 1;156(10):905-915. doi: 10.1001/jamasurg.2021.3301. 

Episode length: 29:28 Part 2 of the AAMC KeyLIME live event. 3. Lipman JM, Park YS, Papp KK, Tekian A. Content of an Educational Handover Letter From Medical Schools to Surgical Residencies: A Mixed Methods Analysis. Acad Med. 2021;96;S136-S143. 4. Colbert-Getz JM, Bierer B, Berry A, Bradley E, Han H, Mooney C, Szauter K, Teal CR, Youm J, O'Brien BC. What is and Innovation Article? A Systematic Overview of Innovation in Health Professions Education Journals. Acad Med. 2021;96;S39-S47. Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Lara Varpio: @LaraVarpio Lara Varpio's Disclaimer: The views expressed in this manuscript are solely those of the authors and do not necessarily reflect those of the Uniformed Services University of the Unites States Department of Defense.  Want to learn more about KeyLIME? Click here! Full transcript for this Episode is available upon request.

Episode length: 29:02 First two papers reviewed at the AAMC on Nov 29, 2021. Brondfield S, Lee K, O'Sullivan PS. The Cognitive Load of Inpatient Consults: A Covergent Parallel Mixed Methods Studay Using the Consult Cognitive Load Instrument. Acad Med. 2021;96;S119-S125. Burk-Rafel J, Reinstein I, Feng J, Kim MM, Miller LH, Cocks PM, Marin M, Aphinyanaphongs Y. Development and Validaton of a Machine Learning-Based Decisions Support Tool for Residency Applicant Screening and Review. Acad Med. 2021;96;S54-S61. Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Lara Varpio: @LaraVarpio Lara Varpio's Disclaimer: The views expressed in this manuscript are solely those of the authors and do not necessarily reflect those of the Uniformed Services University of the Unites States Department of Defense.  Want to learn more about KeyLIME? Click here! Full transcript for this Episode is available upon request.

Dr. Jakub Tolar is the Dean of the University of Minnesota Medical School and is a Distinguished McKnight Professor in the Department of Pediatrics, Blood and Marrow Transplant & Cellular Therapy. He is the Vice President for Clinical Affairs at the University of Minnesota, Board Chair for University of Minnesota Physicians and co-leader of M Health Fairview. We have come to know him not only as a researcher and dean, but as a passionate advocate who is putting artificial intelligence at the forefront of academic medicine. 1:00 MaML @ UMN 2:08 Tools to Alleviate Human Suffering 4:00 The Brain Machine 6:56 How do we know things are real? 9:00 Serving Minnesotans 10:19 Meet the Dean 16:48 Rare Genetic Disorders and ML 18:14 Mori et al. Article (see citation) 19:00 Medical Errors 20:45 AI in Medical Education (see citation) 24:25 Mistakes of Modern Living 24:50 Antiquity and Modernity 30:35 Data Ownership  32:38 The EHR Conundrum 37:29 Technological Liberation 39:15 Epidermolysis bullosa 47:23 Dean Tolar's Advice 51:22 Future of AI in Medicine 54:50 Make Journaling a Part of Your Day! Mori, J., Kaji, S., Kawai, H. et al. Assessment of dysplasia in bone marrow smear with convolutional neural network. Sci Rep 10, 14734 (2020). https://doi.org/10.1038/s41598-020-71752-x Lentz A, Siy JO, Carraccio C. AI-ssessment: Towards Assessment As a Sociotechnical System for Learning. Acad Med. 2021;96(7S):S87-S88. doi:10.1097/ACM.0000000000004104 Interviewer: Madeline Ahern Producer: Melanie Bussan Art: Melanie Bussan Follow us on Twitter: https://twitter.com/TheMaMLPodcast?s=20

Feedback with Dr. Lisa Leggio Participants Jameson Kenerly (MS4) Jessica Davis, DO Lisa Leggio, MD Zachary Hodges, MD Peer review by Dr. Andy Albritton and the MCG Pediatric Podcast Committee About our guest: Dr. Lisa Leggio is a professor of pediatrics here at the Medical College of Georgia and a practicing general pediatrician at the Children's Hospital of Georgia. She is the director of the pediatric clerkship which is commonly voted as a favorite rotation by our medical students. Individually, she is a very successful medical educator and has been recognized as the educator of the year multiple times here at our institution. Learning Objectives: After listening to this podcast, learners should be able to: Recognize and overcome barriers to giving feedback Recognize and overcome barriers to receiving feedback Describe and use 4 techniques for giving feedback FREE CME Credit (requires sign-in): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=8420 Thank you for listening to this episode from the Department of Pediatrics at the Medical College of Georgia. If you have any comments, suggestions, or feedback- you can email us at mcgpediatricpodcast@augusta.edu Remember that all content during this episode is intended for informational and educational purposes only. It should not be used as medical advice to diagnose or treat any particular patient. Clinical vignette cases presented are based on hypothetical patient scenariosWe look forward to speaking to you on our next episode of the MCG Pediatric Podcast.   References: Armson H, Lockyer JM, Zetkulic M, Könings KD, Sargeant J. Identifying coaching skills to improve feedback use in postgraduate medical education. Med Educ. 2019 May;53(5):477-493. doi: 10.1111/medu.13818. Epub 2019 Feb 18. PMID: 30779210. Baldie D et al. Exploring the impact and use of patients' feedback about their care experiences in general practice settings – a realist synthesis.  Family Practice, 2018; 35(1):13-21. Boehler ML, Rogers DA, Schwind CJ, Mayforth R, Quin J, Williams RG, Dunnington G. An investigation of medical student reactions to feedback: a randomised controlled trial. Med Educ. 2006 Aug;40(8):746-9. doi: 10.1111/j.1365-2929.2006.02503.x. PMID: 16869919. Brown, B. (2018). Dare to lead: Brave work. Tough conversations. Whole hearts.New York: Random House. Dweck, C.S. (2008). Mindset: the New Psychology of Success.  New York:  Random House. Ende J. Feedback in clinical medical education. JAMA. 1983 Aug 12;250(6):777-81. PMID: 6876333. Fainstad T, Mcclintock A A, Van Der Ridder M J, et al. (December 11, 2018) Feedback Can Be Less Stressful: Medical Trainee Perceptions of Using the Prepare to ADAPT (Ask-Discuss-Ask-Plan Together) Framework . Cureus 10(12): e3718. doi:10.7759/cureus.3718 Gigante, J., Dell, M., & Sharkey, A. (2011). Getting beyond "Good job": how to give effective feedback. Pediatrics, 127(2), 205–207. https://doi.org/10.1542/peds.2010-3351 Sargeant J. Future Research in Feedback: How to Use Feedback and Coaching Conversations in a Way That Supports Development of the Individual as a Self-Directed Learner and Resilient Professional. Acad Med. 2019 Nov;94(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 58th Annual Research in Medical Education Sessions):S9-S10. doi: 10.1097/ACM.0000000000002911. PMID: 31365395. Stone, D. and Heen, S. (2014). Thanks for the Feedback: the Science and Art of Receiving Feedback Well* even when it is off base, unfair, poorly delivered, and, frankly, you're not in the mood. New York:  Penguin Books.

In this episode, Sarah delves into the psychology of negativity bias. Whether you realize it or not, human beings are naturally wired to focus on the bad experiences in life more than the positive. Sarah discusses why and how we can combat that for better holistic health (and, ya know, overall life satisfaction...)References: Haizlip J, May N, Schorling J, Williams A, Plews-ogan M. Perspective: The negativity bias, medical education, and the culture of academic medicine: Why culture change is hard. Acad Med. 2012;87(9):1205-9. doi:10.1097/ACM.0b013e3182628f03Alberini CM. Long-term memories: The good, the bad, and the ugly. Cerebrum. 2010;21.Cacioppo JT, Cacioppo S, Gollan JK. The negativity bias: Conceptualization, quantification, and individual differences. Behavioral and Brain Sciences. 2014;37(3):309-310. doi:10.1017/s0140525x13002537Goldsmith K, Ravi D. Negativity bias and task motivation: Testing the effectiveness of positively versus negatively framed incentives. Journal of Experimental Psychology: Applied. 2013;19(4):358-366. doi:10.1037/a0034415Hibbing JR, Smith KB, Alford JR. Differences in negativity bias underlie variations in political ideology. Behavioral and Brain Sciences. 2014;37(3):297-307. doi:10.1017/s0140525x13001192Hamlin JK, Wynn K, Bloom P. Three-month-olds show a negativity bias in their social evaluations. Dev Sci. 2010;13(6):923-929. doi:10.1111/j.1467-7687.2010.00951.xHilbig B. Good things don't come easy (to mind): Explaining framing effects in judgments of truth. Experimental Psychology. 2011;59(1):38-46. doi:10.1027/1618-3169/a000124Ito TA, Larsen JT, Smith NK, Cacioppo JT. Negative information weighs more heavily on the brain: The negativity bias in evaluative categorizations. J Pers Soc Psychol. 1998;75(4):887-900. doi:10.1037//0022-3514.75.4.887Kahneman D, Tversky A. Choices, values, and frames. American Psychologist. 1984;39(4):341-350. doi:10.1037/0003-066x.39.4.341Kinderman P, Schwannauer M, Pontin E, Tai S. Psychological processes mediate the impact of familial risk, social circumstances and life events on mental health. PLoS ONE. 2013;8(10):e76564. doi:10.1371/journal.pone.0076564

Adam and Dr. Sheahan join Miss Eilidh Gunn and Dr. Steven Yule to discuss human factors engineering, coaching, and the Non-technical Skills for Surgeons (NOTSS) taxonomy and how they can be applied to improving vascular surgery.  Professor Steven Yule (@NOTSS_lab) is the Chair of Behavioural Sciences at the University of Edinburgh, Associate Professor at Harvard, and Director of Non-Technical Skills at the Royal College of Surgeons of Edinburgh. He is a Human Factors scientist and organizational psychologist. He is internationally recognized for his research on non-technical skills, patient safety, and simulation in surgery. His interests are in peer and computer assessments of surgical performance from video, safety in low and middle-income contexts, surgical coaching, sabermetrics, and astronaut training for long-duration spaceflight. He is also currently the program Director for MSc Patient Safety and Clinical Human Factors at Edinburgh University. To Learn More about NOTSS: RCSEd Let's Talk Surgery Podcast: Performance Project Enhancing Surgical Performance: A Primer on Non-technical Skills NOTSS Handbook Non-technical Skills for Surgeons RCSEd Website Non-Technical Skills for Surgeons Website (notss.org) The future training of non-technical skills for surgeons (NOTSS) - YouTube Relevant links Moulton CA, Regehr G, Mylopoulos M, MacRae HM. Slowing down when you should: a new model of expert judgment. Acad Med. 2007 Oct;82(10 Suppl):S109-16. Hu YY, Peyre SE, Arriaga AF, et al. Postgame analysis: using video-based coaching for continuous professional development. J Am Coll Surg. 2012;214(1):115-124. Sudol NT, Guaderrama NM, Honsberger P, et al. Prevalence and Nature of Sexist and Racial/Ethnic Microaggressions Against Surgeons and Anesthesiologists. JAMA Surg. 2021 May 1;156(5):e210265. CIEHF White Paper: Human Factors for Health Care and Social Care Ariadne Labs Co-hosts Miss Eilidh Gunn (@eil1_g) is currently a PhD candidate in Clinical Surgery at the University of Edinburgh. Her research interests are human factors, non-technical skills and surgical coaching. Dr. Mal Sheahan is a regular contributor to the podcast, editor for Vascular Specialist and co-chair of the SVS wellness taskforce overseeing their new initiative in peer coaching. If you enjoy our content, please contribute to Support Audible Bleeding! Help us improve through our ALL NEW Listener Survey! Follow us on Twitter: @AudibleBleeding

咖啡灌腸是通過肛門注射咖啡以清潔直腸和大腸的灌腸相關程序。沒有醫學和科學證據支持咖啡灌腸的任何積極健康聲明。該過程可導致敗血症，嚴重的電解質紊亂，結腸炎，直腸結腸炎，內部灼熱，直腸穿孔，甚至腦膿腫或心力衰竭。 咖啡灌腸的歷史 History 雖然直腸清潔的想法可以追溯到古埃及人，但咖啡作為灌腸相關物質的概念並不新鮮。它於1917年構思出來。1920年，德國科學家研究了咖啡因對膽管和小腸的影響。 Max Gerson提出咖啡灌腸對胃腸道有積極作用。 Gerson說咖啡灌腸具有積極的排毒作用，有助於恢復患者的健康。他聲稱，與鹽水灌腸不同，灌腸中的咖啡通過小腸的平滑肌進入肝臟。他說，這可以刺激自主神經系統，就像咖啡因口服時一樣，激活肝臟中膽汁的釋放，清除更多的胃腸道並排出比正常灌腸更多的毒素。他經常告訴他的病人，“咖啡灌腸不是為了腸道的功能，而是為了刺激肝臟。” 結腸清潔的實踐經歷了20世紀90年代的復興，此時，咖啡灌腸被用作替代癌症治療。 效用和風險 一些替代醫學的支持者聲稱咖啡灌腸通過“解毒”腫瘤的代謝產物而具有快速解毒作用。但是，目前沒有醫學科學證據支持咖啡灌腸的任何解毒或抗癌作用。咖啡灌腸可能引起嚴重的副作用（一些常見於其他類型的灌腸），包括感染，敗血症，嚴重的電解質紊亂，結腸炎，直腸結腸炎，沙門氏菌，腦膿腫和心力衰竭。 如果咖啡灌入太快或太熱 ，它可能導致內部燒傷或直腸穿孔。 每兩小時給藥一次，由於嚴重的電解質紊亂，低鈉血症，脫水和胸膜和心包積液，咖啡灌腸已經顯示與兩例死亡病例有關。美國食品和藥物管理局（FDA）已經裁定提供咖啡灌腸者必須警告使用者有關咖啡灌腸死亡的風險。 參考資料： Teekachunhatean S, Tosri N, Sangdee C, et al. Antioxidant effects after coffee enema or oral coffee consumption in healthy Thai male volunteers. Hum Exp Toxicol. 2012 Jul;31(7):643-51. Jones LE, Norris WE. Rectal burn induced by hot coffee enema. Endoscopy. 2010;42 Suppl 2:E26. Sashiyama H, Hamahata Y, Matsuo K, et al. Rectal burn caused by hot-water coffee enema. Gastrointest Endosc. 2008 Nov;68(5):1008; Ernst, E. "Colonic irrigation and the theory of autointoxication: a triumph of ignorance over science". Journal of Clinical Gastroenterology. 1997 Jun; 24 (4): 196–198. Lee C, Song S, Jeon J, et al. "Coffee enema induced acute colitis". The Korean Journal of Gastroenterology. 2008; 52 (4): 251–254. Shils ME, Hermann MG (April 1982). "Unproved dietary claims in the treatment of patients with cancer". Bull N y Acad Med. 1982 Apr; 58 (3): 323. Cassileth B. "Gerson regimen". Oncology 2010 Feb;24 (2): 201. Margolin, K.; Green, M. "Polymicrobial enteric septicemia from coffee enemas". The Western Journal of Medicine. 1984;140 (3): 460. Eisele J, Reay D. "Deaths related to coffee enemas". JAMA: The Journal of the American Medical Association. 1980; 244 (14): 1608–1609. Keum B, Jeen YT, Park SC, et al. "Proctocolitis Caused by Coffee Enemas". The American Journal of Gastroenterology. 2010; 105 (1): 229–230. Sashiyama H, Hamahata, Y, Matsuo K, et al.”Rectal burn caused by hot-water coffee enema". Gastrointestinal Endoscopy. 2008; 68 (5): 1008–1009. Paran H, Butnaru G, Neufeld D, et al. "Enema-induced perforation of the rectum in chronically constipated patients". Diseases of the Colon and Rectum. 1999; 42 (12): 1609–1612. Teekachunhatean S, Tosri N, Rojanasthien N, et al. Pharmacokinetics of Caffeine following a Single Administration of Coffee Enema versus Oral Coffee Consumption in Healthy Male Subjects. ISRN Pharmacol. 2013;2013:147238. 咖啡灌腸的風險： 1. 電解質不平衡 2. 腸粘膜燙傷 3. 腸穿孔 4. 腸炎、感染

Dr. Toyin Ajayi, Co-founder and Chief Health Officer at Cityblock Health speaks with Dr. Monica Peek, associate professor of General Internal Medicine at the University of Chicago. This conversation is the second in a series focused on health care sector efforts to increase Awareness about both patient and community-level social conditions. Drs. Ajayi and Peek discuss concerns structurally marginalized people may have in spaces like health care in and outside the context of social risk screening and explore ways health care organizations can earn trust and build rapport with patients of color.Recommended references: Peek ME, Odoms-Young A, Quinn MT et al. Racism in healthcare: Its relationship to shared decision-making and health disparities: A response to Bradby. Soc Sci Med. 2010;71:13-17. Peek ME, Nunez-Smith M, Drum M, Lewis TT. Adapting the Everyday Discrimination Scale to medical settings: Reliability and validity testing in a sample of African-American patients. Ethn Dis. 2011;21(4):502-9. Peek ME, Lopez F, Williams HS et al. Development of a conceptual framework for understanding Shared Decision-Making among African-American LGBT patients and their clinicians. J Gen Intern Med. 2016;31(6):677-87. Tung EL, Johnson TA, O'Neal Y, Steenes AM, Caraballo G, Peek ME. Experiences of Community Violence Among Adults with Chronic Conditions: Qualitative Findings from Chicago. J Gen Intern Med. 2018;33(11): 1913-1920. Tung EL, Cagney K, Hawkley L, Peek ME. Social Isolation, Loneliness, and Violence Exposure in Urban Adults. Health Affairs. 2019;10;2670-2678. Peek ME, Vela MD, Chin MH. Practical lessons for teaching about race and racism: Successfully leading free, frank and fearless discussions. Acad Med. 2020;95:S139–S144. Peek ME, Simons R, Parker WF et al. Our Collective Obligation: An Action Plan for Mitigating COVID-19 Disparities. Am J Public Health. Persad G, Peek ME, Emanuel EJ. Fairly Prioritizing Groups for COVID-19 Vaccine Access. JAMA. 2020;324(16):1601-2.

It’s 2021, and we couldn’t be happier to leave 2020 behind and start a new year. In the past few months, we’ve talked about the past and present of emergency medicine. In this episode, we’ll explore the future. We welcome back some of our specialty’s visionary leaders, Dr. Aimee Moulin, Dr. Gillian Schmitz, Dr. Cherri Hobgood, and Dr. J Adrian Tyndall, to discuss what’s ahead for EM. How has the pandemic changed things? What role will technology play? What should healthcare and insurance look like in the future? Listen and learn along with us.  What do you think lies ahead for emergency medicine or the health system in general? Share your thoughts with us on social media @empulsepodcast, or through our website, ucdavisem.com. ***Please rate us and leave us a review on iTunes! It helps us reach more people.*** Hosts: Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Aimee Moulin, Professor of Emergency Medicine and Psychiatry, and Behavioral Health Director, at UC Davis; previous California ACEP President, Director of California Bridge Gillian Schmitz, Associate Professor of Emergency Medicine at the Uniformed Services University of Health Sciences, Emergency Physician at Brooke Army Medical Center Dr. Cherri Hobgood, Professor and Past Chair of Emergency Medicine at Indiana University Form Chair of the Board of ACEP, and previous President of SAEM Dr. Joseph Adrian Tyndall, Professor and Chair of Emergency Medicine at the University of Florida College of Medicine, Interim Dean of the College of Medicine, Associate Vice President for Academic and Strategic Affairs for University of Florida Health, and Immediate Past Chair of the Florida chapter of ACEP Resources: The Alexandria Plan The State of EM Buntin, MB. A brief window to rethink emergency care. JAMA Health Forum. Published online October 14, 2020. doi:10.1001/jamahealthforum.2020.1297 Sklar DP, Handel DA, Hoekstra J, Baren JM, Zink B, Hedges JR. The future of emergency medicine: an evolutionary perspective. Acad Med. 2010 Mar;85(3):490-5. doi: 10.1097/ACM.0b013e3181ccb628. PMID: 20182124. Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Accreditation can be painful, but it doesn't have to be. Learn how Ryan Palmer a Principal Consultant at Kennedy & Company Education Strategies has found ways to ease the pain of accreditation processes. With his methods, the self-study doesn't feel like running a marathon without training which will likely make it so painful that you won't want to participate in another one again. Ryan Palmer, EdD, MFAPrincipal Consultant at Kennedy & Company Education Strategiesrpalmer@kennedyandcompany.com | LinkedInMentioned Paper:Hunt D, Migdal M, Waechter DM, Barzansky B, Sabalis RF. The Variables That Lead to Severe Action Decisions by the Liaison Committee on Medical Education. Acad Med. 2016 Jan;91(1):87-93. doi: 10.1097/ACM.0000000000000874. PMID: 26287918.

Episode length: 32:50 The 3 papers reviewed in this episode are: Steinert Y, Mann K, Anderson B, et al. A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40. Med Teach. 2016;38(8):769-786. doi:10.1080/0142159X.2016.1181851 McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med. 2011;86(6):706-711. doi:10.1097/ACM.0b013e318217e119 Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79(10 Suppl):S70-S81. doi:10.1097/00001888-200410001-00022 Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Lara Varpio: @LaraVarpio Lara Varpio's Disclaimer: The views expressed in this manuscript are solely those of the authors and do not necessarily reflect those of the Uniformed Services University of the Unites States Department of Defense.  Want to learn more about KeyLIME? Click here! Full transcript for this Episode is available upon request.

Episode length: 32:00 Barrows HS. A taxonomy of problem-based learning methods. Med Educ. 1986;20(6):481-486. doi:10.1111/j.1365-2923.1986.tb01386.x   Colliver JA, Conlee MJ, Verhulst SJ, Dorsey JK. Reports of the decline of empathy during medical education are greatly exaggerated: a reexamination of the research. Acad Med. 2010;85(4):588-593. doi:10.1097/ACM.0b013e3181d281dc   Van der Vleuten CP, Norman GR, De Graaff E. Pitfalls in the pursuit of objectivity: issues of reliability. Med Educ. 1991;25(2):110-118. doi:10.1111/j.1365-2923.1991.tb00036.x   Steinert Y, Mann K, Anderson B, et al. A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40. Med Teach. 2016;38(8):769-786. doi:10.1080/0142159X.2016.1181851   McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med. 2011;86(6):706-711. doi:10.1097/ACM.0b013e318217e119   Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79(10 Suppl):S70-S81. doi:10.1097/00001888-200410001-00022 Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Lara Varpio: @LaraVarpio Lara Varpio's Disclaimer: The views expressed in this manuscript are solely those of the authors and do not necessarily reflect those of the Uniformed Services University of the Unites States Department of Defense.  Want to learn more about KeyLIME? Click here! Full transcript for this Episode is available upon request.

Ruth Staus discusses the necessity of the social sciences in the medical field, the "scientific" foundations of race, teaching, trauma, and her clinical work with her unhoused patients. Dr. Ruth Staus DNP, APRN, ANP-BC is a professor of nursing, global health and social medicine who has been practicing community-based primary care as a nurse practitioner for 25 years. Her scholarly work is focused on the effects of racism on health and she is currently involved in social activism related to structural racism, housing and health. Her recommended resources: Moran-Thomas, A. (2020). How a Popular Medical Device Encodes Racial Bias. Bostonreview.net. (website) bit.ly/3jecfpJ Acquaviva, Kimberly D., Mintz, Matthew (2010) Are We Teaching Racial Profiling? The Dangers of Subjective Determinations of Race and Ethnicity in Case Presentations, Acad Med. 85(4), 702-705. (Full text) bit.ly/31tRDDI Ortiz, A. "Liberation in the Exam Room," (PDF) bit.ly/32yfYrE Oliver, J., "Bias In Medicine: Last Week Tonight," (Youtube video) bit.ly/3hwu1E7

Michelle Morse (@michellemorse) discusses race and antiracism in medicine. Beginning with Camara Jones' metaphor of the Gardener's Tale, she helps to imagine how medicine can work for the good of all and how medicine can move past its entanglements with racist ways of thinking and acting. Michelle Morse MD MPH is a physician, organizer, and social medicine leader who has cofounded EqualHealth, the Social Medicine Consortium, and three residency programs at the Mirebalais University Hospital. She is an assistent professor at Harvard Medical School, a Robert Wood Johnson Health Policy Fellow, and is currently working on the global Campaign Against Racism. Her recommended resources: Jones, C. P. (2000). Levels of racism: A theoretic framework and a gardener's tale. American Journal of Public Health, 90(8), 1212–1215. https://doi.org/10.2105/AJPH.90.8.1212. PDF. Jones CP, Truman BI, Elam-Evans LD, et al. Using "socially assigned race" to probe white advantages in health status. Ethn Dis. 2008;18(4):496-504. PDF. Ford CL, Airhihenbuwa CO. Critical Race Theory, race equity, and public health: toward antiracism praxis. Am J Public Health. 2010;100 Suppl 1(Suppl 1):S30-S35. doi:10.2105/AJPH.2009.171058. PDF. Tsai J, Ucik L, Baldwin N, Hasslinger C, George P. Race Matters? Examining and Rethinking Race Portrayal in Preclinical Medical Education. Acad Med. 2016;91(7):916-920. doi:10.1097/ACM.0000000000001232. Full text. Jee-Lyn García J, Sharif MZ. Black Lives Matter: A Commentary on Racism and Public Health. Am J Public Health. 2015;105(8):e27-e30. doi:10.2105/AJPH.2015.302706. Full text.

July 26th, 2020   Representation Matters: Recruitment and Retention of URM to Vascular Surgery In this second episode from our series on race and representation in medicine, we focus on the challenges of recruitment and retention of racial and ethnic minority groups that are underrepresented in medicine (URM) to vascular surgery. We are very pleased to have with us a number of guests at different levels of training to discuss their experiences and insights.   Dr. Chelsea Dorsey is faculty in the Section of Vascular Surgery at the University of Chicago and serves as the Director of the UChicago Vein Clinic and Ambulatory Medical Director for Cardiac, Vascular, and Thoracic Surgery.  She is a graduate of the Pritzker School of Medicine, where she developed an interest in health care inequalities. In addition, she volunteered her time helping pipeline programs and outreach activities in the community geared toward increasing the number of underrepresented minorities in the medical field.  After completing her Vascular Surgery training at Stanford University as the first woman and first African American accepted into the training program, she returned as faculty at the University of Chicago Medicine.  She serves as Director of Preclinical Advising in the medical school. She has served on the BSD Faculty Diversity Committee since 2017 and was recently appointed Chair of the Diversity, Equity, and Inclusion Steering Committee in the Department of Surgery.     Dr. Elsie Ross is a vascular surgeon and research scientist in the Division of Vascular Surgery at Stanford University. She graduated from Stanford University School of Medicine in 2011 and completed her vascular surgery integrated residency at Stanford University School of Medicine in 2018. During her residency, she completed a two-year post-doctoral fellowship in biomedical informatics. Her current research focuses on using machine learning and electronic health records for early disease identification, precision medicine, and evaluating opportunities to engage in patient education beyond the clinic. She is a Fulbright Scholar and a Soros Fellow, and is a recipient of the Young Investigators Award from the Association for Academic Surgery, as well as the Junior Faculty Award from the Society of University Surgeons.   Dr.  Joel L. Ramirez, MD, is the inaugural UCSF Integrated Vascular Surgery resident. He completed his undergraduate education at the University of California, Irvine, and  received his medical degree from the UCSF School of Medicine, graduating with Distinction in Clinical and Translation Research, and as a member of Alpha Omega Alpha. Dr. Ramirez conducted an NIH-funded pre-doctoral research fellowship between his third and fourth years of medical school with the UCSF Division of Vascular and Endovascular Surgery. In 2018, he was awarded first place for the Western Vascular Society Robert Hye Memorial Best Resident Presentation Award, for his research reporting on long term outcomes of endovascular aortic aneurysm repair. Dr. Ramirez has been the recipient of numerous other research fellowships, awards, and honors, including the American Medical Association Foundation Physicians of Tomorrow Award, the Society for Vascular Surgery Foundation Student Research Fellowship for two consecutive years, the American Heart Association Student Scholarship in Cardiovascular Disease, and the Association for Academic Surgery Senior Medical Student Award, among many others.   Dr. Ronald Dalman is the Walter C. and Elsa R. Chidester Professor and Chief of Vascular Surgery at Stanford University. He is also the current President of the Society for Vascular Surgery. Dr. Dalman earned his medical degree at the University of Michigan and completed surgical training at the University of Washington (Seattle) and his vascular fellowship at the Oregon Health and Sciences University. Dr. Dalman joined Stanford directly out of training and has led the vascular program since 2005. He is a member of the Vascular Surgery Board, American Board of Surgery, and a past member of the Residency Review Committee for Surgery, ACGME. At Stanford Health Care he serves as Co-Director and Chief Quality Officer for the Cardiovascular Service Line. At the School of Medicine, Dr. Dalman is a Steering Committee and founding member of the Cardiovascular Institute (CVI). Dr. Dalman's research laboratory studies the pathophysiology of abdominal aortic aneurysm (AAA) disease, and is actively engaged in identifying and validating new treatment measures for AAA.    Additional Resources:   Dr. Dorsey’s presentation from the VESS paper session at the SVSOnline-  Update on Workforce Diversity in Vascular Surgery: What has changed in 20 years? https://cdmcd.co/RqbR89    Perceptual and Structural Facilitators and Barriers to Becoming a Surgeon: A Qualitative Study of African-American and Latino Surgeons Ulloa et al. Acad Med. 2018 September ; 93(9): 1326–1334. doi:10.1097/ACM.0000000000002282 https://pubmed.ncbi.nlm.nih.gov/29742613/   Structural Solutions for the Rarest of the Rare: Underrepresented-Minority Faculty in Medical Subspecialties Kemi M. Doll, M.D., and Charles R. Thomas, Jr., M.D. N Engl J Med 2020; 383:283-285 DOI: 10.1056/NEJMms2003544   If you enjoy our content, please contribute to Support Audible Bleeding.   Help us improve through our Listener Survey.   Follow us on Twitter: @AudibleBleeding  

On February 12, 2020, we learned that the USMLE Step 1 exam is going pass/fail in 2022. What does this mean? How will this affect medical students? How will residency program directors evaluate applicants? How should medical schools approach their curricula? Our own Dr. Neda Frayha sat down with Dr. J. Bryan Carmody, Assistant Professor of Pediatrics at Eastern Virginia Medical School and a pediatric nephrologist at Children's Hospital of the King's Daughters in Norfolk, VA, to ask these questions about #USMLEPassFail and many others. Dr. Carmody is a leading voice on this subject nationwide; you can find him on Twitter and via his blog, The Sheriff of Sodium.   References: Change to Pass/Fail Score Reporting for Step 1. United States Medical Licensing Examination. https://www.usmle.org/inCus/ (Accessed 15 Feb 2020) Carmody JB. #USMLEPassFail: A Brave New Day. The Sheriff of Sodium. https://thesheriffofsodium.com. (Accessed 19 Feb 2020) Carmody JB. Step 1 Mania: The Case for #USMLEPassFail. 28 April 2019. https://www.youtube.com/watch?v=T-V6dOWxNz0&feature=youtu.be (Accessed 19 Feb 2020) Carmody JB, Rajasekaran SK. More on the Role of Step 1 of USMLE Step 1 in Resident Selection. Acad Med 2019; 94(7):921. doi: 10.1097/ACM.0000000000002744 Carmody JB. On Residency Selection and the Quantitative Fallacy. J Grad Med Educ 2019; 11(4):420-421. doi: 10.4300/JGME-D-19-00453. Carmody JB, Sarkany D, Heitkamp DE. The USMLE Step 1 Pass/Fail Reporting Proposal: Another View. Acad Radiol 2019; 26(10):1403-1406.  Carmody JB, Rajasekaran SK. On Step 1 Mania, USMLE Score Reporting, and Financial Conflict of Interest at the National Board of Medical Examiners. Acad Med 2019 Dec 17. doi: 10.1097/ACM.0000000000003126. [Epub ahead of print] 

Episode length: 40:35 The purpose of this paper is 1) To describe interpretations of commonly used phrases in Letters of reference by PDs other than in pediatrics. 2) To identify areas of agreement or variation between pediatrics, surgery, and IM LORs.  Author  Saudek et. al. Publication  Pediatric, Surgery, and Internal Medicine Program Director Interpretations of Letters of Recommendation. Acad Med. 2019 Nov;94  Audience questions/comments start at: 24:52 36:30 Voting on Methodology and Educational Impact Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Lara Varpio: @LaraVarpio Want to learn more about KeyLIME? Click here!

Episode length - 22:04   This episode was recorded live at the ICRE 2019 in Ottawa. Another 3 classic papers are reviewed by Dr.s Linda Snell, Jonathan Sherbino and Jason Frank. Do they fit your definition of Classic?   00:50  Jason's classic choice. Choudry et. al., Systematic Review: The relationship between clinical experience and quality of health care. Ann Intern Med. 2005 Feb 15;142(4):260-73.   8:25 Jon's  choice Eva et. al., The Ability of the Multiple Mini-Interview to Predict Preclerkship Performance in Medical School Acad Med. 2004 Oct;79(10 Suppl):S40-2.   13:50 Linda's choice. Irby. What clinical teachers in medicine need to know. Acad Med. 1994 May;69(5):333-42.     Voting for the 3 papers 20:50   * There are no abstracts for this episode. Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd    Want to learn more about KeyLIME? Click here!  

The amount of information we are expected to learn in medical school, residency, and beyond can be overwhelming - like drinking from a firehose! In this episode, we explore some ways in which physicians can leverage technology to help manage all of this information and facilitate life long learning. Several residents and attendings discuss what works for them, including using apps and online resources, and listening to podcasts. We then talk with Dr. Ryan Ribeira and Dr. Adam Dougherty of SimX about how they are using augmented and virtual reality to revolutionize medical simulation. Next, we talk with with Dr. Dina Wallin, creator of the Leader’s Library, on how she uses Slack to create a learning community of physicians across the globe. Finally, we discuss with education researcher, Dr. Jeff Riddell, about how and why physicians are turning to podcasts for learning and staying up to date, including some of the benefits and potential caveats.  Do you use technology for lifelong learning? Tell us how you do - or why you don’t! Connect with us on social media at @empulsepodcast, or on our website, ucdavisem.com.  Subscribe and rate us on iTunes - it helps us reach more people!  ***Save the date for the 43rd annual UC Davis Emergency Medicine Winter Conference, February 24th-29th at the Ritz Carlton in Lake Tahoe*** Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guests: Dr. Adam Dougherty, Emergency Medicine Physician at Sutter Medical Center in Sacramento, CA; Chief Medical Officer at SimX Dr. Ryan Ribeira, Clinical Assistant Professor of Emergency Medicine at Stanford University; Founder and Chief Executive Officer of SimX Dr. Dina Wallin, Assistant Clinical Professor of Emergency Medicine and Pediatrics at UCSF Benioff Children’s Hospital; Creator of the ALiEM Leader’s Library Dr. Jeff Riddell, Education Researcher and Assistant Professor of Clinical Emergency Medicine at the University of Southern California Keck School of Medicine Resources: SimX VR and AR digital simulation ALiEM Leader’s Library A Survey of Emergency Medicine Residents' Use of Educational Podcasts. Riddell J, Swaminathan A, Lee M, Mohamed A, Rogers R, Rezaie SR. West J Emerg Med. 2017 Feb;18(2):229-234. doi: 10.5811/westjem.2016.12.32850. Epub 2017 Jan 30. Independent and Interwoven: A Qualitative Exploration of Residents' Experiences with Educational Podcasts. Riddell J, Robins L, Brown A, Sherbino J, Lin M, Ilgen JS. Acad Med. 2019 Sep 10. doi: 10.1097/ACM.0000000000002984. [Epub ahead of print] Dr. Jeff RidellDr. Julia MagañaDr. Sarah MedeirosDr. Ryan Ribeira and Dr. Adam Dougherty *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

In this episode, Professor Tim Wilkinson from the Otago Medical School, University of Otago (New Zealand) talks about conditional passes. We talk about constitutes a conditional pass, developing an action plan, what students might think about this process, and how educators play a role in the process.Tim’s biography can be found here (https://www.otago.ac.nz/healthsciences/expertise/Profile/index.html?id=64)The two papers that Tim refers to during this episode are here:Wilkinson, T.J., Tweed, M.J., Egan, T.G. et al., 2011. Joining the dots: Conditional pass and programmatic assessment enhances recognition of problems with professionalism and factors hampering student progress. BMC Med Educ 11, 29. https://doi.org/10.1186/1472-6920-11-29Wilkinson, T.J., Wade, W.B. and Knock, L.D., 2009. A blueprint to assess professionalism: results of a systematic review. Acad Med, 84(5), pp.551-558. https://doi.org/10.1097/ACM.0b013e31819fbaa2The online clinical supervision course produced by Professor Steve Trumble and the Department of Medical Education can be found here: https://go.unimelb.edu.au/oo96Subscribe now (go.unimelb.edu.au/z6xr) to receive new episodes as they are released. Tell us what you think via Twitter (@EXCITE_UOM) or email us and let us know who and what you would like to hear about in future episodes (mededsource-podcast@unimelb.edu.au).We acknowledge the Traditional Owners of the land on which we work, live and learn. We also pay our respects to Elders past, present and emerging.This podcast was presented by Brett Vaughan (@BrettVaughan4), and produced by Brett Vaughan and Michelle Curtis. Med Ed Source is a production of the Department of Medical Education at University of Melbourne, Australia. This episode was recorded on October 16th 2019. For more information, visit https://medicine.unimelb.edu.au/school-structure/medical-education. You can also find us on Twitter and Facebook. Med Ed Source is licenced under Creative Commons, Copyright 2017, the University of Melbourne.Music: Reach The Top by Shane Ivers - https://www.silvermansound.com

In this episode, Professor Tim Wilkinson from the Otago Medical School, University of Otago (New Zealand) talks about conditional passes. We talk about constitutes a conditional pass, developing an action plan, what students might think about this process, and how educators play a role in the process.Tim’s biography can be found here (https://www.otago.ac.nz/healthsciences/expertise/Profile/index.html?id=64)The two papers that Tim refers to during this episode are here:Wilkinson, T.J., Tweed, M.J., Egan, T.G. et al., 2011. Joining the dots: Conditional pass and programmatic assessment enhances recognition of problems with professionalism and factors hampering student progress. BMC Med Educ 11, 29. https://doi.org/10.1186/1472-6920-11-29Wilkinson, T.J., Wade, W.B. and Knock, L.D., 2009. A blueprint to assess professionalism: results of a systematic review. Acad Med, 84(5), pp.551-558. https://doi.org/10.1097/ACM.0b013e31819fbaa2The online clinical supervision course produced by Professor Steve Trumble and the Department of Medical Education can be found here: https://go.unimelb.edu.au/oo96Subscribe now (go.unimelb.edu.au/z6xr) to receive new episodes as they are released. Tell us what you think via Twitter (@EXCITE_UOM) or email us and let us know who and what you would like to hear about in future episodes (mededsource-podcast@unimelb.edu.au).We acknowledge the Traditional Owners of the land on which we work, live and learn. We also pay our respects to Elders past, present and emerging.This podcast was presented by Brett Vaughan (@BrettVaughan4), and produced by Brett Vaughan and Michelle Curtis. Med Ed Source is a production of the Department of Medical Education at University of Melbourne, Australia. This episode was recorded on October 16th 2019. For more information, visit https://medicine.unimelb.edu.au/school-structure/medical-education. You can also find us on Twitter and Facebook. Med Ed Source is licenced under Creative Commons, Copyright 2017, the University of Melbourne.Music: Reach The Top by Shane Ivers - https://www.silvermansound.com

A special lecture for suicide prevention day, week, and month from our sister podcast, the Psychcast.  Click here for more episodes of the Psychcast. Show Notes By Jacqueline Posada, MD Introduction Suicide in general population increased by 30% since 1999. The suicide rate was 14 people in every 100,000 up from 10.5 people per 100,000 in 1999. 400 physicians die per year. However, there is not great data collection about profession-specific suicide Suicide is the leading cause of death in male residents and the 2nd leading cause of death in female residents This represents a serious loss of the medical profession as well as the thousands of patients who lose their physician as well    Risks factors for physician suicide   Psychological: Physicians tend be contentious, perfectionistic, and compulsive. They are able to cope with delayed gratification, and this may lead to a false sense of ability to cope with all obstacles, without failures. Medicine presents physicians with many obstacles such as the deaths of our patients and human frailty. Human imperfection and physician failures are juxtaposed against these traits listed above Historical and genetic risk factors: Past suicide attempt and presence of mood disorder Untreated depression is an especially high risk for physicians as they may leave their mental illness untreated due to stigma As of 2017, 32 of 48 state licensing boards continue to question doctors about their mental health history. There is increased risk of suicide with the presence of the long arm version of the serotonin transporter gene and history of childhood trauma Workplace risk factors: Physicians identify electronic medical records (EMR) and increased documentation demands as contributing to burnout and less job satisfaction EMR means that doctors feel like they spend more time with records than face to face with patients. With EMR there is less eye contact and direct connection with patients so it’s hard to foster relationships Physicians feel the stress of increased use of technology and connectivity via cell phones and the need to “keep up”    Change in culture As a profession we are starting to talk about physician suicide; acknowledgment of the issue can lead to change. ACGME and other workplaces are starting to integrate physician wellness into curriculums and culture. References:  NCHS Data Brief No. 330. 2018 Nov.“Suicide mortality in the United States, 1999-2017” Yaghmour, NA et al. Acad Med. 2017 Jul. 92(7):976-83.“Causes of death of residents in ACGME-accredited programs 2000 through 2014” Implications for the learning environment” Babbott S et al. J Am Med Inform Assoc. 2014 Feb;21(e1):e100-61. Electronic medical records and physician stress in primary care: Results from the MEMO Study” Gold KJ et al.Gen Hosp Psychiatry. 2013 Jan-Feb;35(1):45-9. “Details on suicide among U.S. physicians: Data from the National Violent Death Reporting System” ACGME Symposium on Physician Well-Being

Lorenzo Norris, MD, host of the MDedge Psychcast and editor in chief of MDedge Psychiatry, interviews the psychiatry residents who produce the PsychEd podcast, which as they put it, is “created by medical learners, for medical learners.” Dr. Norris speaks with some of the members of PsychEd podcast team: Sarah Hanafi, MD, a first-year resident in psychiatry at McGill University, Montreal; Alex Raben, MD, a fourth-year resident in psychiatry at the University of Toronto; Lucy Chen, MD, a fourth-year psychiatry resident at the University of Toronto; and Bruce Fage, MD, a fifth-year psychiatry resident at the University of Toronto. And later, in the “Dr. RK” segment, Renee Kohanski, MD, discusses the role of the placebo in the modern setting. Dr. Kohanski is a member of the MDedge Psychiatry Editorial Advisory Board and is a psychiatrist in private practice in Mystic, Conn. Show Notes by Jacqueline Posada, MD, who is a consultation-liaison psychiatry fellow with the Inova Fairfax Hospital/George Washington University program in Falls Church, Va. Why podcasting? The PsychEd podcast originated when the team identified a gap in podcast-mediated learning for psychiatry trainees. In psychiatry, there have been podcasts that reviewed recent publications, but none that examined foundational topics. Other specialties, such as emergency medicine, have several podcasts covering basic topics aimed at trainees. Podcasts are identified as an asynchronous educational material. They are a medium that can be used in “downtime,” especially because many trainees commute or have other time during which they can consume information. At the American Psychiatric Association’s 2019 Annual Meeting, the PsychEd team presented on the integration of podcasting into medical education. Materials should focus on digital natives vs. digital immigrants. In 2015, one research group polled emergency medicine residents and found a differential in the use of podcasts; 90% of users were residents and 45% were program directors. Podcasts are a supplement to other types of learning Podcasts can distill information as well as engage with information and experts in an alternative fashion. Podcasts are efficient in their use of time and broaden listeners’ exposure to information and experts. Podcasts offer one modality of learning and are not meant to replace other sources. Resources should focus on what information is needed and be tailored to where students, residents, and all learners spend their time. PsychEd beginnings After the team identified the need for a psychiatry education–focused podcast, they started meeting to create an environment for collaboration. Learning how to podcast – using the equipment, editing the recording, and uploading to relevant platforms – was the hardest part. All PsychEd podcasting is done “live.” The team takes their recording equipment to the experts they interview. Presently, their guests are located in Toronto. The team has expanded to Montreal with a new team member, Sarah Hanafi, a first-year psychiatry resident at McGill University. Formatting The podcast started with a case-based format, using a composite case presented to an expert, followed by a junior learner asking questions. Now the team does more prep work to create a structured script that includes educational objectives. Using a script allows for the interview to flow in a more organized structure, which makes for easier editing. Meeting and preparing the script with experts demands time and preparation in order to create the milieu for a generative interview. Most often, the “pearls” come from the unscripted questions that elicit reflections. Experts have been willing and excited to participate in the podcast and to disseminate their knowledge in a format that will reach trainees. PsychEd topics So far, PsychEd has covered basic topics of psychiatry, including major depressive disorder, schizophrenia, bipolar disorder, and anxiety, and it is now expanding to more complex topics. An initial idea was to incorporate the patient perspective to add nuance to the foundational-level topics. Listeners were indifferent to this idea since they already encounter the patient experience on a regular basis and incorporating the patient voice did not necessarily target the educational content. This scenario illustrates in difficulty of choosing topics: Subject matter that will draw in listeners but also are creative and add meaning. There is space for societal topics in psychiatry such Big Data, climate change, technology, and loneliness. PsychEd has been awarded a grant through the University of Toronto to expand subject matter focused on clinical skills to target priorities identified by the Royal Board of Canada through its “Competency by Design” initiative. Other challenges in podcasting Choosing topics is a balance of identifying cutting-edge topics vs. issues universal to all psychiatrists. Should popular topics be revisited? Deciding how to identify topics that can enhance learning but are also professionally enriching to the psychiatrist as an individual. What personal growth has come from podcasting? Learning leadership skills: Leading a small team to create a quality podcast and then expanding to research about the impact. Providing a creative outlet both in content and thinking about the scope of scholarship within psychiatry. Enhancing time management and learning how to juggle interests outside of clinical work. Understanding how to access rich local resources, ranging from experts to other trainees who want to podcast and contribute. Broadening one’s vision and perspective by talking with thought leaders: As psychiatrists, our work resonates with similar themes, and it’s inspiring to talk to others about universal themes. References The PsychEd podcast: https://www.psychedpodcast.org/ Mallin M et al. A survey of the current utilization of asynchronous education among emergency medicine residents in the United States. Acad Med. 2014 Apr;89(4):598-601. Matava CT et al. eLearning among Canadian anesthesia residents: A survey of podcast use and content needs. BMC Med Educ. 2013 Apr 23;13:59. Riddle J et al. A survey of emergency medicine residents’ use of educational podcasts. West J Emerg Med. 2017 Feb; 18(2): 229-234.   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych  

Recap of random pearls and highlights from SGIM19 Day 2 including: methadone and buprenorphine, perioperative buprenorphine, medical cannabis, HPV vaccination, young adult medicine, academic promotions, long term sequelae of childhood kidney disease, stage 1 hypertension, some great free resources in addiction medicine, and more! Special thanks to the Society for General Internal Medicine for their hospitality. Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written, produced, and cohosted by: Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Nora Taranto MS4 (soon to be MD!) Edited by: Matthew Watto MD Time Stamps and Links are included below 00:00 Intro and Disclaimer 02:30 Generalists receive the same number of grants, but publish fewer publications and are less likely to achieve professorship versus medical or surgical subspecialists (JGIM 2017) 05:30 GIM division directors differ in their emphasis on peer-reviewed publications for academic promotion (Acad Med 2015) 07:30 Only about 30% of patients are started on MAT after an overdose despite a known mortality benefit and a known mortality rate of 5% twelve month mortality in this population (Larochelle Annals Int Med 2018) 08:48 A representative in NYC has proposed a bill to get rid of the buprenorphine waiver program. 11:00 Stimulant use is not a contraindication to continuing buprenorphine (expert opinion from SGIM session on Addiction Medicine). 11:45 Perioperative buprenorphine: 1) Consider switching to full agonist therapy or 2) Dose buprenorphine 3-4 times daily and continue use during the perioperative period (Expert opinion from SGIM session titled “Buprenorphine 2.0”) 12:40 Options to transition from methadone to buprenorphine: Option 1) Taper methadone to 30-40 mg once daily. Then, hold methadone for 72 hours before starting buprenorphine. Option 2) “Microdosing” with buprenorphine patch while still on methadone and then start oral buprenorphine. Note: This is expert opinion so consult with your local expert before attempting this on your own! 13:46 UCSF has a “Warm Line” for free consultation about substance use https://nccc.ucsf.edu. Get a free buprenorphine waiver from https://pcss.org 15:10 New joint guidelines on transitions remind providers that young adults need help navigating the healthcare system. Many young adults have never accessed healthcare resources on their own (Pediatrics 2018) 18:50 Childhood kidney disease increases risk for end stage renal disease as an adult (NEJM 2018) 20:35 Two studies concluded that stage 1 hypertension in young adults confers an increased risk for morbidity and treating it confers a benefit (Yano AMA 2018; Son JAMA 2018) 23:35 HPV update: The 9 valent vaccine was approved for young adults age 27-45 years old, but this has not yet made it into the guidelines. The HPV vaccine is effective for preventing cervical cancer (Cochrane Review 2018) and provides some herd immunity (Clin Inf Dis 2018) 26:40 Dr Chan offers tips on how to handle resident mistreatment and phrases that you can use to defuse the situation. 31:30 Some broad comments on the use of medical cannabis for pain management (Expert opinion from SGIM session) 36:30 Newer data suggests that even one drink daily might have adverse health outcomes (Lancet 2019). 39:00 Outro Citation Paul Williams MD, Matthew Watto MD, Justin Berk MD, Carolyn Chan MD, Shreya Trivedi MD, Nora Taranto MS4. Recap SGIM19 Day 2”. The Curbsiders Internal Medicine Podcast https://thecurbsiders.com. May 17, 2019.

In our January episode, #thisisourlane, we spoke with Dr. Garen Wintemute about firearm violence, and discussed the immediate and passionate social media outpouring from physicians in response to an NRA tweet. In this episode, we dive deeper into the topic of physician advocacy, and, more specifically, the role of social media in advocacy. Our guest, Dr. Megan Ranney, is an emergency medicine physician, educator, and digital health and public health researcher, and is an avid social media user herself. She discusses the power of social media to affect change, and offers some tips for how to make your voice heard, and how to navigate some of the pitfalls. Listen through to the end for thoughts from some other well known EM physicians, including Drs. Mike Gisondi, Steve Bird, and Nikita Joshi. How do you use social media? What do you think about health care professionals using social media for advocacy? Tell us how you’re getting involved - or why you’re staying away! Find us on social media as @empulsepodcast, or on our website, ucdavisem.com.  Please subscribe and rate us on iTunes - it helps us reach more people!  Hosts: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Guest: Dr. Megan Ranney, Associate Professor of Emergency Medicine at Brown University, Chief Research Officer at AFFIRM Research Featuring: Dr. Harrison Alter, Research Director for the Highland Department of Emergency Medicine and Founder and Executive Director of the Levitt Center  Dr. Mike Gisondi, Vice Chair of Education for the Department of Emergency Medicine at Stanford University Dr. Vishnu Parthasarathy, Emergency Medicine Resident at UC San Diego Dr. Steve Bird, President of SAEM, Vice Chair of Education at UMass Medical School Dr. Linda Herman, Emergency Medicine Residency Program Director at Kaweah Delta Dr. Nikita Joshi, Emergency Medicine Faculty at Alameda Health System Resources: AFFIRM Research Mayo Clinic 12 Word Social Media Policy Cyberbullying in Academic Medicine: A Framework for Managing Social Media Attacks. Cain J, Linos E, Chretien KC. Acad Med. 2019 Mar 26. doi: 10.1097/ACM.0000000000002649. [Epub ahead of print] Twitter as a tool for communication and knowledge exchange in academic medicine: A guide for skeptics and novices. Choo EK, Ranney ML, Chan TM, Trueger NS, Walsh AE, Tegtmeyer K, McNamara SO, Choi RY, Carroll CL. Med Teach. 2015 May;37(5):411-6. doi: 10.3109/0142159X.2014.993371. Epub 2014 Dec 19. It's Time for More Physicians to Embrace Advocacy, a Scientific American blog post by Dr. Angira Patel, March 13, 2018. ACEP Firearm Safety and Injury Prevention Policy Statement What You Can Do Dr. Julia Magaña and Dr. Sarah MedierosDr. Megan RanneyDr. Mike GisondiDr. Steve BirdDr. Harrison Alter *************************************** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

In this episode of the MDedge Psychcast, Sidney Zisook, MD, gives a Masterclass lecture on physician suicide and Dr. RK talks about what can be spoken into existence.  If you have ideas, suggestions, questions for Dr. Norris or Dr. RK, or feedback for the show, please email us at podcasts@mdedge.com. You can also follow us on Twitter @MDedgePsych.   Show NotesBy Jacqueline Posada, MD Introduction Suicide in general population increased by 30% since 1999. The suicide rate was 14 people in every 100,000 up from 10.5 people per 100,000 in 1999. 400 physicians die per year. However, there is not great data collection about profession-specific suicide Suicide is the leading cause of death in male residents and the 2nd leading cause of death in female residents This represents a serious loss of the medical profession as well as the thousands of patients who lose their physician as well    Risks factors for physician suicide   Psychological: Physicians tend be contentious, perfectionistic, and compulsive. They are able to cope with delayed gratification, and this may lead to a false sense of ability to cope with all obstacles, without failures. Medicine presents physicians with many obstacles such as the deaths of our patients and human frailty. Human imperfection and physician failures are juxtaposed against these traits listed above Historical and genetic risk factors: Past suicide attempt and presence of mood disorder Untreated depression is an especially high risk for physicians as they may leave their mental illness untreated due to stigma As of 2017, 32 of 48 state licensing boards continue to question doctors about their mental health history. There is increased risk of suicide with the presence of the long arm version of the serotonin transporter gene and history of childhood trauma Workplace risk factors: Physicians identify electronic medical records (EMR) and increased documentation demands as contributing to burnout and less job satisfaction EMR means that doctors feel like they spend more time with records than face to face with patients. With EMR there is less eye contact and direct connection with patients so it’s hard to foster relationships Physicians feel the stress of increased use of technology and connectivity via cell phones and the need to “keep up”    Change in culture As a profession we are starting to talk about physician suicide; acknowledgment of the issue can lead to change. ACGME and other workplaces are starting to integrate physician wellness into curriculums and culture. References:  NCHS Data Brief No. 330. 2018 Nov.“Suicide mortality in the United States, 1999-2017” Yaghmour, NA et al. Acad Med. 2017 Jul. 92(7):976-83.“Causes of death of residents in ACGME-accredited programs 2000 through 2014” Implications for the learning environment” Babbott S et al. J Am Med Inform Assoc. 2014 Feb;21(e1):e100-61. Electronic medical records and physician stress in primary care: Results from the MEMO Study” Gold KJ et al.Gen Hosp Psychiatry. 2013 Jan-Feb;35(1):45-9. “Details on suicide among U.S. physicians: Data from the National Violent Death Reporting System” ACGME Symposium on Physician Well-Being

In this episode we reflect on the past year and how to get the results we want in the New Year.  We reinforce, review, and build on some of the tools and information we have discussed thus far in the podcast and put them all together to purposefully create a great new year. References https://www.history.com/news/the-history-of-new-years-resolutions Xu JQ, Murphy SL, Kochanek KD, Bastian B, Arias E. Deaths: Final data for 2016. National Vital Statistics Reports; vol 67 no 5. Hyattsville, MD: National Center for Health Statistics. 2018. Yaghmour, N, Brigham, T, Richter, T; Miller, R, Philibert, I, Baldwin, D, Nasca, T. Causes of Death of Residents in ACGME-Accredited Programs 2000 Through 2014: Implications for the Learning Environment. Acad Med. 2017;92:976–983. This episode also offers an opportunity to win $100 gift cards by leaving an itunes review and letting me know you did so by entering your information at empoweringwomenphysicians.com/reviews. If you have any trouble accessing that site, just email me at sunny@empoweringwomenphysicians.com.

This is the 2nd paper reviewed for KeyLIME LIVE at AAMC in Texas. Linda Snell's chose this article to discuss teaching of technical skills. See one, do one, mess it up? Do one first?  Or see one, do a few and get better with practice and feedback?  Authors: Kulasegaram K et. al.,  Publication details: Do one then see one: Sequencing discovery learning and direct 1 instruction for simulation-based technical skills training Acad Med. 2018 Nov;93  View the abstract here Follow our co-hosts on Twitter!  Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Want to learn more about KeyLIME? Click here!

https://accadandkoka.com/wp-content/uploads/2018/09/TonelliM-e1537221101918.jpg ()Mark Tonelli, MD Can anyone question evidence-based medicine and not be considered some kind of fringe lunatic?  Fortunately it’s possible, as will be demonstrated by our guest, Mark Tonelli, professor of medicine from the University of Washington, and one of the earliest, most thoughtful, and most articulate academic critic of the EBM dogma. Dr. Tonelli holds a BA in philosophy form the University of Colorado in Boulder and a medical doctorate from the University of Colorado in Denver.  He is the author of numerous peer-reviewed articles and book chapters on various aspects of medical science and medical philosophy.  His critique of EBM and his proposal for “case-based reasoning” are both cogent and compelling. GUEST: Professor Mark Tonelli’s faculty http://depts.washington.edu/pulmcc/directory/bio/tonelli.html (Website) LINKS: Mark Tonelli. https://youtu.be/IPgrn2ACWuI (The limits of evidence-based medicine.) (Video of Grand Rounds lecture, University of Washington, 2016) Tonelli MR.  https://accadandkoka.com/wp-content/uploads/2018/09/EBM.casuistry.pdf (Integrating evidence into clinical practice: an alternative to evidence-based approaches). (pdf of paper in J Clin Eval Pract 2006) Tonelli MR.  https://philpapers.org/archive/TONTPL.pdf (The philosophical limits of evidence-based medicine). (pdf of paper in Acad Med 1998) Accad M and Francis D.  https://www.bmj.com/content/362/bmj.k2799.full?ijkey=PeMeQDKT6KUKXYH&keytype=ref (Does evidence-based medicine adversely affect clinical judgment?) (BMJ 2018) NOTE: Dr. Tonelli will kindly make a copy of his book chapter on case-based reasoning available upon request.  You may contact him via his professional website above. WATCH ON YOUTUBE: https://youtu.be/nGSdpOoA2_8 (Watch the episode) on our YouTube channel. Support this podcast

Jon's paper seeks to inform scholars about common reasons for internal editor review rejections, which will hopefully stop letters that start like this 'Dear So and So, Thank you for your submission. Our journal receives many more submissions than it can publish. Unfortunately, we are unable to publish your manuscript'. Authors: Meyer HS, Durning SJ, Sklar D and Maggio LA Publication details: Making the First Cut: An Analysis of Academic Medicine Editors' Reasons for Not Sending Manuscripts Out for External Peer Review. Acad Med. 2017 Aug 1. [Epub ahead of print] View the abstract here Follow our co-hosts on Twitter!  Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Want to learn more about KeyLIME? Click here!

Linda presents two papers in order to answer two questions... How Attending Physicians Negotiate Their Work Environment – “to generate an empiric, detailed, and updated view of the attending physician preceptor role and its interface with the complex work environment.” How evidence from observing attending physicians in the workplace links to a competency-based framework (CanMEDS competencies / Roles) Article 1) Authors: Bacchus M, Ward DR, de Grood J, Lemaire JB Publication details: How evidence from observing attending physicians links to a competency-based framework Med Educ. 2017 Jun; 51(6):633-644. Article 2) Authors: Lemaire JB, Wallace JE, Sargious PM, Bacchus M, Zarnke K, Ward DR, Ghali WA. Publication details: How Attending Physician Preceptors Negotiate Their Complex Work Environment: A Collective Ethnography. Acad Med. 2017 Jun 20. [Epub ahead of print] View the abstract here Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Want to learn more about KeyLIME?

Jason’s chosen article for today’s podcast discusses the assessment tool ITERs and documented narratives. Often ITERs are horribly misused but are still deployed as institutions need to record that a trainee was present and competencies were achieved.   Authors: Hatala R, Sawatsky AP, Dudek N, Ginsburg S, Cook DA. Publication details: Using In-Training Evaluation Report (ITER) Qualitative Comments to Assess Medical Students and Residents: A Systematic Review. Acad Med. 2017 Jun;92(6):868-879. View the abstract here Follow our co-hosts on Twitter! Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Want to learn more about KeyLIME?

*Author’s Note: Some KeyLIME podcast followers will find this a tough episode to discuss.*  Issues of the wellness of health care providers are an increasingly discussed in medical education. The stressors and impact of medical practice on physician health have been documented for decades. So perhaps it is time to document the “mortality rate” of medical training… Jason's selection for this podcast, from Yaghmour et al in Academic Medicine, sets out to study and characterize US resident (postgraduate) trainee deaths from 2000-2014. Authors: Yaghmour NA, Brigham TP, Richter T, Miller RS, Philibert I, Baldwin DC Jr, Nasca TJ. Publication details: Causes of Death of Residents in ACGME-Accredited Programs 2000 Through 2014: Implications for the Learning Environment. Acad Med. 2017 Jul;92(7):976-983. PubMed Link View the abstract here Follow our co-hosts on Twitter!  Jason R. Frank: @drjfrank  Jonathan Sherbino: @sherbino  Linda Snell: @LindaSMedEd  Want to learn more about KeyLIME? Click here!

I was very fortunate to be able to record this conversation with Dr Patricia Miller of McMaster University, in which we explored Pat’s extensive experience in researching, teaching and assessing reflection with physiotherapists. Her key messages in this conversation are that: Reflection is a key skill and activity for professional physiotherapists to improve practice. Studies have shown an individual’s quality and depth of reflection distinguishes novice from expert practitioners. Reflection is about seeking and exploring alternative perspectives and is supported by involving others (peers, mentors, tutors, family etc) and also by using a framework that challenges your thinking. She clarifies the difference between reflection in-action (during practice) and reflection on-action (after the event). The Canadian Physiotherapy Association Clinical Specialty Program includes the evaluation of the candidate’s ability to use clinical reflection in their practice because clinical reflection is integral to the practice of a clinical specialist and leader in their field. If you struggle with reflection or are embarking on a written reflection as part of your studies, for annual registration requirements or as part of the CPA Clinical Speciality Program I think you will both enjoy and benefit from listening to this enlightening conversation To find out more about Pat and connect with her see: Pat Miller’s ResearchGate profile https://www.researchgate.net/profile/Patricia_Miller6 Patricia Miller’s LinkedIn profile https://www.linkedin.com/in/pat-miller-291b0a39 Pat also refers to and recommended the following additional sources of information regarding reflection: Paterson C, Chapman J. Enhancing skills of critical reflection to evidence learning in professional practice. Physical Therapy in Sport. 2013 Aug 31;14(3):133-8. (In particular the appendices) Wainwright FS, Shepard KF, Harman LB, Stephens J. Novice and experienced physical therapist clinicians: a comparison of how reflection is used to inform the clinical decision making process. Physical Therapy 2010;84(7):830-7. Wald HS, Borkan JM, Taylor JS, Anthony D, Reis SP. Fostering and evaluating reflective capacity in medical education: developing the REFLECT rubric for assessing reflective writing. Acad Med 2012;87(1):1-10. Donaghy M, Morss K. An evaluation of a framework for facilitating and assessing physiotherapy students’ reflection on practice. Physiotherapy Theory and Practice, 2007; 23(2):83-94. Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education: a systematic review. Adv Health Sci Educ Theory Pract 2009;14(4):595-621. Sandars J. The use of reflection in medical education: AMEE Guide No. 44. Med Teacher 2009;31:685-95. Williams RM, Wessel J, Gemus M, Foster-Seargeant E. Journal writing to promote reflection by physical therapy students during clinical placements. Physiotherapy Theory And Practice 2002; 18 (1): 5-15..

In our June journal club podcast Ben and Vic discuss the paper of the month.  Cheng et al. “Coaching the Debriefer: Peer Coaching to Improve Debriefing Quality in Simulation Programs” Simulation in Healthcare : The Journal of the Society for Simulation in Healthcare. Publish Ahead of Print, POST AUTHOR CORRECTIONS, 20 May 2017  Ben summarised the blog discussion and Walter Eppich’s expert opinion.    We then reviewed some recent papers  Roussin CJ1, Weinstock P.  SimZones: An Organizational Innovation for Simulation Programs and Centers. Acad Med. 2017 May 30. doi: 10.1097/ACM.0000000000001746. [Epub ahead of print]  And  Bong et al. The effects of active (hot-seat) versus observer roles during simulation-based training on stress levels and non-technical performance: a randomized trial. Advances in Simulation (2017) 2:7  DOI 10.1186/s41077-017-0040-7  (Open Access)  And Ben introduced next month’s paper on simulation faculty development.  Looking forward to another great discussion   Vic 

In an effort to streamline blog posts, we are continuing a merged Journal Club Podcast and monthly wrap post. Please read our pdf summary of the May Journal Club article, the month’s discussion and our expert commentary here   In our May journal club podcast Ben and Vic discuss the papers of the month – a duo on Rapid Cycle Deliberate Practice and the approach to debriefing in this format Structuring feedback and debriefing to achieve mastery learning goals Eppich WJ1, Hunt EA, Duval-Arnould JM, Siddall VJ, Cheng A. Acad Med. 2015;90:00–00.  First published online doi: 10.1097/ACM.0000000000000934 Pediatric resident resuscitation skills improve after “Rapid Cycle Deliberate Practice” training Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, Shilkofski NA. Resuscitation. 2014 Jul;85(7):945-51. doi: 10.1016/j.resuscitation.2014.02.025. Epub 2014 Mar 4.   We then reviewed some recent papers Theilen, Ulf et al.Regular in-situ simulation training of paediatric Medical Emergency Team leads to sustained improvements in hospital response to deteriorating patients, improved outcomes in intensive care and financial savings. Resuscitation , Volume 115 , 61 - 67 A nice segue from Hunt et al – translating outcomes from individual performance improvement to patient and systems level outcomes   Maicher, Kellen et al. Developing a Conversational Virtual Standardized Patient to Enable Students to Practice History-Taking Skills. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: April 2017 - Volume 12 - Issue 2 - p 124–131 One for the technology enthusiasts – using AI/ natural language processing to create patients we can have conversations with. Make sure you watch movies like Ex Machina and Passengers for your background reading    And Ben introduced next month’s paper on peer coaching. Cheng, Adam et al. “Coaching the Debriefer: Peer Coaching to Improve Debriefing Quality in Simulation Programs” Simulation in Healthcare : The Journal of the Society for Simulation in Healthcare. Publish Ahead of Print, POST AUTHOR CORRECTIONS, 20 May 2017   Looking forward to another great discussion Vic

  In our April journal club podcast Ben and Vic discuss the paper of the month – a classic debriefing article.   Jenny W. Rudolph, PhD, Robert Simon, EdD, Ronald L. Dufresne, MS, and Daniel B. Raemer, PhD There’s No Such Thing as “Nonjudgmental” Debriefing: A Theory and Method for Debriefing with Good Judgment. Simulation in Healthcare • Volume 1, Number 1, Spring 2006    We then reviewed some recent papers  The Simnovate series - all FREE for now Rajesh Aggarwal. Simnovate: simulation, innovation and education for better healthcare. BMJ Simulation and Technology Enhanced Learning Mar 2017, 3 (Suppl 1) S1-S2; DOI: 10.1136/bmjstel-2016-000184  Philip H Pucher, et al. Simulation research to enhance patient safety and outcomes: recommendations of the Simnovate Patient Safety Domain Group. BMJ Simulation and Technology Enhanced Learning Mar 2017, 3 (Suppl 1) S3-S7;   Wayne Choi, et al. Engagement and learning in simulation: recommendations of the Simnovate Engaged Learning Domain Group. BMJ Simulation and Technology Enhanced Learning Mar 2017, 3 (Suppl 1) S23-S32; DOI: 10.1136/bmjstel-2016-000177  Simulation Fellowship Programs: An International Survey of Program Directors.  Natal, Brenda MD, MPH; Szyld, Demian MD, EdM; et al. Academic Medicine April 4, 2017  An Innovative Approach: Using Simulation to Teach Primary Care Gynecologic Procedures. Hellier, Susan D. et al. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare January 9, 2017    And Ben introduced next month’s 2 papers – a complementary duo focused on Rapid Cycle Deliberate Practice.  Structuring feedback and debriefing to achieve mastery learning goals Eppich WJ1, Hunt EA, Duval-Arnould JM, Siddall VJ, Cheng A. Acad Med. 2015;90:00–00.  First published online doi: 10.1097/ACM.0000000000000934  Pediatric resident resuscitation skills improve after “Rapid Cycle Deliberate Practice” training Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, Shilkofski NA. Resuscitation. 2014 Jul;85(7):945-51. doi: 10.1016/j.resuscitation.2014.02.025. Epub 2014 Mar 4.    Looking forward to another great discussion   Vic