Tuesday, April 17, 2012

Future of postgraduate med education

This project is a consortium of different colleges of education
They created 10 recommendations and transformative actions

http://www.afmc.ca/future-of-medical-education-in-canada/

I liked the 7th recommendation: "develop,support and recognize clinical teachers"

Interesting-such a big document, but the microphones were open for any inputs or comments. Good how things are built here.

How to implement this? A speaker commented on the need of sharing resources to focus on specific topic depending on what one group pr hierarchic level may work on- altogether the objectives will be achieved.
The hidden curriculum of teachers was touched- after students evaluation and their feedback,negative results may affect future promotion -hoe the university support that? Also what about the time to teach not considered as relevant as the clinical?

What about specialties residents-how to distribute them and use them? Has to do with radiology residents.

Nice reflection and work on med education and social repercussion of that.

Workshop Patient safety and post grad education

Dr A Nakajima Dr V Neira Dr N Caccia

This is a topic 100%present in practice

"CPSI"
-www.patientsafetyinstitute.ca

Reflection on the Relation between six domains of patient safety and the CanMed competencies model for students- which are required for each domain of pat safety?
Would it be necessary to have a specific competency on that?

Disclosure- what do we tell things to the patients? How? What is harm?:impairement
http://www.patientsafetyinstitute.ca/english/toolsresources/disclosure/pages/default.aspx
A change in terminology complicated even more the discussion: interpretation of certain words...

Are we teaching that?

Definitions...pat safety incident
-harmful incident
-not harmful incident
-near miss:it did not reach the patient

Exercise of disclosure-we created a module of education about pat safety

Video in open school inst. health improvement about consequences
http://www.ihi.org/offerings/ihiopenschool/Pages/default.aspx

Interesting and very useful workshop. Heavy framework based on stablished documents and definitions. The practical exercise proved the value of those concepts, although I think one do not need to be limited by them do have some initiative on pat safety education.

Workshop:deconstructing communication

Dr M Gomes Dr R Padmore
-Possible serious Consequences of comm breakdown!
Nejm 91 - adverse events fiest paper on consequences
N Zealand -comm errors are a result of systemic problems. Comm problems involv both transmission and reception (as in communication theory)

Deconstruction of comm
-what is the specific process?
-when it starts and finishes?
-which are the comm steps?
- where are possible flaws?
-how to improve it and make it safe?

-Com failures in OR:observation classf recurrent types and effects
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1743897/pdf/v013p00330.pdf

-occasion fail-situation or context of comm-wrong moment
-content fail-lack or inaccuracy of info
-purpose-why the comm happenrd if nothing was done?purpose is unclear
-audience fail-gaps in composition of group engaged in the comm

-eval of preop checklist 2008 Lingard
Improved results of communication?

How to improve: Briefing?Checklist? Debriefing? Three diff tactics

-2/3 of com failure did not cause Immediate result-but encourages migration from a safety zone to a dangerous zone in which BAD results are very probable

Model-trapezium at the circus - four points to close the loop safelly(both hands of two artists)

CCME - Workshop on Diagnostic reasoning

Great facilitator's job (Dr Fisher and Dr Rolfson- U Alberta)

The analytic x non-analytic (intuitive) lines of though and their interaction towards the diagnostic reasoning.

What makes an expert - Model - After the detection of the problem context, has the ability of rendering a core knowledge to   formulate questions and solve them through an internal  model of "scripts", searching a "best-fit" interactively - all this is in the "intuitive" side of the thought  - when a true doubt appears that toggles or signal the analytic component, which will look for a solution and feedback it to the non-analytical part, until there is a satisfactory solution. An expert does that in the most efficient and shortest way, using only sufficient and necessary elements for the decision (therefore optimizing the time of this whole process)
Heuristics - "rules of the thumb" - shortcuts to the solution. They are embedded with bias and possible errors, and although they are the key of a fast solution, care should be taken to minimize the risks

Some other concepts such as Syntax of the problem and Semantics of the information were also discussed, and it culminated in practical interesting role-playing examples in the room.

This was a top workshop...

I think that an approach through reasons of probability and predictive values and the dance of sensitivities/specificities and pattern recognition we do in radiology is also another nice model of diagnostic reasoning. Fist time I heard that was in med school (5th year) through our internal medicine teacher Dr Francisco Aguiar. His explanation was so simple and clear that the concept was learned at once, imprinted and never more forgotten.

Monday, April 16, 2012

Number of physicians in Canada x origin

Response to task force I on Physician supply in Canada
Debrj Das BMSc U Alberta

More than medicine- global health in a complex world

Dr S Nutt
Interesting info
-600.000 riffles in world. Cost in Somalia less than 50 Us$/weapon
-1billion variable light weapons.
-70 percent with non official forces or civilians

Those are issues beneath African health. Check http://controlarms.com

Another one- this mineral is right here in my hand -
http://www.cbc.ca/news/technology/story/2010/12/10/coltan-faq.html

Her Suggestions for students: 1) read one world news everyday 2) contribute 3) social responsible consumer 4) keep asking the questions about the disparity

Beautiful and provoking lecture specially in the Canadian context. But with respect I'm not shure of what is the final objective. If the direct health attentions are not actually to be palliative, is there a wish that Africa should be "cured" ?. The garbage may actually be right at the backyard...


Ccme 1

CCME

Web based learning workshop

From Netter to iphone...
But no one has yet proved web based learning is better than other tools ...likely it's mainly a complement. But is it worse?

Authority on the theme Dr Cook http://etd.uwc.ac.za/usrfiles/modules/etd/docs/etd_init_6813_1173965430.pdf

Apps-apple in the game:ibooks to create your own book for students

http://sites.wiki.ubc.ca/etec510/Web-Based_Strategies

Amazing example
www.wix.com/evanlewis26/site
18 Jan 2012 – Anatomical Lesion Verifier in Neurology (ALVIN). Coming soon! American Academy of ..

In the workshop we developed the concept of an undergraduate student
Learning module
http://www.mededconference.ca/home.php

That's where I am now - The CCME (Canadian Conference on Medical Education) in Banff

Welcome to MSkases & More !

This blog is about Musculoskeletal Radiology, Medical Education and sometimes about other things of the medical universe

If you are a radiology, orthopedics or rheumatology resident or fellow, medicine or any other type of health care student or professional and you enjoy or are interested in MSK radiology, this is particularly for you

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