#MedEd Defining & defending the finish line of #competency in #CBME is fascinating. It's like balding👨‍🦲 When a trainee is incompetent (stage 1), it's obvious. When they're fully competent (stage 8), it's also obvious. We just can't agree at what point / stage it happens

All feedback of instruction should be video-based imo Some things we just can’t unsee. But more importantly opens door to appreciative inquiry and advances the mental model of teaching. Question is… what’s the biggest barrier to high quality, instructional coaching?

Can you achieve both valid AND authentic assessment in #MedEd? Or by choosing one, do you have to compromise on the other? #Heisenbergprinciple #CertainUncertainties #Fragileconstructs

Cory Rohlfsen Your comments reminded me of the paper by Carlos F. Collares. This could be one of the most underrated papers in #MedEd, though (and possibly because) it requires having some deeper understanding on the fundamentals of assessment. link.springer.com/article/10.100…

#Scriptsfornewdocs ‘Tell me your understanding of the plan based on what _____ (🫁, 🫀, 🦴, 🦠) team told you…’ Never assume. Sometimes trust. Always verify. #Teachback is #Teamwork when it comes to patient communication.

#MedTwitter What lobby supports ophtho? Me: "Type 2 DM with retinopathy, w/ long-term current use of insulin (E11.319, Z79.4)" EMR: "This is too generic for billing. Choose a more specific diagnosis" Me: scrolling 👇 EMR: Me: look up ophtho notes, can't decipher, click!

PGY 1 vs PGY 2 on July 1

Is there an equivalent of #TwiddlerSyndrome for tunneled HD lines? Joel M. Topf, MD FACP Helbert Rondon, MD, MS, FACP, FASN, FNKF Swapnil Hiremath @[email protected] #AskNeph annemergmed.com/article/S0196-… thelancet.com/journals/lance…

#MedEd Friendly reminder as you consider your #feedback to residents or fellows tomorrow after the longest month of the academic calendar year. It’s ok to be effusive in praise 😊 Don’t hold back.

Best PGY quote of the year as I *attempted* to teach the team why it’s unwise to do bilateral thoras at the same time… Me: ‘God gave us 2 🫁 for a reason, let’s not try to outsmart him.’ PGY1: ‘If God was so smart, why didn’t he give us 4 🫁 🫁? Me: Touché 😂 😂 🤣

#MedEd The #clinicallearningenvironment is not a monolith. It’s a living, breathing, dynamic place. Changing minute to minute. Because humans are beautiful & messy, the only norm is chaos. Would a more adequate description help bridge the gap between evidence & practice?

Because MASCC has 💪 negative predictive value, I will anxiously be awaiting real world QI efforts to see if this decreases otherwise unnecessary 🏥 stays. These pts want to be at home for as long as possible. Our anxiety shouldn’t keep low risk pts when it’s safe to dc.

#MedEd #Assessment🔮 In the past, assessment described learning Nowadays, assessment drives learning In the future, assessment will design learning #Precisionlearning starts with #Precisionassessment

My pt whose pain was well controlled for yrs on 3x daily gabapentin disagrees with this. Out of the blue, PBM EmpiRx Health says 2x daily dose should suffice. When I appealed bc his pain is poorly controlled PBM ‘advocacy’ was ‘sorry criteria not met’ He’s still in pain.

This is good advice. Whatever you’re willing to jump out of bed for time & time again without tiring, that’s a good sign you’ve found something special. Medicine is a marathon🏃 Best to choose something that makes you feel alive 💪

#MedTwitter Medicine is more fun & rewarding when you know which rules can and cannot be broken. We should be more transparent about this when teaching.

Lots of fun chatter on #MedTwitter today on diagnostic inertia. It starts sooner than you think. We need better vocabulary to define a ‘leading’ question. Once in a framework, one could argue all deductive Qs are leading.

What if the LDL is 200?