Intern Half Day: Sepsis & Shock

Time: 45 minutes

Audience: Internal Medicine Interns at the University of California - San Francisco

Learning Objectives:

• Discuss the diagnosis and diagnostic pitfalls of sepsis

• Develop a framework for the management of septic shock

• Review post-sepsis care and outcomes after the ICU

Please click on the above image to view the slides

Evaluations: Participant Evaluations 2022

Reflections: I adapted this talk from prior iterations given by others. This was a challenge to cover practical tips for a broad topic in just 45 minutes. I do think the material was appropriate for the target audience and well received. There were some nuanced questions about the data behind fluid resuscitation and the SOFA scores, so further iterations I will plan to have resources available for interested parties to have further reading.

Department of Medicine Grand Rounds "Social Media in Medicine: Perks and Pitfalls"

Time: 45 minutes

Audience: University of Washington Department of Medicine Grand Rounds

Learning Objectives:

• Illustrate the impact of social media plays on dissemination of medical information

• Describe the potential use of social media in epidemiologic surveillance and research

• Demonstrate how social media has been utilized for  outreach and activism in medicine

Please click the image for the recorded talk.

Evaluations: There were no formal evaluations however below are a sample of comments from attendees:

“I have been attending Medical Grand Rounds since 1975. This was one of the most creative, innovative and delightful discussions I can remember - presented with absolutely infectious enthusiasm. Thank you and keep leading!”

“That was nothing short of a brilliant presentation!  Your poise and presentation was remarkable.  Your cadence and voice inflections were perfect.  And your content was so interesting and so well presented in logical format. Kudos”

Introduction to Inpatient Antibiotics

Time: 60 minutes

Audience: Third-year medical students on their Inpatient Medicine Clerkship

Learning Objectives:

• Identify signs and symptoms of common inpatient infections

• Summarize appropriate initial work-up for admitted patients with suspected infection

• Give examples of “bugs” responsible for common infections

• Determine appropriate empiric antibiotic therapy for suspected infections

• Utilize local antibiogram effectively

Interactive digital “whiteboard” with live text-boxes to facility learner participations virtually. Click image for an example of a completed board.

Evaluations: There were no evaluations collected, however informal feedback from medical students included “I finally understand why we choose which antibiotic” and “really helpful!”

Reflections: I have given this session a total of six times to groups of 4-7 medical students. This educational session was initially an in-person session, using a whiteboard, however, due to the Covid-19 pandemic this was transitioned to a virtual session. It was a challenge to maintain the interactivity virtually, particularly given that this talk was intended to serve as practice utilizing resources (antibiotic spectrum and local antibiogram) to pick appropriate empiric antibiotics. In discussion with students they felt that the virtual version was still very helpful.

Vaping Associated Lung Injury

Time: 45 minutes

Audience: Internal Medicine Interns and Residents

Learning Objectives:

• Define E-cigarette history, anatomy and terminology

• Describe the clinical history and proposed underlying pathophysiology of VALI

• Review the use of E-cigarettes and smoking cessation

Please click on the above image to view the slides

Evaluations: There were no evaluations collected, however this talk was cited by residents as an example of excellent adaptation to virtual learning in the setting of the ongoing COVID-19 pandemic.

Reflections: This educational session was a 45 minute session as part of the Academic Half Day curriculum for internal medicine residents. This talk had to be adapted from an in-person setting to a virtual setting due to the COVID-19 pandemic. With the constraints of a virtual format I worked to utilize the chat functions and online polling in order to maximize engagement, which can be particularly difficult in a digital format. This was also a challenge in presented data on a relatively new entity in a practical way for residents.

Pulmonary Physiology Small Group Didactics

Time: Eight total 2-hour long sessions

Audience: First Year Medical Students

Teaching Methods: This was a set of eight small group sessions with eleven students, where each session was comprised of four clinical cases.

Description: The sessions were part of a larger curriculum including lectures on pharmacology, pathophysiology and pathology. These were case-based sessions with 11 students and four cases per session. The cases were used to reinforce basic pulmonary physiology with clinical correlation.

Evaluations:

• Student Evaluations 2019 (unedited)

• Thank-You Letter 2019

• Student Evaluations 2020 (unedited)

• Thank-You Letter 2020

Reflections: This small group was my first experience formally teaching another educator’s materials. It was an exercise in taking the learning objectives and prescribed teaching topics and making them work within my own style as an educator as well as for the group. Additionally, we were challenged by school closures due to inclement weather, so half of our small groups were held via Zoom (digital meeting space). This posed a particular challenge of modifying content that was intended for pair-share and white-board based discussions to a new mode.

I was again able co-teach the small group for the 2020 session. This time all sessions were fortunately able to be completed in person. I worked on connecting content between sessions in order to continually reinforce key concepts. A personal goal is to continue working on being more direct when a learner gets something wrong, a skill I hope to improve upon with every teaching activity I participate in.

Camp Cardiac - Coronary Artery Disease

Time: 60 minutes

Audience: High school juniors and seniors

Teaching Methods: Chalk-talk

Learning Objectives:

• Define coronary artery disease

• Discuss the underlying pathophysiology of coronary artery disease

• Identify symptoms of acute coronary syndromes

• Outline risk factors for coronary artery disease

Description: This was a 1 hour long chalk talk as part of a week long Camp Cardiac session at the University of Washington for local high school students (grades 11 and 12) with interest in a career in medicine. The chalk-talk took place during the second day of a week long course as an introduction to cardiac pathology, prior to this session the learners had lecture on basic cardiac anatomy and function.

Evaluations:

There was no formal feedback however below is an excerpt from a thank-you from the Camp Cardiac coordinators:

“Thank you again for helping us with camp! I got feedback from several campers that your talk was very clear and helpful, and it gave them a solid foundation of understanding to build upon. Also, as a counselor, it was great to have a refresher on these topics as well!”

Reflections: Given this talk was for high-school students I wanted to stay relatively simple with the concepts. The learners were very engaged and asked fantastic questions. I feel the scope was appropriate for the level of the learner and there was enough time to answer questions as we worked through each learning objective.

Teaching Clinical Reasoning

Time: 50 minutes

Audience: Second and third year internal medicine residents

Teaching Method: Chalk Talk, Pair-share

Learning Objectives:

• Outline dual-processing theory as a framework for diagnostic reasoning

• Discuss the use of problem representations as a tool for teaching diagnostic reasoning

• Define components of a well-constructed problem representation

• Practice generating problem representations

Description: This was an adaptation of a 90-minute teaching session given by Dr. Lauren Brown. Our session was condensed into a 40 minute brief introduction to teaching clinical reasoning for a “senior resident only” Academic Half Day session. I reviewed Dual-Process Theory as an introduction to understanding clinical reasoning. Dr. Lauren Noll then took the group through components of a great problem representation. Finally participants worked in small groups to develop their own problem representation of a clinical case that Dr. Noll and I developed together.

Evaluations: Resident Evaluations 2019

Reflections: Much of the Academic Half Day content for our internal residency program tends to be focused on medical content, so I was unsure how a more conceptual topic would be received. It seemed that everyone appreciated the content and we had 100% participation in the pair-share activity. This was also great opportunity to collaborate and adapt another person’s curriculum to fit into a different setting. For the next iteration I think this session would benefit from additional time to incorporate more practice as well as discuss problem solving for learners who are having trouble coming up with problem representations.

Pulmonary Arterial Hypertension

Time: 45 minutes

Audience: Internal Medicine Interns and Residents

Learning Objectives:

• Define pulmonary hypertension 

• Review the five WHO group categories for pulmonary hypertension

• Describe the underlying pathophysiology of pulmonary arterial hypertension and the four major classes of medication

• Develop a framework for identification and management of acute inpatient complications in a patient with pulmonary arterial hypertension

Please click on the above image to view the slides

Evaluations:

• Resident Evaluations 2019

Reflections: I feel the scope was appropriate for internal medicine interns and residents with the aim to provide an overview for a complex topic as well as deliver concrete and practical take-aways for the time on the wards. In future iterations I may add a slide illustrating why volume status is so difficult in these patients. I discussed this point verbally, but it might help to have a slide accompanying it. Additionally topics on the supplemental material did come up (such as the work-up for elevated PASP noted on an echocardiogram). There were some comments from residents requesting clinical cases to consolidate learning. In the next iteration (time permitting) I will include a few cases.