The tag cloud of clinical uncertainty is a graphical representation of the areas of medical research where we still don't have the answers that would help us day to day as practitioners. It is part of the new TripAnswers website, which takes a clinical question answering approach but allows comments from other users. At the moment the site does not seem to be fully functional, but I think it is a great idea.
And for some reason the Tag Cloud of Clinical Uncertainty makes me think of Bill Bailey. I hope that doesn't seem too irreverent ;-)
Monday, December 8, 2008
Patient narratives in medical education.... where are they?
Since my post about students learning from patient narratives in online forums I have been thinking a lot about how much emphasis we place on patient narratives in medical education.
When talking to individual patients we ask students to consider and explore the patient's experience of their illness along with the history of when symptoms developed and how they have responded to treatment. The exercise I blogged about asks students to compare the narratives of one family with that of others in the course and beyond.
But how often are the findings of qualitative research, which is in a sense about bringing together patient narratives, contributing to medical education? For example, there are several qualitative research studies (here and here for example) on heart failure finding that patients want to know more about prognosis from their physicians. But are we teaching students this? Does the Oxford Textbook of Clinical Medicine discuss the experience of being diagnosed with diabetes or heart failure? Well, I can't find it.
Is it time that we stopped seeing patient narratives as an add-on and started moving it to centre-stage in medical education?
When talking to individual patients we ask students to consider and explore the patient's experience of their illness along with the history of when symptoms developed and how they have responded to treatment. The exercise I blogged about asks students to compare the narratives of one family with that of others in the course and beyond.
But how often are the findings of qualitative research, which is in a sense about bringing together patient narratives, contributing to medical education? For example, there are several qualitative research studies (here and here for example) on heart failure finding that patients want to know more about prognosis from their physicians. But are we teaching students this? Does the Oxford Textbook of Clinical Medicine discuss the experience of being diagnosed with diabetes or heart failure? Well, I can't find it.
Is it time that we stopped seeing patient narratives as an add-on and started moving it to centre-stage in medical education?
Del.ic.ious doctors!
I've been using del.ic.ious now for a few weeks, but I have bookmarked very little that is relevant to my other life as a GP. By searching for tags such as appendicitis, bts (for british thoracic society), and rosuvastatin I am establishing that there are few tagging clinicians out there.
It may be hard to convince medical students that social bookmarking will be relevant to their lives unless there are a few examples of early adopter clinicians using it well.
Are there clinicians out there using social bookmarking? I'd be interested to find you. And if there aren't, why not?
It may be hard to convince medical students that social bookmarking will be relevant to their lives unless there are a few examples of early adopter clinicians using it well.
Are there clinicians out there using social bookmarking? I'd be interested to find you. And if there aren't, why not?
Thursday, December 4, 2008
Students learning from the patient's online voice
I've been thinking about how students can learn from accessing online communities which are publicly available.
I lead a project where students visit families who are hopefully in reasonably good health. The students are early in the course and we want their learning to be around individuals and families negotiating the choices (or lack of choice) they make with regards to their health and interaction with health services.
The assessment includes a 1500 word essay where they focus on a topic that particularly interested them when they were getting to know the families. The topics can be diverse as how social housing is managed in Cardiff, antenatal screening, or the impact of growing up in a multilingual environment. They are encouraged to compare the experience of the family to accounts in the literature, quantitative and qualitative, and to other families who are participating in the project who have had similar experiences. Students can ask their colleagues about the families they are visiting through a discussion board. As there are only 150 families in the project quite often students will come across issues which no other families have been through. I have suggested to students that they might look at publicly accessible community forums and see if the topics are being discussed there.
Since until this year the project only involved visiting families with new babies or young children, and young mothers can be quite active participants in forums such as mumsnet, babycentre and bounty, there has been lots of material for them to access if they wanted to. For example, last week a student said she wanted to explore cholestatis in pregnancy. I've searched and can't find any qualitative literature on the topic, but threads such as this on the bounty forum can give students many insights into how women perceive the investigation and management of the condition and the impact it has on their lives.
Students learn from the narratives of the patients they meet face-to-face in practice. This is central to medical education. It seems that there could be many valuable opportunities for students to learn from online patients as well.
What do you think? What problems could there be with this approach? What are the possibilities?
I lead a project where students visit families who are hopefully in reasonably good health. The students are early in the course and we want their learning to be around individuals and families negotiating the choices (or lack of choice) they make with regards to their health and interaction with health services.
The assessment includes a 1500 word essay where they focus on a topic that particularly interested them when they were getting to know the families. The topics can be diverse as how social housing is managed in Cardiff, antenatal screening, or the impact of growing up in a multilingual environment. They are encouraged to compare the experience of the family to accounts in the literature, quantitative and qualitative, and to other families who are participating in the project who have had similar experiences. Students can ask their colleagues about the families they are visiting through a discussion board. As there are only 150 families in the project quite often students will come across issues which no other families have been through. I have suggested to students that they might look at publicly accessible community forums and see if the topics are being discussed there.
Since until this year the project only involved visiting families with new babies or young children, and young mothers can be quite active participants in forums such as mumsnet, babycentre and bounty, there has been lots of material for them to access if they wanted to. For example, last week a student said she wanted to explore cholestatis in pregnancy. I've searched and can't find any qualitative literature on the topic, but threads such as this on the bounty forum can give students many insights into how women perceive the investigation and management of the condition and the impact it has on their lives.
Students learn from the narratives of the patients they meet face-to-face in practice. This is central to medical education. It seems that there could be many valuable opportunities for students to learn from online patients as well.
What do you think? What problems could there be with this approach? What are the possibilities?
Tuesday, December 2, 2008
Gout.... what we don't know.
So, I'm exploring RSS feeds and today added BMJ's Clinical Evidence to my Google Reader. I've just got an update on gout. Unfortunately it seems that we really don't know very much about the treatment of gout. So how should I now treat gout? How does this summary help me?
What are the effects of treatments for acute gout?
| Unknown effectiveness |  |
|---|
What are the effects of treatments to prevent gout in people with prior acute episodes?
| Unknown effectiveness | |
|---|
Thursday, November 27, 2008
The networked student!
Techticker linked to this great clip earlier. The fact that my teaching involves a project over 6 months, where students work independently, with little face to face teaching, and where I am not co-located with them has forced me to think about engaging new technologies faster than I would if I only taught students in our practice. But I wonder how much this approach should be used in medical courses even if our students are beside us. What does a medical student's personal learning environment look like?
It's worth it!!!!
Just had a student call in for a chat about his project. I asked if he had seen my course blog. You could have bowled me over when he told me that not only had he found it but he had clicked on the RSS feed tab and now got my updates directly through to his Vista desktop and wished that much more of Blackboard operated like this.
So my course blog is really a blog and students are starting to develop their personal learning environments. Yay!
So my course blog is really a blog and students are starting to develop their personal learning environments. Yay!
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