Group items tagged

"WHAT TO DO WHEN A PATIENT LACKS CAPACITY - The degree and urgency with which to act on findings of impaired capacity depends on multiple factors, including the expected duration of impairment, the severity of the impairment, and the seriousness of the decision. Unless the urgency of a patient's medical condition requires that a substituted decision be made immediately, efforts should be made to identify and correct any reversible causes of the impairment [26]. This is particularly relevant in hospitalized patients with impaired capacity due to delirium. Treatment of the underlying causes of delirium may restore decision-making capacity. Patients with mild to moderate cognitive impairment that is not expected to fluctuate may benefit from more intensive efforts at education to improve understanding of the relevant facts, followed by reassessment of decision-making abilities. A randomized trial found that a memory and organizational aid given to patients with mild stage Alzheimer disease dementia (n = 80) improved performance on understanding, which in turn increased the likelihood of being judged capable of providing informed consent to enroll in a clinical trial [34]. This enhancement was also effective in a randomized trial with middle-aged and older adults with schizophrenia [35]. For patients whose impairments are severe enough that they are judged to lack the capacity to make a decision, there is a clear ethical obligation to seek out a substitute decision maker. Substitute or surrogate decision makers should ideally have been chosen by the patient in advance. In the absence of a designated surrogate, laws may vary in terms of which people can serve in this proxy role and their hierarchy; in general, the order is the spouse, adult children, parents, siblings, and other relatives. (See "Legal aspects in palliative and end of life care", section on 'Surrogate decision makers'.) When making a substituted decision, the proxy should take into consideration

"To describe the essential components of the medical model of substance use disorders. To delineate the interviewing skills necessary to screen effectively for substance use and abuse. To understand the high rate of psychiatric and medical co-morbidity and more effectively screen patients for these disorders. To demonstrate skills for evaluating patients' stage of change, readiness to accept the diagnosis, and readiness to undertake behavior change. To clearly and supportively recommend treatment to patients with substance use disorders. To describe the skills required for addiction prevention counseling. To define the skills that help set respectful limits on patient requests for prescription medication. To demonstrate awareness of how physician/clinician attitudes toward patients with substance use disorders impact recognition, diagnosis, and treatment of patients. To demonstrate knowledge of substance use disorder treatment standards and the ability to recommend appropriate referrals."

"Professionalism in medicine is, in essence, a conversation about what it means to be a good doctor. It has been a major topic of discussion in the field for many years and will likely remain so for years to come. Physicians still debate how to define it, how to assess it and how to teach it. Younger doctors sometimes have different ideas on what it means to be a professional than older colleagues. "

"And yet a lot of people don't know how to listen to someone venting. Usually, people take one of two attitudes. Option 1 is to jump in and give advice -- but this is not the same as listening, and the person doing the venting may respond with "Just listen to me! Don't tell me what to do." Option 2 (usually attempted after Option 1) is to swing to the other extreme, and sit there silently. But this doesn't actively help the person doing the venting to drain their negative emotions. Consequently, it is about as rewarding as venting to your dog."

"These are just a few ideas on how you can use Twitter in the classroom. Because of how flexible the medium is, there really is no end to how creative you can be using Twitter in an educational environment."

"You need to learn how to exercise mindful deployment of your attention online if you are going to become a critical consumer of digital media; productive use of Twitter or YouTube requires knowledge of who your public is, how your participation meets their needs (and what you get in return), and how memes flow through networked publics. Ultimately, the most important fluency is not in mastering a particular literacy but in being able to put all five of these literacies together into a way of being in digital culture."

To avoid health risks in using herbal medicines, always stick to the prescription given to you by your health expert. The prescription is also part of the treatment process, making sure that your body will have enough of the curative properties to boost your body's recovery.

"Patients and clinicians share why it's important to ask questions and offer ways that you can ask questions and get your health care needs met. In these short, compelling videos, patients talk about how simple questions can help you take better care of yourself, feel better, and get the right care at the right time. Doctors and nurses talk about how your questions help them take better care of you and offer advice on how you can be an active member of your health care team and get your most pressing questions answered."

We have put together a short guide answering these questions, showing new users how to get started on Twitter and hone their tweeting style, as well as offering advice to more experienced users on how to use Twitter for research projects, alongside blogging, and for use in teaching.

This week when I lead a faculty development workshop* I'll ask participants to consider their readiness to make use of social media. Are you feeling ready, but you wonder how to take the first (or next) steps? Do you want to find out what all the fuss is about? Are you skeptical about mixing social media with your career as a health care professional, medical educator, trainees, and/or student?

We have put together a short guide answering these questions, showing new users how to get started on Twitter and hone their tweeting style, as well as offering advice to more experienced users on how to use Twitter for research projects, alongside blogging, and for use in teaching.

"I do not fault people; no one teaches you how to network with others. School does not teach us how to build strategic partnerships or develop interpersonal skills that are helpful with creating a profitable referral network."

"A short guide for faculty on how to use Twitter at conferences. You are welcome to use this in your faculty development sessions in keeping with the Creative Commons license conditions."

"Most people instinctively avoid conflict, but as Margaret Heffernan shows us, good disagreement is central to progress. She illustrates (sometimes counterintuitively) how the best partners aren't echo chambers -- and how great research teams, relationships and businesses allow people to deeply disagree."

"Those planning medical curricula would be wise to engage their colleagues from philosophy and educational psychology to help elucidate these ideas and to learn how to construct longitudinal mentorship programs. The conceptual basis of these programs need to acknowledge that the boundary between being and doing is porous and that, through a maieutic process, mentors can catalyze and guide personal transformations in learners.

This is a website by an emergency medicine physician from Maryland who is interested in teaching how to become effective medical educators. http://www.emrapee.com/episodes/ there is one podcast in particular that deals with how to make podcasts.

"They want you to study by yourself and become obsessed with how well you understanding the material. ergo - stop caring about whether anyone else understands it. It would be a great system to develop overconfident get-mine solo practice doctors, but everyone knows there's too much paperwork to run a solo practice these days. We're also coming upon the age of specialists when collaboration will be at a premium. A disease like diabetes is complex. You might need primary care physicians working with vascular surgeons, endocrinologists, ophthalmologists, I could list every specialty. Not to mention nutritionists, personal trainers, policy makers."