Medliorate

Improving medical students

Archive for the ‘Communication’ Category

Developing an Approach to Patient Handoffs

Posted by medliorator on November 1, 2009

handoff

Pauline W. Chen, M.D.

I worry that I am playing some real-life medical version of the children’s game “Telephone” where the complexity of my patient’s care will be watered down, misinterpreted and possibly mangled with each re-telling.

While older patients with multiple chronic conditions will see up to 16 doctors a year, some of the healthiest younger patients I see count not only a primary care physician among their doctors but also a handful of specialists. Hospitalized patients, no longer cared for by their primary care doctors but by teams of fully trained doctors, or hospitalists, in addition to groups of doctors-in-training, are passed between doctors an average of 15 times during a single five-day hospitalization. And young doctors, with increasing time pressures from work hours reforms, will sign over as many as 300 patients in a single month during their first year of training.

researchers have begun looking for new ways to approach patient handoffs, studying other high-stakes shift-oriented industries like aviation, transportation and nuclear power, as well as other groups of clinicians.

By incorporating more efficient methods of communication, the hope is that patient care transitions will eventually become seamless and less subject to errors.

When Patient Handoffs Go Terribly Wrong [NYT Health]

Posted in Business of Medicine, Communication | Comments Off on Developing an Approach to Patient Handoffs

Common Phrases Medical Students Must Avoid

Posted by medliorator on August 10, 2009

1. This won’t hurt at all – many procedures do hurt, at least a little, even when performed with skill, and patients would rather know that going in. Pediatricians, in particular, must be careful that patients don’t eventually take such assurances as a prelude to pain. Try, “This could be a little uncomfortable,” or “This will hurt some, but it’ll be over before you know it.”

2. We’re just really busy – uttering these words can disparage the patient, who is probably also quite busy and perhaps missing work for this appointment… apologize and give your patient an estimate for when he will be seen.

3. I understand how you feel – you don’t want to insult your patient or belittle her experiences. Instead, try expressing empathy by saying, “I can only imagine how you feel.”

5. I’m sure it’s nothing serious – false promises are a death blow to patient trust. Instead, provide assurance through thorough exams and attentive listening to patient concerns.

6 Things You Should NEVER Say to a Patient [Physicians Practice]

Posted in Clinical Rotations, Communication | Comments Off on Common Phrases Medical Students Must Avoid

Pronunciation Challenge

Posted by medliorator on March 19, 2009

Homonymous hemianopsia: It’s a complex, yet quick way of saying that a person has lost the same field of vision in both eyes.

Prader-Willi Syndrome: a spectrum of disorders caused by a deletion or doubling on chromosome 15, resulting in a person’s never, ever, ever feeling like they’ve had enough to eat. There are related problems (including a lack of muscle mass and sometimes mild mental retardation), but the feeling of overwhelming and constant hunger is the hallmark of Prader-Willi.

Hemiasomatognosia
: aka “neglect”. A person who’s had a stroke or other brain injury forgets about half of their body. In severe cases, they lose all concept of one side of the universe, so that “left” or “right” no longer exists.

Apneustic breathing: It happens when you get a bonk or a tumor in your lower pons (v. important part of brain): you breathe in deeply, pause, breathe out…(wait about a minute)…repeat.

Jo’s Fun List Of Medical Terms Nobody Can Pronounce! [Head Nurse]

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Resume: Creating a Medical CV

Posted by medliorator on March 13, 2009

Laura Brammar:

Being able to provide evidence of skills and abilities is vital in order to produce an excellent CV… It is not enough to simply list your experience; instead you need to provide examples of when you have used the core skills required for the post. Many applicants fail to provide the best example of the highlighted skill as the information gets lost in a long chronological record of previous roles and rotations.

Below is an outline of the common sections, in order, found on a medical CV

  • Personal details – Name, Contact details—telephone; email, General Medical Council registration number and national training number, Medical Defence Union number
  • Career statement – Focus on the goals that you have for yourself in certain aspects of your professional life and keep it short and simple.
  • Education and qualifications – University (medical degree, awards, prizes and scholarships, intercalated degree)
  • Present position
  • Career history (ensure that any gaps in employment are accounted for)
  • Clinical skills and experience
  • Management and leadership experience
  • Interests
  • Referees – Always secure agreement from your proposed referees before listing their details on your CV, and provide them with a job description and recent CV to help them to write a focused reference.

Take care with dates and make sure any gaps are accounted for.

Medical CV writing skills [BMJ Careers]

Posted in Communication, Interviewing, Writing | Comments Off on Resume: Creating a Medical CV

How to Learn a New Language

Posted by medliorator on February 1, 2009

If you were a student of English (though the list can be adapted to most languages), [the top 100 most common written words in English] would deliver the greatest ROI per hour invested for the initial 1-3 weeks of study

Content and vocabulary selection beyond the most common 300-500 words should be dictated by subject matter interest. The most pertinent questions will be “What will you spend your time doing with this language?”

Once the framework of grammar has been transferred to long-term memory, acquiring vocabulary is a simple process of proper spaced repetition

How to Learn Any Language in 3 Months [Tim Ferriss]

Posted in Communication, How-To | Comments Off on How to Learn a New Language

Some Interviewing Basics

Posted by medliorator on January 12, 2009

Laura Brammar:

Motivation is key in an interview, and failure to show enthusiasm for the role can often lead to rejection. Use the research you have done into the job to convince that this is the role for you. Don’t be afraid to refer back to your motivation for the role as regularly as possible, without sounding too evangelical.

If you’re asked a question which you don’t understand or are unclear about, ask the panel to clarify it before you begin your answer.

  • Structure your answer by “bookending” your response with a review of the question—for example, Q: Why do you want this post? A: I want this post for a variety of reasons, such as X, Y, and Z. In summary, I want this role for the diverse reasons I’ve just outlined. This technique reminds you of the key part of the question, provides a framework to your answer, and, crucially, provides a neat end to what you are saying
  • Include enough information about what you actually did. Use the STAR acronym (situation, task, action, result) to provide further structure and help you to focus on the specific question
  • Don’t undersell yourself; try to use as many first person statements as possible, especially in combination with active verbs—for example, “I coordinated . . .’’or “I liaised with . . .” Avoid using “we” as it is often too vague to highlight effectively your individual input.

It is likely you’ll be asked whether you have any questions at the end of the interview. This is the final impression you will leave on the panel, and therefore rather than provide a monosyllabic “no” [capitalize] on the opportunity to remind them of your enthusiasm for the role—for example, “No thank you. I’ve had the opportunity to clarify any questions I had and I am satisfied that this is exactly the type of role I’m looking for.” While it would not make a good impression to ask a trivial question, it would be useful to have a couple of substantial questions in mind. Either way, don’t forget to thank the panel before you leave the room.

Interview skills [BMJ Careers]

Posted in Communication | Comments Off on Some Interviewing Basics

Slide Presentation Skills for Medical Students

Posted by medliorator on January 4, 2009

Presentation:

1. Assume your audience is not interested or doesn’t care about your topic it has to be simple, visually accessible and clearly explained. Clarity will not frustrate those who are interested. But it is folly to make your presentation too complicated for those who don’t care.
4. Less explanation is more – Excessive explanation can get boring, and make it seem more complicated. Inadequate explanation can be cleared up in question time.
5. Answer the question – The first thing out of your mouth should be the answer – “yes”, “no”, “we don’t know” or “That is a limitation of the study.”
6. If you need thinking time, tell the questioner they asked a good question – If you do this for every question, you look like an idiot, but it can be effective once or twice.

Content:

1. If presenting research or a journal club article, your last slide should be “Implications of this data”
2. Don’t write full sentences on slides
3. Avoid words of more than one syllable wherever possible
5. Avoid lengthy explanations of background and basic theory
7. Your conclusion slide must be able to be read from the back of the room – This may be the only slide your audience reads.

How to prepare a medical slide presentation [AppleQuack]

Posted in Communication | Comments Off on Slide Presentation Skills for Medical Students

Email Tips for Busy People

Posted by medliorator on November 26, 2008

1. Stop Checking Email – Rather than keeping your email program up on your screen all the time, plan to open it only at set intervals. For example, make “Email Time” at 11:00am, 1:00pm, and 4:00pm. By doing so, you force yourself to concentrate on other matters rather than using email as a way to avoid work.

4. Respond When You Read – When you see an email, answer it immediately. Why? Because if you don’t, it will get pushed down the list of important things to handle. Once they are marked as “read” on your inbox, they will get mixed with all the others. In addition, this process will take up less time so you don’t need to read each email a second time before remembering what you will need to say in the reply.

5. Keep It Short and Sweet – If it takes more than 5 lines, pick up the phone – it will take less time, and you can ramble on a voice mail message without needing to take up your valuable typing time.

6. Have Multiple Accounts – Your friend needs to ask you a question, you mother sends one of those, “Why don’t you call as often as you should?” messages, and your opposing counsel sends a stipulation for your review. If you have one email address they all get lumped together, creating havoc and disorganization. But when you keep multiple addresses, personal stuff stays personal and business remains business

How To Manage Your Email More Effectively [backruptcy practice pro]

Correlate: 5 tips for Better Email

Correlate: E-Mail Secrets – Preventing Errors with Microsoft Outlook

Posted in Communication, Productivity | Comments Off on Email Tips for Busy People

Long Term Impacts of Pimping

Posted by medliorator on September 8, 2008

Woe be the person who can’t answer. Or, worse yet, dissolves into tears. It took the young Doc Gurley longer than it should have to realize that your first answer should be the most obvious answer. I would get asked something like “Can you tell us what this patient has?” and the only possible answer (to me), based on the patient’s two-week hospitalization that had baffled eight sub-specialty services and their nineteen invasive procedures, was “uh, no.” Unfortunately, the correct first answer was “This patient has a fever. It won’t go away. No one knows why.” The next correct answer was “A fever of unknown origin can be divided into two categories – true and false.” Sigh.

One of my goals post-training has been to ask more often than I tell. It’s a shockingly positive thing to do – when done gently and considerately – and a wonderful form of post-pimping-rehab for those of us in recovery from the trauma of medical residency. When you ask someone what they think is going on, the answer can be really surprising. Everything from “I just want to know I’m not pregnant,” to “I’m pretty sure I’m dying” (when he is…).

Asking: Or Is It Pimping? [Doc Gurley]

Correlate: Pimping: How to Cope

Correlate: Pimping: What to Expect

Correlate: Pimping in Action

Correlate: Survive OR Pimping

Posted in Communication, Pimping | Comments Off on Long Term Impacts of Pimping

E-Mail Secrets – Preventing Errors with Microsoft Outlook

Posted by medliorator on August 19, 2008

Don’t let the convenience of email compromise your professional image.  For Microsoft Outlook users, the following features will help you to undo e-mail blunders and save face…

Outlook Attachment Reminder
This Outlook macro will politely remind you to attach a file if it finds the word “attach” in your email and no actual attached file.   In Outlook, select the Tools >> Macro >> Visual Basic Editor menu option.  Paste the code into the big white empty pageand click Save

Undo Sent Message
Using the “Defer” rule in outlook, setup a rule that delays message delivery for a few minutes after you click the Send button.  After implementation, sent messages sit in the Outbox for a few minutes. If you want to stop a message from going out, your best bet is to just delete it from the Outbox, but you could attempt to just fix the mistake and then resend.

Posted in Communication, Software | Comments Off on E-Mail Secrets – Preventing Errors with Microsoft Outlook