Tuesday, 16 December 2014

Finding additional value in collections of case reports

Just blogged about a paper that used BMJ Case Reports in its methods.

By analysing the case reports the authors looked at the value of radiology in clinical decision making.


What other value may be lurking in case reports waiting to be discovered? Would be very interested in seeing what other potential papers may be out there!

The Flipped patient?

Move over flipped classrooms ... medical students could now be using flipped patients.

A viewpoint article (paywalled I'm afraid) in JAMA (1) explores the concept of 'flipping' the experience of medical students meeting patients - presenting them with an electronic health record derived construct before seeing the real thing.

The flipped patient model might be described as seeing an electronic patient presentation first (the iPatient). In this article a virtual construct of the patient is described, generated from the electronic health record. After reviewing this construct the students then head off to see the real patient in the emergency room to better understand how the history, examination, and investigations relate to a real-world presentation.

The authors describe the reality of 'unflipped' classrooms in their introduction. "A common sight in the first 2 years of US medical education is that of a professor speaking in a lecture hall that is only half full. An hour later, in the library or elsewhere, students who did not attend the lecture can be seen wearing headsets, watching the recorded lecture at 2× to 4× speed on a desktop, while looking up reference material on their laptop. This trend should not be surprising, because the much-talked-about “millennial” generation has many distinguishing characteristics—but it is their facility with technology and their attitudes toward learning that stand out and that have changed the educational landscape."


This flipped patient is an interesting way of separating the cognitive skills required in learning the complex task of taking a history, examining a patient, reviewing the results, and considering the differential diagnoses. Whether this semi-automated method of constructing a brief from the electronic health record is any better than a good introduction to the case by a clinical teacher is yet to be seen. Certainly it also adds the experience of the workplace reality of making sense of electronic records.

1 Chi J, Verghese A. Clinical education and the electronic health record: The flipped patient. JAMA 2014;312:2331–2. doi:10.1001/jama.2014.12820

Introducing BPG - Better Portable Graphics (better than JPEG)

BPG: A new, superior image format that really ought to kill off JPEG

"For all of the massive technological advances that we’ve seen over the last few years, there are still a number of dinosaurs from a bygone era that, rather unfortunately, just won’t die. JPEG is one of the most prominent examples: It was created more than 20 years ago, and yet its antiquated, bloated, blocky algorithm still dominates the web. You would think, with the modern web being so image-oriented, that we would replace JPEG with something better — but no, it’s 2014 and JPEGs (and multi-megabyte GIFs!) still reign supreme."


Infusionarium ... making chemotherapy that little bit easier.

"Like most patients who get intravenous medication at a pediatric clinic, Nick typically receives treatment in a small, curtained cubicle with hospital-green walls, outdated video games that are often broken, tiny TV monitors, and dividers that don’t muffle hallway clatter or the wails of a child in the next cubicle.

But now Nick, whose baseball cap doesn’t disguise his gleaming bald head, emerges from his cubicle, holding his IV pole. He saunters down the hall toward velvety black curtains. Parting them, he slips inside and eases into a reclining chair.

Adrenalized thumping music fills the makeshift space, called the Infusionarium. Roiling close-ups of extreme sports spring across four high-definition monitors, each five-feet tall: skateboarding stunts, parachute-skiing, kayaking over waterfalls."


5 Reasons Your Portfolio Should Be A Blog

"Blogging for me has been hugely beneficial for my learning, because of the power to not only think of an audience (making me think deeper about what I write), but also about connecting with the audience.  For the past few years, we have been working on this project in Parkland School Division (Our Digital Portfolio Project), and it takes time because it is meant to showcase learning over a long period of time.  If learning is non-linear and takes time to develop, so should the work that aligns with it.  Patience is necessary." George Couros


I agree with George Couros's post (via Stephen Downes). Blogging has been very useful for my personal learning. Being able to go back, reference, and reflect on posts is a real advantage. Controlling your own posts is much better than leaving it to your favourite social media platform's news feed. We recently had a strategy meet at BMJ Case Reports and getting back to blogging regularly there would be useful too!

Source: https://flic.kr/p/dUnZaM