#jhmchat Transcript

Healthcare social media transcript of the #jhmchat hashtag.
().
See #jhmchat Influencers/Analytics.

Sign up for FREE Symplur Account and Get
  • Create Transcripts with Custom Dates
  • Get Custom Influencer Lists
  • 3x Hashtag Search Results
Sign Up Now
ProfileTweet
J Hospital Medicine @JHospMedicine
Let's get started! I'm @WrayCharles your moderator for tonight's #JHMChat covering @andrewolsonMD & colleagues' recent article on feedback during handoffs (aka. The Loop Project): https://t.co/gTOfBeG2X6 Go ahead and introduce yourself while we wait for others to join... https://t.co/wkTrAdOWQC
Improve Diagnosis @ImproveDX
RT @JHospMedicine: Let's get started! I'm @WrayCharles your moderator for tonight's #JHMChat covering @andrewolsonMD & colleagues' recent a…
J Hospital Medicine @JHospMedicine
Don't forget to tag your tweets with #JHMChat! We have 3 discussion topics for tonight's chat. Topic 1 up in a moment… #JHMChat
Gopi Astik @gopiastik
I'm Gopi and i'm an academic hospitalist in Chicago and current @ImproveDX fellow. #JHMChat #teachDX
Jen Readlynn, MD @jenreadlynn
@JHospMedicine @WrayCharles @andrewolsonmd Jen Readlynn - academic hospitalist in Rochester, NY. So excited for tonight's chat! #jhmchat #teachdx
Andrew Olson, MD @andrewolsonmd
@JHospMedicine @WrayCharles Thanks, @WrayCharles - excited to be here. I'm @andrewolsonmd - clinician-educator @umnmedschool and convener of #teachDX chats! Excited for this! #JHMChat
Annie Massart @Annie_Massart_
@JHospMedicine @WrayCharles @andrewolsonmd Hi everyone! I'm Annie, an academic hospitalist in Atlanta. I'm looking forward to chatting with y'all! #JHMChat #TeachDx
J Hospital Medicine @JHospMedicine
Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation for bringing you #JHMChat tonight. Don't forget to grab CME here after the chat --> https://t.co/MLkS3Taaoa
Brian McGillen, MD @bmcgillen26
I'm Brian - academic hospitalist in Hershey, PA. Looking forward to this! #JHMChat
Andrew Olson, MD @andrewolsonmd
RT @JHospMedicine: Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation for bringing you #JHMChat tonight. Don't forget t…
Grace Farris MD @gracefarris
@JHospMedicine @WrayCharles @andrewolsonmd Grace Farris joining from NYC! #JHMChat ready to tackle this topic! https://t.co/TtBZLwxf0p
Andrew Olson, MD @andrewolsonmd
@gracefarris @JHospMedicine @WrayCharles And @gracefarris is off and running with the amazing art! #teachDX #JHMChat
Jennifer Caputo @jennifermcaputo
@JHospMedicine @WrayCharles @andrewolsonmd I’m Jen, hospitalist in Tampa #JHMChat
J Hospital Medicine @JHospMedicine
We're excited to be partnering with our colleagues at @ImproveDx tonight and looking for some great cross-pollination between groups #JHMChat
J Hospital Medicine @JHospMedicine
RT @gracefarris: @JHospMedicine @WrayCharles @andrewolsonmd Grace Farris joining from NYC! #JHMChat ready to tackle this topic! https://t.c…
Andrew Olson, MD @andrewolsonmd
@HannahRAbrams @JHospMedicine @WrayCharles Welcome, @HannahRAbrams -longtime friend of #teachDX ! #JHMChat
J Hospital Medicine @JHospMedicine
@bmcgillen26 glad to have on-board, Brian #JHMChat
Sonya TG @STangGirdwood
@JHospMedicine @WrayCharles @andrewolsonmd Sonya, #PedsHM fellow from @CincyPHMFellows #JHMChat
Andrew Olson, MD @andrewolsonmd
@JHospMedicine @ImproveDX And we are excited and grateful for the collaboration from @ImproveDX ! #JHMChat #teachDX
Mona Krouss MD FACP @kroussMD
@JHospMedicine @WrayCharles @andrewolsonmd I'm Mona Krouss, hospitalist in NYC. Looking forward! #JHMCHAT
Society of Hospital Medicine @SocietyHospMed
Welcome to our #JHMChat, everyone! Meet your moderator, @WrayCharles, and guest, @andrewolsonmd for tonight's discussion: the Importance of Hospital Medicine 👋 Stay tuned here and #JHMChat & #teachDX for the latest from our discussion with Dr. Olson & @ImproveDX
J Hospital Medicine @JHospMedicine
Let's get started...Topic 1 for tonight's #JHMChat https://t.co/pVS8SYAxQo
Society of Hospital Medicine @SocietyHospMed
RT @gracefarris: @JHospMedicine @WrayCharles @andrewolsonmd Grace Farris joining from NYC! #JHMChat ready to tackle this topic! https://t.c…
Andrew Olson, MD @andrewolsonmd
@thilanMD @JHospMedicine @WrayCharles @ImproveDX welcome @thilanMD -delighted to have you! #JHMChat #teachDX
J Hospital Medicine @JHospMedicine
RT @SocietyHospMed: Welcome to our #JHMChat, everyone! Meet your moderator, @WrayCharles, and guest, @andrewolsonmd for tonight's discuss…
J Hospital Medicine @JHospMedicine
@kroussMD @WrayCharles @andrewolsonmd Welcome aboard, Mona! Glad you could make it #jhmchat
Improve Diagnosis @ImproveDX
RT @JHospMedicine: Let's get started...Topic 1 for tonight's #JHMChat https://t.co/pVS8SYAxQo
Andrew Olson, MD @andrewolsonmd
A1: Excited to hear ideas, but I'll weigh in. We view handovers as barriers - but can we seem them as opportunities for learning? It's kind of amazing that every patient gets an automatic second opinion now! #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
@thilanMD @WrayCharles @andrewolsonmd @ImproveDX Glad you could make it, Thilan! #jhmchat #improvedx
Society of Hospital Medicine @SocietyHospMed
RT @andrewolsonmd: @JHospMedicine @WrayCharles Thanks, @WrayCharles - excited to be here. I'm @andrewolsonmd - clinician-educator @umnmeds
Chris Moriates, MD @ChrisMoriates
Hi #JHMChat - Chris from @DellMedSchool and @CostsofCare joining from hotel bar in Denver, with one eye on the World Series and the other on #JHMChat. Looking forward to learning w you
Jennifer Caputo @jennifermcaputo
@JHospMedicine @andrewolsonmd Night admissions are when residents are making their most autonomous clinical decisions, w/o effective #feedback mechanism we are missing huge learning opportunity to advance those clinical decision making skills #JHMChat
J Hospital Medicine @JHospMedicine
@andrewolsonmd I have never heard of a handover as an "automatic second opinion"? What a great way of reconceptualizing this... #jhmchat
Improve Diagnosis @ImproveDX
RT @andrewolsonmd: A1: Excited to hear ideas, but I'll weigh in. We view handovers as barriers - but can we seem them as opportunities for…
Bani Galyaan. @drtokir
RT @JHospMedicine: Let's get started! I'm @WrayCharles your moderator for tonight's #JHMChat covering @andrewolsonMD & colleagues' recent a…
Gopi Astik @gopiastik
A1: Handoff is the perfect opportunity to give and obtain feedback. You can leverage these inherent transitions to critically evaluate decisions that were made by other physicians and ask for feedback as well. #JHMChat #teachDX
Society of Hospital Medicine @SocietyHospMed
@jennifermcaputo @JHospMedicine @WrayCharles @andrewolsonmd Welcome to the #JHMChat Jen! Is this your first Chat with us?
Brian McGillen, MD @bmcgillen26
@jennifermcaputo @JHospMedicine @andrewolsonmd Definitely agree with this. We have dedicated #nocturnists in our group, but their overnights can be brutally busy. Feedback from daytime attendings to admitting overnight residents is a must. #JHMChat
Andrew Olson, MD @andrewolsonmd
@jennifermcaputo @JHospMedicine So agree with you! And lost opportunity if there isn't learning with these. #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
RT @andrewolsonmd: A1: Excited to hear ideas, but I'll weigh in. We view handovers as barriers - but can we seem them as opportunities for…
Jen Readlynn, MD @jenreadlynn
@JHospMedicine @andrewolsonmd Feedback allows for the admitter to refine their differential diagnosis, reconsider findings that were initially deemed as not relevant/contributory, and see how someone else would handle the information. #JHMChat #teachdx
Andrew Olson, MD @andrewolsonmd
@bmcgillen26 @jennifermcaputo @JHospMedicine And remember they will get it right most of the them = fun feedback to get. #teachDX #JHMChat
Jennifer Caputo @jennifermcaputo
@JHospMedicine @andrewolsonmd Too often I’m asked “how were my overnight admissions” at the end of a 1 or 2 week stretch and honestly unless there was something egregious, my response is a less than helpful “fine”. Feedback needs to specific and timely to work #JHMChat
J Hospital Medicine @JHospMedicine
@bmcgillen26 @jennifermcaputo @andrewolsonmd Importantly, though...how do you build this into the day-to-day...? #jhmchat
J Hospital Medicine @JHospMedicine
RT @andrewolsonmd: @jennifermcaputo @JHospMedicine So agree with you! And lost opportunity if there isn't learning with these. #teachDX #…
Sonya TG @STangGirdwood
@andrewolsonmd Agreed! Whenever I am receiving handoffs as an overnight attending, I use the opportunity to ask clarifying questions...not to cast doubt on the diagnosis, but for me to understand better and learn. And sometimes it helps the physician signing out think thru things too. #JHMChat
Society of Hospital Medicine @SocietyHospMed
@jenreadlynn @JHospMedicine @WrayCharles @andrewolsonmd Hi Jen! Welcome to the Chat! Is this your first #JHMChat?
Andrew Olson, MD @andrewolsonmd
YES!! This is calibration in action. It is pretty easy to think my batting average is 100% if I never hear differently. #teachDX #JHMChat (And yes that was a #WorldSeries2019 reference)
Paul Shaniuk @PShaniuk
@JHospMedicine @WrayCharles @andrewolsonmd I’m Paul. Academic hospitalist at the @ClevelandVAMC #JHMChat excited for the discussion!
Society of Hospital Medicine @SocietyHospMed
@STangGirdwood @JHospMedicine @WrayCharles @andrewolsonmd @CincyPHMFellows Welcome, Sonya! So happy you could join us tonight. We hope you have some questions or thoughts to share with us #JHMChat #teachDX
Mona Krouss MD FACP @kroussMD
@JHospMedicine @bmcgillen26 @jennifermcaputo @andrewolsonmd Certainly easier when night float presents directly to the attendings in the morning, but there isn't always time for feedback then. #JHMchat
A Solberg MD, Interventional Specialist @AgnesSolberg
@JHospMedicine @andrewolsonmd #JHMChat A1 - I’m VIR, but we always go over cases during sign out and talk about what we would have done differently... sometimes different approaches are not incorrect, but we can always learn a different way! @Gnarlynickb #irad #TwittIR @RadiologyChicks
J Hospital Medicine @JHospMedicine
@PShaniuk @WrayCharles @andrewolsonmd @ClevelandVAMC Welcome, Paul! Glad you could make it #jhmchat
Annie Massart @Annie_Massart_
A1: We've observed intern nightly handoffs using feedback rubrics. Interns received immediate feedback on their signout, including guidance for how to improve it. It's a different part of inpatient care, but still w/ the hope of improving patient care. #JHMChat #TeachDX
Andrew Olson, MD @andrewolsonmd
@jennifermcaputo @JHospMedicine So true - occurs for so many reasons. That's why in the study we standardized the form to make "fine" not an option. #teachDX #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @andrewolsonmd: @JHospMedicine @WrayCharles Thanks, @WrayCharles - excited to be here. I'm @andrewolsonmd - clinician-educator @umnmeds
Improve Diagnosis @ImproveDX
RT @jenreadlynn: @JHospMedicine @andrewolsonmd Feedback allows for the admitter to refine their differential diagnosis, reconsider findings…
Brian McGillen, MD @bmcgillen26
@JHospMedicine @jennifermcaputo @andrewolsonmd Made a template note in my EMR. Started sending e-messages to overnight admitting residents each day. Always available to them via secure text if they have questions. #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Let's get started! I'm @WrayCharles your moderator for tonight's #JHMChat covering @andrewolsonMD & colleagues' recent a…
Jen Readlynn, MD @jenreadlynn
@JHospMedicine @bmcgillen26 @jennifermcaputo @andrewolsonmd Personally, I set aside time after an admitting shift to review my patients 1-2 days out to see what happened. I don't see residents doing this anymore at my institution (their shifts are insanely busy), so I think building it into your practice is important. #jhmchat #teachdx
Andrew Olson, MD @andrewolsonmd
@Annie_Massart_ Love this - is there a way to give feedback further back in the process? #teachDX #JHMChat
Jennifer Caputo @jennifermcaputo
@JHospMedicine @bmcgillen26 @andrewolsonmd I think something electronic like this project utilized is key given on opposite time schedules with very limited face to face contact #JHMChat
Society of Hospital Medicine @SocietyHospMed
And we're off! Here is the first topic of the night: How can we use feedback to improve patient care during handoffs? Don't forget to use the hashtags: #JHMChat & #teachDX so that everyone can see your tweets & chime in!
Ryan Bonner @RWBonner91
@JHospMedicine @WrayCharles @andrewolsonmd Ryan - PGY2 in Boston. Great topic! #JHMChat
J Hospital Medicine @JHospMedicine
The Loop Project was aimed at Interns -- but would such a project/intervention be helpful for more seasoned clinicians as well? #jhmchat #improveDx
Andrew Olson, MD @andrewolsonmd
@jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo This is great - and studies show this happens rarely. https://t.co/eQCgq0nXOI #JHMChat #teachDX
Vinny Arora MD MAPP @FutureDocs
Better late than never on #JHMChat. @wraycharles flying solo...managing bedtime...handoffs..now i just need feedback. what else is new?
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: The Loop Project was aimed at Interns -- but would such a project/intervention be helpful for more seasoned clinicians a…
Gopi Astik @gopiastik
@jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo @andrewolsonmd I've started asking patients if I can "chart-stalk" them to see what happens. Nobody has ever said no and it gives me peace of mind to review it later. #JHMChat #teachDX
Sonya TG @STangGirdwood
@andrewolsonmd And when I’m signing out, if I have an uncertain diagnosis, a new term we’ve started in our division, I use the opportunity to provide more details so I can process out loud and get some feedback on what I have done and ideas of what to do next.#JHMChat Q1
J Hospital Medicine @JHospMedicine
Love the multidisciplinary engagement on this chat. Feedback during transitions isn't a #hospitalist issue alone... #jhmchat
Paul Shaniuk @PShaniuk
@jennifermcaputo @JHospMedicine @andrewolsonmd Agree with this 100%. I sometimes send an email to residents when I’m either very impressed or disagree 180 degrees. I don’t do this enough. The residents seem to universally appreciate the feedback. I’d love to see this standardized more! #JHMChat
Benjamin P. Geisler @ben_geisler
@JHospMedicine @WrayCharles @andrewolsonmd A bit late to the game, Ben Geisler, adult hospitalist in Boston #JHMChat
Andrew Olson, MD @andrewolsonmd
@JHospMedicine We talked a lot about this - and actually tried with faculty in a pilot way too. Short answer YES - but has to be part of culture. Our friend @rltrowb had sone work on this @MaineMed #teachDX #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @andrewolsonmd: @JHospMedicine We talked a lot about this - and actually tried with faculty in a pilot way too. Short answer YES - but…
Mona Krouss MD FACP @kroussMD
@STangGirdwood @andrewolsonmd I love this idea! It is very helpful to know when the diagnosis is less certain as it automatically makes the receiving provider think about the case in a different light. #JHMCHAT
Jen Readlynn, MD @jenreadlynn
@JHospMedicine Absolutely! None of us our perfect and need to continue to refine our clinical reasoning skills. We hold case conferences for just our attendings where we talk through some confusing or difficult cases. It's so helpful to hear your colleagues think out loud. #jhmchat #teachdx
Improve Diagnosis @ImproveDX
RT @STangGirdwood: @andrewolsonmd And when I’m signing out, if I have an uncertain diagnosis, a new term we’ve started in our division, I u…
Andrew Olson, MD @andrewolsonmd
@PShaniuk @jennifermcaputo @JHospMedicine yes yes yes - they are hungry to learn. (and btw, shouldn't faculty be too?) #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
@ben_geisler @WrayCharles @andrewolsonmd Glad you could make it, Ben! #jhmchat
Jennifer Caputo @jennifermcaputo
@JHospMedicine At our institutions it’s senior residents doing the overnight admissions and consistently they say they want more feedback, so I think this would be a valuable tool to apply at all levels of training #JHMChat
Benjamin P. Geisler @ben_geisler
A1: It's important that the receiver of a handoff feels that they can give feedback
Andrew Olson, MD @andrewolsonmd
@jenreadlynn @JHospMedicine And this is my feeling only (no evidence) but this is when joy comes in the job for me too. #teachDX #JHMChat
Society of Hospital Medicine @SocietyHospMed
@jenreadlynn says that feedback allows for differential diagnosis, reconsidering findings, and exploring additional perspectives... Do you agree? Chime in to #JHMChat now! 🤓⬇️
Hyung (Harry) Cho, MD @HyungChoMD
RT @JHospMedicine: Let's get started! I'm @WrayCharles your moderator for tonight's #JHMChat covering @andrewolsonMD & colleagues' recent a…
Andrew Olson, MD @andrewolsonmd
@SocietyHospMed @jenreadlynn It's been said that with shifts there is a danger in knowing only the beginning, middle, or end of an illness script. #teachDX #JHMChat
Chris Moriates, MD @ChrisMoriates
@jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo @andrewolsonmd With handoffs we have disrupted the natural feedback loop of seeing what happened over the course of the first 30 hours of admission so I think important to encourage these practices to develop understanding of what happened to build experiential knowledge #jhmchat
Sonya TG @STangGirdwood
@jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo @andrewolsonmd Oh, I thought this was the norm. I always f/u on patients I’ve admitted from night shift or who are still hospitalized after my week of service. Many attendings seem to do this b/c we will ask one another how patients are doing. I also keep an “interesting patient” list. #JHMchat
Society of Hospital Medicine @SocietyHospMed
@PShaniuk @jennifermcaputo @JHospMedicine @andrewolsonmd Welcome to the #JHMChat tonight, Paul! Glad you could be here to share your feedback/thoughts with us! #teachdx
J Hospital Medicine @JHospMedicine
While your institution may not have The Loop project formally implemented, @PShaniuk with the poor-man's version of offering feedback after a night admission #jhmchat #improveDx cc: @andrewolsonmd
Andrew Olson, MD @andrewolsonmd
@ChrisMoriates @jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo Agreed -although I don't think I learned much when I'd been up for 30 hours. That said as in previous tweet - we have to learn the natural history somehow! #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
RT @SocietyHospMed: @jenreadlynn says that feedback allows for differential diagnosis, reconsidering findings, and exploring additional per…
Sonya TG @STangGirdwood
@kroussMD @andrewolsonmd Our “uncertain diagnosis” flag has come out of some great work done by Dr. Ipsaro, @Hagedorn_MD, @TMarshall_MD, @spatelDO #JHMChat
J Hospital Medicine @JHospMedicine
Great discussion so far! We'll have Topic 2 coming up momentarily...#jhmchat #improveDx
Jen Readlynn, MD @jenreadlynn
@andrewolsonmd @SocietyHospMed It's so true. I ask about patients after I go off service. I heard @CPSolvers recommend calling a patient about a week after discharge just to check in and see how they're doing. I did it this week and it was a lovely follow-up. #jhmchat #teachdx
Andrew Olson, MD @andrewolsonmd
@SocietyHospMed @FutureDocs @WrayCharles there is an art to the timing of feedback, of course. Welcome @FutureDocs - #teachDX has never had a @NASEM_Health member before! #teachDX #JHMChat
Society of Hospital Medicine @SocietyHospMed
@AgnesSolberg @JHospMedicine @andrewolsonmd @Gnarlynickb @RadiologyChicks Thanks for joining us tonight, and for chiming in Agnes! Have you taken part in a #JHMChat before?
Andrew Olson, MD @andrewolsonmd
@STangGirdwood @kroussMD @Hagedorn_MD @TMarshall_MD @spatelDO YES! This is a great project to bring uncertainty into the open and lean into it! #teachDX #JHMChat
Vinny Arora MD MAPP @FutureDocs
@andrewolsonmd @SocietyHospMed @WrayCharles @NASEM_Health Awww shucks ! #JHMChat #teachdx
J Hospital Medicine @JHospMedicine
Topic 2 for tonight's #jhmchat & #improveDx: https://t.co/GM4LLwft9U
Paul Shaniuk @PShaniuk
@JHospMedicine @andrewolsonmd better feedback would allow for in the moment critical thinking about the differential, which is better and efficient for pts. always seems that on service, half the patients are admitted by night float? We’re intentional about critically evaluating their assessment/plan #JHMchat
Andrew Olson, MD @andrewolsonmd
@AgnesSolberg @SocietyHospMed @JHospMedicine @Gnarlynickb @RadiologyChicks welcome! #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
RT @jenreadlynn: @andrewolsonmd @SocietyHospMed It's so true. I ask about patients after I go off service. I heard @CPSolvers recommend cal…
Andrew Olson, MD @andrewolsonmd
@PShaniuk @JHospMedicine So true - we talk about it on rounds, but how to share this super key discussion with the night float? #teachDX #JHMChat
Andrew Olson, MD @andrewolsonmd
RT @JHospMedicine: Topic 2 for tonight's #jhmchat & #improveDx: https://t.co/GM4LLwft9U
J Hospital Medicine @JHospMedicine
@andrewolsonmd @SocietyHospMed @FutureDocs @WrayCharles @NASEM_Health We figured she was out celebrating. But nope, she's here with her tribe #jhmchat #improveDx
Society of Hospital Medicine @SocietyHospMed
@jenreadlynn @JHospMedicine @WrayCharles @andrewolsonmd You're a seasoned veteran to the #JHMChat! Love that 😎 Thanks for spending time with us on Twitter often!!
J Hospital Medicine @JHospMedicine
RT @andrewolsonmd: @PShaniuk @JHospMedicine So true - we talk about it on rounds, but how to share this super key discussion with the night…
Gopi Astik @gopiastik
A2: I was taught if you teach a topic, they'll remember for a day. If you teach about a patient, they will remember forever. Be direct, specific, give examples and making it a positive teaching/learning point. #JHMChat #teachDX
Andrew Olson, MD @andrewolsonmd
@gopiastik So true. Thanks @gopiastik who is doing AMAZING work in this space. #teachDX #JHMChat
Improve Diagnosis @ImproveDX
RT @JHospMedicine: Topic 2 for tonight's #jhmchat & #improveDx: https://t.co/GM4LLwft9U
Joshua Ryan Mastin @RyanMastin3
RT @jenreadlynn: @JHospMedicine @andrewolsonmd Feedback allows for the admitter to refine their differential diagnosis, reconsider findings…
A Solberg MD, Interventional Specialist @AgnesSolberg
@JHospMedicine #JHMchat A2: Feedback needs to be constructive. I usually point out something positive; then feedback or question - suggest some reading; then wrap up with something positive. 👍 I make sure residents and med studs have enough time to read what I assigned. #Meded #RadChicks
Society of Hospital Medicine @SocietyHospMed
@AgnesSolberg @JHospMedicine @andrewolsonmd @Gnarlynickb @RadiologyChicks Yahoo! Well, welcome :) We hope this won't be your last, either! #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
Fantastic example of centering your feedback on the patient and not the topic. Does this always work...? #jhmchat #improveDx
Andrew Olson, MD @andrewolsonmd
@AgnesSolberg @JHospMedicine Wait, so not effective to assign like 15 articles? #teachDX #JHMChat
Improve Diagnosis @ImproveDX
RT @gopiastik: A2: I was taught if you teach a topic, they'll remember for a day. If you teach about a patient, they will remember forever.…
Andrew Olson, MD @andrewolsonmd
@JHospMedicine I think this is all about context - ie this patient had pneumonia because X, Y, Z rather than pneumonia looks like A, B, C... #teachDX #JHMChat
Annie Massart @Annie_Massart_
@JHospMedicine A2: It's important to hear the thought process behind decisions we disagree with so we can localize the error and focus feedback on that. I try to normalize mistakes, acknowledge the intense effort put forth. #JHMChat #Teach Dx
Bob Trowbridge @rltrowb
Make it regular, expected, and routine...avoid the "do you remember..." scenario. Include the positive feedback. #jhmchat #teachdx
J Hospital Medicine @JHospMedicine
@andrewolsonmd @AgnesSolberg As long as they're @JHospMedicine articles, we're ok with this teaching method? #jhmchat #improveDx
Vinny Arora MD MAPP @FutureDocs
@JHospMedicine @andrewolsonmd @SocietyHospMed @WrayCharles @NASEM_Health I wish you could see my form of celebration 😂😂😂#jhmchat #teachdx bedtime is achieved !
Annie Massart @Annie_Massart_
@JHospMedicine A2: I've also learned to use "we/our" rather than "you/your" to avoid isolating a learner in the midst of formative feedback. #JHMChat #TeachDx
Improve Diagnosis @ImproveDX
RT @Annie_Massart_: @JHospMedicine A2: It's important to hear the thought process behind decisions we disagree with so we can localize the…
Andrew Olson, MD @andrewolsonmd
@thilanMD @JHospMedicine True. My favorite hypothesis is that the diagnostic safety of an institution is directly related to how comfortable people are saying "I don't know." #teachDX #JHMChat
Sonya TG @STangGirdwood
@jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo @andrewolsonmd If there was a major change in management or the patient became acutely sick whether or not the diagnosis changed, I will often send a “heads up” email to residents to let them know before they come back to their next shift. I invite them to meet with me if interested #JHMchat
A Solberg MD, Interventional Specialist @AgnesSolberg
@andrewolsonmd @JHospMedicine In radiology we have Radiographics journal which is FULL of excellent topic reviews. Is there something like this for IM exc UpToDate? #jhmchat #RadChicks
Vinny Arora MD MAPP @FutureDocs
RT @Annie_Massart_: @JHospMedicine A2: I've also learned to use "we/our" rather than "you/your" to avoid isolating a learner in the midst o…
Andrew Olson, MD @andrewolsonmd
@Annie_Massart_ @JHospMedicine RT x 1000 here. Our learners (even at night) are NEVER alone. I use "you" with successes and "me/I" with failures often. #teachDX #JHMChat
Paul Shaniuk @PShaniuk
@Annie_Massart_ @JHospMedicine Right! Night float is still part of the team! It’s not “you” it’s “us!” #JHMChat
Andrew Olson, MD @andrewolsonmd
RT @PShaniuk: @Annie_Massart_ @JHospMedicine Right! Night float is still part of the team! It’s not “you” it’s “us!” #JHMChat
J Hospital Medicine @JHospMedicine
Great mantra to remember when thinking about giving #feedback! #jhmchat #improveDx
Sonya TG @STangGirdwood
@jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo @andrewolsonmd If there are minor changes, we have opportunity to share the feedback to senior residents during designated time after their block of overnights. #JHMChat
Society of Hospital Medicine @SocietyHospMed
#JHMChat x #teachDX conversation is up & running 👋 Follow us here tonight for the latest from @andrewolsonmd, @JHospMedicine, @ImproveDX, and our incredible participants shaping tonight's conversation! (*Cough* @gopiastik)
Andrew Olson, MD @andrewolsonmd
@STangGirdwood @jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo Love this - and how to 1) make this systematic and 2) get your colleagues to do it? #teachDX #JHMChat
Thilan Wijesekera @thilanMD
@JHospMedicine I offer areas where I struggle with that particular case or similar cases. Can help (at least I hope) ease the learners worries and show we're all learning together #teachDX #JHMChat
Jennifer Caputo @jennifermcaputo
@JHospMedicine A2 Feedback should be frequent, timely, specific, and should be given for positives as well as to address errors #JHMChat
Jen Readlynn, MD @jenreadlynn
@JHospMedicine Biggest thing I have to tell myself over & over again is that it's about a behavior & not a judgement. Making this part of the culture would remove the biggest barriers so everyone knows that this truly trying to help improve skills, just like practicing procedures. #jhmchat
Vinny Arora MD MAPP @FutureDocs
This goes out to every night float on call tonight. You are part of the care team #JHMChat #teachDX
J Hospital Medicine @JHospMedicine
@alvinseattle @WrayCharles @andrewolsonmd Welcome, Alvin. Glad you could join! #jhmchat #improveDx
Improve Diagnosis @ImproveDX
RT @thilanMD: @JHospMedicine I offer areas where I struggle with that particular case or similar cases. Can help (at least I hope) ease the…
Vinny Arora MD MAPP @FutureDocs
RT @jennifermcaputo: @JHospMedicine A2 Feedback should be frequent, timely, specific, and should be given for positives as well as to addre…
J Hospital Medicine @JHospMedicine
RT @andrewolsonmd: @thilanMD @JHospMedicine True. My favorite hypothesis is that the diagnostic safety of an institution is directly relat…
Andrew Olson, MD @andrewolsonmd
@jenreadlynn @JHospMedicine I think feedback has gotten a bad rap because people equate with grades. Instead, can we move to a coached model? #teachDX #JHMChat
Andrew Olson, MD @andrewolsonmd
@FutureDocs So true. #teachDX #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @andrewolsonmd: @jenreadlynn @JHospMedicine I think feedback has gotten a bad rap because people equate with grades. Instead, can we…
Sucharita Kher MD @sucharitakher
RT @rltrowb: Make it regular, expected, and routine...avoid the "do you remember..." scenario. Include the positive feedback. #jhmchat #t
J Hospital Medicine @JHospMedicine
RT @FutureDocs: This goes out to every night float on call tonight. You are part of the care team #JHMChat #teachDX https://t.co/EEjF3t83Bw
J Hospital Medicine @JHospMedicine
RT @jenreadlynn: @JHospMedicine Biggest thing I have to tell myself over & over again is that it's about a behavior & not a judgement. Maki…
J Hospital Medicine @JHospMedicine
RT @jennifermcaputo: @JHospMedicine A2 Feedback should be frequent, timely, specific, and should be given for positives as well as to addre…
Temple Ratcliffe @templeratcliffe
Checking in late from San Antonio — looking forward to catching up! #JHMChat #TeachDx
Vinny Arora MD MAPP @FutureDocs
@andrewolsonmd @jenreadlynn @JHospMedicine I think the feedback sandwich also killed it #JHMChat #teachdx
J Hospital Medicine @JHospMedicine
RT @SocietyHospMed: #JHMChat x #teachDX conversation is up & running 👋 Follow us here tonight for the latest from @andrewolsonmd, @JHospMe
Andrew Olson, MD @andrewolsonmd
@templeratcliffe Welcome to longtime #teachDX friend @templeratcliffe #teachDX #JHMChat
Jen Readlynn, MD @jenreadlynn
@JHospMedicine I agree with @gopiastik. Centering on the patient helps us remember the information but also why we're receiving/giving feedback in the first place. It's all about the patient. #jhmchat #teachdx
Andrew Olson, MD @andrewolsonmd
@FutureDocs @jenreadlynn @JHospMedicine So true. Made it feel like a game rather than something so integral to our learning. #teachDX #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @SocietyHospMed: #JHMChat x #teachDX conversation is up & running 👋 Follow us here tonight for the latest from @andrewolsonmd, @JHospMe
Andrew Olson, MD @andrewolsonmd
@jenreadlynn @JHospMedicine @gopiastik This is why we did patient-centered feedback in the #loop study. Was well-received despite being an extra step. #teachDX #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @jenreadlynn: @JHospMedicine I agree with @gopiastik. Centering on the patient helps us remember the information but also why we're rece…
Brian McGillen, MD @bmcgillen26
@jenreadlynn @JHospMedicine @gopiastik ...and to dovetail on @andrewolsonmd , this is about coaching better physicians. Feedback needs to be centered on helping learners improve, rather than pointing out faults. #JHMChat #clinicalreasoning
Vinny Arora MD MAPP @FutureDocs
RT @gopiastik: A2: I was taught if you teach a topic, they'll remember for a day. If you teach about a patient, they will remember forever.…
Grace Farris MD @gracefarris
@andrewolsonmd @jenreadlynn @JHospMedicine I like this idea in theory but what does it mean? #JHMCHAT https://t.co/7TjhftWxMX
J Hospital Medicine @JHospMedicine
Great conversation so far. We've got Topic 3 coming up in a few minutes...#jhmchat #improveDx
Andrew Olson, MD @andrewolsonmd
@rltrowb welcome @rltrowb #teachDX #JHMChat Glad to see you are giving it another whirl :)
Jen Readlynn, MD @jenreadlynn
@Annie_Massart_ @JHospMedicine Have been working on this more this year with my resident teams. Trying to think out loud more. I had a resident this past week who would reflect on what we possibly could have done to prevent deterioration. It was such a brave and great discussion for a new upper level. #jhmchat
Alvin Calderon, MD, PhD, FACP @alvinseattle
@JHospMedicine @andrewolsonmd #JHMChat A1: As a routine, we CC: the admission teams on DC summaries. This is a way of keeping the admission team informed regarding the outcome of their admissions.
Paul Shaniuk @PShaniuk
RT @JHospMedicine: Let's get started! I'm @WrayCharles your moderator for tonight's #JHMChat covering @andrewolsonMD & colleagues' recent a…
Andrew Olson, MD @andrewolsonmd
@jenreadlynn @Annie_Massart_ @JHospMedicine And wow what an example for everyone on the team. #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
Getting into the nuances of #coaching vs. #feedback in tonight's #jhmchat with #improvedx...
Margaret Fleming @mlsfleming2
RT @gopiastik: A2: I was taught if you teach a topic, they'll remember for a day. If you teach about a patient, they will remember forever.…
Kathleen Lane @klanemd
@bmcgillen26 @jenreadlynn @JHospMedicine @gopiastik @andrewolsonmd Absolutely! And there is value in positive reinforcement too -- all of it is good for ongoing calibration. #JHMChat #teachDX
J Hospital Medicine @JHospMedicine
RT @alvinseattle: @JHospMedicine @andrewolsonmd #JHMChat A1: As a routine, we CC: the admission teams on DC summaries. This is a way of kee…
Sonya TG @STangGirdwood
@JHospMedicine When we do feedback w/our seniors who finish a block of nights, we usually ask them if they had any questions about admissions or why we changed management on rounds. They usually have many ?’s. I know I did when I was a senior. So, they’re inviting you to give feedback. #jhmchat
Gopi Astik @gopiastik
@jenreadlynn @Annie_Massart_ @JHospMedicine Normalizing the #debriefs is key. Those are another perfect opportunity for feedback in the right environment. #JHMChat #teachDX
Vinny Arora MD MAPP @FutureDocs
@alvinseattle @JHospMedicine @andrewolsonmd That is very cool - do people appreciate ? #JHMCHAT #teachdx
Manpreet Malik @medmanny
@JHospMedicine Feedback should be a 2 way street. If you provide constructive feedback, ask for some also.. always. #jhmchat
Thilan Wijesekera @thilanMD
@Annie_Massart_ @JHospMedicine A2: Trust the process. Piggybacking off of that, I try to generalize the teaching point to future cases that learners might see. Makes it feel less like they're being graded on that particular case as opposed to empowering them with strategies moving forward #teachDX #JHMChat
Sucharita Kher MD @sucharitakher
Feedback should be not written, should be verbal and in person and if possible Just In Time. #JHMChat
Annie Massart @Annie_Massart_
@jenreadlynn @JHospMedicine That's awesome! Those conversations are how we can collectively raise the bar of excellent patient care. #JHMChat #TeachDx
Chris Moriates, MD @ChrisMoriates
RT @alvinseattle: @JHospMedicine @andrewolsonmd #JHMChat A1: As a routine, we CC: the admission teams on DC summaries. This is a way of kee…
Andrew Olson, MD @andrewolsonmd
@gracefarris @jenreadlynn @JHospMedicine It means to me that you set it up. "I'll be giving you feedback every day about X, Y, Z. I want to see you improve based on it and meet goals A, B, C. If we do that together you'll succeed." #teachDX #JHMChat
Society of Hospital Medicine @SocietyHospMed
#TeamworkMakesTheDreamWork ☺️ Agreed! @Annie_Massart @PShaniuk (Take for example: tonight's #JHMChat with #ImproveDX)
Andrew Olson, MD @andrewolsonmd
RT @Annie_Massart_: @jenreadlynn @JHospMedicine That's awesome! Those conversations are how we can collectively raise the bar of excellent…
J Hospital Medicine @JHospMedicine
Topic 3 for tonights #jhmchat with #improveDx: https://t.co/7UHfwubU8t
J Hospital Medicine @JHospMedicine
RT @Annie_Massart_: @jenreadlynn @JHospMedicine That's awesome! Those conversations are how we can collectively raise the bar of excellent…
J Hospital Medicine @JHospMedicine
RT @andrewolsonmd: @gracefarris @jenreadlynn @JHospMedicine It means to me that you set it up. "I'll be giving you feedback every day abou…
Vinny Arora MD MAPP @FutureDocs
RT @STangGirdwood: @JHospMedicine When we do feedback w/our seniors who finish a block of nights, we usually ask them if they had any quest…
J Hospital Medicine @JHospMedicine
RT @thilanMD: @Annie_Massart_ @JHospMedicine A2: Trust the process. Piggybacking off of that, I try to generalize the teaching point to fut…
Andrew Olson, MD @andrewolsonmd
A3: Clearly I'm biased, but I think the MOST effective strategy is feedback. Otherwise easy to believe I am 100% good at pneumonia because NO ONE has told me I've been wrong for years. #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
RT @andrewolsonmd: A3: Clearly I'm biased, but I think the MOST effective strategy is feedback. Otherwise easy to believe I am 100% good at…
Vinny Arora MD MAPP @FutureDocs
@alvinseattle @JHospMedicine @andrewolsonmd Great to hear #jhmchat #teachdx seems like easy to implement w #ehr
Andrew Olson, MD @andrewolsonmd
@medmanny @JHospMedicine Totally - and change because of it. Best feedback: Dr Olson, you talk too much. #teachDX #JHMChat
María José H. Woodbine @Mariajose_hw
RT @gopiastik: A2: I was taught if you teach a topic, they'll remember for a day. If you teach about a patient, they will remember forever.…
Improve Diagnosis @ImproveDX
RT @JHospMedicine: Topic 3 for tonights #jhmchat with #improveDx: https://t.co/7UHfwubU8t
Andrew Olson, MD @andrewolsonmd
@FutureDocs @alvinseattle @JHospMedicine Some awesome work happening this space to close these loops but also esp focus on diagnosis changes. #teachDX #JHMChat
Society of Hospital Medicine @SocietyHospMed
@sucharitakher Hi Sucharita! In case we didn't get a chance to say hello and welcome... Hello & welcome! Happy to have you here #JHMChat #teachDX
Trisha Marshall @TMarshall_MD
@STangGirdwood @kroussMD @andrewolsonmd @Hagedorn_MD @spatelDO Labeling uncertain diagnoses helps remove the stigma of not knowing, there is uncertainty in almost every aspect of medicine and embracing it can certainly only help #JHMChat
María José H. Woodbine @Mariajose_hw
😍😍
Jennifer Caputo @jennifermcaputo
@JHospMedicine A3 As others have mentioned, role modeling, talking through your reasoning process in front of the team so they see how you arrived at x diagnosis or treatment plan. #JHMChat
María José H. Woodbine @Mariajose_hw
RT @Annie_Massart_: @JHospMedicine A2: I've also learned to use "we/our" rather than "you/your" to avoid isolating a learner in the midst o…
Vinny Arora MD MAPP @FutureDocs
While not night float, I recently passed off 16 patients - 10 new / 6 old and definitely epic stalked to find out what happened to the new admits...useful form of feedback #Jhmchat #teachdx
Andrew Olson, MD @andrewolsonmd
@TMarshall_MD @STangGirdwood @kroussMD @Hagedorn_MD @spatelDO It's #eras season and NO ONE has every applied to IM or peds saying "I really like treating cellulitis." We all love the puzzles, so embrace 'em. #teachDX #JHMChat
Improve Diagnosis @ImproveDX
RT @TMarshall_MD: @STangGirdwood @kroussMD @andrewolsonmd @Hagedorn_MD @spatelDO Labeling uncertain diagnoses helps remove the stigma of no…
Sonya TG @STangGirdwood
RT @TMarshall_MD: @STangGirdwood @kroussMD @andrewolsonmd @Hagedorn_MD @spatelDO Labeling uncertain diagnoses helps remove the stigma of no…
Ryan Bonner @RWBonner91
@alvinseattle @JHospMedicine @andrewolsonmd Awesome idea. Some folks have brought up the idea of keeping a case log to track the course of admissions and tricky clinical decisions in general, and this step would lower the “activation energy” to doing so #JHMChat #TeachDx
J Hospital Medicine @JHospMedicine
RT @jennifermcaputo: @JHospMedicine A3 As others have mentioned, role modeling, talking through your reasoning process in front of the team…
Thilan Wijesekera @thilanMD
@JHospMedicine Modeling. More than just saying "that's reasonable", our learners want to hear how we would make problem representations, prioritize differentials, and make management decisions. #teachDX #JHMChat
Jennifer Caputo @jennifermcaputo
@JHospMedicine A3 cont and also role modeling diagnostic uncertainty and tolerance for ambiguity #JHMChat
Andrew Olson, MD @andrewolsonmd
@FutureDocs Agreed - although I have a tendency to look at the ones I'm curious/worried about rather than those that totally would surprise me. This also falls off when I get busy... #teachDX #JHMChat
Society of Hospital Medicine @SocietyHospMed
@RWBonner91 @alvinseattle @JHospMedicine @andrewolsonmd Hi there, Ryan! Welcome to the #JHMChat with @ImproveDX :) Thanks for tuning in tonight!
J Hospital Medicine @JHospMedicine
Interesting ways of improving your diagnostic skills being proposed in tonight's #jhmchat with #improveDx... Do others have experiences in this method?
Gopi Astik @gopiastik
A3: I think feedback is the best way but on rounds I like team learning with cases where students are teamed with residents and we reason through cases together. It takes the pressure off because they answer together. #JHMChat #teachDX
Rebecca Jaffe, MD @RJmdphilly
@alvinseattle @JHospMedicine @andrewolsonmd Cool idea #JHMchat #lateArrival
Jonathan Lim @JonLimMD
Lurking/catching the second half of #teachDX #JHMChat hailing from Houston, TX! Go Astros!
Grace Farris MD @gracefarris
A3- prob not this #JHMChat https://t.co/42NdZ3jeLg
Andrew Olson, MD @andrewolsonmd
@thilanMD @JHospMedicine #MedEd is odd - imagine telling someone else in your life that something is "reasonable." "Why yes, thanks chef, dinner was reasonable..." #teachDX #JHMChat
Mona Krouss MD FACP @kroussMD
@JHospMedicine Taking even "simple" cases and challenging them if x happened, what are you thinking and why? Anticipatory guidance is so important! #JHMCHAT
J Hospital Medicine @JHospMedicine
RT @FutureDocs: While not night float, I recently passed off 16 patients - 10 new / 6 old and definitely epic stalked to find out what hap…
Sonya TG @STangGirdwood
@JHospMedicine Unpopular opinion: as an overnight admitting intern, I liked staying for rounds the next morning to present patients so I could talk thru our differential and management, and learned from the ensuing discussion about what others thought. Interns don’t stay anymore. #jhmchat
Andrew Olson, MD @andrewolsonmd
@gracefarris RIGHT!!!! I think we aren't talking about 30 minute sit -downs. We are talking about micro-moments focused on specific tasks. #teachDX #JHMChat
Vinny Arora MD MAPP @FutureDocs
@RWBonner91 @alvinseattle @JHospMedicine @andrewolsonmd For the tough diagnostic dilemma cases I keep them on a list to see if things materialize as outpatients. Sometimes it takes time to complete a workup and some patients don’t meet inpatient criteria to get worked up in house #jhmchat #teachdx
Rebecca Jaffe, MD @RJmdphilly
A3 -show your work (Though as with @andrewolsonmd this does sometimes lead to the feedback that I talk too much) #JHMChat
Society of Hospital Medicine @SocietyHospMed
One of our #JHMChat x #teachDX participants encourages us to embrace the unknown in medicine 🙌 Do you agree with @TMarshall_MD? Join us with @andrewolsonmd, @ImproveDX for our #JHMchat - there's still ~20 minutes to chime in!
Annie Massart @Annie_Massart_
A3: As others said, I try to share my own diagnostic reasoning in a coherent way (which is sometimes a challenge!). Also, I share the reasoning of those smarter than myself. I use my iPad to share @CPSolvers' diagnostic schema, tweetorials from @tony_breu, etc. #JHMChat #TeachDx
Sucharita Kher MD @sucharitakher
At time of patient discharge from hosp, I often ask residents/ students what is the 1 thing they learnt when caring for this patient. #jhmchat #improvedx
Vinny Arora MD MAPP @FutureDocs
@andrewolsonmd True I def like the idea of the forcing feedback function #TeachDx #jhmchat
Jonathan Lim @JonLimMD
A3: we recently started a twilight admitting shift for residents. The first hour is protected without admissions for a dedicated, structured reflection tool to look back at prior admissions. Rather than feedback, this teaches self-directed learning #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
We're lucky at JHM to have in-house graphic artist @gracefarris to capture the nuances (and hilarity) in being a doctor. Especially around the topic of #feedback... #jhmchat #improveDx
Society of Hospital Medicine @SocietyHospMed
@RJmdphilly @alvinseattle @JHospMedicine @andrewolsonmd Hi Rebecca! (#LateArrival, but there's still plenty of #TimeOnTheClock) Welcome! #JHMchat #teachDX
Temple Ratcliffe @templeratcliffe
A3: Ask learners to identify aspects of a case that don’t fit their leading Dx. No case is a perfect fit. #JHMChat #TeachDx
Vinny Arora MD MAPP @FutureDocs
RT @JonLimMD: A3: we recently started a twilight admitting shift for residents. The first hour is protected without admissions for a dedica…
Jen Readlynn, MD @jenreadlynn
@andrewolsonmd @Annie_Massart_ @JHospMedicine Seriously! I was so impressed. The senior and I just sat and talked in front of the whole team about what we learned or would have done differently - all initiated by her. I wrote it down as something to keep doing. #jhmchat #teachdx
Herman Scholtz @hscholtz
RT @JHospMedicine: Interesting ways of improving your diagnostic skills being proposed in tonight's #jhmchat with #improveDx... Do others…
Andrew Olson, MD @andrewolsonmd
TOTALLY agree with this. #teachDX #JHMChat
Vinny Arora MD MAPP @FutureDocs
@JonLimMD Do you mind sharing what the hours of “twilight” are? #JHMChat #TeachDx
Jonathan Lim @JonLimMD
The structure reflection is also supposed to be facilitated by faculty for built in collaborative reflection and feedback. That is to say, I think promoting practice based learning and improvement and self-directed learning can also improve diagnostic reasoning #teachDX #JHMChat
Rebecca Jaffe, MD @RJmdphilly
@gracefarris Hahahahaha Grace that is me. I can’t help myself #jhmchat
Grace Farris MD @gracefarris
RT @JHospMedicine: We're lucky at JHM to have in-house graphic artist @gracefarris to capture the nuances (and hilarity) in being a doctor.…
J Hospital Medicine @JHospMedicine
RT @FutureDocs: @RWBonner91 @alvinseattle @JHospMedicine @andrewolsonmd For the tough diagnostic dilemma cases I keep them on a list to see…
J Hospital Medicine @JHospMedicine
RT @RJmdphilly: A3 -show your work (Though as with @andrewolsonmd this does sometimes lead to the feedback that I talk too much) #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @TMarshall_MD: @STangGirdwood @kroussMD @andrewolsonmd @Hagedorn_MD @spatelDO Labeling uncertain diagnoses helps remove the stigma of no…
J Hospital Medicine @JHospMedicine
RT @SocietyHospMed: One of our #JHMChat x #teachDX participants encourages us to embrace the unknown in medicine 🙌 Do you agree with @TMars
J Hospital Medicine @JHospMedicine
RT @Annie_Massart_: A3: As others said, I try to share my own diagnostic reasoning in a coherent way (which is sometimes a challenge!). Als…
Improve Diagnosis @ImproveDX
RT @gracefarris: A3- prob not this #JHMChat https://t.co/42NdZ3jeLg
Andrew Olson, MD @andrewolsonmd
@FutureDocs @JonLimMD I would love to hear more too - and also do you collect these reflections? Are you using after Mamede et al? #JHMChat #teachDX
Kathleen Lane @klanemd
@jennifermcaputo @JHospMedicine I think it's incredibly powerful to tell our trainees "I don't know" and also share how our heuristics may be coloring our diagnostic decision making. #JHMChat #teachDX
Improve Diagnosis @ImproveDX
RT @Annie_Massart_: A3: As others said, I try to share my own diagnostic reasoning in a coherent way (which is sometimes a challenge!). Als…
Rebecca Jaffe, MD @RJmdphilly
@kroussMD @JHospMedicine Great technique -taking the case one step farther, adding different variables...#jhmchat
Trisha Marshall @TMarshall_MD
@andrewolsonmd @STangGirdwood @jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo I would love to receive more peer feedback from my colleagues in HM, but would also really value a mechanism that allows bidirectional feedback and follow-up with other specialties, especially the ED and the ICU. #JHMChat
Vinny Arora MD MAPP @FutureDocs
@andrewolsonmd @RWBonner91 @alvinseattle @JHospMedicine I should have known - study done by my once co intern 😂 @sumantranji #JHMChat #TeachDx
Andrew Olson, MD @andrewolsonmd
@jenreadlynn @Annie_Massart_ @JHospMedicine Amazing moment for her and clearly as @thilanMD mentioned - great learning environment must be present. #teachDX #JHMChat
Grace Farris MD @gracefarris
@RJmdphilly I can’t with bayes #JHMCHAT https://t.co/u2MJcBWmMB
J Hospital Medicine @JHospMedicine
RT @TMarshall_MD: @andrewolsonmd @STangGirdwood @jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo I would love to receive more peer…
Temple Ratcliffe @templeratcliffe
@klanemd @jennifermcaputo @JHospMedicine Humility is key. As is pointing out both the power and potential diwnsides of heuristics in clinical reasoning. #JHMChat #TeachDx
Alvin Calderon, MD, PhD, FACP @alvinseattle
@JHospMedicine I have residents express their diagnostic certainty as a probability. Kind of like the probability of a win in a game. Then after each "diagnostic maneuver" which maybe a test or a treatment, we re-declare our diagnostic probability. This can evolve over time. #JHMChat https://t.co/eSgbwyKfof
Kathleen Lane @klanemd
@templeratcliffe I love doing this too. You can adapt the Red Team Blue Team challenge from Australia and even assign other learners to play the devil's advocate. #JHMChat #teachDX
Andrew Olson, MD @andrewolsonmd
@FutureDocs @RWBonner91 @alvinseattle @JHospMedicine @sumantranji Who was my attending too :) #teachDX #JHMChat
Gopi Astik @gopiastik
@klanemd @jennifermcaputo @JHospMedicine I agree. There are plenty of times on rounds that i'm stumped and we take a "field trip" to a white board or computer to look up/write out ideas. The 5 mins it takes shows the team its OK not to know everything and it also engages the team much more in the plan. #JHMChat #teachDX
Grace Farris MD @gracefarris
@alvinseattle @JHospMedicine #bayes #JHMchat @RJmdphilly
Andrew Olson, MD @andrewolsonmd
@klanemd @templeratcliffe And WELCOME to the LOOP study lead author @klanemd #teachDX #JHMChat
Rebecca Jaffe, MD @RJmdphilly
@gracefarris I bust it out in rounds. I think formalizing the process can help some learners. We don’t usually do math - just identify the variables. Sometimes it’s a lightbulb moment. Sometimes not...#jhmchat
J Hospital Medicine @JHospMedicine
@alvinseattle Alvin, I do believe you just made a fan in @andrewolsonmd #jhmchat #improveDx
Sonya TG @STangGirdwood
@TMarshall_MD @andrewolsonmd @jenreadlynn @JHospMedicine @bmcgillen26 @jennifermcaputo I’ve been advocating for buddy attendings!! Receive feedback in real time after rounds. That’s what I loved about first year of fellowship. #JHMChat
Andrew Olson, MD @andrewolsonmd
@alvinseattle @JHospMedicine This is calibration in action (and sweet baseball reference) #teachDX #JHMChat
Rebecca Jaffe, MD @RJmdphilly
@alvinseattle @JHospMedicine 💯 #jhmchat
Kathleen Lane @klanemd
@templeratcliffe @jennifermcaputo @JHospMedicine Humility and vulnerability are powerful tools when teaching about diagnostic decision making. #JHMChat #TeachDX
venk like vancomycin @VenkBellamkonda
RT @STangGirdwood: @kroussMD @andrewolsonmd Our “uncertain diagnosis” flag has come out of some great work done by Dr. Ipsaro, @Hagedorn_MD
Jen Readlynn, MD @jenreadlynn
@JHospMedicine A3: I encourage & model practicing. I tell them I listen to @CPSolvers, @thecurbsiders, @COREIMpodcast and use @hdx to keep up my own skills. Sometimes, I try to change one part of the case in a patient we're seeing and ask if that would change things for them. #jhmchat #teachdx
Vinny Arora MD MAPP @FutureDocs
@andrewolsonmd @RWBonner91 @alvinseattle @JHospMedicine @sumantranji Small world 🌎 #JHMChat #TeachDx Like all IM residents who weren’t applying to subspecialty fellowship we wondered if we were abnormal and at least we were not alone 😂😂😂
Grace Farris MD @gracefarris
@RJmdphilly @alvinseattle @JHospMedicine @ebtapper have you been converted to this approach yet? #JHMchat
Jimmy beck @Jbbeck7
A3. #jhmchat #teachDX. So each night when I check in with my overnight sr resident, I ask them which admissions from the prior night, do they want to talk about.
Rebecca Jaffe, MD @RJmdphilly
@JonLimMD @estewart2099 @JeffIMchiefs this is a brilliant structural change to improve learning. Great idea.#jhmchat
Andrew Olson, MD @andrewolsonmd
@Jbbeck7 This is fantastic - and we also have found key to ask the day teams which patients they want to GIVE feedback about too. Not completely overlapping Venn Diagram. #teachDX #JHMChat
Society of Hospital Medicine @SocietyHospMed
Before we get the #JHMChat started 👀 SHM's Accreditation & Designation Statement: Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians: https://t.co/aJ76JeTpml
J Hospital Medicine @JHospMedicine
We've got about 10 min left in tonight's co-#jhmchat & #improveDx chat... Wanted to leave these last few minutes open for general comments on: Feedbacks, Handoffs, and Diagnostic Reasoning...
J Hospital Medicine @JHospMedicine
RT @SocietyHospMed: Before we get the #JHMChat started 👀 SHM's Accreditation & Designation Statement: Society of Hospital Medicine is acc…
Andrew Olson, MD @andrewolsonmd
@FutureDocs @RWBonner91 @alvinseattle @JHospMedicine @sumantranji It appears you have done ok. #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
RT @jenreadlynn: @JHospMedicine A3: I encourage & model practicing. I tell them I listen to @CPSolvers, @thecurbsiders, @COREIMpodcast and…
Improve Diagnosis @ImproveDX
RT @JHospMedicine: We've got about 10 min left in tonight's co-#jhmchat & #improveDx chat... Wanted to leave these last few minutes open…
Jimmy beck @Jbbeck7
#jhmchat #teachdx. I ask that question before I ‘run the list’ of established patients - which is my subtle way of giving feedback.
Alvin Calderon, MD, PhD, FACP @alvinseattle
@JHospMedicine Here's my favorite article: diagnostic accuracy of residents: 66%. Diagnostic accuracy of attendings (who built on residents' assessements) : 78%. Accuracy changes over time and with added information. #JHMChat https://t.co/F6EIBpZfrq
J Hospital Medicine @JHospMedicine
RT @templeratcliffe: @klanemd @jennifermcaputo @JHospMedicine Humility is key. As is pointing out both the power and potential diwnsides of…
Improve Diagnosis @ImproveDX
RT @alvinseattle: @JHospMedicine Here's my favorite article: diagnostic accuracy of residents: 66%. Diagnostic accuracy of attendings (who…
Society of Hospital Medicine @SocietyHospMed
Important lessons being taught here tonight with @JHospMedicine, @ImproveDX, and @klanemd ☺️ What are other powerful tools or resources for how you teach diagnostic decision making? Chime in here: #JHMChat #teachDX (...There's still 10 minutes!)
Andrew Olson, MD @andrewolsonmd
@alvinseattle @JHospMedicine This is a classic - and the whole point of our study was that diagnoses change and we have a duty to make sure people know that after they handover. #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
RT @SocietyHospMed: Important lessons being taught here tonight with @JHospMedicine, @ImproveDX, and @klanemd ☺️ What are other powerful t…
Vasudha Goel MD @PainDocGoel
RT @andrewolsonmd: A1: Excited to hear ideas, but I'll weigh in. We view handovers as barriers - but can we seem them as opportunities for…
Society of Hospital Medicine @SocietyHospMed
@Jbbeck7 (Welcome to the #JHMChat tonight, Jimmy!)
venk like vancomycin @VenkBellamkonda
RT @andrewolsonmd: A1: Excited to hear ideas, but I'll weigh in. We view handovers as barriers - but can we seem them as opportunities for…
Vinny Arora MD MAPP @FutureDocs
I like twilight shift better than what we call “bridge” in hosp medicine -sounds so calming ironically #JHMChat #TeachDx
Improve Diagnosis @ImproveDX
RT @templeratcliffe: @klanemd @jennifermcaputo @JHospMedicine Humility is key. As is pointing out both the power and potential diwnsides of…
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: We've got about 10 min left in tonight's co-#jhmchat & #improveDx chat... Wanted to leave these last few minutes open…
Andrew Olson, MD @andrewolsonmd
@FutureDocs sign me up for the twilight shift! #teachDX #JHMChat
Jen Readlynn, MD @jenreadlynn
@andrewolsonmd @Jbbeck7 This is a great way to get those "surprise" diagnoses that the admitting team thought was a slam dunk. #jhmchat #teachdx
Jonathan Lim @JonLimMD
Other powerful tools to teach diagnostic decision making is having a shared mental model of milestones in this competency. What does a year 1 vs 2 vs 3 vs master clinician look like. How are you yet/not yet there. I think will be forthcoming in 2.0 milestones. #JHMchat #TeachDx
Andrew Olson, MD @andrewolsonmd
@jenreadlynn @Jbbeck7 So true. This happened to me recently in a patient who I was *sure* had a PE.... Heparin treats pneumonia too, right? #teachDX #JHMChat
Kathleen Lane @klanemd
@gopiastik @jennifermcaputo @JHospMedicine That's great! I'll also bring up Isabel and talk about what variables we should input, and discuss the diagnoses it suggests. And show learners how we all Google things behind the scenes. #JHMChat #TeachDX
J Hospital Medicine @JHospMedicine
Appreciate everyone showing up for tonight's #JHMChat and #ImproveDx with @andrewolsonMD and the @ImproveDX team! Stellar conversation that we hope was enlightening and thought-provoking...
Andrew Olson, MD @andrewolsonmd
@JonLimMD They are a big step forward. #teachDX #JHMChat
Vinny Arora MD MAPP @FutureDocs
@andrewolsonmd @RWBonner91 @alvinseattle @JHospMedicine @sumantranji Yes we both did:) still amazing how much career uncertainty one has early in training #JHMChat #teachdx
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Appreciate everyone showing up for tonight's #JHMChat and #ImproveDx with @andrewolsonMD and the @ImproveDX team! Stel…
J Hospital Medicine @JHospMedicine
@klanemd @gopiastik @jennifermcaputo Glad we were able to get you in the #jhmchat conversation, @klanemd
Improve Diagnosis @ImproveDX
@JHospMedicine @andrewolsonmd Great conversation tonight! Thanks to @SocietyHospMed/@JHospMedicine for hosting this chat! #TeachDx #JHMChat
Jimmy beck @Jbbeck7
#jhmchat #teachDX. Does anyone belong to a division that has a built in mechanism for providing peer to peer feedback?
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Appreciate everyone showing up for tonight's #JHMChat and #ImproveDx with @andrewolsonMD and the @ImproveDX team! Stel…
J Hospital Medicine @JHospMedicine
RT @klanemd: @gopiastik @jennifermcaputo @JHospMedicine That's great! I'll also bring up Isabel and talk about what variables we should in…
Vinny Arora MD MAPP @FutureDocs
RT @Jbbeck7: #jhmchat #teachDX. Does anyone belong to a division that has a built in mechanism for providing peer to peer feedback?
Vinny Arora MD MAPP @FutureDocs
RT @ImproveDX: @JHospMedicine @andrewolsonmd Great conversation tonight! Thanks to @SocietyHospMed/@JHospMedicine for hosting this chat! #T
Andrew Olson, MD @andrewolsonmd
Thanks for the invitiation and the collaboration. SO much work to do in this space. Thanks to all! Also some nice resources for diagnosis here at https://t.co/PinVrXVCvF and join us for our DEM conference next month! #JHMChat #teachDX
Society of Hospital Medicine @SocietyHospMed
RT @ImproveDX: @JHospMedicine @andrewolsonmd Great conversation tonight! Thanks to @SocietyHospMed/@JHospMedicine for hosting this chat! #T
J Hospital Medicine @JHospMedicine
RT @alvinseattle: @JHospMedicine Here's my favorite article: diagnostic accuracy of residents: 66%. Diagnostic accuracy of attendings (who…
J Hospital Medicine @JHospMedicine
RT @andrewolsonmd: Thanks for the invitiation and the collaboration. SO much work to do in this space. Thanks to all! Also some nice res…
Gopi Astik @gopiastik
@Jbbeck7 This is my current research project! I hope to have some results in the coming months! #JHMChat #teachDX
Andrew Olson, MD @andrewolsonmd
We piloted a few years back and @rltrowb has for years - glad to share more, Jimmy! #teachDX #JHMChat
Jimmy beck @Jbbeck7
#jhmchat #teachdx. Three days after I go off service I always email the attending who took over for me. Asking for feedback. But most of the time I don’t get much feedback 😔
Improve Diagnosis @ImproveDX
RT @andrewolsonmd: Thanks for the invitiation and the collaboration. SO much work to do in this space. Thanks to all! Also some nice res…
J Hospital Medicine @JHospMedicine
RT @gopiastik: @Jbbeck7 This is my current research project! I hope to have some results in the coming months! #JHMChat #teachDX
Gopi Astik @gopiastik
@andrewolsonmd @jenreadlynn @Jbbeck7 My current project came to be because I missed a PE in a flu patient. #lifelonglearning #teachDX #JHMChat
Andrew Olson, MD @andrewolsonmd
@Jbbeck7 True dat. Has become part of my practice too and excited when mentees like @klanemd do the same. #teachDX #JHMChat
J Hospital Medicine @JHospMedicine
We're working on our next #JHMChat topic -- so stay tuned for dates and time in the coming weeks. Thanks again, everyone!
Annie Massart @Annie_Massart_
@Jbbeck7 We tried launching peer observation of teaching attendings a few years back. It dissolved after about 18 months bc of a lack of interest. I'm still trying to think of ways to generate enthusiasm for it bc I think it's an incredible faculty development tool. #JHMChat #TeachDx
Vinny Arora MD MAPP @FutureDocs
Closing thought -love the LOOP as a way to improve education and care on night or admitting rotations. Our prior work has shown night work can be very isolating so this def provides a way to stay connected to team and patients #JHMChat #TeachDX
Vinny Arora MD MAPP @FutureDocs
RT @andrewolsonmd: Thanks for the invitiation and the collaboration. SO much work to do in this space. Thanks to all! Also some nice res…
Kathleen Lane @klanemd
@andrewolsonmd @Jbbeck7 Taking inspiration from Wes Miller and @andrewolsonmd ! Practice what we preach and spread the culture change. #JHMChat #teachDX
Andrew Olson, MD @andrewolsonmd
@FutureDocs Thanks for your support @FutureDocs - much work to do but a good step. Night shifts aren't going anywhere so let's embrace them to make them great learning opps. #teachDX #JHMChat
Society of Hospital Medicine @SocietyHospMed
Thank you to everyone who participated in tonight's #JHMChat + #teachDX discussion w @JHospMedicine & @ImproveDX! 🍂 We'd also like to thank our guest expert @AndrewOlsonMD & JHM moderator, @WrayCharles for leading the discussion. We learned so much! 'Til next time! 👋
Improve Diagnosis @ImproveDX
RT @SocietyHospMed: Thank you to everyone who participated in tonight's #JHMChat + #teachDX discussion w @JHospMedicine & @ImproveDX! 🍂…
Dr. Sima Pendharkar @SimaPendharkar
Great paper @andrewolsonmd and important topic. It is surprising to see that 44% of diagnoses were changed, we need to do better here! #JHMchat
J Hospital Medicine @JHospMedicine
RT @SocietyHospMed: Thank you to everyone who participated in tonight's #JHMChat + #teachDX discussion w @JHospMedicine & @ImproveDX! 🍂…
Jen Readlynn, MD @jenreadlynn
@SocietyHospMed @JHospMedicine @ImproveDX @andrewolsonmd @WrayCharles Thank you so much for this chat! It was so great and I have way too many ideas floating around my head now! Hope to meet at least some of you in Chicago this week for #midwesthospmed! #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @jenreadlynn: @SocietyHospMed @JHospMedicine @ImproveDX @andrewolsonmd @WrayCharles Thank you so much for this chat! It was so great and…
Andrew Olson, MD @andrewolsonmd
@SimaPendharkar I think that ok that 44% changed - but a tragedy that without feedback people think 0% changed.... #teachDX #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @SocietyHospMed: Thank you to everyone who participated in tonight's #JHMChat + #teachDX discussion w @JHospMedicine & @ImproveDX! 🍂…
Society of Hospital Medicine @SocietyHospMed
RT @jenreadlynn: @SocietyHospMed @JHospMedicine @ImproveDX @andrewolsonmd @WrayCharles Thank you so much for this chat! It was so great and…
Alvin Calderon, MD, PhD, FACP @alvinseattle
@JHospMedicine #jhmchat #improveDx I ask my residents NOT "are you sure?" (yes/no), rather, "how sure are you?" (%). The follow up questions: What will make you change your mind? They don't have to be "confident," altho they have to know how "confident they are."
J Hospital Medicine @JHospMedicine
@jenreadlynn @SocietyHospMed @ImproveDX @andrewolsonmd @WrayCharles Glad you enjoyed it, Jen! #jhmchat #improveDx
J Hospital Medicine @JHospMedicine
RT @SimaPendharkar: Great paper @andrewolsonmd and important topic. It is surprising to see that 44% of diagnoses were changed, we need to…
J Hospital Medicine @JHospMedicine
RT @alvinseattle: @JHospMedicine #jhmchat #improveDx I ask my residents NOT "are you sure?" (yes/no), rather, "how sure are you?" (%). The…
Brian McGillen, MD @bmcgillen26
Thanks to @WrayCharles for moderating! Great work @klanemd and @andrewolsonmd . Really enjoyed this work, and it's already changed my practice. #JHMChat
Benjamin P. Geisler @ben_geisler
Another great #JHMchat @andrewolsonmd and @WrayCharles
Abby Spencer, MD, MS, FACP @abbyCCim
RT @JonLimMD: Other powerful tools to teach diagnostic decision making is having a shared mental model of milestones in this competency. Wh…
Society of Hospital Medicine @SocietyHospMed
A reminder: You still have time to claim CME from this #JHMChat 📚 Credit available until 11:59 PM ET (10.22) 👉 This way to claim: https://t.co/I7yAwFP16X https://t.co/FIWP84gPBN
Lekshmi Santhosh @LekshmiMD
@JHospMedicine I'm a big fan of asking "What ifs?" In a more "straightforward" case. What if they also had bad R heart failure? What if this was their third admission for this same problem? #JHMChat #teachDx
R Logan Jones, M.D. @rloganjonesmd
@JHospMedicine A3) instill lifelong excellence: 1️⃣ditch the paper 2️⃣emphasize long term pt tracking (emphasize behaviors, not knowledge) 3️⃣try calling 1 pt a week to see how they’re doing (follow up) 4️⃣do so respecting pt privacy & autonomy #JHMChat #teachdx @andrewolsonmd @FutureDocs https://t.co/YIqkOGcLon
Andrew Olson, MD @andrewolsonmd
RT @rloganjonesmd: @JHospMedicine A3) instill lifelong excellence: 1️⃣ditch the paper 2️⃣emphasize long term pt tracking (emphasize behavio…
Emily Fridenmaker @emily_fri
RT @LekshmiMD: @JHospMedicine I'm a big fan of asking "What ifs?" In a more "straightforward" case. What if they also had bad R heart failu…
Brian may @Bmayzing
RT @alvinseattle: @JHospMedicine Here's my favorite article: diagnostic accuracy of residents: 66%. Diagnostic accuracy of attendings (who…
minisingh @drminisingh
RT @JHospMedicine: The countdown is on! #JHMChat is Tues, Oct 22 at 9PM EST. We'll be discussing Handoffs, Feedback and Clinical Reasoning…
J Hospital Medicine @JHospMedicine
RT @rloganjonesmd: @JHospMedicine A3) instill lifelong excellence: 1️⃣ditch the paper 2️⃣emphasize long term pt tracking (emphasize behavio…
Chris Moreland @cjmoreland
@Jbbeck7 @FutureDocs Our @UTHealthHospMed division implemented peer obs of teaching w/ good results, though hard to maintain w/ clinical volume. Needs sustained engagement & shared mental model, w/ someone (eg, staff member) driving regular connections & f-up on peer observations. #MedEd #JHMChat
#jhmchat content from Twitter.