#jhmchat Transcript
Healthcare social media transcript of the #jhmchat hashtag.
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See #jhmchat Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Eliezer Shinnar @Amraphel18 Excited to join my first #JHMChat tonight! |
 | Journal of Hospital Medicine @JHospMedicine Greetings, I'm @WrayCharles your moderator for tonight's #JHMChat examining the variability in exposure & confidence in managing hospital acute events. Go ahead and introduce yourself while we wait for others to join |
 | Daniel Ricotta, MD, SFHM @DanielRicottaMD Hi all! Looking forward to this chat - Dan Ricotta checking in from Boston! #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation 4 bringing you #JHMChat tonight |
 | Society of Hospital Medicine @SocietyHospMed #JHMChat is on! Come on in for some great convo on #meded with @JHospMedicine. |
| Journal of Hospital Medicine @JHospMedicine Don't forget to tag your tweets with #JHMChat! Topic 1 up in a moment… |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: #JHMChat is on! Come on in for some great convo on #meded with @JHospMedicine. |
 | Anika Kumar, MD (she/her) @freckledpedidoc @JHospMedicine @WrayCharles Hi #JHMChat! It’s Anika Kumar, Peds Hospitalist from Cleveland. Excited to learn about #MedEd in Adult-land. |
| Journal of Hospital Medicine @JHospMedicine RT @JHospMedicine: Greetings, I'm @WrayCharles your moderator for tonight's #JHMChat examining the variability in exposure & confidence in managing hospital acute events. Go ahead and introduce yourself while we wait for others to join |
 | Ben Kinnear @Midwest_MedPeds Very excited to be part of the conversation! Checking in from Cincinnati #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Don't forget to tag your tweets with #JHMChat! Topic 1 up in a moment… |
| Journal of Hospital Medicine @JHospMedicine Joining the #JHMChat tonight? Grab your CME here: |
 | Andrew Olson, MD @andrewolsonmd RT @SHMLive: #JHMChat is on! Come on in for some great convo on #meded with @JHospMedicine. |
 | Vinny Arora MD MAPP @FutureDocs RT @SHMLive: #JHMChat is on! Come on in for some great convo on #meded with @JHospMedicine. |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Greetings, I'm @WrayCharles your moderator for tonight's #JHMChat examining the variability in exposure & confidence in managing hospital acute events. Go ahead and introduce yourself while we wait for others to join |
 | Kaishauna Guidry, MD, HMDC @DrMamaKai @JHospMedicine @WrayCharles Hello from Southern California. I’m a hospice physician in Riverside. #JHMchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Joining the #JHMChat tonight? Grab your CME here: Joining the #JHMChat tonight? Grab your CME here: |
 | Jen Readlynn, MD, FHM (she/her) @jenreadlynn Jen Readlynn, hospitalist from Rochester, NY #jhmchat |
 | The Human Diagnosis Project @hdx RT @SHMLive: #JHMChat is on! Come on in for some great convo on #meded with @JHospMedicine. |
 | Jennifer Caputo-Seidler, MD @jennifermcaputo @JHospMedicine @WrayCharles Jen Caputo, hospitalist in Tampa #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Tonight's chat covers a lot of territory and we're lucky to have our guests @MelissaPlesacMD (A JHM Editorial Fellow) and @andrewolsonmd to help us make sense of it all...#JHMChat |
| Vinny Arora MD MAPP @FutureDocs Hi Vinny Arora from @UChicagoMed and #jhmchat moderator off duty tonight but excited for #JHMChat on #meded article and welcome to any #HMIEducators ! |
| Society of Hospital Medicine @SocietyHospMed #JHMChat is underway! Don't miss out on the conversation with @JHospMedicine, @WrayCharles, @MelissaPlesacMD and @andrewolsonmd on the variability in #mededtraining! |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Tonight's chat covers a lot of territory and we're lucky to have our guests @MelissaPlesacMD (A JHM Editorial Fellow) and @andrewolsonmd to help us make sense of it all...#JHMChat |
 | Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @JHospMedicine @WrayCharles Sonya, #PedsHM fellow from Cincy! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Let's get going with Q1 of tonights #JHMChat: https://t.co/FjxkAK7HQf |
 | VC @doctorvec Victor Collier Academic Hospitalizt and PD checking in from Myrtle Beach #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Let's get going with Q1 of tonights #JHMChat: Let's get going with Q1 of tonights #JHMChat: https://t.co/FjxkAK7HQf |
| Journal of Hospital Medicine @JHospMedicine @jennifermcaputo @WrayCharles Welcome, Jen! #jhmchat |
 | Zach Lauer @RealZachLauer Excited to be a part of the discussion! Current chief resident w/ @kuimchiefs and hospitalist starting this summer. Checking in from Kansas City #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @doctorvec Glad you could make it, Victor! #JHMChat |
| Andrew Olson, MD @andrewolsonmd @JHospMedicine @MelissaPlesacMD Maybe! We will try! Many layers of this #meded onion... #JHMChat |
| Andrew Olson, MD @andrewolsonmd RT @FutureDocs: Hi Vinny Arora from @UChicagoMed and #jhmchat moderator off duty tonight but excited for #JHMChat on #meded article and welcome to any #HMIEducators ! |
| Andrew Olson, MD @andrewolsonmd RT @Midwest_MedPeds: Very excited to be part of the conversation! Checking in from Cincinnati #JHMChat |
 | Kristina Dzara, PhD, MMSc @KristinaDzara RT @JHospMedicine: Let's get going with Q1 of tonights #JHMChat: Let's get going with Q1 of tonights #JHMChat: https://t.co/FjxkAK7HQf |
| Journal of Hospital Medicine @JHospMedicine Tonight's discussion could definitely use our #meded trainee perspective. Glad to have you join in, @RealZachLauer #jhmchat |
| Ben Kinnear @Midwest_MedPeds Q1: Our assessment system is in large part based on observable skills. We audit this periodically to see what our residents are assessed on. Does not reflect entirety of experience though @JHospMedicine #JHMChat |
| Vinny Arora MD MAPP @FutureDocs winning-- enter your first twitter chat as a discussant :) #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Let's get going with Q1 of tonights #JHMChat: Let's get going with Q1 of tonights #JHMChat: https://t.co/FjxkAK7HQf |
| Kristina Dzara, PhD, MMSc @KristinaDzara Kristina here checking in for #jhmchat. Thanks to @FutureDocs for inviting all of us #HMIEducators to join the conversation this evening! #MedEd https://t.co/PdvlkfoysH |
| Journal of Hospital Medicine @JHospMedicine @andrewolsonmd @MelissaPlesacMD Yeah, but its you guys....#jhmchat |
| Kristina Dzara, PhD, MMSc @KristinaDzara RT @FutureDocs: Hi Vinny Arora from @UChicagoMed and #jhmchat moderator off duty tonight but excited for #JHMChat on #meded article and welcome to any #HMIEducators ! |
| Vinny Arora MD MAPP @FutureDocs RT @kristinadzara: Kristina here checking in for #jhmchat. Thanks to @FutureDocs for inviting all of us #HMIEducators to join the conversation this evening! #MedEd https://t.co/PdvlkfoysH |
| Kristina Dzara, PhD, MMSc @KristinaDzara RT @JHospMedicine: Don't forget to tag your tweets with #JHMChat! Topic 1 up in a moment… |
| Andrew Olson, MD @andrewolsonmd A1: This is hard in residency - but What if we move even further back? Like entering residency - we assume they all start the same place. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @kristinadzara: Kristina here checking in for #jhmchat. Thanks to @FutureDocs for inviting all of us #HMIEducators to join the conversation this evening! #MedEd https://t.co/PdvlkfoysH |
 | Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser @FutureDocs #jhmchat make sure it goes on your CV!! right @FutureDocs @WrayCharles @ETSshow ?? |
| Society of Hospital Medicine @SocietyHospMed 😂💯 ALWAYS use #JHMChat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @JHospMedicine As residents, we were supposed to log in different experiences based on ACGME requirements. They were reviewed by PDs during annual check-ins. But many residents waited til 3rd yr to log everything. Experience gaps are probably best identified when admitted by trainee. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Are there any programs/individuals out there who have really formalized this process...? #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Q1 #jhmchat a few years ago i realized a trainee had never seen a case of end stage AIDS in hospital. it symbolized how far we have come with the treatment of HIV, but impt to ensure ways to get clinical expertise with cases that ideally will never occur. like MEASLES |
| Jennifer Caputo-Seidler, MD @jennifermcaputo A1 Try to augment clinical experience with simulation especially for procedures and codes going into PGY2, I’m not sure that we have a system in place to measure expose to specific diagnoses #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Lots of truth here. Data is only as good as how available it is...#JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Are there any programs/individuals out there who have really formalized this process...? #JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser @FutureDocs #jhmchat that's a fantastic point. and not just across time/era, but also geography. A medical student from Oregon has probably never diagnosed Lyme Disease...and may find themselves in the NE for residency |
| Anika Kumar, MD (she/her) @freckledpedidoc A1. I agree with @aoglasser. Although I know nothing about IM residency, the Peds residency programs have used feedback, written evaluations and verbal feedback through focus groups. #JHMChat |
| Kaishauna Guidry, MD, HMDC @DrMamaKai @JHospMedicine #JHMChat I haven’t observed a standard way to identify gaps. |
| Ben Kinnear @Midwest_MedPeds @STangGirdwood @JHospMedicine Even this is flawed. Experiences are not all the same. DKA w hypotenson severe acidocis and hyponatremia does not equal mildly acidotic feeling well DKA. How do you know when you've "experienced" a condition when one condition can present 1000 ways? @JHospMedicine #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @JHospMedicine . @ijanders1 has looked into this for subinterns using @yammer as a way to augment experience for subinterns- see @jmir https://t.co/vJhAwG5Jqm #jhmchat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @jennifermcaputo A1: I believe this is our system as well. Doing simulation for high stakes things like codes but don't really recall logging cases, only procedures. I think ITE was used as a surrogate. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Great example. Does anyone, say on Day1, survey their residents for their "experience gaps"? @MelissaPlesacMD @andrewolsonmd #JHMChat |
| Andrew Olson, MD @andrewolsonmd It's been said that if you don't see it you won't see it. This is true, but we cannot (as this study shows) rely on the #learningenvironment in #meded to deliver curriculum! #JHMChat |
 | Harvard Macy @HarvardMacy RT @kristinadzara: Kristina here checking in for #jhmchat. Thanks to @FutureDocs for inviting all of us #HMIEducators to join the conversation this evening! #MedEd https://t.co/PdvlkfoysH |
| Society of Hospital Medicine @SocietyHospMed If you're participating in #JHMChat, remember to use the hashtag in each tweet to ensure they're a part of the larger conversation! |
| Harvard Macy @HarvardMacy RT @FutureDocs: Hi Vinny Arora from @UChicagoMed and #jhmchat moderator off duty tonight but excited for #JHMChat on #meded article and welcome to any #HMIEducators ! |
 | MedEdBot @MedEdBot RT @JHospMedicine: Tonight's discussion could definitely use our #meded trainee perspective. Glad to have you join in, @RealZachLauer #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @andrewolsonmd: A1: A1: This is hard in residency - but What if we move even further back? Like entering residency - we assume they all start the same place. #JHMChat |
| MedEdBot @MedEdBot RT @kristinadzara: Kristina here checking in for #jhmchat. Thanks to @FutureDocs for inviting all of us #HMIEducators to join the conversation this evening! #MedEd https://t.co/PdvlkfoysH |
| Harvard Macy @HarvardMacy RT @jac2thersq: Looking forward to this #JHMChat tonight! |
| Ben Kinnear @Midwest_MedPeds Q1 Blueprinting content for a field as massive as IM or Peds is impossible - too much to see/learn to experience everything. More important is ensuring learners: 1. Know when they don't know 2. Know where to find answers 3. Know when/how to ask for help #JHMChat |
| MedEdBot @MedEdBot RT @andrewolsonmd: It's been said that if you don't see it you won't see it. This is true, but we cannot (as this study shows) rely on the #learningenvironment in #meded to deliver curriculum! #JHMChat |
 | Lonika Sood @sood_lonika @JHospMedicine @WrayCharles Lonika Sood, from Spokane wa #jhmchat |
 | Subha Airan-Javia MD FAMIA (she/her) @subhaairan @JHospMedicine A1 - Prob not the level of interaction you are looking for, but I usually ask students/trainees at the start of a rotation what they feel like they need help with/haven’t seen or done enough of, so we can prioritize it for them #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @andrewolsonmd: It's been said that if you don't see it you won't see it. This is true, but we cannot (as this study shows) rely on the #learningenvironment in #meded to deliver curriculum! #JHMChat |
| Andrew Olson, MD @andrewolsonmd There are examples of this in the literature - but not adaptive learning. #JHMChat https://t.co/1HmOwgm9xd |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood RT @Midwest_MedPeds: @STangGirdwood @JHospMedicine Even this is flawed. Experiences are not all the same. DKA w hypotenson severe acidocis and hyponatremia does not equal mildly acidotic feeling well DKA. How do you know when you've "experienced" a condition when one condition can present 1000 ways? @JHospMedicine #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @andrewolsonmd . we assume trainees are blank slates but they are not. just ask all incoming interns the last time they saw a patient - the answer will be all over the place with best answer usu within 3 months, the worst >6 months. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine @sood_lonika @WrayCharles Glad you could make it, Lonika! #jhmchat |
| Lonika Sood @sood_lonika @subhaairan @JHospMedicine A1: listening in to correct this at #ume level #JHMchat |
| Kristina Dzara, PhD, MMSc @KristinaDzara RT @JHospMedicine: Tonight's discussion could definitely use our #meded trainee perspective. Glad to have you join in, @RealZachLauer #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Great example. Does anyone, say on Day1, survey their residents for their "experience gaps"? @MelissaPlesacMD @andrewolsonmd #JHMChat |
 | Rebecca Jaffe, MD @RJmdphilly #JHMChat I'm here! Catching up! (bedtime interlude while husband takes a turn herding the wild things) |
| Journal of Hospital Medicine @JHospMedicine Great insights so far, we've got Question #2 coming shortly... #JHMChat |
| Andrew Olson, MD @andrewolsonmd @aoglasser @jenreadlynn @jennifermcaputo @OHSUIMRes Love it! I think that this is a real advertisement for competency-based medical education. Know the outcomes we want, measure progress, and design curricula to meet gaps. Not the same for everyone. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @freckledpedidoc i had to drop this in there for you #tweetiatrician #vaccineswork #jhmchat |
| Eliezer Shinnar @Amraphel18 @aoglasser @jenreadlynn @jennifermcaputo @OHSUIMRes I do remember having diagnosis logs as a med student. I just signed off one for my subI #JHMChat |
| Kristina Dzara, PhD, MMSc @KristinaDzara RT @SHMLive: If you're participating in #JHMChat, remember to use the hashtag in each tweet to ensure they're a part of the larger conversation! |
| Anika Kumar, MD (she/her) @freckledpedidoc Great point @Midwest_MedPeds! #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @gracefarris @andrewolsonmd Tweetorial with links! #JHMChat https://t.co/lkqDrk0YXK |
| Vinny Arora MD MAPP @FutureDocs RT @Midwest_MedPeds: Q1 Blueprinting content for a field as massive as IM or Peds is impossible - too much to see/learn to experience everything. More important is ensuring learners: 1. Know when they don't know 2. Know where to find answers 3. Know when/how to ask for help #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Here's Question #2 for tonights #JHMChat: https://t.co/eIhwraVa9x |
| Daniel Ricotta, MD, SFHM @DanielRicottaMD RT @RJmdphilly: @gracefarris @andrewolsonmd Tweetorial with links! #JHMChat https://t.co/lkqDrk0YXK |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Great insights so far, we've got Question #2 coming shortly... #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Here's Question #2 for tonights #JHMChat: Here's Question #2 for tonights #JHMChat: https://t.co/eIhwraVa9x |
 | Jackcy Jacob @jac2thersq This is definitely difficult. Creating MICRO-sim sessions on the fly (rather than waiting to do large sim sessions that require a lot more organization) might be one way to get exposure to illnesses during "down times" on the wards (does that even happen these days???) #JHMChat |
| Lonika Sood @sood_lonika @JHospMedicine A2: deliberate practice, mastery learning in authentic clinical contexts, coaching #JHMchat |
| Rebecca Jaffe, MD @RJmdphilly @gretchendiemer @dmitripapa |
| Anika Kumar, MD (she/her) @freckledpedidoc @aoglasser @jenreadlynn @jennifermcaputo @OHSUIMRes Our #PedsHM fellows have “diagnosis logs”. It’s a way we assess if our fellows experiential learning #JHMChat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @Midwest_MedPeds @JHospMedicine So true. Trainees don’t know what they don’t know if they aren’t sure what all exists in the clinical world. #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @Amraphel18 @aoglasser @jennifermcaputo @OHSUIMRes Med students definitely do - and use Aquifer cases to ensure all are exposed but I don't think our residents do. Our sub-Is don't. #JHMChat |
| Subha Airan-Javia MD FAMIA (she/her) @subhaairan @MelissaPlesacMD @JHospMedicine @andrewolsonmd Totally true. I work part time - very part time. So I have those gaps as well! when learners identify gaps that I have as well, I say “great! I need help with as well - we can learn together” #JHMchat |
| Journal of Hospital Medicine @JHospMedicine Fantastic insight @MelissaPlesacMD! We've been talking about our learners as if they exist in isolation -- but a more complex and realistic way to think about the issue is in the context of who is their educator, as well...#jhmchat |
| Daniel Ricotta, MD, SFHM @DanielRicottaMD A2: Lots of literature suggesting comfort / confidence does not equate with competence - I would make similar parallels to quality #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @jac2thersq: This is definitely difficult. Creating MICRO-sim sessions on the fly (rather than waiting to do large sim sessions that require a lot more organization) might be one way to get exposure to illnesses during "down times" on the wards (does that even happen these days???) #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Here's Question #2 for tonights #JHMChat: Here's Question #2 for tonights #JHMChat: https://t.co/eIhwraVa9x |
| Subha Airan-Javia MD FAMIA (she/her) @subhaairan @Midwest_MedPeds Yes yes yes!!!! Can’t like this enough! #JHMchat |
| Vinny Arora MD MAPP @FutureDocs @CarolMarceloMD @JHospMedicine @WrayCharles welcome to #jhmchat! |
| Rebecca Jaffe, MD @RJmdphilly @Midwest_MedPeds @STangGirdwood @JHospMedicine don't you have the answer for this one @midwest_MedPeds? If not I feel like we might all be at a loss... #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @DanielRicottaMD: A2: A2: Lots of literature suggesting comfort / confidence does not equate with competence - I would make similar parallels to quality #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @CarolMarceloMD @WrayCharles Glad to have you, Carol! Haven't seen @michellebr00ks tonight...:) #jhmchat |
| Society of Hospital Medicine @SocietyHospMed Don’t miss out on insights from your #hospitalist colleagues across the world on #JHMChat in progress now! |
| Ben Kinnear @Midwest_MedPeds Q2 Dunning and Kruger showed that confidence does not equal competence. In fact, often the opposite. Hard to know if those with more confidence are truly more competent or not. Depends where they are on the curve. @JHospMedicine #JHMChat https://t.co/G6ILnVzRiZ |
| Zach Lauer @RealZachLauer @FutureDocs @andrewolsonmd Also, those experiences are not equal. One of my resident colleagues first time rounding on a large interdisciplinary academic team was his first day of residency. Ultimately, a great resident but not a similar background coming in and different case exposure. #JHMChat |
| Jennifer Caputo-Seidler, MD @jennifermcaputo A2 confidence doesn’t always equate with quality or competency, anecdotally we’ve all seen incorrect management done with confidence, gets back to importance of knowing what you don’t know #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Don’t miss out on insights from your #hospitalist colleagues across the world on #JHMChat in progress now! |
| Vinny Arora MD MAPP @FutureDocs Q2 Confidence does not equal competency. see Dunning Kruger Effect.. https://t.co/ecia5Ejuh1 #jhmchat |
| Journal of Hospital Medicine @JHospMedicine It's always a good #jhmchat when a Dunning-Kruger curve makes a showing... |
| Jackcy Jacob @jac2thersq Agreed - Honesty and self-reflection is the best way to address the gaps. What we don't want is to end up a in place where one is stigmatized for "not knowing how to manage that" #JHMChat |
| Daniel Ricotta, MD, SFHM @DanielRicottaMD @aoglasser @JHospMedicine Totally agree - the blind spot is a dangerous place to practice #jhmchat |
 | Jennifer Zagursky @JennZag4 @jennifermcaputo #JHMChat. I think it is not only knowing what you don’t know but also being willing to, and be in an accepting environment, to admit “I don’t know” |
| Kaishauna Guidry, MD, HMDC @DrMamaKai @JHospMedicine #JHMChat Confidence can be a subjective & vary with personality types. So no, it does not translate to quality. Simulation lab can bridge both the naturally confident active resident AND the knowledgeable inactive resident. |
| Daniel Ricotta, MD, SFHM @DanielRicottaMD @GraceHuangMD |
| Andrew Olson, MD @andrewolsonmd RT @JHospMedicine: Fantastic insight @MelissaPlesacMD! We've been talking about our learners as if they exist in isolation -- but a more complex and realistic way to think about the issue is in the context of who is their educator, as well...#jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @jennifermcaputo: A2 confidence doesn’t always equate with quality or competency, anecdotally we’ve all seen incorrect management done with confidence, gets back to importance of knowing what you don’t know #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @jac2thersq And that can be such a tough social construct to overcome...#jhmchat |
| Rebecca Jaffe, MD @RJmdphilly Sounds like self directed learning to me. If not all gaps are the same (as to @Midwest_MedPeds's point on Q1 that DKA is not a homogeneous thing) then they really need to be diagnosed in the context of a self-improvement loop (#coaching) #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: It's always a good #jhmchat when a Dunning-Kruger curve makes a showing... |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: It's always a good #jhmchat when a Dunning-Kruger curve makes a showing... |
| Subha Airan-Javia MD FAMIA (she/her) @subhaairan @Midwest_MedPeds @JHospMedicine Love this graph. It is so true. I am very weary of over confident trainees. One of my goals is to teach them that they can’t know everything. Experienced people in medicine have humility because they know that. #JHMchat |
| Vinny Arora MD MAPP @FutureDocs RT @Midwest_MedPeds: Q2 Dunning and Kruger showed that confidence does not equal competence. In fact, often the opposite. Hard to know if those with more confidence are truly more competent or not. Depends where they are on the curve. @JHospMedicine #JHMChat https://t.co/G6ILnVzRiZ |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @jennifermcaputo Yes, we call that the confidence:ability or confidence:knowledge mismatch. More often than not, I’ve seen residents be under-confident leading to a lot of hesitation to act, which can also be as detrimental as over-confidence. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly RT @Midwest_MedPeds: Q1 Blueprinting content for a field as massive as IM or Peds is impossible - too much to see/learn to experience everything. More important is ensuring learners: 1. Know when they don't know 2. Know where to find answers 3. Know when/how to ask for help #JHMChat |
| Ben Kinnear @Midwest_MedPeds @JHospMedicine Us #MedEd folks are suckers to post one of a few things: 1. Dunning-Kruger curve 2. Miller's pyramid 3. Bloom's taxonomy 4. Kittens (just because) @JHospMedicine #jhmchat |
| Andrew Olson, MD @andrewolsonmd @JHospMedicine This study shows this is true in #diagnosis as well. Cases get harder, we get worse, we have no change in confidence.... #JHMChat https://t.co/sLVeAp9tUk |
| Jennifer Caputo-Seidler, MD @jennifermcaputo @JennZag4 Absolutely, I always try to model for learners that it’s okay to say I don’t know and far better than trying to fake it #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Sonia, taking to the other side of the argument on the confidence:ability...#jhmchat |
| Anika Kumar, MD (she/her) @freckledpedidoc @subhaairan @Midwest_MedPeds @JHospMedicine I still read about 1 patient every day when I’m on-service. #JHMChat |
 | la_toque @la_toque RT @FutureDocs: Q2 Confidence does not equal competency. see Dunning Kruger Effect.. https://t.co/ecia5Ejuh1 #jhmchat |
| Subha Airan-Javia MD FAMIA (she/her) @subhaairan @JennZag4 @jennifermcaputo Yes. And I believe as attendings we should set that tone on day 1. “I would rather you tell me you don’t know something than pretend you do. There will be a lot I don’t know. We can learn together.” #JHMchat |
| Rebecca Jaffe, MD @RJmdphilly @BethGentilesco @CRBerginMD @BUthlaut |
 | Rebecca Berger 🇮🇱 @RebeccaEBerger Hi it’s Rebecca, hospitalist in NYC at @WeillCornell @WCMGIM joining late - back on service next week after maternity leave and excited for my first #jhmchat! |
| Journal of Hospital Medicine @JHospMedicine @Midwest_MedPeds Add puppies in there and you'll capture all the rest...#jhmchat |
| Andrew Olson, MD @andrewolsonmd yes yes yes! Intentional reading habits are KEY. Also BTW remember you can get free CME from @UpToDate if your institution subscribes. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @RebeccaEBerger @aoglasser @MGHMedicine hilariously i was told by someone that is required in every differential in a boston hospital! (never seen a case) #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @andrewolsonmd: @JHospMedicine This study shows this is true in #diagnosis as well. Cases get harder, we get worse, we have no change in confidence.... #JHMChat https://t.co/sLVeAp9tUk |
| Anika Kumar, MD (she/her) @freckledpedidoc @Midwest_MedPeds @JHospMedicine I’m glad you brought up Bloom’s Taxonomy. No #MedEd discussion is complete without mentioning Bloom. #JHMChat |
| Andrew Olson, MD @andrewolsonmd RT @RJmdphilly: Sounds like self directed learning to me. If not all gaps are the same (as to @Midwest_MedPeds's point on Q1 that DKA is not a homogeneous thing) then they really need to be diagnosed in the context of a self-improvement loop (#coaching) #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Topic #3 coming up... #JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser @FutureDocs @RebeccaEBerger @MGHMedicine #JHMChat scurvy. scurvy needs to be on every differential... right @PDX_Tom? |
 | Mark Shapiro, MD @ETSshow @kristinadzara @FutureDocs Mark Shapiro here, sorry to have to miss out! Will catch up tomorrow! #JHMchat |
| Andrew Olson, MD @andrewolsonmd @aoglasser @subhaairan @JennZag4 @jennifermcaputo Remiss to not mention @rabihmgeha and @DxRxEdu and @medrants here! #JHMChat |
 | Grant Turner, MD, MHA, FACP @GrantTurnerMD RT @subhaairan: @JennZag4 @jennifermcaputo Yes. And I believe as attendings we should set that tone on day 1. “I would rather you tell me you don’t know something than pretend you do. There will be a lot I don’t know. We can learn together.” #JHMchat |
| Vinny Arora MD MAPP @FutureDocs @Midwest_MedPeds @JHospMedicine 5. Kirkpatrick pyramid. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @Midwest_MedPeds: @JHospMedicine Us #MedEd folks are suckers to post one of a few things: 1. Dunning-Kruger curve 2. Miller's pyramid 3. Bloom's taxonomy 4. Kittens (just because) @JHospMedicine #jhmchat |
| Rebecca Berger 🇮🇱 @RebeccaEBerger A2 - confidence and quality can definitely be mismatched - I have met the occasional resident/med student/attending who was “strong and wrong” #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @jac2thersq What is down time? I love the idea of microsims - but I have a hard time imagining what that looks like for diagnosis and management rather than process/procedural skill. Have an example in mind? #JHMChat |
| Andrew Olson, MD @andrewolsonmd @aoglasser @FutureDocs @RebeccaEBerger @MGHMedicine @PDX_Tom My first patient as an attending had 4 organs transplanted. No idea what to do.... Took me three days to figure out which organs. Thank goodness for senior colleagues. #JHMChat |
| Jackcy Jacob @jac2thersq @JHospMedicine Well, normalizing the variation helps! I hope we don't start creating comparisons over short intervals about how much one institution "exposes their learners to" vs. another - I'm sure that there will be some variability over time #JHMchat |
| Journal of Hospital Medicine @JHospMedicine Moving on to Question #3 for tonights #JHMChat... https://t.co/T75vHQH0bQ |
 | T. A. Marnegie @TAMarnegie RT @JHospMedicine: It's always a good #jhmchat when a Dunning-Kruger curve makes a showing... |
 | Temple Ratcliffe, MD, MS-HPEd @templeratcliffe RT @subhaairan: @Midwest_MedPeds @JHospMedicine Love this graph. It is so true. I am very weary of over confident trainees. One of my goals is to teach them that they can’t know everything. Experienced people in medicine have humility because they know that. #JHMchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Moving on to Question #3 for tonights #JHMChat... https://t.co/T75vHQH0bQ |
| Andrew Olson, MD @andrewolsonmd Thanks for asking!!! I think that we have to use adaptive assessment-learning to supplement real patient encounters. Learner admits someone with CP - they get 4 other quick virtual patients with CP to compare and contrast. #meded #JHMChat |
| Andrew Olson, MD @andrewolsonmd Oh and also - the days of residents as workforce must end. Then we can design education. #JHMChat @Midwest_MedPeds |
| Anika Kumar, MD (she/her) @freckledpedidoc @subhaairan @JennZag4 @jennifermcaputo That’s part of my “Monday morning introduction”. It’s ok not to know the answer. I have role-modeled saying “I am not sure” at times to families in front of my team. #JHMChat |
| Andrew Olson, MD @andrewolsonmd @MelissaPlesacMD @CarolMarceloMD @jac2thersq @JHospMedicine Any day! Get ready for baseball quotes and analogies. #JHMChat |
| Subha Airan-Javia MD FAMIA (she/her) @subhaairan @JHospMedicine A3 - Definitely not! We need to equip them with the tools to recognize what they don’t know, know when & how to ask for help, and where to find help. I sure don’t know a lot & use these skills every day! #JHMchat |
| Rebecca Jaffe, MD @RJmdphilly @gretchendiemer @dmitripapa (#IBLE material here Dimitri! #ABetterQuestion) #JHMChat This is amazing |
| Ben Kinnear @Midwest_MedPeds Is it fair to ask a Med-Peds hospital med attending who is 5 years out of training to know everything? If so, then I can finally pursue that trapeze career I've been dreaming about @JHospMedicine #JHMChat |
| Vinny Arora MD MAPP @FutureDocs For anyone wondering what life as a new attending is like, I present my first month as an attending on #jhmchat ... |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn I think everyone has made a great case tonight that this is not the goal. Admitting you don't know something and asking for help is the better goal. I certainly don't know "everything" several years out from training. We learn everyday. #JHMChat |
| Jackcy Jacob @jac2thersq @RJmdphilly Yes, I do micro-sims with an iPad program which portrays derangements in vitals/ cardiac rhythm that the learner needs to respond to. The portability of the iPads makes it easy to use. #JHMChat |
 | Amulya Nagarur @AmulyaNagarurMD @JHospMedicine @WrayCharles Hello! I’m a hospitalist and clinician educator from Boston. This will be my first #jhmchat. |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @JHospMedicine I’m pretty sure I won’t know ‘everything’ in #PedsHM by the time I retire. I have a hard time keeping up with all the new febrile neonate guidelines and algorithms to wean HFNC! 😂 #JHMChat |
| Andrew Olson, MD @andrewolsonmd @aoglasser @JHospMedicine @subhaairan We have researched this (working on getting it out) showing the attending sets the tone. If she doesn't say I don't know, no one does. #JHMChat |
 | The Blonde Broker @gracefarris @FutureDocs This is so good 🤣#JHMChat |
| Andrew Olson, MD @andrewolsonmd Tell us more! #JHMChat |
| Temple Ratcliffe, MD, MS-HPEd @templeratcliffe A3: 😂 Not fair for attendings much less trainees. The longer I practice (emphasis on practice) the more I realize 1) modern medicine has innumerable gaps in evidence & 2) as experience/wisdom increase, my awareness of my own limitations/knowledge gaps grows #JHMChat |
| Rebecca Berger 🇮🇱 @RebeccaEBerger A3: Absolutely not! That would be hypocritical, as attendings we surely don’t know everything. Goal is for trainees to 1) know how to ask the right questions, 2) find the info they need, 3) know when to ask for help (from senior colleagues or consultants PRN) #JHMChat |
| Andrew Olson, MD @andrewolsonmd RT @RebeccaEBerger: A3: A3: Absolutely not! That would be hypocritical, as attendings we surely don’t know everything. Goal is for trainees to 1) know how to ask the right questions, 2) find the info they need, 3) know when to ask for help (from senior colleagues or consultants PRN) #JHMChat |
| Kaishauna Guidry, MD, HMDC @DrMamaKai @JHospMedicine #JHMChat yes it’s fair! Curriculum should expose trainees to all that they’ll see as hospitalists or minimally the tools to figure it out quickly. |
| Journal of Hospital Medicine @JHospMedicine This is why we invited @andrewolsonmd to this conversation...#jhmchat |
| Andrew Olson, MD @andrewolsonmd @kristenyoung @CarolMarceloMD @jac2thersq @MelissaPlesacMD @JHospMedicine Is it extra or built into FTE? #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @jac2thersq What's the program (New iPad owner...) #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @AmulyaNagarurMD @WrayCharles Welcome aboard, Amulya! Glad you could make it #jhmchat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @andrewolsonmd That's great! I recently listened to an @COREIMpodcast that did this with PE (3 presentations, same diagnosis) and wanted to make it mandatory listening for all med students I was working with (I did strongly recommend it). #JHMChat |
| Andrew Olson, MD @andrewolsonmd @DrMamaKai @JHospMedicine The recent @JHospMedicine paper shows - as @MelissaPlesacMD and I said in the editorial - that residency doesn't do this, though. So I think rather than MORE training, it needs to be DIFFERENT. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: This is why we invited @andrewolsonmd to this conversation...#jhmchat |
| Andrew Olson, MD @andrewolsonmd Compare and contrast..... over and over and over. #JHMChat |
| Jackcy Jacob @jac2thersq @andrewolsonmd Sure, I don't have anything published on it of course (no downtime!) but here is the program that the med school purchased that I use: https://t.co/1b2BKUGYMj #JHMChat |
| Zach Lauer @RealZachLauer @JHospMedicine I dont think we can know everything, not realistic. Need a base, but more importantly skills to think thru diseases/situations and be able to identify what we dont know & how to figure it out. Our knowledge and skills are always "works in progress" i.e. lifelong learning #jhmchat |
| Daniel Ricotta, MD, SFHM @DanielRicottaMD Busted by my Division Chief and VCE @EileenEReynolds for participating in #JHMChat during intern retreat dinner 😬 #committment? props for #multitasking? |
| Vinny Arora MD MAPP @FutureDocs RT @andrewolsonmd: @DrMamaKai @JHospMedicine The recent @JHospMedicine paper shows - as @MelissaPlesacMD and I said in the editorial - that residency doesn't do this, though. So I think rather than MORE training, it needs to be DIFFERENT. #JHMChat |
 | Eric Schultz @ericschul @JHospMedicine I hope not! Definitely a field where lifelong learning is required. But getting equipped with the skills to figure out how to handle something you don’t know is essential. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs @freckledpedidoc #jhmchat https://t.co/Me2R0AiGjS |
| Anika Kumar, MD (she/her) @freckledpedidoc @andrewolsonmd @aoglasser @JHospMedicine @subhaairan Thank you for referring to the attending as “she”! #HeForShe #JHMchat |
| Andrew Olson, MD @andrewolsonmd @rita_hurd @Midwest_MedPeds And we seem to think that if we just have you do more of something you will learn it. Lots of cases is important, but variation and breadth is key. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine We would like to point out that @MelissaPlesacMD was one of our stellar JHM Editorial Fellows this year who was able to work with @andrewolsonmd. Proud of the work they've produced together #jhmchat |
| Jennifer Caputo-Seidler, MD @jennifermcaputo A3 As a trainee I thought my attendings were all knowing, imagine my surprise when I graduated and wasn’t magically endowed with all there is to know in medicine #JHMChat |
| Ben Kinnear @Midwest_MedPeds Q3Things that make knowing everything an impossible task: 1. Too much to learn/know 2. Ebbinghaus forgetting curve - our brains are not harddrives https://t.co/lU9XjyWFuM 3. New data/info/studies/updates coming at lightning speed 4. Ain't nobody got time @JHospMedicine #JHMChat |
| Andrew Olson, MD @andrewolsonmd @JHospMedicine @MelissaPlesacMD And @WrayCharles runs this amazing fellowship @JHospMedicine with me as a crappy co-director. We'll be starting year 2 this summer! #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: We would like to point out that @MelissaPlesacMD was one of our stellar JHM Editorial Fellows this year who was able to work with @andrewolsonmd. Proud of the work they've produced together #jhmchat |
| Jennifer Caputo-Seidler, MD @jennifermcaputo @CarolMarceloMD @JHospMedicine With the pace at which knowledge is currently advancing I don’t think it will ever be possible to know it all #JHMChat |
| Vinny Arora MD MAPP @FutureDocs A3 - FWIW any rare or esoteric diagnosis I have ever made (and there are several memorable ones) all required that I "looked it up" - in fact that was the only intervention that really worked...beyond another imaging or lab test. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine @andrewolsonmd @MelissaPlesacMD @WrayCharles Not sure how you delete a portion of some else's Tweet, but the later part should read as "amazing co-director" #jhmchat |
| Eliezer Shinnar @Amraphel18 @MelissaPlesacMD @JHospMedicine @andrewolsonmd Will definitely look into it. #JHMChat |
| Andrew Olson, MD @andrewolsonmd All together now: Practice doesn't make perfect - it makes habits. Deliberate practice makes better but it requires knowing your outcomes. #JHMChat We live in a no news is good news #meded system - and no news is just no news. |
| Journal of Hospital Medicine @JHospMedicine RT @Midwest_MedPeds: Q3Things that make knowing everything an impossible task: 1. Too much to learn/know 2. Ebbinghaus forgetting curve - our brains are not harddrives https://t.co/lU9XjyWFuM 3. New data/info/studies/updates coming at lightning speed 4. Ain't nobody got time @JHospMedicine #JHMChat |
 | Robert Centor MD MACP 🇮🇱 @medrants #JHMChat catching up on the chat. As a very long time attending (39 years) I would suggest that when time is available, it is the attendings responsibility to discuss key dangers - have the interns consider what ifs |
| Andrew Olson, MD @andrewolsonmd @CarolMarceloMD @kristenyoung @jac2thersq @MelissaPlesacMD @JHospMedicine PLEASE do!!! #JHMChat |
| Anika Kumar, MD (she/her) @freckledpedidoc A3. Um, absolutely not! I learn something new everyday. Just today I had to remind myself about the lead chelation guidelines! As @Midwest_MedPeds said earlier, we have to know what we don’t know, where to learn it or whom to ask for help. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Final topic of the night coming up...#JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @andrewolsonmd @rita_hurd @Midwest_MedPeds And reflection. And if there isn't a learning objective and some sort of assessment it sort of doesn't count. #JHMChat |
| Ben Kinnear @Midwest_MedPeds @MelissaPlesacMD @JHospMedicine Totally! We all feel guilt about this. See this awesome Twitter thread from @cincyim about the guilt of being a physician. So important to acknowledge and talk about! https://t.co/Y5EXYIGoXS @JHospMedicine #jhmchat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @JHospMedicine @MelissaPlesacMD @andrewolsonmd Now you're really making me want to apply! #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @JHospMedicine no #JHMChat |
| Ben Kinnear @Midwest_MedPeds RT @andrewolsonmd: All together now: All together now: Practice doesn't make perfect - it makes habits. Deliberate practice makes better but it requires knowing your outcomes. #JHMChat We live in a no news is good news #meded system - and no news is just no news. |
| Andrew Olson, MD @andrewolsonmd @CarolMarceloMD @kristenyoung @jac2thersq @MelissaPlesacMD @JHospMedicine Worry that all these "extra" things added on can hurt especially #WomenInMedicine - would encourage (and will work for here) this being part of FTE. #JHMChat |
| Kaishauna Guidry, MD, HMDC @DrMamaKai @MelissaPlesacMD @andrewolsonmd @JHospMedicine #JHMChat is the structural limitation duty hours? |
| Journal of Hospital Medicine @JHospMedicine Final Question for tonight's #JHMChat: https://t.co/60q8h3ncm3 |
| Kaishauna Guidry, MD, HMDC @DrMamaKai @JHospMedicine #JHMChat all of the above ❓ |
| Vinny Arora MD MAPP @FutureDocs @gracefarris @andrewolsonmd @RJmdphilly i totally missed out on burritos. and i love mexican food. can someone help me ? @RJmdphilly #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Moving on to Question #3 for tonights #JHMChat... https://t.co/T75vHQH0bQ |
| Andrew Olson, MD @andrewolsonmd RT @FutureDocs: @gracefarris @andrewolsonmd @RJmdphilly i totally missed out on burritos. and i love mexican food. can someone help me ? @RJmdphilly #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @andrewolsonmd @aoglasser @JHospMedicine @subhaairan Gave a big high five to my awesome subI last week for saying "I don't know" on rounds. Was a winning moment. It literally took me saying I had no idea what RTA the patient had or how to figure it out and that we would all come back with the answer the next day. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs @gracefarris @andrewolsonmd Isn't there great Mexican in Chicago? #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @andrewolsonmd @JHospMedicine haha #JHMChat |
| Eliezer Shinnar @Amraphel18 @JHospMedicine I think part of it is a change in culture, how attendings view their role in addressing the issue. Hopefully #JHMChat will help with that |
| Andrew Olson, MD @andrewolsonmd @JHospMedicine A4: A major redesign where training is learner centered and not based on workforce needs. Right now nearly all GME is based on the hospital's needs - we have to change this and design learning rather than learning be secondary. @RJmdphilly might have thoughts. #JHMChat |
| Zach Lauer @RealZachLauer @JHospMedicine A2 for multi step skills i.e. procedures, simulation and agreed upon standard practice with assessment and feedback help bridge the gap. We utilize a standard check list for CVC insertion that all of our residents are graded on in yearly simulations. #JHMChat |
| Andrew Olson, MD @andrewolsonmd Maybe we need to do this for residency? https://t.co/64pry7RKvv #JHMChat |
| Ben Kinnear @Midwest_MedPeds Q4 - I think has to be multimodal. One idea: 1. Link assessments (e.g. WBAs) to curriculum 2. Identify learning/experience gaps 3. Fix those gaps 4. Use assessment data to drive learning for program and resident @JHospMedicine #JHMChat |
| Andrew Olson, MD @andrewolsonmd Sounds like @Midwest_MedPeds and I need to start a residency program. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Final Question for tonight's #JHMChat: Final Question for tonight's #JHMChat: https://t.co/60q8h3ncm3 |
| Vinny Arora MD MAPP @FutureDocs @RJmdphilly @gracefarris @andrewolsonmd yes ...i meant does it have a hidden meaning? is it a new form of feedback like the "feedback burrito"? #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Great advice to other trainees out there from @collinflan on tonight's #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Great advice to other trainees out there from @collinflan on tonight's #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @andrewolsonmd @JHospMedicine Flattered to be referenced in this tweet. Whole heartedly agree that structural change is 100% necessary. I don't think we can solve this w curricular patches. Learners need time to think and reflect. Faculty need new skill sets in order to teach/coach. No quick fix IMO #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @Midwest_MedPeds: Q4 - I think has to be multimodal. One idea: 1. Link assessments (e.g. WBAs) to curriculum 2. Identify learning/experience gaps 3. Fix those gaps 4. Use assessment data to drive learning for program and resident @JHospMedicine #JHMChat |
| Jackcy Jacob @jac2thersq @andrewolsonmd @JHospMedicine @RJmdphilly Agree but recently participated in a journal club discussing "learning-centered" vs. learner centered working environments --> forces us to discard the inefficiencies to take back our lives as teachers, learners, and healers. #JHMChat #HMIEducators @FutureDocs |
| Andrew Olson, MD @andrewolsonmd @MelissaPlesacMD @JHospMedicine @RJmdphilly One of my operating principles in life is that all logistic barriers are overcomeable.... #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @andrewolsonmd @JHospMedicine @RJmdphilly Agree with re-prioritizing for both residents and attendings. Reflection seems to happen a lot offline and needs to be at the forefront. More modeling of "I don't know" from all levels. #JHMChat |
| Ben Kinnear @Midwest_MedPeds @andrewolsonmd I'm in on 3 conditions: 1. Tacos for lunch every day 2. Mandatory bid naps 3. Naps can also be prn #jhmchat @JHospMedicine |
| Vinny Arora MD MAPP @FutureDocs RT @jac2thersq: @andrewolsonmd @JHospMedicine @RJmdphilly Agree but recently participated in a journal club discussing "learning-centered" vs. learner centered working environments --> forces us to discard the inefficiencies to take back our lives as teachers, learners, and healers. #JHMChat #HMIEducators @FutureDocs |
 | Kristen Young @kristenyoung @Midwest_MedPeds @JHospMedicine 🙌🏼 pulling out the forgetting curve, also this is why didactics+practice are so important. But really not enough time for spaced repetition on every medicine topic. But we sure try. 😬 #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @andrewolsonmd @JHospMedicine To broadly reference Russel Ackoff - I think we need to Desolve this problem, not solve it within current constraints. #JHMChat |
 | Charlie M. Wray, DO, MS @WrayCharles @FutureDocs @RJmdphilly @gracefarris @andrewolsonmd Everything mixed together, making the even the bad parts taste good...? #jhmchat |
| Anika Kumar, MD (she/her) @freckledpedidoc @Midwest_MedPeds @JHospMedicine ☝🏽what @Midwest_MedPeds said & increased learner-centered educatiom with the learner collaborating in development of goals & objectives. #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Great advice to other trainees out there from @collinflan on tonight's #JHMChat |
| Andrew Olson, MD @andrewolsonmd RT @RJmdphilly: @andrewolsonmd @JHospMedicine To broadly reference Russel Ackoff - I think we need to Desolve this problem, not solve it within current constraints. #JHMChat |
| Andrew Olson, MD @andrewolsonmd Sold. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs A4 what about just asking everyone to look up one thing and bring it back... normalize the idea that you need to go find the answer #jhmchat |
| Journal of Hospital Medicine @JHospMedicine 10 min. left in the #JHMChat tonight...Would love to hear any final thoughts or comments... |
| The Blonde Broker @gracefarris @FutureDocs @RJmdphilly @andrewolsonmd No it’s just plain burritos. But maybe now there can be a meded paper on feedback loops- the clinical working and learning environment burrito @RJmdphilly pls write that #JHMchat |
| Andrew Olson, MD @andrewolsonmd RT @FutureDocs: A4 what about just asking everyone to look up one thing and bring it back... normalize the idea that you need to go find the answer #jhmchat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @jac2thersq @andrewolsonmd @JHospMedicine @RJmdphilly @FutureDocs I want to know more about this discussion! #JHMChat |
| Jennifer Zagursky @JennZag4 @FutureDocs @RJmdphilly @gracefarris @andrewolsonmd Sorry forgot the #jhmchat. Can we please all agree to call it this from now on!!! |
| Vinny Arora MD MAPP @FutureDocs @gracefarris @RJmdphilly @andrewolsonmd i think we just created the "feedback burrito" with @WrayCharles #jhmchat |
| Journal of Hospital Medicine @JHospMedicine As we wrap up tonight's #JHMChat, want to say thanks for everyone showing up and leading to a lively conversation! Especially love our new faces and the welcoming environment our veterans create... |
| Rebecca Jaffe, MD @RJmdphilly @jac2thersq @andrewolsonmd @JHospMedicine @FutureDocs This sounds promising #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs @gracefarris @andrewolsonmd @WrayCharles It wouldn't be a #JHMChat if we didn't come up with a pipe dream of a new model of something |
| Amulya Nagarur @AmulyaNagarurMD RT @SHMLive: #JHMChat is on! Come on in for some great convo on #meded with @JHospMedicine. |
| Society of Hospital Medicine @SocietyHospMed Don't forget to claim your #CME for tonight's #JHMChat! Your chance ends at 11:59 p.m. ET, so log in now: https://t.co/eVeCkCp1Xc |
| Journal of Hospital Medicine @JHospMedicine A final shout out to @MelissaPlesacMD & @andrewolsonmd for their fantastic editorial and guidance on tonight's #JHMChat discussion: https://t.co/P04B1iPnkq https://t.co/kJBF8cT4Ul |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: A final shout out to @MelissaPlesacMD & @andrewolsonmd for their fantastic editorial and guidance on tonight's #JHMChat discussion: https://t.co/P04B1iPnkq https://t.co/kJBF8cT4Ul |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: 10 min. left in the #JHMChat tonight...Would love to hear any final thoughts or comments... |
| Rebecca Jaffe, MD @RJmdphilly @freckledpedidoc @JennZag4 @FutureDocs @gracefarris @andrewolsonmd That's really cute feedback... #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: Don't forget to claim your #CME for tonight's #JHMChat! Your chance ends at 11:59 p.m. ET, so log in now: Don't forget to claim your #CME for tonight's #JHMChat! Your chance ends at 11:59 p.m. ET, so log in now: https://t.co/eVeCkCp1Xc |
 | Dink Jardine, MD, FACS @dinkjardine RT @RJmdphilly: @gracefarris @andrewolsonmd Tweetorial with links! #JHMChat https://t.co/lkqDrk0YXK |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: A final shout out to @MelissaPlesacMD & @andrewolsonmd for their fantastic editorial and guidance on tonight's #JHMChat discussion: https://t.co/P04B1iPnkq https://t.co/kJBF8cT4Ul |
| Ben Kinnear @Midwest_MedPeds @RJmdphilly @FutureDocs @gracefarris @andrewolsonmd @WrayCharles Isn't that what @andrewolsonmd and my new program with tacos and naps is? #jhmchat @JHospMedicine |
| Andrew Olson, MD @andrewolsonmd Thanks @JHospMedicine and @WrayCharles and @FutureDocs - and thanks @MelissaPlesacMD for being a great mentee! #JHMchat |
 | Med Peds Hospitalist @medpedshosp RT @Midwest_MedPeds: Q3Things that make knowing everything an impossible task: 1. Too much to learn/know 2. Ebbinghaus forgetting curve - our brains are not harddrives https://t.co/lU9XjyWFuM 3. New data/info/studies/updates coming at lightning speed 4. Ain't nobody got time @JHospMedicine #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Grab your #CME from tonights #jhmchat below: |
| Jackcy Jacob @jac2thersq @jenreadlynn @andrewolsonmd @JHospMedicine @RJmdphilly @FutureDocs A4: I'm not sure didactics is the answer. Practicing the skills to manage the rare diseases and anchoring it to an emotional experience as best as possible - i.e old fashioned story telling by a patient who survived to give their narrative about the harrowing experience #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly This is why learners should get on twitter Flattens hierarchies (@aoglasser ) etc #JHMChat |
| Andrew Olson, MD @andrewolsonmd @Midwest_MedPeds @RJmdphilly @FutureDocs @gracefarris @WrayCharles @JHospMedicine Oh my we may just make this happen. #JHMchat |
| Journal of Hospital Medicine @JHospMedicine RT @andrewolsonmd: Thanks @JHospMedicine and @WrayCharles and @FutureDocs - and thanks @MelissaPlesacMD for being a great mentee! #JHMchat |
| Society of Hospital Medicine @SocietyHospMed Whether you’re a #JHMChat regular or a newcomer, it’s easy to say that we always have a good time while discussing the latest research! |
| Ben Kinnear @Midwest_MedPeds @rita_hurd @andrewolsonmd @JHospMedicine R squared = 1.0 :) #jhmchat |
| Vinny Arora MD MAPP @FutureDocs Closing thought #jhmchat- we can create a "deliberate learning" model through blending case learning in real life with case learning online and data and feedback to improve exposure to diagnostic dilemmas. |
| Anika Kumar, MD (she/her) @freckledpedidoc RT @SHMLive: Whether you’re a #JHMChat regular or a newcomer, it’s easy to say that we always have a good time while discussing the latest research! |
 | Carol Marcelo @CarolMarceloMD @FutureDocs This is an awesome idea! I tell my residents I look up stuff all the time but never demonstrate it in real time - I should do as I say so to speak! Also can help establish an open/team-building learning climate! #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly I think tonight's questions were some to the most compelling and tangled yet. Every one was a tour de force for redesigning #MedEd. If we could answer these we would really be making progress. Glad to know you are all in it with me, or rather i'm in it with you!! #JHMChat |
| Harvard Macy @HarvardMacy RT @jac2thersq: @andrewolsonmd @JHospMedicine @RJmdphilly Agree but recently participated in a journal club discussing "learning-centered" vs. learner centered working environments --> forces us to discard the inefficiencies to take back our lives as teachers, learners, and healers. #JHMChat #HMIEducators @FutureDocs |
| VC @doctorvec Thanks for all the info. Have a great night #JHMChat |
| VC @doctorvec RT @FutureDocs: Closing thought #jhmchat- we can create a "deliberate learning" model through blending case learning in real life with case learning online and data and feedback to improve exposure to diagnostic dilemmas. |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @jac2thersq @andrewolsonmd @JHospMedicine @RJmdphilly @FutureDocs Agree that didactics is not the answer. Love this storytelling aspect. There are some QI teams in our hospital that have patients on them. Now they can be an active part of our education team. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @RJmdphilly Love your insights, Rebecca and we're glad to have you on the #jhmchat team |
| Vinny Arora MD MAPP @FutureDocs @aoglasser @gracefarris now im hungry and feeling like i need to complete evals 🤣 #jhmchat |
 | Seth Trueger @MDaware !!! |
| Rebecca Jaffe, MD @RJmdphilly @gracefarris Because dragons HATE spicy salsa. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine That's a wrap, folks! Thanks again for a great #JHMChat and we'll catch you all again on the next one... |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @Midwest_MedPeds @JHospMedicine It wasn’t until I started sitting in the #PedsHM faculty workroom as a fellow that I realized how much consulting happens between fellows and attendings because we simply didn’t know what was going on with some patients. It was eye opening! #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn Was just about to say the same thing (I learned from the best! @RJmdphilly @aoglasser @michellebr00ks @MargMChapman) #JHMChat |
 | Lawrence Sherman @meducate I love that a tweetchat is proving credit! It’s where we need to be!! |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: That's a wrap, folks! Thanks again for a great #JHMChat and we'll catch you all again on the next one... |
| Anika Kumar, MD (she/her) @freckledpedidoc Thanks @JHospMedicine for another great #JHMChat and for coining the term #feedbackburrito! Remember, just wrap your feedback in a warm tortilla and you’ll get a feedback burrito. https://t.co/ILGUL9Mes9 |
| Kaishauna Guidry, MD, HMDC @DrMamaKai RT @JHospMedicine: As we wrap up tonight's #JHMChat, want to say thanks for everyone showing up and leading to a lively conversation! Especially love our new faces and the welcoming environment our veterans create... |
| Rebecca Jaffe, MD @RJmdphilly @Midwest_MedPeds @FutureDocs @gracefarris @andrewolsonmd @WrayCharles @JHospMedicine I need details. Is this like a night eating thing? #JHMChat |
 | Alvin Calderon, MD, PhD, FACP @alvinseattle @JHospMedicine A2: To bridge the gap with early learners and build confidence, I tell them it's OK to be unsure, although I expect them to know 100% what they are going to say. For instance, "I'm 100% clear that this is my plan, and 30-40% confident that it's the right thing to do." #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @JHospMedicine thanks @WrayCharles @andrewolsonmd @MelissaPlesacMD for a great #jhmchat! |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: That's a wrap, folks! Thanks again for a great #JHMChat and we'll catch you all again on the next one... |
| Vinny Arora MD MAPP @FutureDocs @JHospMedicine love the "wrap" pun btw #feedbackburrito #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @CarolMarceloMD @FutureDocs See @greenQOD #GreenQOD and #Postitpearls for two models of how to formalize this kind of thing (and use social media at the same time) #JHMChat |
 | Abby Spencer, MD, MS, FACP @abbyWUim RT @andrewolsonmd: @JHospMedicine A4: @JHospMedicine A4: A major redesign where training is learner centered and not based on workforce needs. Right now nearly all GME is based on the hospital's needs - we have to change this and design learning rather than learning be secondary. @RJmdphilly might have thoughts. #JHMChat |
| Abby Spencer, MD, MS, FACP @abbyWUim @CCF_IMCHIEFS!! |
| Abby Spencer, MD, MS, FACP @abbyWUim RT @andrewolsonmd: @JHospMedicine A4: @JHospMedicine A4: A major redesign where training is learner centered and not based on workforce needs. Right now nearly all GME is based on the hospital's needs - we have to change this and design learning rather than learning be secondary. @RJmdphilly might have thoughts. #JHMChat |
| Abby Spencer, MD, MS, FACP @abbyWUim RT @alvinseattle: @JHospMedicine A2: @JHospMedicine A2: To bridge the gap with early learners and build confidence, I tell them it's OK to be unsure, although I expect them to know 100% what they are going to say. For instance, "I'm 100% clear that this is my plan, and 30-40% confident that it's the right thing to do." #JHMChat |
| Subha Airan-Javia MD FAMIA (she/her) @subhaairan @freckledpedidoc @andrewolsonmd @aoglasser @JHospMedicine Yes! That was not lost on me either! #JHMchat |
| MedEdBot @MedEdBot RT @RJmdphilly: I think tonight's questions were some to the most compelling and tangled yet. Every one was a tour de force for redesigning #MedEd. If we could answer these we would really be making progress. Glad to know you are all in it with me, or rather i'm in it with you!! #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @MelissaPlesacMD @andrewolsonmd @JHospMedicine I want to get a whole bunch of folks on #JHMChat in a room & have a blue sky discussion about what training should/could look like. Something broad enough to compel redesign, concrete enough to get in the weeds a little, and with burritos. |
| VC @doctorvec RT @Midwest_MedPeds: Q1 Blueprinting content for a field as massive as IM or Peds is impossible - too much to see/learn to experience everything. More important is ensuring learners: 1. Know when they don't know 2. Know where to find answers 3. Know when/how to ask for help #JHMChat |
| Zach Lauer @RealZachLauer @JHospMedicine A4-Multi-step approach. Hands on skills like procedures are best served w/ simulation. Clinical reasoning requires deliberate practice & teaching. These are constrained by hospital needs: dc time, huddle, notes and require engaged faculty to guide & navigate effectively #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @gretchendiemer @dmitripapa I really like "Learning Centered" in place of learner centered. Trying it on for size... |
 | Belinda Kakos ܒܠܝܢܕܐ @EMIMeducator RT @templeratcliffe: A3: A3: 😂 Not fair for attendings much less trainees. The longer I practice (emphasis on practice) the more I realize 1) modern medicine has innumerable gaps in evidence & 2) as experience/wisdom increase, my awareness of my own limitations/knowledge gaps grows #JHMChat |
 | Michelle Brooks, MD, SFHM @michellebr00ks @JHospMedicine @CarolMarceloMD @WrayCharles Got a little bogged down with admissions! I will get my learning on asynchronously tomorrow! #JHMChat |
| Alvin Calderon, MD, PhD, FACP @alvinseattle @CarolMarceloMD @FutureDocs I say "what I know I don't know is far vaster than what you know you don't know." While they expect to know more with time/exp., I think they are surprised that what they don't know grows exponentially faster along the way. Have a good relationship with your unknowing. #JHMChat |
 | Mike Tchou @TchouMd RT @Midwest_MedPeds: Q1 Blueprinting content for a field as massive as IM or Peds is impossible - too much to see/learn to experience everything. More important is ensuring learners: 1. Know when they don't know 2. Know where to find answers 3. Know when/how to ask for help #JHMChat |
| Zach Lauer @RealZachLauer @JHospMedicine We have to acknowledge those in hospital challenges and find ways to turn them into opportunities/not stunt learning. They will exist outside of the learning environment. Navigating them is a key to success. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @MelissaPlesacMD @DrMamaKai @andrewolsonmd @JHospMedicine I think it misses the mark to blame incr requirements. Reqs are an attempt to meet the needs/future needs of pts/populations/profession. They are a tool/symptom (& if you're an accrediting body, you only have the hammers you've been given), but not the driver itself. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @MelissaPlesacMD @DrMamaKai @andrewolsonmd @JHospMedicine The reality is there is too much to know and change happens too quickly. Even if you learned EVERYTHING in the static moment of now, it's not enough a year later. Need to train Master Adaptive Learners/Adaptive Expertise. Give learners tools to continue learning. #JHMChat |
| Andrew Olson, MD @andrewolsonmd RT @RJmdphilly: @MelissaPlesacMD @andrewolsonmd @JHospMedicine I want to get a whole bunch of folks on #JHMChat in a room & have a blue sky discussion about what training should/could look like. Something broad enough to compel redesign, concrete enough to get in the weeds a little, and with burritos. |
| Temple Ratcliffe, MD, MS-HPEd @templeratcliffe RT @RJmdphilly: @MelissaPlesacMD @andrewolsonmd @JHospMedicine I want to get a whole bunch of folks on #JHMChat in a room & have a blue sky discussion about what training should/could look like. Something broad enough to compel redesign, concrete enough to get in the weeds a little, and with burritos. |
 | BIDMC Shapiro Inst. @BIDMC_Education RT @RJmdphilly: I think tonight's questions were some to the most compelling and tangled yet. Every one was a tour de force for redesigning #MedEd. If we could answer these we would really be making progress. Glad to know you are all in it with me, or rather i'm in it with you!! #JHMChat |
| Daniel Ricotta, MD, SFHM @DanielRicottaMD RT @RJmdphilly: I think tonight's questions were some to the most compelling and tangled yet. Every one was a tour de force for redesigning #MedEd. If we could answer these we would really be making progress. Glad to know you are all in it with me, or rather i'm in it with you!! #JHMChat |
| Daniel Ricotta, MD, SFHM @DanielRicottaMD RT @RJmdphilly: This is why learners should get on twitter Flattens hierarchies (@aoglasser ) etc #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks @andrewolsonmd @CarolMarceloMD @kristenyoung @jac2thersq @MelissaPlesacMD @JHospMedicine We’ve also experienced difficulty getting this published despite every reviewer acknowledging that it is a good idea (won the wild card at SHM posters) and having pretty good experience at implementing it practically - ?research bias vs novice writers #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @MelissaPlesacMD @DrMamaKai @andrewolsonmd @JHospMedicine Here is attempt my colleagues & I made at #MC2019 to link related concepts of Self Directed Learning, Deliberate Practice, Adaptive Expertise, & Lifelong Learning. When this happens in the Learning & Working Env it can involve work-based assessment too (@Midwest_MedPeds) #JHMChat https://t.co/aQQXHRM1bb |
| Rebecca Jaffe, MD @RJmdphilly @andrewolsonmd @JHospMedicine Can we sub in "Learning Centered"? Curious as to your thoughts on whether that is helpful...#JHMChat |
| Daniel Ricotta, MD, SFHM @DanielRicottaMD RT @RJmdphilly: @MelissaPlesacMD @andrewolsonmd @JHospMedicine I want to get a whole bunch of folks on #JHMChat in a room & have a blue sky discussion about what training should/could look like. Something broad enough to compel redesign, concrete enough to get in the weeds a little, and with burritos. |
 | Jason Silverman @DrJSilverman Anything has to beat the feedback sandwich … especially with Jack cheese 🧀! #MedEd #humor |
| Rebecca Jaffe, MD @RJmdphilly !!! Agree "Your job is to do your job" So if it's part of my job make it a part of my job |
#jhmchat content from Twitter.