#jhmchat Transcript

Healthcare social media transcript of the #jhmchat hashtag.
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Eliezer Shinnar @Amraphel18
Excited to join my first #JHMChat tonight!
J 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, FHM @DanielRicottaMD
Hi all! Looking forward to this chat - Dan Ricotta checking in from Boston! #jhmchat
J Hospital Medicine @JHospMedicine
Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation 4 bringing you #JHMChat tonight
Society of Hospital Medicine @SHMLive
#JHMChat is on! Come on in for some great convo on #meded with @JHospMedicine.
J Hospital Medicine @JHospMedicine
Don't forget to tag your tweets with #JHMChat! Topic 1 up in a moment…
J Hospital Medicine @JHospMedicine
RT @SHMLive: #JHMChat is on! Come on in for some great convo on #meded with @JHospMedicine. https://t.co/UuSedRLqrD
Anika Kumar, MD @freckledpedidoc
@JHospMedicine @WrayCharles Hi #JHMChat! It’s Anika Kumar, Peds Hospitalist from Cleveland. Excited to learn about #MedEd in Adult-land.
J Hospital Medicine @JHospMedicine
RT @JHospMedicine: Greetings, I'm @WrayCharles your moderator for tonight's #JHMChat examining the variability in exposure & confidence in…
Ben Kinnear @Midwest_MedPeds
Very excited to be part of the conversation! Checking in from Cincinnati #JHMChat
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Don't forget to tag your tweets with #JHMChat! Topic 1 up in a moment…
J 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. https://t.co/UuSedRLqrD
Vinny Arora MD MAPP @FutureDocs
RT @SHMLive: #JHMChat is on! Come on in for some great convo on #meded with @JHospMedicine. https://t.co/UuSedRLqrD
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Greetings, I'm @WrayCharles your moderator for tonight's #JHMChat examining the variability in exposure & confidence in…
Kaishauna Guidry, MD @DrMamaKai
@JHospMedicine @WrayCharles Hello from Southern California. I’m a hospice physician in Riverside. #JHMchat
Melissa Plesac @MelissaPlesacMD
@JHospMedicine @WrayCharles Hi! Its Melissa Plesac, current Chief Resident soon to be Hospitalist at University of Minnesota. So excited for my first ever twitter chat!! #JHMChat
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Joining the #JHMChat tonight? Grab your CME here: https://t.co/uzVqCiEVQp
Jen Readlynn, MD @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. https://t.co/UuSedRLqrD
Avital O'Glasser, MD FACP FHM @aoglasser
#JHMchat hi there! Avi O'Glasser from Portland, OR (@OHSU_DHM & @OHSUIMRes). got stuck at work so just got come. slow, aging laptop also tried to stall me...
Jennifer Madeline @jennifermcaputo
@JHospMedicine @WrayCharles Jen Caputo, hospitalist in Tampa #JHMChat
J 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 @SHMLive
#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 @SHMLive
RT @JHospMedicine: Tonight's chat covers a lot of territory and we're lucky to have our guests @MelissaPlesacMD (A JHM Editorial Fellow) an…
Sonya Tang Girdwood @STangGirdwood
@JHospMedicine @WrayCharles Sonya, #PedsHM fellow from Cincy! #JHMChat
J 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 @SHMLive
RT @JHospMedicine: Let's get going with Q1 of tonights #JHMChat: https://t.co/FjxkAK7HQf
J 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
J 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
Avital O'Glasser, MD FACP FHM @aoglasser
@JHospMedicine A1 #JHMchat great Q. @OHSUIMRes is actively working on it (not me, my amazing #meded colleagues incl @BonuraErin). Critically reappraising evaluations as not just feedback but to include EPAs, "did we see you do/diagnosis/manage XYZ"
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 wel…
Andrew Olson, MD @andrewolsonmd
RT @aoglasser: #JHMchat hi there! Avi O'Glasser from Portland, OR (@OHSU_DHM & @OHSUIMRes). got stuck at work so just got come. slow, agin…
Andrew Olson, MD @andrewolsonmd
RT @Midwest_MedPeds: Very excited to be part of the conversation! Checking in from Cincinnati #JHMChat
Grace Farris MD @gracefarris
#jhmchat already forgot the first rule! https://t.co/etsh41iNKt
Kristina Dzara, PhD, MMSc @kristinadzara
RT @JHospMedicine: Let's get going with Q1 of tonights #JHMChat: https://t.co/FjxkAK7HQf
Avital O'Glasser, MD FACP FHM @aoglasser
@gracefarris #jhmchat hi Grace!!
J Hospital Medicine @JHospMedicine
Tonight's discussion could definitely use our #meded trainee perspective. Glad to have you join in, @RealZachLauer #jhmchat
Grace Farris MD @gracefarris
@aoglasser Hi! #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: 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
J 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 wel…
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 convers…
Kristina Dzara, PhD, MMSc @kristinadzara
RT @JHospMedicine: Don't forget to tag your tweets with #JHMChat! Topic 1 up in a moment…
Rita Hurd @rita_hurd
@andrewolsonmd @JHospMedicine @WrayCharles if the @Twins are on the west coast i will gladly spend my evening with #JHMchat instead
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
Vinny Arora MD MAPP @FutureDocs
RT @gracefarris: #jhmchat already forgot the first rule! https://t.co/etsh41iNKt
J Hospital Medicine @JHospMedicine
RT @kristinadzara: Kristina here checking in for #jhmchat. Thanks to @FutureDocs for inviting all of us #HMIEducators to join the convers…
Avital O'Glasser, MD FACP FHM @aoglasser
@FutureDocs #jhmchat make sure it goes on your CV!! right @FutureDocs @WrayCharles @ETSshow ??
Society of Hospital Medicine @SHMLive
😂💯 ALWAYS use #JHMChat
Janet Yackle @janet_yackle
RT @rita_hurd: @andrewolsonmd @JHospMedicine @WrayCharles if the @Twins are on the west coast i will gladly spend my evening with #JHMchat
Avital O'Glasser, MD FACP FHM @aoglasser
@OHSU_DHM @OHSUIMRes #jhmchat for the record, this chat participation is brought to you (me?) thanks to leftovers last night and my kiddos watching game 4 of the western conference finals. #RipCity!!!
Sonya Tang Girdwood @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
J 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 Madeline @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
Jennifer Madeline @jennifermcaputo
RT @gracefarris: #jhmchat already forgot the first rule! https://t.co/etsh41iNKt
J Hospital Medicine @JHospMedicine
Lots of truth here. Data is only as good as how available it is...#JHMChat
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Are there any programs/individuals out there who have really formalized this process...? #JHMChat https://t.co/iM73sNVj8w
Avital O'Glasser, MD FACP FHM @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 @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 @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 @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
J 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
Grace Farris MD @gracefarris
A1- I’m still stuck on @andrewolsonmd med Ed onion #JHMChat https://t.co/kT01hq2vfn
Harvard Macy @harvardmacy
RT @kristinadzara: Kristina here checking in for #jhmchat. Thanks to @FutureDocs for inviting all of us #HMIEducators to join the convers…
Society of Hospital Medicine @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!
Harvard Macy @harvardmacy
RT @FutureDocs: Hi Vinny Arora from @UChicagoMed and #jhmchat moderator off duty tonight but excited for #JHMChat on #meded article and wel…
MedEdBot @MedEdBot
RT @JHospMedicine: Tonight's discussion could definitely use our #meded trainee perspective. Glad to have you join in, @RealZachLauer #jhmc
Vinny Arora MD MAPP @FutureDocs
RT @andrewolsonmd: A1: This is hard in residency - but What if we move even further back? Like entering residency - we assume they all st…
MedEdBot @MedEdBot
RT @kristinadzara: Kristina here checking in for #jhmchat. Thanks to @FutureDocs for inviting all of us #HMIEducators to join the convers…
Harvard Macy @harvardmacy
RT @jac2thersq: Looking forward to this #JHMChat tonight! https://t.co/oLdIF7LNVJ
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
Avital O'Glasser, MD FACP FHM @aoglasser
@gracefarris @andrewolsonmd @RJmdphilly #JHMchat omg omg omg that is awesome! @gracefarris on the fly, mid-chat drawing!
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…
Lonika Sood, MD, MHPE @sood_lonika
@JHospMedicine @WrayCharles Lonika Sood, from Spokane wa #jhmchat
Subha Airan-Javia, MD FAMIA @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
Rita Hurd @rita_hurd
RT @gracefarris: A1- I’m still stuck on @andrewolsonmd med Ed onion #JHMChat https://t.co/kT01hq2vfn
J Hospital Medicine @JHospMedicine
RT @gracefarris: A1- I’m still stuck on @andrewolsonmd med Ed onion #JHMChat https://t.co/kT01hq2vfn
J 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…
Andrew Olson, MD @andrewolsonmd
There are examples of this in the literature - but not adaptive learning. #JHMChat https://t.co/1HmOwgm9xd
Grace Farris MD @gracefarris
@andrewolsonmd That’s pithy! #jhmchat
Melissa Plesac @MelissaPlesacMD
@JHospMedicine A1: #JHMChat @Umnmedresidency has an innovative coaching system that pairs faculty with each trainee. Each trainee is discussed by a larger group to review milestones q6months, but with a large residency time is limited and conversation often evolves into "he/she is doing great!"
Sonya Tang Girdwood @STangGirdwood
RT @Midwest_MedPeds: @STangGirdwood @JHospMedicine Even this is flawed. Experiences are not all the same. DKA w hypotenson severe acidoci…
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
Avital O'Glasser, MD FACP FHM @aoglasser
@jenreadlynn @jennifermcaputo #jhmchat i remember having procedure logs, but I don't remember ever having "diagnosis" logs as a resident... @OHSUIMRes now has an #InternIntensive week that includes a ton of simulations esp for high stakes cases...
J Hospital Medicine @JHospMedicine
@sood_lonika @WrayCharles Glad you could make it, Lonika! #jhmchat
Lonika Sood, MD, MHPE @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 #jhmc
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Great example. Does anyone, say on Day1, survey their residents for their "experience gaps"? @MelissaPlesacMD @andrewols
Daniel Ricotta, MD, FHM @DanielRicottaMD
RT @gracefarris: A1- I’m still stuck on @andrewolsonmd med Ed onion #JHMChat https://t.co/kT01hq2vfn
Society of Hospital Medicine @SHMLive
RT @gracefarris: A1- I’m still stuck on @andrewolsonmd med Ed onion #JHMChat https://t.co/kT01hq2vfn
Rebecca Jaffe @RJmdphilly
#JHMChat I'm here! Catching up! (bedtime interlude while husband takes a turn herding the wild things)
Grace Farris MD @gracefarris
@aoglasser @andrewolsonmd @RJmdphilly Burritos are a significant layer #jhmchat in my experience
J Hospital Medicine @JHospMedicine
Great insights so far, we've got Question #2 coming shortly... #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@RJmdphilly #jhmchat hi Rebecca!!!
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
Andrew Olson, MD @andrewolsonmd
RT @aoglasser: @jenreadlynn @jennifermcaputo #jhmchat i remember having procedure logs, but I don't remember ever having "diagnosis" logs a…
Melissa Plesac @MelissaPlesacMD
@JHospMedicine @andrewolsonmd I think this is especially difficult for new attendings! I still have quite a few of my own "experience gaps" and am not always sure what is a normal experience gap vs something that we should prioritize addressing #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 conversa…
Anika Kumar, MD @freckledpedidoc
Great point @Midwest_MedPeds! #JHMChat
Melissa Plesac @MelissaPlesacMD
RT @FutureDocs: @andrewolsonmd . we assume trainees are blank slates but they are not. just ask all incoming interns the last time they sa…
Rebecca Jaffe @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 every…
J Hospital Medicine @JHospMedicine
Here's Question #2 for tonights #JHMChat: https://t.co/eIhwraVa9x
Vinny Arora MD MAPP @FutureDocs
RT @MelissaPlesacMD: @JHospMedicine @andrewolsonmd I think this is especially difficult for new attendings! I still have quite a few of my…
Daniel Ricotta, MD, FHM @DanielRicottaMD
RT @RJmdphilly: @gracefarris @andrewolsonmd Tweetorial with links! #JHMChat https://t.co/lkqDrk0YXK
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Great insights so far, we've got Question #2 coming shortly... #JHMChat
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: 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
Avital O'Glasser, MD FACP FHM @aoglasser
@RJmdphilly @gracefarris @andrewolsonmd #JHMchat for the record, this is @RJmdphilly AMAZING tweetorial walking through her awesome, recent #meded publication
Lonika Sood, MD, MHPE @sood_lonika
@JHospMedicine A2: deliberate practice, mastery learning in authentic clinical contexts, coaching #JHMchat
Melissa Plesac @MelissaPlesacMD
RT @Midwest_MedPeds: Q1 Blueprinting content for a field as massive as IM or Peds is impossible - too much to see/learn to experience every…
Rebecca Jaffe @RJmdphilly
@gretchendiemer @dmitripapa
Anika Kumar, MD @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 @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 @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 @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
J 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
Grace Farris MD @gracefarris
RT @aoglasser: @RJmdphilly @gracefarris @andrewolsonmd #JHMchat for the record, this is @RJmdphilly AMAZING tweetorial walking through her…
Daniel Ricotta, MD, FHM @DanielRicottaMD
A2: Lots of literature suggesting comfort / confidence does not equate with competence - I would make similar parallels to quality #JHMChat
Carol Marcelo @CarolMarceloMD
@JHospMedicine @WrayCharles HI, I'm Carol Marcelo, academic hospitalist at VCU in Richmond, VA. First twitter chat ever for me! #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 req…
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Here's Question #2 for tonights #JHMChat: https://t.co/eIhwraVa9x
Subha Airan-Javia, MD FAMIA @subhaairan
@Midwest_MedPeds Yes yes yes!!!! Can’t like this enough! #JHMchat
Vinny Arora MD MAPP @FutureDocs
@CarolMarceloMD @JHospMedicine @WrayCharles welcome to #jhmchat!
Avital O'Glasser, MD FACP FHM @aoglasser
@JHospMedicine A2 #JHMchat I think we would all like to think that it does, but it doesn't not necessarily correlate. and, perceived confidence WITHOUT competency could be more dangerous than lack of confidence--ex, do you not know to ask for help??
Rebecca Jaffe @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: Lots of literature suggesting comfort / confidence does not equate with competence - I would make similar parallel…
Melissa Plesac @MelissaPlesacMD
RT @freckledpedidoc: @aoglasser @jenreadlynn @jennifermcaputo @OHSUIMRes Our #PedsHM fellows have “diagnosis logs”. It’s a way we assess if…
Society of Hospital Medicine @SHMLive
Don’t miss out on insights from your #hospitalist colleagues across the world on #JHMChat in progress now!
J Hospital Medicine @JHospMedicine
@CarolMarceloMD @WrayCharles Glad to have you, Carol! Haven't seen @michellebr00ks tonight...:) #jhmchat
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 Madeline @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
J Hospital Medicine @JHospMedicine
RT @SHMLive: Don’t miss out on insights from your #hospitalist colleagues across the world on #JHMChat in progress now! https://t.co/fBGRZL…
Vinny Arora MD MAPP @FutureDocs
Q2 Confidence does not equal competency. see Dunning Kruger Effect.. https://t.co/ecia5Ejuh1 #jhmchat
J 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, FHM @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 @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, FHM @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 co…
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 w…
J Hospital Medicine @JHospMedicine
@jac2thersq And that can be such a tough social construct to overcome...#jhmchat
Rebecca Jaffe @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
Carol Marcelo @CarolMarceloMD
@MelissaPlesacMD @JHospMedicine @andrewolsonmd YES! It's not just gaps in medical experience but also teaching experience we new(ish) attendings feel. This was one of the reasons my group started a peer observation/feedback model to identify potential gaps in teaching knowledge #JHMChat
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: It's always a good #jhmchat when a Dunning-Kruger curve makes a showing... https://t.co/mvgq4Cvh62
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: It's always a good #jhmchat when a Dunning-Kruger curve makes a showing... https://t.co/mvgq4Cvh62
Subha Airan-Javia, MD FAMIA @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…
Sonya Tang Girdwood @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 @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 every…
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 Madeline @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
J Hospital Medicine @JHospMedicine
Sonia, taking to the other side of the argument on the confidence:ability...#jhmchat
Anika Kumar, MD @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 @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 @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!
J 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
J 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 i…
Anika Kumar, MD @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 n…
Avital O'Glasser, MD FACP FHM @aoglasser
@subhaairan @JennZag4 @jennifermcaputo #JHMchat YES!!! and I think there are incredible mentors in medicine, including on #medtwitter lately, driving the conversations on that vernacular
J Hospital Medicine @JHospMedicine
Topic #3 coming up... #JHMChat
Mark Shapiro MD @ETSshow
@kristinadzara @FutureDocs Mark Shapiro here, sorry to have to miss out! Will catch up tomorrow! #JHMchat
Avital O'Glasser, MD FACP FHM @aoglasser
@FutureDocs @RebeccaEBerger @MGHMedicine #JHMChat scurvy. scurvy needs to be on every differential... right @PDX_Tom?
Daniel Ricotta, MD, FHM @DanielRicottaMD
RT @aoglasser: @subhaairan @JennZag4 @jennifermcaputo #JHMchat YES!!! and I think there are incredible mentors in medicine, including on #m
Andrew Olson, MD @andrewolsonmd
@aoglasser @subhaairan @JennZag4 @jennifermcaputo Remiss to not mention @rabihmgeha and @DxRxEdu and @medrants here! #JHMChat
Grant Turner @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 y…
Carol Marcelo @CarolMarceloMD
@jac2thersq @MelissaPlesacMD @JHospMedicine @andrewolsonmd It has! My group and I have presented our data locally and nationally, and we are currently working hard to publish our manuscript. Anecdotally it was great to observe my colleagues utilize different teaching strategies! #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.…
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
Avital O'Glasser, MD FACP FHM @aoglasser
@andrewolsonmd @subhaairan @JennZag4 @jennifermcaputo @rabihmgeha @DxRxEdu @medrants #jhmchat yup yup yup you beat me to it :)
Melissa Plesac @MelissaPlesacMD
A1: I have been trying to improve the immediacy of my feedback to help reinforce competence and build confidence when things are done well, but also to help trainees self-reflect when things are still fresh in their minds when things aren't going so well #JHMChat
Rebecca Jaffe @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
Rebecca Jaffe @RJmdphilly
RT @aoglasser: @RJmdphilly @gracefarris @andrewolsonmd #JHMchat for the record, this is @RJmdphilly AMAZING tweetorial walking through her…
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
J 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... https://t.co/mvgq4Cvh62
Temple Ratcliffe @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…
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Moving on to Question #3 for tonights #JHMChat... https://t.co/T75vHQH0bQ
Grace Farris MD @gracefarris
@RebeccaEBerger @WeillCornell @WCMGIM Welcome back!! Not easy to return 😘#jhmchat
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
Grace Farris MD @gracefarris
@subhaairan @JennZag4 @jennifermcaputo Setting this as the tone is 🔑 #jhmchat
Andrew Olson, MD @andrewolsonmd
Oh and also - the days of residents as workforce must end. Then we can design education. #JHMChat @Midwest_MedPeds
Avital O'Glasser, MD FACP FHM @aoglasser
@JHospMedicine A3 #JHMchat whew, that's the BIG question-but I don't think we can squeeze all of IM into 3 years. Where's the line for what's "enough" for independent practice? What's enough for "I need to know I can still look it up or ask" to continue from there?
Anika Kumar, MD @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
Rita Hurd @rita_hurd
@JHospMedicine -1 for the med peds folks here #jhmchat
Andrew Olson, MD @andrewolsonmd
@MelissaPlesacMD @CarolMarceloMD @jac2thersq @JHospMedicine Any day! Get ready for baseball quotes and analogies. #JHMChat
Subha Airan-Javia, MD FAMIA @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 @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 ...
Avital O'Glasser, MD FACP FHM @aoglasser
@JHospMedicine #jhmchat like as @subhaairan & @andrewolsonmd just tweeted, as attendings we need to model still being able to say "I don't know"--so where the line of a resident "not knowing" and an attending "not knowing"?
Jen Readlynn, MD @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 @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
Grace Farris MD @gracefarris
@FutureDocs This is so good 🤣#JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@andrewolsonmd @JHospMedicine @subhaairan #JHMchat good luck! I anticipate that will be crucially important work to disseminate
Andrew Olson, MD @andrewolsonmd
Tell us more! #JHMChat
Temple Ratcliffe @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
Grace Farris MD @gracefarris
@AmulyaNagarurMD @JHospMedicine @WrayCharles Welcome! #JHMChat
Andrew Olson, MD @andrewolsonmd
RT @RebeccaEBerger: A3: Absolutely not! That would be hypocritical, as attendings we surely don’t know everything. Goal is for trainees to…
Kaishauna Guidry, MD @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.
Avital O'Glasser, MD FACP FHM @aoglasser
RT @RebeccaEBerger: A3: Absolutely not! That would be hypocritical, as attendings we surely don’t know everything. Goal is for trainees to…
J Hospital Medicine @JHospMedicine
This is why we invited @andrewolsonmd to this conversation...#jhmchat
Avital O'Glasser, MD FACP FHM @aoglasser
RT @templeratcliffe: A3: 😂 Not fair for attendings much less trainees. The longer I practice (emphasis on practice) the more I realize 1…
Andrew Olson, MD @andrewolsonmd
@kristenyoung @CarolMarceloMD @jac2thersq @MelissaPlesacMD @JHospMedicine Is it extra or built into FTE? #JHMChat
Rebecca Jaffe @RJmdphilly
@jac2thersq What's the program (New iPad owner...) #JHMChat
Carol Marcelo @CarolMarceloMD
@JHospMedicine A3- I'm not sure if it's even possible to "know everything" no matter how many years you've been practicing- medicine is ever evolving! Not that far out from med school and I've learned so many things that weren't in the books before #JHMChat
Rita Hurd @rita_hurd
RT @RebeccaEBerger: A3: Absolutely not! That would be hypocritical, as attendings we surely don’t know everything. Goal is for trainees to…
J Hospital Medicine @JHospMedicine
@AmulyaNagarurMD @WrayCharles Welcome aboard, Amulya! Glad you could make it #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @CarolMarceloMD: @JHospMedicine A3- I'm not sure if it's even possible to "know everything" no matter how many years you've been practic…
Jen Readlynn, MD @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 @SHMLive
RT @JHospMedicine: This is why we invited @andrewolsonmd to this conversation...#jhmchat https://t.co/uumt7QC59G
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
Melissa Plesac @MelissaPlesacMD
@JHospMedicine A3 #JHMChat Definitely not! Even so, I often find myself struggling to move away from the "if I only worked just a little bit harder I would know everything" attitude that comes with studying for med school exams. I have to remind myself that this isn't how real medicine works!
Andrew Olson, MD @andrewolsonmd
RT @MelissaPlesacMD: @JHospMedicine A3 #JHMChat Definitely not! Even so, I often find myself struggling to move away from the "if I only wo…
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, FHM @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…
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 @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
J 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 Madeline @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
Rita Hurd @rita_hurd
@andrewolsonmd @Midwest_MedPeds i agree. lots of cases w/ little to no feedback on outcomes of cases, direct observation during cases, etc = not learning #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 @SHMLive
RT @JHospMedicine: We would like to point out that @MelissaPlesacMD was one of our stellar JHM Editorial Fellows this year who was able to…
Melissa Plesac @MelissaPlesacMD
@JHospMedicine @andrewolsonmd I am so grateful for the opportunity!! It has been a fantastic year and I have been so fortunate to meet all of you!Would highly recommend!! #JHMChat
Jennifer Madeline @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
Grace Farris MD @gracefarris
@DanielRicottaMD @EileenEReynolds Amazing! #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@jennifermcaputo #JHMchat agreed--part of the reason to model that life-long learning and humility as an attending. model that learning for those about to cross over from residency to being an attending v leave them hanging
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
J 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
Carol Marcelo @CarolMarceloMD
@kristenyoung @jac2thersq @MelissaPlesacMD @JHospMedicine @andrewolsonmd Maybe I need to do a tweetorial on this? Wish I could do my SHM poster presentation on twitter! #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.
J Hospital Medicine @JHospMedicine
RT @Midwest_MedPeds: Q3Things that make knowing everything an impossible task: 1. Too much to learn/know 2. Ebbinghaus forgetting curve -…
Avital O'Glasser, MD FACP FHM @aoglasser
@gracefarris @DanielRicottaMD @EileenEReynolds #jhmchat I'm also trying to fold laundry... at least I'm not on the elliptical for this chat... (talk about #worklifebalance...)
Robert Centor @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
Grace Farris MD @gracefarris
What a testament to the @JHospMedicine edit fellowship!
Carol Marcelo @CarolMarceloMD
@andrewolsonmd @kristenyoung @jac2thersq @MelissaPlesacMD @JHospMedicine It's extra--for now? #JHMChat
Andrew Olson, MD @andrewolsonmd
@CarolMarceloMD @kristenyoung @jac2thersq @MelissaPlesacMD @JHospMedicine PLEASE do!!! #JHMChat
Anika Kumar, MD @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
J Hospital Medicine @JHospMedicine
Final topic of the night coming up...#JHMChat
Rebecca Jaffe @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 @jenreadlynn
@JHospMedicine @MelissaPlesacMD @andrewolsonmd Now you're really making me want to apply! #JHMChat
Rebecca Jaffe @RJmdphilly
@JHospMedicine no #JHMChat
Ben Kinnear @Midwest_MedPeds
RT @andrewolsonmd: All together now: Practice doesn't make perfect - it makes habits. Deliberate practice makes better but it requires kn…
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 @DrMamaKai
@MelissaPlesacMD @andrewolsonmd @JHospMedicine #JHMChat is the structural limitation duty hours?
Avital O'Glasser, MD FACP FHM @aoglasser
@andrewolsonmd @CarolMarceloMD @kristenyoung @jac2thersq @MelissaPlesacMD @JHospMedicine #JHMchat do it!!
J Hospital Medicine @JHospMedicine
Final Question for tonight's #JHMChat: https://t.co/60q8h3ncm3
Melissa Plesac @MelissaPlesacMD
RT @Midwest_MedPeds: @MelissaPlesacMD @JHospMedicine Totally! We all feel guilt about this. See this awesome Twitter thread from @cincyim
Kaishauna Guidry, MD @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
Grace Farris MD @gracefarris
@aoglasser @DanielRicottaMD @EileenEReynolds #JHMChat : From laundry to the Harvard Club!
Andrew Olson, MD @andrewolsonmd
RT @FutureDocs: @gracefarris @andrewolsonmd @RJmdphilly i totally missed out on burritos. and i love mexican food. can someone help me ? @R
Rebecca Jaffe @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 @RJmdphilly
@FutureDocs @gracefarris @andrewolsonmd Isn't there great Mexican in Chicago? #JHMChat
Rebecca Jaffe @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
Rita Hurd @rita_hurd
@JHospMedicine in my opinion - reducing the burden of “busy work” on residents, particularly interns. documentation is only one piece, and it feels like that’s the piece we focus on to a fault #JHMchat
Melissa Plesac @MelissaPlesacMD
@DrMamaKai @andrewolsonmd @JHospMedicine Definitely to a degree, but definitely not the only limitation. Also things like ACGME requirements for in and outpatient rotations, increased requirements for QI exposure in residency, focus on wellness etc. etc. #JHMChat
Melissa Plesac @MelissaPlesacMD
RT @andrewolsonmd: @JHospMedicine A4: A major redesign where training is learner centered and not based on workforce needs. Right now ne…
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
Melissa Plesac @MelissaPlesacMD
@andrewolsonmd @JHospMedicine @RJmdphilly Completely agree!! When I hear about competency based duration of training for undergraduate medical education I often wonder what that would look like for residency, but the logistics seem overwhelming #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
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Final Question for tonight's #JHMChat: https://t.co/60q8h3ncm3
Andrew Olson, MD @andrewolsonmd
Sounds like @Midwest_MedPeds and I need to start a residency program. #JHMChat
Rita Hurd @rita_hurd
@Amraphel18 @JHospMedicine yes - i am always so grateful when attendings stick around beyond rounds, or come back in the afternoon, to teach about topics pertinent to our patient list #JHMchat
Grace Farris MD @gracefarris
@andrewolsonmd @JHospMedicine @RJmdphilly So true! #JHMChat
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
J 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 https://t.co/SFRawl2yPT
Rebecca Jaffe @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/exper…
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
Grace Farris MD @gracefarris
@rita_hurd @JHospMedicine Wait, you’re typing that like you live in NYC where residents draw their own bloods and place peripheral IVs ! #JHMChat cc @mike_natter
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 @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"…
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 @RJmdphilly
@andrewolsonmd @JHospMedicine To broadly reference Russel Ackoff - I think we need to Desolve this problem, not solve it within current constraints. #JHMChat
Melissa Plesac @MelissaPlesacMD
@rita_hurd @JHospMedicine Agree! I think its much more system based than that! Ex: When residents are on rotations with sub-par educational opportunities, but the hospital needs the resident to show up and care for that patient to run. #JHMChat
Charlie M. Wray @WrayCharles
@FutureDocs @RJmdphilly @gracefarris @andrewolsonmd Everything mixed together, making the even the bad parts taste good...? #jhmchat
Anika Kumar, MD @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 @SHMLive
RT @JHospMedicine: Great advice to other trainees out there from @collinflan on tonight's #JHMChat https://t.co/SFRawl2yPT
Andrew Olson, MD @andrewolsonmd
RT @RJmdphilly: @andrewolsonmd @JHospMedicine To broadly reference Russel Ackoff - I think we need to Desolve this problem, not solve it wi…
Rita Hurd @rita_hurd
@RebeccaEBerger @JHospMedicine exactly. writing notes is a helpful thought processing tool for me so i really don’t mind it, but the hours each day i spend on the phone with outside hospital medical records departments? woof. #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
J Hospital Medicine @JHospMedicine
10 min. left in the #JHMChat tonight...Would love to hear any final thoughts or comments...
Melissa Plesac @MelissaPlesacMD
@andrewolsonmd @JHospMedicine @RJmdphilly I feel like the fact that such logistical scheduling barriers exist is a testament to the fact that the whole system needs a re-design! If we can't individualize training based on what our learners need because of scheduling complexities that is a HUGE problem #JHMChat
Grace Farris MD @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 th…
Jen Readlynn, MD @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
Daniel Ricotta, MD, FHM @DanielRicottaMD
RT @gracefarris: @aoglasser @DanielRicottaMD @EileenEReynolds #JHMChat : From laundry to the Harvard Club!
J 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 @RJmdphilly
@jac2thersq @andrewolsonmd @JHospMedicine @FutureDocs This sounds promising #JHMChat
Melissa Plesac @MelissaPlesacMD
RT @gracefarris: A1- I’m still stuck on @andrewolsonmd med Ed onion #JHMChat https://t.co/kT01hq2vfn
Rebecca Jaffe @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. https://t.co/UuSedRLqrD
Avital O'Glasser, MD FACP FHM @aoglasser
#jhmchat final thoughts-- from the article...re the list of rare diagnoses that residents didn't have confidence managing...I was struck by how many might be "I know to have on my differential, I know how to triage to higher level of care"...like aortic dissection...thoughts?
Society of Hospital Medicine @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: https://t.co/eVeCkCp1Xc
J 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
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: 10 min. left in the #JHMChat tonight...Would love to hear any final thoughts or comments...
Rebecca Jaffe @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: https://t.co/eVeCkCp…
Dink Jardine, MD @dinkjardine
RT @RJmdphilly: @gracefarris @andrewolsonmd Tweetorial with links! #JHMChat https://t.co/lkqDrk0YXK
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: A final shout out to @MelissaPlesacMD & @andrewolsonmd for their fantastic editorial and guidance on tonight's #JHMChat
Melissa Plesac @MelissaPlesacMD
RT @RJmdphilly: @andrewolsonmd @JHospMedicine Flattered to be referenced in this tweet. Whole heartedly agree that structural change is 100…
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 -…
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
J 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
Grace Farris MD @gracefarris
The feedback burrito, a beta recipe #JHMChat https://t.co/k7KajItCuo
Rebecca Jaffe @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
J Hospital Medicine @JHospMedicine
RT @andrewolsonmd: Thanks @JHospMedicine and @WrayCharles and @FutureDocs - and thanks @MelissaPlesacMD for being a great mentee! #JHMchat
Grace Farris MD @gracefarris
RT @JHospMedicine: A final shout out to @MelissaPlesacMD & @andrewolsonmd for their fantastic editorial and guidance on tonight's #JHMChat
Avital O'Glasser, MD FACP FHM @aoglasser
@gracefarris #JHMChat wow. just wow.
Society of Hospital Medicine @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!
Avital O'Glasser, MD FACP FHM @aoglasser
@RJmdphilly #jhmchat indeed!
Grace Farris MD @gracefarris
RT @RJmdphilly: This is why learners should get on twitter Flattens hierarchies (@aoglasser ) etc #JHMChat https://t.co/y2nhqmkhmb
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 @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…
Melissa Plesac @MelissaPlesacMD
@aoglasser Me too! Just because you don't technically "see" something as the final diagnosis doesn't mean you didn't learn about it while you considered it as a diagnosis. Maybe we don't always recognize the learning that is right in front of us! #JHMChat
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 @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
Vinny Arora MD MAPP @FutureDocs
RT @gracefarris: The feedback burrito, a beta recipe #JHMChat https://t.co/k7KajItCuo
Jennifer Madeline @jennifermcaputo
RT @gracefarris: The feedback burrito, a beta recipe #JHMChat https://t.co/k7KajItCuo
Harvard Macy @harvardmacy
RT @jac2thersq: @andrewolsonmd @JHospMedicine @RJmdphilly Agree but recently participated in a journal club discussing "learning-centered"…
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 cas…
Jen Readlynn, MD @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
J Hospital Medicine @JHospMedicine
@RJmdphilly Love your insights, Rebecca and we're glad to have you on the #jhmchat team
Avital O'Glasser, MD FACP FHM @aoglasser
@MelissaPlesacMD #JHMchat also, some where diagnoses that I think any R3 must have on their radar for an acute, emergent condition, but would still have type to research diagnostic/management options. ex. TTP/HUS
Vinny Arora MD MAPP @FutureDocs
@aoglasser @gracefarris now im hungry and feeling like i need to complete evals 🤣 #jhmchat
Melissa Plesac @MelissaPlesacMD
This gives me all the more reason to throw out that poor sad feedback sandwich for good! #JHMChat
Seth Trueger @MDaware
!!!
Rebecca Jaffe @RJmdphilly
@gracefarris Because dragons HATE spicy salsa. #JHMChat
J 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 @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 @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 @SHMLive
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 @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
Avital O'Glasser, MD FACP FHM @aoglasser
#JHMchat I actually remembered to complete this before midnight east coast time! (usually I get sucked into bedtimes, computer catch up immediately afterwards out here on the west coast, and then poof, it's 9pm in Portland...)
Kaishauna Guidry, MD @DrMamaKai
RT @JHospMedicine: As we wrap up tonight's #JHMChat, want to say thanks for everyone showing up and leading to a lively conversation! Espec…
Melissa Plesac @MelissaPlesacMD
Thank you all so much! First twitter chat was a blast, can't wait for the next one. And @andrewolsonmd thanks for always encouraging me to think for myself, supporting my ideas, and promoting my accomplishments. Mentorship 💯
Rebecca Jaffe @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 @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 @abbyCCim
RT @andrewolsonmd: @JHospMedicine A4: A major redesign where training is learner centered and not based on workforce needs. Right now ne…
Abby Spencer, MD, MS, FACP @abbyCCim
@CCF_IMCHIEFS!!
Abby Spencer, MD, MS, FACP @abbyCCim
RT @andrewolsonmd: @JHospMedicine A4: A major redesign where training is learner centered and not based on workforce needs. Right now ne…
Abby Spencer, MD, MS, FACP @abbyCCim
RT @rita_hurd: @JHospMedicine in my opinion - reducing the burden of “busy work” on residents, particularly interns. documentation is only…
Abby Spencer, MD, MS, FACP @abbyCCim
RT @alvinseattle: @JHospMedicine A2: To bridge the gap with early learners and build confidence, I tell them it's OK to be unsure, although…
Abby Spencer, MD, MS, FACP @abbyCCim
RT @aoglasser: @JHospMedicine #jhmchat like as @subhaairan & @andrewolsonmd just tweeted, as attendings we need to model still being able t…
Subha Airan-Javia, MD FAMIA @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…
Rebecca Jaffe @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 every…
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 @RJmdphilly
@gretchendiemer @dmitripapa I really like "Learning Centered" in place of learner centered. Trying it on for size...
Belinda Kakos @EMIMeducator
RT @templeratcliffe: A3: 😂 Not fair for attendings much less trainees. The longer I practice (emphasis on practice) the more I realize 1…
Michelle Brooks, MD, FACP, FHM @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 every…
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 @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 @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…
Temple Ratcliffe @templeratcliffe
RT @RJmdphilly: @MelissaPlesacMD @andrewolsonmd @JHospMedicine I want to get a whole bunch of folks on #JHMChat in a room & have a blue sky…
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…
Daniel Ricotta, MD, FHM @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…
Daniel Ricotta, MD, FHM @DanielRicottaMD
RT @RJmdphilly: This is why learners should get on twitter Flattens hierarchies (@aoglasser ) etc #JHMChat https://t.co/y2nhqmkhmb
Michelle Brooks, MD, FACP, FHM @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 @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 @RJmdphilly
@andrewolsonmd @JHospMedicine Can we sub in "Learning Centered"? Curious as to your thoughts on whether that is helpful...#JHMChat
Daniel Ricotta, MD, FHM @DanielRicottaMD
RT @RJmdphilly: @MelissaPlesacMD @andrewolsonmd @JHospMedicine I want to get a whole bunch of folks on #JHMChat in a room & have a blue sky…
Jason Silverman @DrJSilverman
Anything has to beat the feedback sandwich … especially with Jack cheese 🧀! #MedEd #humor
Rebecca Jaffe @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.