Core IM | Internal Medicine Podcast Core IM Team

How do you learn from diagnostic errors? Walk through a case that the host had initially gotten wrong and uncover possible reasons as why from data gathering to hypothesis generation to the interplay between hypothesis generation and evaluation. Learn interesting tidbits on prior work in medical education around how we think, particularly around diagnostic failures.
CME Credit: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im)
Time Stamps

* 02:39 Case Introduction
* 04:46 Yes/No questions with our first two discussants
* 18:43 The diagnosis is revealed
* 21:14 Why did I miss the diagnosis?
* 27:44 Using diagnostic problem solving to break down the case and understand our errors
* 30:20 The importance of data gathering
* 30:49 Introducing our third clinician
* 34:17 Hypothesis generation
* 37:11 The interplay between hypothesis generation and evaluation
* 38:34 The win-stay, lose-shift heuristic
* 41:33 Cognitive forcing strategies
* 49:32 Knowledge vs. experience

Tags: Dermatology, rash, DRESS, AGEP, varicella

Why is prognostication hard? How do we improve at communicating prognosis? How should we approach uncertainty? Explore this and more on this At the Bedside episode!
Prognosis Calculators, Transcript and References (https://www.coreimpodcast.com/2020/01/01/prognosis/)
Time Stamps

* 02:48 What is prognosis?
* 04:00 Why offer prognostication?
* 08:32 Why is prognostication hard?
* 16:41 How do we improve at communicating prognosis?
* 21:56 How should we approach uncertainty?
* 31:06 Take Aways

Tag: life expectancy, CoreIM

Dive deeper into hx of the influenza virus, how vaccines are made and vaccine effectiveness !
Time Stamps
 

* 02:59 The history of the influenza virus
* 08:18 What does the influenza vaccine target?
* 13:20 Chickens, and bugs, and mammalian cells, oh my! How the vaccine is made.
* 14:00 What to do about egg allergies.
* 15:53 Vaccine effectiveness and herd immunity.
* 17:43 Waning immunity and other debates

Show Notes, Transcript and References (https://www.coreimpodcast.com/2019/12/18/influenza-history-and-vaccine/)
Get CME-MOC credit (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im) with ACP!

Explore gaps in your knowledge about the home health world, particularly on home health aides!

* Get CME-MOC credit (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im) with ACP !
* Full transcript, show notes, references (https://www.coreimpodcast.com/2019/11/27/home-health-aides-interprofessional-education-series/)

Time Stamps:
02:33 What support do our patients have at home and how does those people play a role in their care?
06:00 Are there various types of home care workers?
07:25 What role do home attendants play in caring for a patient?
08:31 What tasks do home health aides do?
10:11 What are the types of "skilled carez'?
13:17 What can Medicare cover for older adults in terms of home health aides?
15:17 How does Medicare define homebound?
16:03 How does having Medicaid impact access to home care?
19:10 What if a patient isn’t eligible for Medicare or Medicaid?
19:43 What is the cost to use a private agency for home health services?
24:02 What are some challenges that home health aides face?
25:42 What are “plans of care”?
30:01 Who makes up the home care workforce?
31:52 When patients get discharged from the hospital, do they go home to the same home care assistance?

 
Get CME Credit (https://www.acponline.org/cme-moc/online-learning-center/heparin-induced-thrombocytopenia-5-pearls-segment) with ACP!

Full Transcript with references and show notes (https://www.coreimpodcast.com/2019/11/13/5-pearls-on-heparin-induced-thrombocytopenia/)

Time Stamps

4:30 What is the daily risk of thrombosis if HIT Is left untreated?
5:40 What happens during platelet activation?
07:11 How long does it take for patients to develop for IgG antibodies to Heparin to form?
09:52 Is HIT common?
10:28 Who is at higher risk for HIT?
11:48 Why does low molecular weight heparin have a lower risk for HIT than unfractionated heparin?
15:30 Approach to thrombocytopenia
17:44 How do medications cause thrombocytopenia?
18:38 With medications, what is the time course between medication initiation and thrombocytopenia?
22:20 What is the sensitivity and specificity of anti-PF4 antibody?
23:58 How does the serotonin-release assay (SRA) work?
29:10 What type of anticoagulant do you choose for treating HIT?
31:58 Why is it important to not use warfarin in patients with platelet counts

House of God author, Samuel Shem and Prof Katharine Watson share thought-provoking takes on Gallows Humor.
Laugh and listen to this captivating take on the different shades of humor in the day-to-day of medicine.

Time Stamps


* 02:33 Episode preview and Guest Introductions
* 04:20 Definition of Gallows Humor
* 07:25 Gallows Humor by Comedians vs Patients vs Physicians


The Good


* 08:15 Benefits/Functions of Humor in General
* 11:10  Connection
* 13:07 Coping/Catharsis
* 16:22 Resistance Against Oppression
* 19:03 Humor as our Authenticity/Humanity


The Bad, The Ugly


* 21:01 Unintended Audiences (e.g., patients, families)
* 25:30 “Corporeal” Joking
* 28:00 Toxic Role Modeling
* 31:10 Desensitization/Losing Empathy
* Tips, Takeaways & Conclusion33:48 Challenging Inappropriate Jokes
* 35:45 Excessive Gallows Humor:  Signal of Distress?
* 37:17 Using Gallows Humor: Questions to Ask Yourself
* 38:40 Keeping the Faith!




* 41:11 Excerpt from Man’s 4th Best Hospital by Samuel Shem


Transcript and References (https://www.coreimpodcast.com/2019/10/30/gallows-humor/)
Tag: medical humanities, medical ethics, CoreIM, IMCore