Teaching Clinical Reasoning

Time: 50 minutes

Audience: Second and third year internal medicine residents

Teaching Method: Chalk Talk, Pair-share

Learning Objectives:

  • Outline dual-processing theory as a framework for diagnostic reasoning

  • Discuss the use of problem representations as a tool for teaching diagnostic reasoning

  • Define components of a well-constructed problem representation

  • Practice generating problem representations

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Description: This was an adaptation of a 90-minute teaching session given by Dr. Lauren Brown. Our session was condensed into a 40 minute brief introduction to teaching clinical reasoning for a “senior resident only” Academic Half Day session. I reviewed Dual-Process Theory as an introduction to understanding clinical reasoning. Dr. Lauren Noll then took the group through components of a great problem representation. Finally participants worked in small groups to develop their own problem representation of a clinical case that Dr. Noll and I developed together.

Evaluations: Resident Evaluations 2019

Reflections: Much of the Academic Half Day content for our internal residency program tends to be focused on medical content, so I was unsure how a more conceptual topic would be received. It seemed that everyone appreciated the content and we had 100% participation in the pair-share activity. This was also great opportunity to collaborate and adapt another person’s curriculum to fit into a different setting. For the next iteration I think this session would benefit from additional time to incorporate more practice as well as discuss problem solving for learners who are having trouble coming up with problem representations.

Pulmonary Physiology Small Group Didactics

Time: Eight total 2-hour long sessions

Audience: First Year Medical Students

Teaching Methods: This was a set of eight small group sessions with eleven students, where each session was comprised of four clinical cases.

Description: The sessions were part of a larger curriculum including lectures on pharmacology, pathophysiology and pathology. These were case-based sessions with 11 students and four cases per session. The cases were used to reinforce basic pulmonary physiology with clinical correlation.

Evaluations:

Reflections: This small group was my first experience formally teaching another educator’s materials. It was an exercise in taking the learning objectives and prescribed teaching topics and making them work within my own style as an educator as well as for the group. Additionally, we were challenged by school closures due to inclement weather, so half of our small groups were held via Zoom (digital meeting space). This posed a particular challenge of modifying content that was intended for pair-share and white-board based discussions to a new mode. One personal goal for myself for the session next year is to work on connecting content between sessions.

Pulmonary Arterial Hypertension

Time: 45 minutes

Audience: Internal Medicine Interns and Residents

Learning Objectives:

  • Define pulmonary hypertension 

  • Review the five WHO group categories for pulmonary hypertension

  • Describe the underlying pathophysiology of pulmonary arterial hypertension and the four major classes of medication

  • Develop a framework for identification and management of acute inpatient complications in a patient with pulmonary arterial hypertension

Please click on the above image to view the slides

Please click on the above image to view the slides

Evaluations:

Reflections: I feel the scope was appropriate for internal medicine interns and residents with the aim to provide an overview for a complex topic as well as deliver concrete and practical take-aways for the time on the wards. In future iterations I may add a slide illustrating why volume status is so difficult in these patients. I discussed this point verbally, but it might help to have a slide accompanying it. Additionally topics on the supplemental material did come up (such as the work-up for elevated PASP noted on an echocardiogram). There were some comments from residents requesting clinical cases to consolidate learning. In the next iteration (time permitting) I will include a few cases.