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Category Archives: Neurology

Electronic medical record (EMR) – review of pros and cons in Cleveland Clinic medical journal

Some negatives regarding the use of EMR:

- So far, electronic systems are not interconnectable
- Do electronic records improve or worsen the quality of care?
- Accuracy vs copying and pasting
- A third party in the examination room
- Devoid of real medical thought

A contrasting view:

- Connectivity will improve
- Staying focused on the patient, even with a computer in the room
- Doctor-doctor communication is enhanced

References:
The electronic medical record: Diving into a shallow pool? CCJM.
The electronic medical record: Learning to swim. CCJM.

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Blogs read by 20% of UK medical students, but only 8% write their own

A wide range of social media tools has become readily available in recent years, to the extent that the use of Facebook in particular is perceived as "second nature" by many students. There is increasing interest in the possibilities of using this social media services for medical education - blogs, wikis, Twitter and Facebook.

This UK study included a self-administered questionnaire survey of 212 first year medical students.
Over 90% used instant messaging. Social networking sites were also highly used - by 70%. There was no significant difference between males and females.
Blogs were read by 20% of students and a small number (8%) wrote their own blogs.
20% of males were users of media sharing and contributed to wikis.
Social bookmarking was rarely used by either gender.
Medical educators need to recognise the potential of social software in medical education but it is essential that students maintain the informality and privacy of these sites. The challenge is how to integrate social software into current curricula and institutional Virtual Learning Environments.

References:
Web 2.0 and social software: the medical student way of e-learning. Sandars J, Homer M, Pell G, Crocker T. Med Teach. 2010 Jun 18.

Comments from Twitter:

@DrVes I didn't expect that 8% of med students in the study wrote blogs - this is not my experience from teaching students and residents at Cleveland Clinic, Case Western and Creighton University.

@sandnsurf Medical education blog vs tumblr/posterous blog possibly. My students are at 10% for blog writing but 1% are actually medical.

@DrVes This is way higher than the stats here in the U.S. "Everybody's on Facebook, nobody has a blog"... 🙂

@doctorwhitecoat Not to jump mid convo, but at my school, I can say that most don't have blogs... at most maybe 3-5% and those that do... don't update.

@DrVes 2-5% is high. There was only one blogging student at Cleveland Clinic medical school who stopped after 1-2 years.

Image source: Blogger.com.

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25% of medical students use Facebook for education – with mixed success

This Australian study aimed to evaluate how effectively medical students may be using Facebook for education.
Researchers surveyed 759 medical students at one Melbourne university, and explored the design and conduct of 4 Facebook study groups.
25.5% of students reported using Facebook for education-related reasons and another 50.0% said they were open to doing so.
The case studies showed conservative approaches in students' efforts to support their development of medical knowledge and mixed successes.
The study authors concluded that Facebook as part of learning and teaching is as much of a challenge for many students as it may be for most educators.
References:
Medical students' use of Facebook to support learning: Insights from four case studies. Gray K, Annabell L, Kennedy G. Med Teach. 2010;32(12):971-6.

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Current school system is failing boys – how to re-engage them in learning – TED video

At TEDxPSU, Ali Carr-Chellman pinpoints 3 reasons boys are tuning out of school in droves, and lays out her bold plan to re-engage them: bringing their culture into the classroom, with new rules that let boys be boys. The first part of the talk points to some eye-opening facts about how the current school system is failing boys.

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Acute bronchitis: Many patients expect to be treated with antibiotics and cough meds but this differs from guidelines


Mind map of differential diagnosis of cough. See more Allergy and Immunology mind maps here.

Cough is the most common symptom bringing patients to the primary care physician's office. The most common diagnosis in these patients is acute bronchitis, according to a recent review in the official journal of AFP, American Family Physician.
Acute bronchitis should be differentiated from other common causes of cough such as pneumonia and asthma - because the therapies are clearly different.
Symptoms of acute bronchitis typically last 3 weeks. As we already know, the presence of colored (e.g., yellow or green) sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections.
Viruses cause more than 90% of acute bronchitis, and therefore, antibiotics are generally not indicated. They should be used only if pertussis is suspected to reduce transmission or if the patient is at increased risk of developing pneumonia (e.g., patients 65 years or older).
The typical therapies that have been traditionally used for managing acute bronchitis symptoms have been shown to be ineffective. The U.S. Food and Drug Administration recommends against using cough and cold preparations in children younger than 6 years.
The supplement pelargonium may help reduce symptom severity in adults.
Many patients expect to be treated with antibiotics and cough medications but this differs from evidence-based recommendations.
The CNN video below tries to decipher what hides behind the names of common cough and cold medications:

References:
Diagnosis and treatment of acute bronchitis. Albert RH. Am Fam Physician. 2010 Dec 1;82(11):1345-50.

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iPad use by medical residents gets rave reviews, increases productivity

View more videos at: http://www.nbcchicago.com.

The Internal Medicine Residents at the University of Chicago Medical Center are now equipped with iPads as their primary device for clinical use.

In the summer of 2010, the Internal Medicine Residency (IMR) program began piloting a project to study the use of iPads on the inpatient wards. Initiated by the Chairman's Office, the project was intended to enhance efficiency of patient care activities on the wards with the goals of improved patient care and more robust conference attendance.
The pilot was overwhelmingly positive and has led to broader use of the devices for all IMR residents. The DOM Internal Medicine Residency program is the first training program in the country to utilize the device.

As an Assistant Professor at University of Chicago, I work with the residents on a daily basis and I can confirm that they love their iPads.

References:
University of Chicago Medical Center
iPads Helping Doctors. NBC.

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