Internal Medicine Residency News: June 2, 2014

By admin3

From the Director

DUKE.RESEARCH.NIGHT.03 (1)June 1st! That is unbelievable to me….we had a fantastic time Saturday night celebrating our AMAZING SARs.  A huge thank you to Erin and Lynsey for setting up and ensuring that we had a beautiful venue for our SARs and their significant others to enjoy toasts, roasts, and some very spot on awards!  If you want to see some highlights, ask Howard Lee who took at least 1,000 pictures. Kudos this week go to VA QI Chief Joel Boggan for his fantastic grand rounds — the amount of work that was accomplished this year in the realm of QI is pretty unbelievable.  And Joel showed us that he is a pretty accomplished speaker as well.  Make sure to be there Friday for VAISHALI!  Other kudos go to Phil Lehman and Jess Morris from Mike Woodworth for great care of a very sick patient at the VA, to Adrienne Belasco, Nick Rohrhoff, Phil Lehman,  and John Yeatts for volunteering to cover the SARs who were supposed to be on call for the SAR dinner.  Thank you so much. We are looking forward to seeing all of you at RESIDENT RESEARCH NIGHT on Tuesday! We have a record of 40+ posters (!) and are also looking forward to the Califf Award Presentations by Mandar Aras, Alex Fanaroff and Laura Musselwhite.  The event will take place in the Trent Siemens Center – please come out and support your colleagues. This week starts the renovations in the Med Res library…it will be well worth it to have our favorite room on the 8th floor as "off limits" for a short time to bring us new and improved conferencing equipment.  No more calling to DRH on the shoe phone! This week's pubmed from the program goes to all of the residents presenting at Research Night (INSERT LIST HERE) and also to our former VA Chief Jason Webb for his recent publication with mentor Arif Kamal. J Pain Symptom Manage. 2014 May 23. pii: S0885-3924(14)00259-0. doi: 10.1016/j.jpainsymman.2014.05.002. [Epub ahead of print]   Integrating the Biopsychosocial Model into Quality Measures in Palliative Care: A Case for Improving the Hospice Item Set.  Webb JA1, Kamal AH2. Have a great week! Aimee

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What Did I Read This Week?

Bedside Teaching Rounds Reconsidered  JAMA 2014; 311 (19): 1971-1972;  

Author:  Steven McGee, MD

submitted by:  Suzanne Woods, MD 

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Well I actually have read a lot lately given I was on gen med. But our most fascinating case on the wards may be a chairs conference, so I can’t share that reading with you!  What I truthfully just read was “Me Before You” by Jojo Moyes for my book club.  I recommend it but warn you…. Keep the Kleenex nearby as crying is expected. I would be happy to talk with anyone interested about the book!128708_suzanne_woods_prd For “real reading” I chose the following, which is actually a Piece of my Mind from JAMA.  Bedside Teaching Rounds Reconsidered  JAMA 2014 Why did I read this article: As noted above, I just finished gen med and bedside rounds are challenging to fit into the daily schedule and do not resemble the traditional bedside rounds of the past. This is a marked change from when I started my internship 20 years ago! Authors thoughts:  Dr. McGee begins this piece by reflecting on Sir William Osler and how he stated one of his greatest accomplishments was teaching medical students on the wards.  The author comments that physicians spend less than 25% of teaching time at the bedside and rather we are holed up in workrooms or talk in the hallway about patients instead of in the patients room.  Current barriers identified to bedside teaching are “insufficient time to teach, dependence of diagnosis on technology, obstacles created by infection control, and distractions from clinical responsibilities at distant computer stations.”  Many physicians today also find teaching at the bedside difficult for a number of other reasons.  The author does list several reasons that teaching should occur at the bedside despite the obstacles. These reasons include:
  • Helps to calm patients
  • Makes patients view physicians/trainees more favorably
  • Allows teachers to role model for residents and students
  • Patient “satisfaction and pleasure” in assisting to educate learners
Tips on how to make bedside presentations successful include:
  • Succinct presentations
  • Teacher understanding of what is best taught at the bedside vs in the classroom
Things best taught at the bedside:
  • Communication, professionalism, clinical skills
  • Examples:  “introduction to patients, address patient concerns, elicit key details, ask permission to examine, explain symptoms, avoid jargon, respect the medical team, bond with the patient”
My thoughts:  We do spend so much time in the workrooms, space behind the HUC, the bunker and other locations that physicians are with the patients far less than they are with the computers.  The push for efficiency with rounds is such that time at the bedside with the learners has gone away in many settings.  There is a tremendous amount that can be learned from seeing the patients together and talking as team with patients and families.  There are also many physical exam findings that are best seen at the bedside (rashes, skin/soft tissue infections) and the conversations with patients can be priceless.  With time and experience the challenges for the teachers will be second the benefits from derived.

QI Corner (Joel Boggan, MD)

SAQ extended for one more week We still have until June 6th to fill out the Safety Attitudes Questionnaire from PascalMetrics (search in your inbox)!  We are pushing 70% and Med-Peds has hit near 80%.  Please fill it out this weekend if you have a few minutes! Take my job (in 2015)! If you are interested in applying for the CRQS position beginning in July 2015, please see the following link and let me know ASAP:  https://news.medicine.duke.edu/2014/05/call-for-applications-dvamc-chief-resident-for-quality-improvement-and-patient-safety. Feel free to contact me with any questions!

From the Chief Residents

Grand Rounds

Presenter:  Dr. Vaishali Patel VA Chief Resident Grand Rounds

Noon Conference

Date Topic Lecturer Time Vendor Room
6/2 MKSAP Mondays Chiefs 12:00 China King 2002
6/3 MED-PEDS Combined: Contraception Mgmt OR Difficult Death Debrief Beverly Gray / Galanos 12:00 Pita Pit 2002
6/4 IM-ED Combined Conference 12:00 Picnic Basket 2002
6/5 Rebekah Moehring from ID--topic TBD Rebekah Moehring 12:00 Sushi 2001
6/6 Chair's Conference Chiefs 12:00 Domino's 2002
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From the Residency Office

Housestaff Annual Survey 2014

As part of survey month at Duke University Hospital, please take note of the email that you received on Monday, May 19 from the GME Office.  The email contained a link to the Housestaff Annual Survey. This survey helps to provide information on the educational and working environment. It is important that you complete the survey as a high response rate gives a more accurate view of the successes and challenges in graduate medical education at Duke.

Changes to the Med Res Library

Reminder that this week the library will be off limits as we proceed with the 1st phase of upgrading the IT system

Information/Opportunities

 

Upcoming Dates and Events

  • June 3: Annual Resident Research Conference

  • June 6: Serve dinner at the Ronald McDonald House

Useful links

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