Saturday, December 17, 2011

Free Emergency Medicine Ultrasound "Course"

EM ultrasound is difficult to learn by using books with text and static images.  I’m just finishing a quick week of introductory ultrasound in which the interns walk around the department with a senior resident or attending and free-scan patients.  You can’t learn ultrasound without doing it.  But, going home and reviewing the images you saw and reading about the specifics in static books seems backwards to me.  So, I decided to learn mostly by videos/images and short directed articles.

I've also been thinking a lot about crowdsourcing lately.  As a resident, I don't have time for much else besides medicine and my loved ones.  So how does a busy person take big ideas and make them into reality?  By soliciting the help of a crowd of experts.  

At BIDMC/HAEMR, a fellow resident and I set up an internal site on our resident-wiki page where residents post info to help one another out in our EM learning.  I started collecting the links of all the ultrasound videos I watched this week in order to post them onto this site.  But, I realized that the crowd of ultrasound learners could be much larger than just the 36 other residents at my program.

So I've begun to design a free ultrasound course.  I've posted the first 3 lessons (cardiac, aorta, and GB/RUQ), and as I continue to learn ultrasound, I will post more lessons.  

I am in no way an expert on ultrasound, so I'll need your help to crowdsource this project.  Please comment to this post, and contribute your own videos/sites/podcasts/apps/etc, and I’ll update the “course” appropriately.

Note: I have no affiliation with any of the resources that I posted.  If I ever do, I'll be sure to disclose it.  If you post a resource that you are affiliated with, please let us know that as well.

- Teach, MD

Tuesday, October 25, 2011

Fear of Twitter

A fellow resident recently wrote an article for the Emergency Medicine Resident Association (EMRA) periodical called "Emergency Medicine Education 2.0: A Brief Overview."  The article is a synopsis of uses of technology in EM medical education today.  But, it also is a call to arms, attempting to encourage educators and physicians to get on board with technology.    

My liberal arts education told me that prejudice stems from fear of the unknown.  In medical school, a fellow student led a movement to video-capture all of our lectures and to post them on I-tunes-U.  Some faculty and administration were threatened by this initiative and would make public comments letting the school know their objections.  But change occurred, and now I-tunes-U is wildly popular.  Technology like IBM's Watson scares doctors because they think it threatens the way they will practice in the future.  They are right, we will practice differently in the future.  But we must not be resistant to change simply because we are fearful of change.  

The EMRA article ends with a comment about tweeting.  It's not apparent to me why I should have a twitter account, because I admittedly don't understand it's utility.  This fact highlights why technology and education are linked, whether they like it or not.  Education is about pushing yourself into the parts of the world you don't understand; technology is the tool that we can use to accomplish this goal.

I don't know how to use it yet, but here is my new twitter account: @TimothyCPeckMD

Friday, September 23, 2011

TeachMD Verbal MCAT Videos Have Been Launched!

I have been teaching the Verbal MCAT for a decade now and have been developing the TeachMD method.  In the first video I introduce the idea that every Verbal MCAT passage is the same.  In the subsequent videos I hope to show how understanding this fact translates to success.

I originally started out working for some of the big test prep companies, but then moved on to tutoring privately as well as working for a great company Advantage Testing, who allowed me the freedom to use my own methods when teaching my students.  A few years ago I was encouraged by a colleague to sit down and write a book.  I did, and I thought it was pretty good, but it didn't quite capture the energy and focus that I have when sitting with a student one-on-one or standing in front of a classroom.  So I never published it.  But then I learned about the Khan Academy videos and it inspired me to use this new format; it also inspired me to publish it on-line for free.

This method works.  It's novel, and it has brought me self worth and satisfaction by working with students and waiting for the moment when it becomes their own.  I've also used it to support myself financially as I've gone through medical school and to fund my unpaid time in the developing world and at home.  But now I can financially support myself through being a physician and am able to give over my methods at no charge.

My mother is good at her job, and it has always amazed me that she takes a 4 week vacation every summer.  How can she feel comfortable leaving her job for that long?  She likes to say, the sign of a good manager is that when you leave work everything still gets done.  Being successful is no longer being needed.  I hope these videos will embody that sentiment and help as many people as possible.

This method isn't applicable only to the MCAT.  I've used it successfully with students taking other standardized tests, especially the GRE.  But what impresses me the most is when students tell me that everything they read has become easier for them to understand.  Our education system teaches us to read words, but it leave us on our own to figure out how to read critically and understand the authors' arguments.  And so my larger goal is to change that, one student at a time.

Please leave comments here on the videos and the method, and feel free to start conversations about your methods of teaching and how you have successfully reached students.

Sunday, August 21, 2011

Khan Academy

Recently I began to follow the work of Salman Khan.  He has become a celebrity in many circles, and I would not be surprised if he makes the cover of Time within the next year.  He is changing education by changing the method of it's delivery.

At his 2011 TED talk, Khan said something extremely profound and the audience didn't react.  After Kahn began his next sentence, and after the profound statement had time to creep into the minds of the audience members, the crowd suddenly errupted into applause.

At about 6:30 into the you-tube video, Kahn says, 

"I assign the lectures for homework, and what used to be homework, I now have students doing in the classroom."

Watch the video here:

This will change the method of delivery for medical education and in reality, many medical schools are already inadvertently using the Khan method at their schools!

For example, when I was going through my basic science years at NYU, I rarely went to lecture.  Instead, I sat in my bedroom and listened to the recorded lectures and read along with the PowerPoints that had been video-captured.  I would rewind when I didn't understand a lecturer's point, I would press stop when I wanted to eat lunch or was getting board, and I would press fast forward and listen to the lecture in 2.5 times speed when I came upon content that I already knew.  The big part missing from my method of study that Khan's method embraces, was the "doing in the classroom" "what used to be homework ."

Why can't medical education take advantage of this sensible method of delivery?  Students can watch lectures and read required texts and articles at home.  Then, they can be parsed into knowledge groups in which those groups meet with a professor to discuss relevant patient cases and medical content.  Those with a high understanding of the content might meet with a professor for a shorter period of time than those with a lower level of understanding.  Or those with higher understanding could go over more advanced topics pertaining to the lectures that they watched.

Better yet, after doing the work at home, students could sign up for which class they wanted to take.  Those who feel they've mastered the content at home, would have a small group with a professor who would discuss more advanced topics or related topics like medical ethics or public health; those who prefer learning in person to the Khan method, could have their own more traditional method grouping; the possibilities for groupings are endless.

How do you think the Khan Academy could change medical education?    

Monday, August 1, 2011

New Hofstra Medical School Doing It Right

If we are to apply inductive reasoning to medical education, we must think of creative ways to expose novice level medical students early on in their education to the undifferentiated patient.  We should not expect students to try to understand the basic science behind a myocardial infarction without those students first witnessing chest pain, without them witnessing what a heart attack actually looks like.

The brand new Hofstra/North Shore - Long Island Jewish  School of Medicine has taken advantage of its unique advantage of creating a medical school curriculum from scratch.  The school's first class will have the opportunity to learn via inductive reasoning by seeing patients with chest pain before they learn all the factual parts of what makes up a myocardial infarction.  They will know chest pain and from that knowledge point, as they continue onwards with their more traditional studies, they will then have the advantage of context.  The students will know what cardiac cell necrosis looks like, and what troponin bumps look like, and what statins are designed to prevent, and what the past event is that pathological q-waves represent.

Here is an excerpt from an article found on PRNewswire-USNewswire from July 27, 2011:

"Within the first weeks of their arrival, students will be trained and certified as emergency medical technicians and begin working in ambulances. By learning to be EMTs and practicing emergency care from the beginning of their studies, students will be exposed as members of an emergency-response team to patients in crisis situations. The school's ground-breaking academic course content offers students the unique opportunity to learn medicine through a new and innovative curriculum that integrates basic science with hands-on clinical experience throughout the four years of medical school."

If you know of other schools practicing novel approaches to expose medical students early to patients, especially to patients who are in their first stages of presentation, please leave a comment.

Thank you to Hofstra for getting it right.

-Teach, MD

Friday, July 29, 2011

3 Basic Tenets

Problems in medical education can be solved by considering three basic tenets:

1. Inductive Reasoning:  The practice of medicine is an art of interpretation of the chief complaint and patient presentation.  Medical education has traditionally been built around deduction, i.e. creating what patients and pathologies might appear to look like from learned facts.  Education can be more efficient and effective if we teach the same way that we practice.

2. Experience: We can never know something without first experiencing it.  We must create methods to ensure a standardized clinical experience for each level of medical education.  If we understand how to give all students the opportunity to meet high standards, we can be ensured that our students have seen what we intend them to see, and therefore know what we intend them to know.  From this standard, we can then create individualized curricula that meet the diverse interests of student bodies.

3. Expectations: No educational intervention can be successful unless all parties involved are aware of what is expected of them.  Unless both students and educators are well aware of the details and scope of curricula, teaching cannot be effective.  Students cannot be expected to perform well unless “well” is defined.  Failing to properly orient students wastes time and creates angst.

A Philosophy of Medical Education

I scribbled this out in between lectures last week.  It is the lens through which I see problems in medical education transforming into solutions; it will also be the subject of this blog. 


I do not expect anyone to be able to interpret this Venn at this point.  So why would I post it?  

Because nothing gets done unless you start it.  And, it gives me the opportunity to teach my ideas, rather than let them circle about in my own mind.