Conversations to inspire critical thinking in clinical medicine and education
Welcome to IM Reasoning with your hosts Dr. Art Nahill and Dr. Nic Szecket, two general internists with a passion for teaching clinical reasoning.
Join us for case discussions, conversations and interviews that explore issues important to medical students, trainees and practitioners of clinical medicine, with a special focus on clinical reasoning, the once-mysterious process behind the remarkable abilities of the master clinician.
Hot off the mic.
Catch our latest episodes.
Love the podcasts – been binging on the series after discovering them a couple weeks ago. I’m currently in a masters program in med ed and am considering a thesis about how to build systems for diagnostic feedback to allow deliberate practice for junior faculty as they strive to improve and grow in their reasoning, physical exam, and procedural skills. You’ve teased such an approach during your show and I’m excited to hear what you’ve learned. You should also think about having Lisa Sanders, MD, from Yale onto the show. She writes the diagnostic dilemma series in the New York… Read more »
Thanks Alex for the comments and suggestions. Still working on the “automated diagnostic feedback tool” (ADFT – just made that up…). Actually, we plan to call it “diagKnowsis”. We’ll keep you updated on progress. We’ll definitely look into Dr. Sanders and her series!
Hi guys – I don’t know whether I am the only surgeon listening to your podcast but I am finding it fascinating. 1. It would be great to hear about the other types of cognitive biases and how they affect decision making. 2. You focus (not unsurprisingly) on diagnostic reasoning but not therapeutic or interventional reasoning. RACS runs this course (http://www.surgeons.org/for-health-professionals/register-courses-events/professional-development/clinical-decision-making/) to address these issues but it’s often said that there is a fundamental divide between “how physicians think” and “how surgeons think”. Does this really exist and if so why? I’d love to hear an ED physician or a… Read more »
Brings back fond memories of General Medicine. Amongst the tsunami of patients admitted on take, the most challenging and perplexing (but also the most fun) was the patient who didn’t fit into any particular diagnostic category and needed some inventive detective work and outside-the-box thinking. Good on you!
Very cool podcast. Cheers. Any chance you will interview John E Brush Jr about his book ‘The Science and Art of Medicine: A Guide to Medical Reasoning’?
Thanks Harry for the suggestion. We will look into it!
Just listened to your last two episodes back to back. Love this series, and especially fellow geriatrician David Sprigg’s interview, his support and openness with other doctors is inspiring.
Having a play with Human Dx app, has a way to go yet but very exciting potential.
Thanks Jackie for the words of encouragement. We love these episodes too! I think you will also enjoy an interview we just recorded with Tony Fernando, psychiatrist, about compassion in health care. That will be episode 12, after another “stump the chumps”. Spread the word!
Many thanks for this site, and especially for the podcasts.
RE the definition of diagnostic error – the importance of checking the diagnostic impression against the patient’s experience of the illness can’t be overemphasized. But perhaps the definition would better include a qualifier, like “appropriate” communication, to the patient. There are always some patients for whom too much information, or too much too soon, can itself be an error, can exacerbate the illness, can create a new diagnosis…
Fantastic! We love the attention you’re bringing to the process, both art and science, of clinical reasoning. Keep up the good work!
Cheers,
Cameron Powell
CEO
http://www.PhysicianCognition.com
Art and Nic
I’m a Paediatrician from Australia with an interest in diagnostic error. Well done for your podcasts. I’m back at SIDM this year and would like to catch up if possible
Are you interested in patient experiences? I am an RN/patient who developed a problem which no doctor was able to correctly diagnose or treat (fortunately a PT knew what was going on). 17 months of misdiagnosis! Bursitis, tendonitis, hernia of the tensor fascia lata, were some misdiagnoses. One doctor thought the bump had always been there, but I’d just never noticed it. He was wrong too. I don’t want to see this happen to other patients. I’d like to see us educate ourselves, then our patients. Had I been so educated at the time of surgery, I could have prevented… Read more »
HI Art and Nic
I love the site – great idea and interesting and stimulating topics.
regards
Margaret