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.
Hi Nic and Art, I’ve recently been listening to your fantastic podcast and really enjoying this. I’m a public health physician who works part time as a supervisor on the Australian Field Epidemiology Program, and part time as a GP registrar and so I have been finding your podcast interesting from both the angle of improving my clinical reasoning, as well as the teaching and training angle. As part of my work on the Australian Field Epi Training program I’ve recently been looking at how we train people in outbreak response, and particularly at aspects of supervision – it’s an… Read more »
Wow Steph, your work sounds pretty amazing. Glad you find some relevance in what we do- it’s really gratifying to hear!
Art and Nic
Nic and Art,
I am a colleague of Casey’s in Broome and he sent me the link. This is a fantastic podcast, interestingly presented and with what is a novel take, but which resonates so deeply with our everyday experience as diagnosticians in this complex environment.
Keep it up!
All best,
David Berger
Wow, Broome sounds like the place to be! Keep up the good work. Glad you find what we do of interest.
Art and Nic
Hi Nic and Art
Just discovered your excellent podcast… somehow managed to evade me despite many shared ideas!
Will be giving you guys a plug for our education sessions and to the wider audience out there in the ether!
Great stuff
Keep it up
Dr Casey Parker
Hi Casey. Glad you discovered us. Had a look through your blog- lots of great stuff there as well. Keep up the good work!
Art
Dr Nahil
I am listening to this great series
I was your house surgeon 9 years ago in Auckland Hospital I am a rural Gp in Australia
I find this very very useful
And very interesting
Yes Aseel, I remember you! Glad you’re finding the podcast useful. It’s great fun to produce, it’s really educational for us as well, plus it beats doing ‘regular’ work! Be well.
Art
Thanks for plugging my diagnostic iOS app DxLogic on one of your recent podcasts! If you didn’t know, I did release it for Android a few months ago too. Finally, it can be accessed from any desktop device at http://www.lrdatabase.com
Please let me know if you have any comments or suggestions about my project.
Michael, sorry for the delayed response. So glad you listen to the podcast! Really think your efforts are worthwhile and use your app with students and junior doctors regularly. Keep up the good work!
Art
Hi Dr. Szecket and Dr. Nahill, Thanks for the latest episode on the evidence behind various clinical signs, I found it particularly fascinating as I have often wondered about the evidence of a lot of the historic practices that we continue to use. Just the other day I put in a request form for a CTPA for a woman in whom I suspected a PE (Wells score = 7) and I wrote on the form “Left leg positive Homan’s sign.” I know you said on the podcast “we shall never mention Homan’s sign again,” as I now know that it… Read more »
Thanks Jimmy. Listen, we’ve all been there, late at night, trying to wrangle what we think is best for the patient, using whatever means we have available, INCLUDING useless physical signs (assuming that the person on the other end of the phone doesn’t appreciate the poor likelihood ratios for that sign)! I would argue though that with a Wells score of 7, the pretest probability of PE was already so high the scan just should have been approved- end of discussion!
Regards, Art
Hi Nic and Art
Stump the chumps is superb! It’s excellent and fun and also make us easy to memorize the case and the disease. I remember symptoms and signs of AOSD now 🙂 Please kindly do more of these. I love this episode so much plus the jokes 😀 Thanks a million for teaching an interesting case.
Suggestion: when doing Stump the Chumps, please include US values for labs. Those of us listening in the US are completely lost with your SI values…
I’m a hospitalist and clinical faculty at New York Medical College/Westchester Medical Center, in the suburbs of New York City. I was privileged, twice this year, to meet Dr. Jeff Wiese from Tulane in New Orleans. Jeff lectures often on clinical reasoning. I strongly recommend his book “Teaching in the Hospital,” which provides both a framework for thinking and teaching, and a series of Socratic dialogs specifically designed to make learners think about their processes.
Thanks for the recommendation Randy. Have heard of the book but will definitely have a read.
Art
Hello Art and Nic, I’m a GP registrar working in Canberra, Australia and I’ve been using my half hour commute over the past couple of weeks to listen to many of your podcasts. Thank you for your time and energy and good humour, I’m really enjoying them. I have a comment / question about the content in one of the early podcasts – about framing biases and how they impact on the lives of junior doctors. It has been my experience as a junior (intern, resident) that, while working in ED or on the wards that, in order to “sell”… Read more »
Thanks Steve. An excellent observation that we can all relate to. It is true, and in some ways unfortunate that we feel we have to “embellish” the case in order to gain the attention of the service we are consulting. It becomes a fine balance between, achieving your goal of having the service review your patient, and not “over-biasing” the recipient of the handover. The classic case is Radiology; how do you convince the radiologist that it is worth scanning your patient? Well, you might emphasise the abdominal pain, even though you felt that it was not really the main… Read more »