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.
I’m an IM resident in Washington state, and have been loving your podcast. I just listened to your interview with Dr. Dhaliwal on becoming an expert diagnostician, and the discussion of consolidating learning from cases reminded me of the book “Make it Stick,” by Peter Brown. It’s a great synopsis of the current evidence regarding learning, teaching, and developing expertise. If you haven’t read it, I can’t recommend it highly enough. If you have, I’d love to hear your take on applying those concepts to clinical reasoning and medical education.
Thanks for the recommendation David. Haven’t read it but it’s now on my ‘must-read’ list.
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Listening to the early episode on Differential Diagnosis I realise how fortunate we are in Rural Medicine. We see our patients all the way through admissions, see them in outpatients and hear back from local GPs. The only patients difficult to catch up on are the ones who go to tertiary centres.
Yes I think you are right Gordon. Having continuity with patients is critical to diagnostic accuracy and learning but alas the situation in secondary and tertiary care, at least in Auckland, is that continuity is increasingly being sacrificed for the sake of expedience and patient through-put. Is suspect that we are not alone in noticing this.
Hi Art and Nik, Thanks for the great podcast, it really gets me thinking! I am a (recently minted) General Physician and (almost minted) Addiction Medicine Physician in Australia. I spend a lot of my day (in consultation liaison) reading through notes without the distraction of managing the acute problem (often). This gives me a bit of time to ponder and dismay at the diagnostic process (with a lot of hindsight bias). Your podcasts, particularly the cognitive autopsies, have helped me to think through these cases in a more systematic way. Addiction Medicine in the acute patient is the source… Read more »
Hello Art and Nic, Long time listener, first time writer – and a little disappointed that I can’t find an email address since I’m not usually the public posting sort. I must confess I took a break from medical podcasts after my exams last year but reading this month’s Clinical Communique from the Victorian Institute of Forensic Medicine reminded me a lot about the content you’ve discussed on the factors that lead to diagnostic errors and ultimately poor outcomes for our patients. I hope you enjoy the read and I look forward to re-engaging with your podcast in 2019. http://vifmcommuniques.org/wp-content/uploads/2019/04/CC-Mar-2019.pdf… Read more »
Art and Nick! I am a big fan. Philosophy and reasoning meet medicine? Sign me up! After a recent visit to our hospital by Dr. Dhaliwal and his recommendation of the podcast the residents and our Program Director are now are hooked on your show. I think the “Racist Patient” most recently was a look at something we often thoughtlessly discard when dealing with patients. Thank you. Are you going to be in the US for the DEM conference this upcoming fall? I am currently the chief resident and would love to have you all as Grand Rounds speakers if… Read more »
Hi David. Thanks for the feedback. Glad you and your colleagues are getting something from the podcasts. We’re not sure if we’re going to the DEM conference in the US this year as we’ve been involved in organizing the Australasian DEM coming up in April and trying to keep our carbon footprints reasonable. Check back with us in a few months and we may have a better idea of our upcoming plans.
Cheers
Hello Art & Nic I am a paediatrician specialising in ID & vaccines who recently moved to Dunedin from Sydney. Introduced to your great podcast by my son, who is a medical student in Sydney. Congratulations on series – a general & a specific question: General: have you had any paediatricians involved in podcast/paediatric cases? I ask this because in Australian urban centres general internal medicine struggles but general paediatrics still thrives as it does in NZ so plenty of scope Specific: Thought your Bawa Garba podcast generally excellent but you started off early on with a comment about clinical… Read more »
Hi Peter. Thanks for your comments, esp re: the Bawa-Garba case. Re: your general query, no at this point we haven’t ventured into the world of paediatrics. We also haven’t dipped our toes in the surgical world. We are general internists and struggle to combine our clinical work with this podcast so probably won’t be expanding the scope anytime soon.
Hi Art and Nic,
I am an avid listener of your podcasts on my way to work at Copenhagen University Hospital, Denmark.
I am a ID specialist with a huge interest in medical education, so your podcasts have been my daily inspiration for the past few weeks. I love stump the chumps, but also all the tips that you throw in, here and there, for teaching clinical reasoning.
Please keep up the good work.
Best wishes
Michala Rose
Thanks for the support Michala. We’d love a STC case from Denmark!
Greetings Dr Art Nahil from one of your former colleagues at Somerville Family Health!
Love IM Reasoning! Thanks for putting this out there.
I formerly worked with you as an OB/GYN NP, now am doing Primary Care/HIV and Homeless Team. Still at Cambridge Health Alliance.
Deidre! A voice from the distant past! I occasionally hear from Sarah B via Facebook but have lost track of Evelyn and Karen, your OB/GYN colleagues. Still in touch with Amna and Randy if you remember them. So glad you’ve listened in and are still fighting the good fight!
Art
Hello Art and Nick! Wondering if you could help with something. Do you have any tips as how to teach the process of clinical reasoning/critical thinking to clinicians without using a clinical case? It’s for staff development and we want them to go through the process of reasoning with something they don’t know in order to understand what it is like for students. Any suggestions would be appreciated!
Hi M. a couple of things to try: one is to use a photo of something well known (e.g. a common bird) that is pixelated or largely blocked out. Ask participants what it is a photo of and why they think what they say. Slowly you can add in details and see how their responses develop and change as they get more information. (We have done this with a picture of the Mona Lisa). Another things to try is to choose a piece of art that has some sort of narrative happening in the painting but is ambiguous enough to… Read more »