SIDM's priority: Translating ideas into action

Shantanu Nundy shantanu at HUMANDX.ORG
Thu Nov 5 14:39:49 UTC 2015


Colleagues,
I share the sentiments expressed by Pat and Thom. A Critical Thinking
Module is an actionable and high leverage way to begin taking concrete
steps towards safer diagnosis, and is relevant across clinicians,
specialties and tenure.

The question is how should we construct such a module to drive change at
scale? A one-time didactic curriculum is unlikely to be impactful.

Repeated cycles of performance and feedback are arguably the most effective
way to learn. This is how we learn to ride a bicycle and never forget. They
are also highly engaging. In medicine, our analog is case base learning.
Cases that can be solved as brief simulations and provide immediate
feedback on clinical reasoning may present a useful tool for achieving our
aims here.

At the Human Diagnosis Project, we have developed a case based learning
interface that enables rapid case simulation and feedback. As an open
medical project, this tool is freely available and has been co-created with
input from many individuals across SIDM (search "Human Dx" on Apple App
Store or visit www.humandx.org). Case takes 2-3 minutes to solve on any
connected device and so far our global community of contributors has grown
to over 35 countries.

I welcome the opportunity to co-develop critical thinking cases with this
group and disseminate it widely.

-Shantanu Nundy, M.D.


-- 
*The Human Diagnosis Project. <http://www.humandx.org/>*
One open system.
Created by the global medical community.
For all of *humankind*.

ᐧ

On Thu, Nov 5, 2015 at 7:47 AM, Mayer, Thom <tmayer at best-practices.com>
wrote:

> Folks:
>
>
>
> In support of Pat’s excellent idea-and as symbol of how deep the problem
> is, I teach a large portion of the American College of Emergency Physicians
> (ACEP) Emergency Department Directors’ Academy course,, which addresses
> both physician and nurse leadership.  To date, we have had over 1,500
> physician and nurse leaders go through the course, part of which highlights
> the often disparate ways in which physicians and nurses are educated.
>
>
>
> 100% of the nurse leaders have told me that “critical thinking skills” are
> the single most important attribute in hiring emergency department nurses.
> And yet when I ask the physicians, less than 10 had any idea whatsoever
> what that term meant, simply because they are not exposed to that specific
> concept.  A decidedly unscientific sample, to be sure, but one which I fear
> would hold true in other specialties.
>
>
>
> Obviously, I think a Critical Thinking module is an excellent idea.
>
>
>
> Best,
>
>
>
> Thom
>
>
>
> Thom A. Mayer, MD, FACEP, FAAP
>
> Founder and CEO
>
> [image: BP]
>
>
>
>
>
>
>
> *From:* Pat Croskerry [mailto:croskerry at EASTLINK.CA]
> *Sent:* Wednesday, November 04, 2015 3:52 PM
> *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> *Subject:* Re: [IMPROVEDX] SIDM's priority: Translating ideas into action
>
>
>
> Mark: these all look worthwhile initiatives.
>
> I’d like to add a further one: given that a number of studies now point to
> a significant proportion of diagnostic failure being due to thinking
> failures, and given that meta-analytic studies demonstrate conclusively
> that by far the most effective way of improving reasoning and problem
> solving skills is through critical thinking interventions, I advocate for
> the introduction of critical thinking interventions at UGME and PGME.
> Others have already designated critical thinking as a meta-competency and
> some programs have embarked on this in separate initiatives. Others in the
> ethics domain have strongly proposed that this be done as an ‘ethical
> imperative’, and, given the unacceptably high estimates of preventable
> deaths from diagnostic failure it’s hard to argue with that.
>
> Rather than each inventing our own wheels, how about developing a generic
> Critical Thinking Module that would be available off the shelf that medical
> educators could use? The content could be approved by a consensus
> committee. This would be an inexpensive project with potentially high
> returns.
>
> Pat
>
>
>
> On 11/04/15 12:43 PM, *Mark Graber *<mark.graber at IMPROVEDIAGNOSIS.ORG>
> wrote:
>
> With the IOM report now officially out on the street, SIDM is now focused
> on how to change practice to improve diagnosis.  The "Coalition to Improve
> Diagnosis" will be our first priority; the Coalition steering committee has
> had several meetings already, and the next steps are for each organization
> to identify at least one action they can take, and for all the members to
> agree on a common action. The Coalition will also be growing very soon to
> include another set of key national organizations.
>
>
>
> We are also urging federal agencies to step up to the plate.  Founding
> Board member David Newman-Toker represented SIDM at a meeting yesterday of
> the AHRQ National Advisory Committee, and publicly thanked AHRQ for being a
> key supporter of our efforts through funding of our Diagnostic Error
> Conferences, the IOM report itself, and through the new R01 and R18 grant
> funding to study diagnostic error they have recently made available. We
> asked the NAC to support 3 initiatives deriving from the IOM report:  1)
> Developing a Common Format for organizations to report diagnostic errors to
> their Patient Safety Organizations; 2) Working with DOD, HHS, VA and others
> to develop the national research priorities for diagnosis, and to develop a
> public-private partnership to promote research; and 3) Providing dedicated
> funding for AHRQ to support research on diagnostic error in proportion to
> the harm associated with diagnostic error.
>
>
>
> Later this month I'll be addressing a group at the CDC to emphasize the
> actions we'd like to see them take: 1) Resurrect the clinical pathologist
> position by providing funding for this type of consultation; 2) Resuscitate
> autopsies at key designated centers as a way to learn about errors; 3) Help
> develop and use failsafe procedures for test reporting; and 4) Use second
> opinions in anatomic pathology.
>
>
>
> We'll provide updates on these activities as they come up, and would love
> to hear about initiatives that the listserv readership might also know
> about, or be involved with.
>
>
>
> *  Mark*
>
>
>
> Mark L Graber MD FACP
> President, SIDM  www.improvediagnosis.org
> 919 990-8497
>
>
> ------------------------------
>
>
>
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>
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>
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
>
>
>
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
> Medicine
>
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
>
>
> ------------------------------
>
>
>
> To unsubscribe from IMPROVEDX: click the following link:
>
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
>
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
>
>
>
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
> Medicine
>
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
>
> ------------------------------
>
>
> To unsubscribe from IMPROVEDX: click the following link:
>
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
>
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
> Medicine
>
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
>






Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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