Practice Based Learning
Information Mastery
Feeling good about not knowing everything!
Krishna Desai, MD, FAAFP
NYP/CUMC Family Medicine
Resident Didactics
August 11, 2022
Objectives
Why is this skill valuable?
Why is this skill useful?
Critical thinking skills.
EBM Principles
DISEASE oriented vs. PATIENT ORIENTED evidence that matters (POEMS)
Hypothetical and not true examples.
EBM Principles
DISEASE oriented vs. PATIENT ORIENTED evidence that matters (POEMS)
Critical thinking skills.
RED FLAGS for when we need to put on our critical thinking skill hats and turn to evidence!
Clinicians often do not change their practice even if evidence points to a different direction.
Data: medical community follows “opinion leaders” in the field
Another preceptor told me…
When I was on derm, they often used…
Dr. so and so really likes to use chlorthalidone instead of hydrochlorothiazide…
EBM Principles
EBM Principles: Basic EBM concepts
Information Mastery and Management
What resources do you use and how do you keep track of what you learn?
DYNAMED
UPTODATE
Information Mastery and Management
https://library.cumc.columbia.edu/
Information Mastery and Management
Point of care apps
Information Mastery and Management
EPIC!
Let’s Practice…
66 year old comes in for HCM needs, should I get a DEXA?
29 year old pregnant female tests positive for chlamydia, how do you treat?
63 year old female presents with RUQ abdominal pain, what is your ddx?
4 year old child comes in for wcc but did not get MMR and Varicella at 1 year old, how do you catch them up?
66 year old female with COPD has received PPSV23 in past, what pneumonia vaccine should she receive?
36 year old G1P0 female has abnormal pap results: HPV POS, HSIL, what is next step in management?
44 year old male with morbid obesity wants to know how high his risk is for cardiovascular disease, and has heard of some additional blood tests that can be done to evaluate this, what do you recommend?
He also wants to know if he should take a daily aspirin? He heard it reduces risk of colon cancer too.
16 year old female is going to Nigeria with family over the summer months, what do you offer to prep her for travels?
70 year old man with chronic back pain due to spinal stenosis has been going to kava bar on LES, he tells you it’s really been helpful for his pain. What the heck is kava? He also drinks alcohol, what labs might you get?
Information Mastery and Management
Life-long learning
Information Mastery and Management
Life-long Learning