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Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
Integration of EMB Tools and Curriculum
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Integration of EMB Tools and Curriculum

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  • http://www.onlineplus.com.tw/Events/080916.html http://www.mmh.org.tw/taitam/medical_edu/mmhedu/edu_20080916.htm
  • Transcript

    1. 實證工具 與 教學課程 之 結合 長庚醫院.基隆分院 風濕過敏免疫科.實證中心 楊宗翰醫師
    2. <ul><li>Clinical Medicine </li></ul><ul><li>實證工具 </li></ul><ul><li>教學課程 </li></ul><ul><li>結合 </li></ul><ul><li>總結 </li></ul>
    3. 教學課程 - Clinical Medicine <ul><li>背 </li></ul><ul><li>懂 </li></ul>
    4. 教學課程 - Clinical Medicine 用
    5. Clinical Medicine <ul><li>Student </li></ul><ul><li>Clerk </li></ul><ul><li>Intern </li></ul><ul><li>Resident </li></ul><ul><li>Fellow </li></ul><ul><li>Reciting </li></ul><ul><li>Applying </li></ul><ul><li>Studying </li></ul>
    6. Clinical Medicine Data Subjective Objecitive Hypothesis Generation & Diagnosis Confirm Diagnosis by testing Plan in Treatment & Advice Write present illness to suggest the diagnosis and differential Write assessment In diagnosis & treatment Look it up and present it to seek other’s opinion
    7. Clinical Medicine Comprehension, Application Analysis, Synthesis, Evaluation Collection Analysis Synthesis Evaluation Value, Cost-Benefit Experience, Intuition, Bias Evidence Knowledge Reasoning
    8. <ul><li>Clinical Medicine </li></ul><ul><li>實證工具 </li></ul><ul><li>教學課程 </li></ul><ul><li>結合 </li></ul><ul><li>總結 </li></ul>
    9. 實證工具 – 生活五步驟 <ul><li>問: Question Log Book </li></ul><ul><li>查: Databases </li></ul><ul><li>讀: Appraisal Tools & Calculators </li></ul><ul><li>用: Biological & Pathophysiological Knowledge </li></ul><ul><li>審:… </li></ul>
    10. 問: Question Log Book
    11.  
    12. 查: Databases <ul><li>Background </li></ul><ul><li>Basics: Books </li></ul><ul><li>Drugs: Micromedex </li></ul><ul><li>Clinical Medicine: </li></ul><ul><ul><li>Books </li></ul></ul><ul><ul><li>Dynamed </li></ul></ul><ul><ul><li>MD Consults </li></ul></ul><ul><ul><li>Uptodate </li></ul></ul><ul><li>Foreground </li></ul><ul><li>Secondary </li></ul><ul><ul><li>EBM reviews, … </li></ul></ul><ul><li>Primary </li></ul><ul><ul><li>CENTRAL </li></ul></ul><ul><ul><li>PudMed/Medline </li></ul></ul><ul><ul><li>EMBASE, CIHNAL </li></ul></ul>
    13. 讀: Appraisal Tools & Calculators <ul><li>Appraisal Tools </li></ul><ul><ul><li>Type of Articles Dx/Rx/Ex/Px </li></ul></ul><ul><ul><li>CASP </li></ul></ul><ul><ul><li>JAMA - Worksheets </li></ul></ul><ul><ul><li>Oxford – RAMboo </li></ul></ul><ul><ul><li>… </li></ul></ul><ul><li>Calculators </li></ul><ul><ul><li>Risk Calculators </li></ul></ul><ul><ul><ul><li>Stroke </li></ul></ul></ul><ul><ul><ul><li>CV/MI </li></ul></ul></ul><ul><ul><ul><li>Osteoporotic fracture </li></ul></ul></ul><ul><ul><li>Stat Calculators </li></ul></ul><ul><ul><ul><li>95% CI & p-value </li></ul></ul></ul><ul><ul><ul><li>NNT/NNH </li></ul></ul></ul><ul><ul><ul><li>Sen/Spe/PPV/NPV/LR </li></ul></ul></ul>
    14. 用 & 審 <ul><li>Communication </li></ul><ul><li>Hx/PE, Reasoning </li></ul><ul><li>patient value </li></ul><ul><li>preference </li></ul>Biology & Pathophysiology Evidence Expectation Expertise
    15. <ul><li>Clinical Medicine </li></ul><ul><li>實證工具 </li></ul><ul><li>教學課程 </li></ul><ul><li>結合 </li></ul><ul><li>總結 </li></ul>
    16. 122 activities / a mo @ KCGMH
    17. Schedules <ul><li>Morning Meeting </li></ul><ul><ul><li>Case x 3, M&M x1, Lecture x1 </li></ul></ul><ul><li>Block </li></ul><ul><ul><li>EKG, CXR, ABG, GI (NG, digital, LFT) </li></ul></ul><ul><li>OPDs </li></ul><ul><li>Rounds </li></ul>
    18. <ul><li>Clinical Medicine </li></ul><ul><li>實證工具 </li></ul><ul><li>教學課程 </li></ul><ul><li>結合 </li></ul><ul><li>總結 </li></ul>
    19. Lectures
    20. Rounds
    21. Meetings
    22. Summary <ul><li>Clinical Medicine </li></ul><ul><li>實證工具 </li></ul><ul><li>教學課程 </li></ul><ul><li>結合 </li></ul><ul><li>總結 </li></ul>
    23. Intern <ul><li>Basic Clinical Skills (History, PE) </li></ul><ul><li>Basic Knowledge (Anatomy, Physiology, Pathology, Pathophysiology, *ologies) </li></ul><ul><li>Use “Current Best Evidence” to care our patients. </li></ul><ul><li>Integration of Evidence, Expertise, Expectation. </li></ul><ul><li>5 steps </li></ul><ul><ul><li>問,查,讀,用,審 </li></ul></ul>
    24. Resident <ul><li>The center of clinical medicine </li></ul><ul><ul><li>Reasoning , Evidence , & Knowledge </li></ul></ul><ul><li>P resent your cases </li></ul><ul><ul><li>34 items in 5 minutes </li></ul></ul><ul><li>Asking questions about your cases </li></ul><ul><ul><li>P.I.C.O. </li></ul></ul><ul><li>Finding answers </li></ul><ul><ul><li>Secondary > Primary sources </li></ul></ul>
    25. Fellow <ul><li>Search </li></ul><ul><ul><li>Using Medline or Clinical queries </li></ul></ul><ul><ul><li>MeSH or keywords </li></ul></ul><ul><ul><li>Focus or explode </li></ul></ul><ul><ul><li>Limit and combination </li></ul></ul><ul><ul><li>Boolean search </li></ul></ul><ul><li>Appraise </li></ul><ul><ul><li>Critical appraisal. </li></ul></ul><ul><ul><li>Knowledge of Epi & Biostat </li></ul></ul><ul><li>Browse the Journal. </li></ul><ul><ul><li>Up to minutes … </li></ul></ul><ul><li>Journal Club </li></ul>
    26. Teachers <ul><li>Using their eyes to watch … </li></ul><ul><li>Using their minds to feel … </li></ul><ul><li>Using their brain to teach … </li></ul><ul><li>Finally , just using their mouth ... </li></ul>

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