The Clinical Problem Solvers

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Episode title: Episode 359 Neurology VMR – altered mental status

Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Vale presents a case of altered mental status to Aye.

Neurology DDx Schema

Aye Chan Moe Thant

Aye graduated from University of Medicine, Mandalay, Myanmar, and has been working with her mentor neurologist, one of only three neurologists covering the Upper Myanmar region of 23 million population. Through her experiences witnessing the challenges faced by patients in underserved areas and hearing their stories, Aye is dedicated to advancing health equity, global health initiatives, and various aspects of neurology, both in clinical practice and medical education. She is going to apply for a neurology residency program this year. Outside of work, she spends time playing piano, jogging along trails, and listening to music.

 

Valeria Roldan

@valeroldan23

Valeria Roldan was born and raised in Lima, Peru. She recently graduated medical school at Universidad Peruana Cayetano Heredia and is excited to pursue a career in Neurology. She is passionate about LGBTQ+ health, particularly advocating for trans rights, as well as medical education. She would describe herself as an optimist and outside of medicine you probably will find her running or talking about pop culture over a glass of wine.

 

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Frameworks discussed in the episode: 

Shock

Fever in The ICU

Fever in The ICU 2.0

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Episode description: Kirtan presents a fascinating case of altered mental status that ends in an unexpected way!

Featuring: Kirtan PatoliaAnna FretzPriyanka Athavale SchemasAltered Mental StatusHyponatremiaPancytopenia 

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Title  – All about the exam

 

Episode description

Reza and Rabih discuss a fascinating case of a swollen foot

 

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Alex and Andrew discuss a fascinating case of Hypoglycemia presented by Aimme.

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CPSolvers: Anti-Racism in Medicine Series

Episode 25 – Live from SGIM 2024: Best of Antiracism Research at the Society of General Internal Medicine’s 2024 Annual Meeting

Show Notes by Ashley M. Cooper

September 19, 2024

Summary: This episode highlights a selection of antiracism research presentations at a live recording of the podcast at the 2024 SGIM Annual Meeting. This year’s episode, our fourth conducted at SGIM, is focused on the importance of qualitative research and the role it plays in antiracism research, community-based work, and scholarship. During this episode, we hear from Dr. S. Michelle Ogunwole, MD, PhD, an internist and social epidemiologist who specializes in the care of women with chronic medical conditions and racial disparities in maternal health outcomes, and Dr. Caroline Sloan, MD, a general internist whose research focuses on how financial considerations are imbued into medical decision-making. This episode is hosted by Ashley Cooper and Sudarshan (Sud) Krishnamurthy. The show notes for this episode were written by Ashley M. Cooper.

Episode Learning Objectives

After listening to this episode, learners will be able to…

1. Understand how they can better center patient experiences by engaging with, and conducting their own, qualitative research.
2. Describe the positive impacts of qualitative methods on healthcare provision and/or policies in clinical settings. 
3. Identify the critical role that qualitative research plays in antiracism and health equity work.

Credits

• Written and produced by: Ashley Cooper, Sudarshan Krishnamurthy, Team
• Hosts: Ashley M. Cooper, Sudarshan Krishnamurthy
• Infographic: Canva
• Audio Edits: Ashley M. Cooper
• Show Notes: Ashley M. Cooper
• Guests: Dr. Michelle Ogunwole and Dr. Caroline Sloan

Time Stamps

00:00: Opening

00:10: Introductions

01:03: Guest Introduction 1 – Dr. S. Michelle Ogunwole

01:54: Guest Introduction 2 – Dr. Caroline Sloan

02:48: Background and Inspiration for Guests

7:21: Barriers to Pursuing Qualitative Research in Medicine

12:31: The Role of Qualitative Research in Cultivating Health Equity

19:37: Qualitative Research as a vehicle towards centering patient experiences in research

28:14: Audience Questions

28:16: Meta-Cognition: Evaluating Biases in Interpreting Qualitative Data

34:05: Trajectory of Qualitative Research’s Incorporation into Medical Curricula

39:33: Qualitative Research at the Nexus of Storytelling and Narrative Medicine

45:42: Honoring Community Stakeholders in Qualitative Research

49:00: Fostering Communal Trust: Advocacy and Patient-Centered Care

52:33: Humility and Community Involvement 

56:55: Closing Remarks

Speaker biographies (Abbreviated)

• Dr. S. Michelle Ogunwole, MD, PhD is a health disparities researcher, social epidemiologist and General Internal Medicine physician specializing in the care of women with chronic medical conditions. She has advanced training in Quality Improvement and Patient Safety Science. She currently practices at Johns Hopkins Hospital in Baltimore, MD. Her research is focused on racial disparities in maternal health outcomes among African American women.

• Dr. S. Michelle Ogunwole, MD, PhD is a health disparities researcher, social epidemiologist and General Internal Medicine physician specializing in the care of women with chronic medical conditions. She has advanced training in Quality Improvement and Patient Safety Science. She currently practices at Johns Hopkins Hospital in Baltimore, MD. Her research is focused on racial disparities in maternal health outcomes among African American women.

References

Ogunwole, S. M., Chen, X., Mitta, S., Minhas, A., Sharma, G., Zakaria, S., Vaught, A. J., Toth-Manikowski, S. M., & Smith, G. (2021). Interconception Care for Primary Care Providers: Consensus Recommendations on Preconception and Postpartum Management of Reproductive-Age Patients With Medical Comorbidities. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 5(5), 872–890. https://doi.org/10.1016/j.mayocpiqo.2021.08.004

Ogunwole, S. M., Karbeah, J., Bozzi, D. G., Bower, K. M., Cooper, L. A., Hardeman, R., & Kozhimannil, K. (2022). Health Equity Considerations in State Bills Related to Doula Care (2015–2020). Women’s Health Issues, 32(5), 440–449. https://doi.org/10.1016/j.whi.2022.04.004

Ogunwole, S. M., Oguntade, H. A., Bower, K. M., Cooper, L. A., & Bennett, W. L. (2023). Health Experiences of African American Mothers, Wellness in the Postpartum Period and Beyond (HEAL): A Qualitative Study Applying a Critical Race Feminist Theoretical Framework. International Journal of Environmental Research and Public Health, 20(13), Article 13. https://doi.org/10.3390/ijerph20136283

Sinaiko, A. D., Sloan, C. E., Soto, M. J., Zhao, O., Lin, C.-T., & Goss, F. R. (2023). Clinician Response to Patient Medication Prices Displayed in the Electronic Health Record. JAMA Internal Medicine, 183(10), 1172–1175. https://doi.org/10.1001/jamainternmed.2023.3307

Sloan, C. E., Millo, L., Gutterman, S., & Ubel, P. A. (2021). Accuracy of Physician Estimates of Out-of-Pocket Costs for Medication Filling. JAMA Network Open, 4(11), e2133188. https://doi.org/10.1001/jamanetworkopen.2021.33188

Sloan, C. E., & Ubel, P. A. (2019). The 7 Habits of Highly Effective Cost-of-Care Conversations. Annals of Internal Medicine, 170(9_Supplement), S33–S35. https://doi.org/10.7326/M19-0537

Disclosures 

The hosts and guests report no relevant financial disclosures.

Citation

Ogunwole M, Sloan C, Cooper A, Krishnamurthy S, Calac A, Pitre A, Pierce G, Essien UR, Fields NF, Lopez-Carmen V, Nolen L, Onuoha C, Watkins A, Williams J, Tsai J, Khazanchi R. “Episode 25: Live from SGIM 2024: Best of Antiracism Research at the Society of General Internal Medicine’s 2024 Annual Meeting” The Clinical Problem Solvers Podcast – Antiracism in Medicine Series. https://clinicalproblemsolving.com/antiracism-in-medicine/. September 19, 2024.

Show Transcript

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In this Clinical Reasoning Rafael Medina Subspecialty episode, Dr. Kuchal Agadi presents a case to Dr. John Woller and Dr. Areeb Masood of a 67 year-old male with altered mental status. 

Session facilitator: Hui Ting Ruan

The goal of this session is to expand access to subspecialty, primary care, and internal medicine-adjacent specialty education to learners around the world. If you would like to get involved as a case presenter or discussant (or nominate an attending/educator), fill out the form HERE.

Case discussant: 

Dr. John Woller is an academic hospitalist working in the Johns Hopkins Hospital in the Division of Hospital Medicine. As a clinical coach and Associate Program Director for clinical reasoning and bedside medicine, John is enthusiastic about teaching medical students and Osler residents at the bedside.

And Dr. Areeb Masood, is a third-year internal medicine resident at Johns Hopkins Hospital in the Osler Internal Medicine Residency and Urban Health Track. He earned his undergraduate degree from The University of Texas at Austin and his medical degree from The University of Texas Rio Grande Valley School of Medicine. After completing his residency, he aims to practice a blend of hospital medicine and HIV primary care. @areebmasoodMD

Case presenter: 

Dr. Kuchal Agadi, is first year Resident at a community hospital in Chicago. Kuchal is passionate about medical education. Apart from medicine she is a fitness enthusiast, and enjoys a good workout routine with Kettle bells. 

To join us live and present a case, check out our virtual morning reports!

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Title  – The Wrong Context

 

Episode description

Reza and Rabih discuss a fascinating case of jaundice

 

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Episode title: Episode 351 Neurology VMR – headache and double vision

Episode description: We continue our campaign to #EndNeurophobia, with the help of Dr. Aaron Berkowitz. This time, Aye presents a case of bilateral lower limb weakness to Valeria.

Neurology DDx Schema

 

Aye Chan Moe Thant

Aye graduated from University of Medicine, Mandalay, Myanmar, and has been working with her mentor neurologist, one of only three neurologists covering the Upper Myanmar region of 23 million population. Through her experiences witnessing the challenges faced by patients in underserved areas and hearing their stories, Aye is dedicated to advancing health equity, global health initiatives, and various aspects of neurology, both in clinical practice and medical education. She is going to apply for a neurology residency program this year. Outside of work, she spends time playing piano, jogging along trails, and listening to music.

 

Valeria Roldan

@valeroldan23

Valeria Roldan was born and raised in Lima, Peru. She recently graduated medical school at Universidad Peruana Cayetano Heredia and is excited to pursue a career in Neurology. She is passionate about LGBTQ+ health, particularly advocating for trans rights, as well as medical education. She would describe herself as an optimist and outside of medicine you probably will find her running or talking about pop culture over a glass of wine.

  

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Episode description: Mukund presents a case of nausea, vomiting and syncope with many twists and turns to Valeria and Jas.

Featuring: Mukund RaguramJasdeep BajwaValeria Roldan SchemasSyncopeNausea and vomiting thought trainImage negative abdominal pain 

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