Ep 201 How EM Experts Think Part 2: Data Gathering, Diagnostic and Treatment Decision Making, Test Ordering and Interpretation, Documentation, Emotional Resilience

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 7 January 2025

⏱️ 83 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this Part 2 of our 2-part podcast series on How EM Experts Think with Dr. Reuben Strayer, Dr. Mike Betzner and Dr. Scott Weingart we dive deep into the nuances of practicing smarter, faster, and better in the ED. We answer questions like: How should we employ hypothetico-deductive reasoning in our daily practice of Emergency Medicine? How can we best streamline thorough data gathering for each case so that we don't miss key data points? How do the master EM clinicians perform an efficient and targeted history and physical exam? How can the concept of heuristic cycling help you avoid outdated or faulty thinking? How can we document our clinical encounter in a way that considers a differential diagnosis that prioritizes dangerous conditions and improve our thinking around cases? How can we use the 2-10% rule for pre-test probabilities and the concept of preferred error to guide our decision making for tests and treatments in the ED? What strategies can we use to avoid anchoring bias and keep your mind open to all possibilities? What’s the role of shared decision-making when navigating diagnostic uncertainty? How does understanding the vigilance pendulum help us assess our risk tolerance better? How can post-shift decision journaling, conducting pre-mortems and meditation improve our decision making and boost our emotional resilience on shift? and many more...The accompanying blog An EM Expert Mindset - A Female Perspective is recommended reading with this podcast https://emergencymedicinecases.com/the-em-expert-mindset-a-female-perspective/ Please consider a small donation to EM Cases to ensure ongoing high quality FOAMed: https://emergencymedicinecases.com/donation/

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases podcast. I'm your host, Dr. Anton Hellman, bringing you the brightest minds in emergency medicine from around the world.
0:07.8	EM cases is brought to you by Shremi, the Schwartz-Riesman Emergency Medicine Institute. That's a non-profit organization dedicated to improving EM care through high-quality research and education. The opinions expressed on this podcast are intended for information and education purposes only and should not be used to diagnose, treat, or prevent any medical condition, nor should they be used as a substitute for medical advice from a qualified practicing physician.
0:07.3	This episode is... The opinions expressed on this podcast are intended for information and education purposes only and should not be used to diagnose treat or prevent any medical condition, nor should they be used as a substitute for medical advice from a qualified practicing physician.
0:24.0	This episode is brought to you by easy recess to the resuscitation assistant. This amazing app has drug dosing, equipment size calculation, treatment algorithms, all in under three clicks. Rapid access to life-saving critical info in a user-friendly interface.
0:39.1	Try the app for free with the promo code EMCases or visit easy recess.com slash
0:45.7	EMCases. That's easy recess.com slash EMC-A-S-E-S.
0:55.3	In part one of this two-part podcast on how the experts think, we covered pre-shift prep,
1:01.0	tips while on shift to keep you sharp, how to think before, during, and after a resuscitation.
1:07.1	And in this part two, we'll talk about how master clinicians think in complex non-recess cases
1:14.1	and what we can do outside of our ED shifts or after our shifts at home to improve the way we think and perform in the ED.
1:22.9	We'll discuss how the master clinician thinks about history taking, physical examination,
1:32.1	how they develop a differential diagnosis, test ordering, test interpretation,
1:38.6	cognitive debiasing, how they use heuristics, decisions around treatments, how to best document to improve your performance, and then outside of your shift, we'll touch on all kinds of performance enhancing strategies
1:45.8	from stress inoculation training to strategies on managing adversity to decision-making
1:51.2	journals, to deliberate practice and mental rehearsal, and maybe even more.
1:55.5	Although we'll see how much time we have.
1:57.6	Welcome back, gentlemen, Dr. Strayer, Dr. Betzner, and Dr. Weingart. Thank you.
2:02.6	Pleasure to be with you guys. Likewise. Hey, hey. So let's start with history taking.
2:06.8	Now, while history taking sounds pretty elementary, and we might all think that we're pretty
2:11.3	good history takers, I suspect that the master clinicians get the diagnosis right, probably
2:16.0	a little bit more of the time than most of us do.
2:18.5	And it's probably because of their history taking skills mostly. I liken it to the data on
	...

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