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Writer's pictureDr. Chris Le

Title: Making Space

Presenter(s): Dr. Julia Chronopoulos

Date: March 7, 2020

PEARL: Updating language.

  • Organ inventory: Do you have all your parts that you were born with them?

  • Sexual history: Do you have sex with anyone who has sperm? Are you having sex with anyone with uterus and ovaries?

  • Gender: "People born with testes", "People born with a uterus", Is there any particular way that you identify? What does that mean to you?

PEARL: Sexual history a la Chronopoulos:

  • Infectious disease - swabs: Do you currently have any sexual partners? Do you need to talk about STI prevention or testing? What parts of your body do you use for sex? I ask because the current STI guidelines suggest that we swab whatever you are using. What parts of the body do your partners use for sex?

  • Infectious diseases - blood: Are you aware of the HIV status of all of your partners? Are you doing anything to prevent HIV and other STIs?

  • Pregnancy: Do you need to talk about pregnancy prevention? Could any of the sex you are having result in pregnancy?

  • Survival sex: Are you ever required to have sex that you would prefer not to be having?

PEARL: Make space in our patterns of speaking.

  • Ask what people want to be called

  • Ask where they want to be called it

  • Ask their gender identity

  • Ask their pronouns

  • Ask where they want them used

  • De-gender all other language

  • Check before using potentially triggering language

  • Learn some lingo

DISCLAIMER: This post contains my interpretation of the presentation. This post is not intended as medical advice. If you have medical concerns, contact a health care provider for assessment. If there are any copyright concerns, please contact me directly to remove the relevant material.

Title: Advanced Care Planning: Having These Important Conversations

Presenter(s): Dr. Amy Tan

Date: March 7, 2020

PEARL: Substitute decision makers.

  • Make sure that patients inform the SDM!!

PEARL: ACP conversation with health patients.

  • Is there anything for catastrophic events?

  • If something catastrophic happens, are there things you would find unacceptable?

  • Consider asking elderly if they want to know the diagnosis.

PEARL: Focus on function.

  • What is living for you?

  • What's a good day?

  • What do you want the healthcare team to be on the same page about to help you achieve your goals?

  • The magic is in the narrative.

DISCLAIMER: This post contains my interpretation of the presentation. This post is not intended as medical advice. If you have medical concerns, contact a health care provider for assessment. If there are any copyright concerns, please contact me directly to remove the relevant material.

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Title: Metacognition and Avoiding Clinical Errors in Medical Decision-Making

Presenter(s): Dr. Vu Kiet Tran

Date: March 7, 2020

PEARL: Front-line medicine

  • Primarily a cognitive profession, subject to cognitive biases that lead to errors

PEARL: Diagnosis and Treatment are Probabilistic and Not Absolute.

  • There is no certainty, only progressively more convincing evidence.

PEARL: Anchoring (Diagnosis Momentum)

  • The greatest barrier to the proper diagnosis is a prior diagnosis

PEARL: Risk factors for cognitive errors

  • Cognitive overload

  • High decision density

  • Interruptions and distractions

  • Sleep deprivation

  • Fatigue

  • Emotional perturbations (affective state)

PEARL: A wise person learns from other’s mistakes

DISCLAIMER: This post contains my interpretation of the presentation. This post is not intended as medical advice. If you have medical concerns, contact a health care provider for assessment. If there are any copyright concerns, please contact me directly to remove the relevant material.

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