Thyroid Cancer & Differential Diagnosis of Lumps in Neck for Medical Students and Foundation Doctors
A complete guide to the diagnosis and managment of thyroid cancer and how to clinically differentiate lumps in the neck. This resource is aimed at medical students in clinical years and foundation doctors.
about 9 years ago
I created this e-learning resource during my first Undergraduate Pharmacology BSc degree and it was used as a teaching aid to explain fundamental Pharmacokinetic principles to scientists carrying out Therapeutic Drug Monitoring. Having studied aspects of Pharmacology during the first year of my Graduate Entry Medical Degree at the University of Leicester, myself and my colleagues have found this interactive learning tool a valuable resource. The easy to use and interactive nature of learning allows the user to navigate around the resource and also test their knowledge on questions at the end. The effectiveness of the resource and feedback received from users is published in the journal Bioscience Horizons and can be found at http://biohorizons.oxfordjournals.org/content/2/2/113.full.pdf+html.
over 9 years ago
Providing medical students with an abundance of free and exclusive e-learning stations for studying for Objective Structured Clinical Examinations (OSCEs)
about 6 years ago
http://www.handwrittentutorials.com - This tutorial takes a look at the production of thyroid hormones in the Thyroid Gland. This includes the transport of iodine and the production of thyroglobulin in the Thyroid Follicles. For more entirely FREE tutorials and accompanying PDFs visit http://www.handwrittentutorials.com
Handwritten Tutorial Videos
over 6 years ago
PDF file detailing Anatomy Review, a student-led online anatomical learning resource used at Warwick Medical School. The website contains high quality images of anatomy models used in examinations, associated labels and relevant short answer questions. The resource has received positive feedback and continued use, especially during revision periods.
over 9 years ago
Introduction Hello and welcome! I am finally back to blogging after having a brief hiatus in order to take my final exams. Whilst the trauma is still fresh in my mind, I would like to share with you the top 5 social media tips that helped me through the dark days of undergraduate medicine. Some of you may have already read my old essay on 'How Medical Students should interact with Social Media Networking Sites' and this document deals with some of the problems with professionalism surrounding the use of social media. This blog will not cover such issues, but will instead focus on how you can use social media to benefit your learning/ revision processes. Top Tip 1: YouTube For those of you who are unaware, YouTube is a video-sharing website. Sometimes the site is overlooked as a 'social media' resource but if you consider the simple definition of Social Networking Sites as 'those with user led content,' you can quickly see how YouTube definitely falls into the social media category. It wasn't until I got to University that I realised the potency of YouTube as an educational tool. It has a use at every stage of medical education and it is FREE. If you are still in your pre-clinical training then there are a wealth of videos that depict cellular processes and 3D anatomy - very useful content for the visual learner. For the clinical student, there are a number of OSCE demonstration videos that may be useful in honing your examination skills. There are also a number of presentations on clinical topics that have been uploaded, however, YouTube has no quality control measures for these videos (to my knowledge) so it may be best to subscribe to a more official source if you like to use podcasts/ uploaded presentations for your revision. Another reason YouTube comes in as my number 1 top tip is because I find it difficult to procrastinate whilst using the site. Sure, you can start looking up music and videos that have nothing to do with medicine but personally I find that having a little bit of music on in the background helps me work for longer periods, which is a definite bonus during the revision period. On the other hand, there are many that find YouTube difficult to harness due to the draw of funny videos and favourite Vloggers (Video Bloggers) that can distract the unwary from revision for hours on end. At the end of the day, YouTube was created for funny videos (predominantly of cats it seems) and not for medical education, and this should be kept in mind if you choose to use it as a tool for your learning. Top Tip 2: Facebook Yes, the dreaded Facebook comes in at number two for me. Facebook is by far and away my largest source of procrastination when it comes to writing / working / revising or learning. It is a true devil in disguise, however, there are some very useful features for those who like to work in groups during their revision... For example, during the last six months I have organised a small revision group through Facebook. We set up a 'private page' and each week I would post what topics would be covered in the weeks session. Due to the nature of Facebook, people were obviously able to reply to my posts with suggestions for future topics etc. We were also able to upload photos of useful resources that one or more of us had seen in a tutorial in which the other students hadn't been able to attend. And most importantly, we were able to upload revision notes for each other via the Facebook 'files' tab. This last feature was invaluable for sharing basic notes between a few close colleagues. However, for proper file sharing I strongly recommend the file sharing service 'Dropbox,' which provides free storage for your documents and the ability to access files from any computer or device with internet. Coming back to Facebook, my final thoughts are: if you don't like group work or seeing what your colleagues are doing via their statuses or private messages then it probably isn't a useful resource for you. If you have the motivation (unlike myself) to freeze your Facebook account I can imagine you would end up procrastinating far less (or you'll start procrastinating on something else entirely!). Top Tip 3: Twitter Twitter is a microblogging site. This means that users upload microblogs or 'Tweets' containing useful information they have found on the internet or read in other people's tweets. Twitter's utility as an educational resource is directly related to the 'type' of people you follow. For example, I use Twitter primarily to connect with other people interested in social media, art & medicine and medical education. This means my home screen on twitter is full of people posting about these topics, which I find useful. Alternatively, I could have used my Twitter account to 'follow' all the same friends I 'follow' on Facebook. This would have meant my Twitter home page would have felt like a fast-paced, less detailed version of my Facebook feed just with more hashtags and acronyms - not very useful for finding educational resources. With this in mind, consider setting up two twitter accounts to tease apart the useful tweets about the latest clinical podcast from the useless tweets about what your second cousin once removed just had for lunch. A friend suggested to me that if you really get into twitter it is also possible to use one account and 'group' your followers so that you can see different 'types' of tweets at different times. This seems like a good way to filter the information you are reading, as long as you can figure out how to set up the filters in the first place. Like all Social Media Sites, Twitter gets its fair share of bad press re. online professionalism and its tendency to lure users into hours of procrastination. So again, use with caution. Top Tip 4: Meducation It would not be right to write this blog and not include Meducation in the line-up. Meducation is the first website that I have personally come across where users (students, doctors etc) upload and share information (i.e. the very soul of what social networking is about) that is principally about medicine and nothing else. I'm sure there may be other similar sites out there, but the execution of this site is marvellous and that is what has set it apart from its competitors and lead to its rapid growth (especially over the last two years, whilst i've been aware of the site). When I say 'execution,' I mean the user interface (which is clean and simple), the free resources (giving a taste of the quality of material) and the premium resources (which lecture on a variety of interesting clinical topics rather than sticking to the bread and butter topics 24/7). One of my favourite features of Meducation is the ability to ask 'Questions' to other users. These questions are usually asked by people wishing to improve niche knowledge and so being able to answer a question always feels like a great achievement. Both the questions and answers are mostly always interesting, however the odd question does slip through the net where it appears the person asking the question might have skipped the 'quick google search' phase of working through a tough topic. Meducation harnesses social networking in an environment almost free from professionalism and procrastination issues. Therefore, I cannot critique the site from this angle. Instead, I have decided to highlight the 'Exam Room' feature of the website. The 'Exam Room' lets the user take a 'mock exam' using what I can only assume is a database of questions crafted by the Meducation team themselves (+/- submissions from their user base). However, it is in my opinion that this feature is not up to scratch with the level and volume of questions provided by the competitors in this niche market. I feel wrong making this criticism whilst blogging on Meducation and therefore I will not list or link the competitors I am thinking of here, but they will be available via my unaffiliated blog (Occipital Designs). I hope the Meducation team realise that I make this observation because I feel that with a little work their question database could be improved to the point where it is even better than other sites AND there would also be all the other resources Meducation has to offer. This would make Meducation a truly phenomenal resource. Top Tip 5: Blogging Blogging itself is very useful. Perhaps not necessarily for the learning / revision process but for honing the reflective process. Reflective writing is a large component of undergrad medical education and is disliked by many students for a number of reasons, not least of which is because many find some difficulty in putting their thoughts and feelings on to paper and would much prefer to write with the stiffness and stasis of academic prose. Blogging is great practice for breaking away from essay-writing mode and if you write about something you enjoy you will quickly find you are easily incorporating your own personal thoughts and feelings into your writing (as I have done throughout this blog). This is a very organic form of reflection and I believe it can greatly improve your writing when you come to write those inevitable reflective reports. Conclusion Thanks for reading this blog. I hope I have at least highlighted some yet unharnessed aspects of the sites and resources people already commonly use. Please stay tuned in the next week or two for more on social media in medicine. I am working together with a colleague to produce 'Guidelines for Social Media in Medicine,' in light of the recent material on the subject by the General Medical Council. Please feel free to comment below if you feel you have a Top Tip that I haven't included! LARF Twitter Occipital Designs My Blog As always, any views expressed here are mine alone and are not representative of any organisation. A Worthy Cause... Also, on a separate note: check out Anatomy For Life - a charity medical art auction raising money for organ donation. Main Site Facebook Twitter
Dr. Luke Farmery
about 7 years ago
Introduction Over the last three years there has been a rapid increase in the amount of medical education resources on the web. The contributors tend to fall into three main areas: Individuals or small groups producing material Large organisations / universities producing material Organisations creating sites (such as Meducation) which are one-stop-shops for content and act as a portal for other sites. Individuals Most students are required to produce and present a certain amount of educational material during their studies. Many, therefore, end up with PowerPoints and documents on various topics. The more ambitious may create videos: either animations in flash, or more real-life videos that demonstrate something such as an examination technical. Some of these students enjoy this so much that they have developed sites dedicated to such material. Sites such as Podmedics and Surgery and Medicine are examples of students who have grouped together to upload their work to a central place where it can be shared in the community. They advertise on Facebook and Twitter and gain a small following. Large Organisations And Universities Some organisations have realised that there is a market for the production of multimedia resources and have invested time and money into producing them. Companies such as MD Kiosh and ORLive run subscription services for high quality videos and have developed full time businesses around this work. Universities have also realised the potential for creating high quality media and some, such as the University of California and the University of Wisconsin, have invested into television-like streams, trying to tap in to the students natural viewing habits. As time goes on it seems likely that most medical education will move away from textbooks and towards the multimedia resources. There will always be a need for the written word but it is likely that it will become more incorporated into other forms of media, such as presentations and annotated videos. One-Stop-Shops The final, and possibly most influential type of contributor is the social network / portal site. Here, all the information from around the web is culminated in one place, where users can go to find what they are looking for These sites act as portals for all the other types of site and help spread their reach well beyond their local community. Here at Meducation, we have contributors from over 100 countries and pride ourselves on making easy-to-find resources for everyone. As time goes on and more users start to discover portal sites, more traffic will flood to the sites they support and the whole infrastructure can grow incrementally.
over 10 years ago
I have recently spent a few days following around registrars on military ward rounds. It has been a fantastic experience for learning about trauma care and rehab, but more importantly it has shown me just how vital team spirit is to modern health care! The military ward round is done once a week. It starts with a huge MDT of almost 40 people, including nurses, physios, registrars and consultants from all of the specialities involved in trauma and rehab. The main trauma ward round team then go to speak to all of the patients in the hospital. The team normally consists of at least one T+O consultant, one plastics, two physios, two nurses, 3 registrars and a few others. This ward round team is huge, unweildly and probably very costly, but those military patients receive a phenomenal level of care that is very quick and efficient. Having then compared this level of care with what I have experience on my 4th year speciality medicine placement, I now feel the NHS has a lot to learn about team work. I am sure that everyone working in healthcare can relate to situations where patients have been admitted under the care of one team, who don’t really know what to do with the patient but struggle on bravely until they are really lost and then look around to see who they can beg for help. The patient then gets ping-ponged around for a few days while management plans are made separately. All of the junior doctors are stressed because they keep having to contact multiple teams to ask what should be done next. The patient is left feeling that their care wasn’t handled very well and is probably less than happy with the delay to their definite treatment. The patient, thankfully, normally ends up getting the correct treatment eventually, but there is often a massive prolongation of their stay in hospital. These prolonged stays are not good for the patient due to increasing risks of complications, side effects, hospital acquired infections etc. They are not good for the health care staff, who get stressed that their patients aren’t receiving the optimum care. The delays are very bad for the NHS managers, who might miss targerts, lose funding and have to juggle beds even more than normal. Finally, it is not good for the NHS as a hole, which has to stump up the very expensive fees these delays cause (approximately £500 a night). There is a simple solution to this which would save a huge amount of time, energy and money. TEAM WORK! Every upper-GI ward round should be done with the consultant surgeon team and a gastroenterologist (even a trainee would probably do) and vice versa, every Gastroenterology ward round should have a surgeon attached. Every orthopaedic ward round should be done with an elderly care physician, physio/rehab specialist and a social worker. Every diabetic foot clinic should have a diabetologist, podiatrist, vascular surgeon and/or orthopaedic surgeon (even trainees). Etc. etc. etc. A more multi-disciplinary team approach will make patient care quicker, more appropriate and less stressful for everyone involved. It would benefit the patients, the staff and the NHS. To begin with it might not seem like an easy situation to arrange. Everyone is over worked, no one has free time, no one has much of a spare budget and everyone has an ego. But... Team work will be essential to improving the NHS. Many MDTs already exist as meetings. MDTs already exist as ED trauma teams, ED resus teams and Military trauma teams. There is no reason why lessons can’t be learnt from these examples and applied to every other field of medicine. I know that as medical students (and probably every other health care student) the theory of how MDTs should work is rammed down our throats time after time, but I personally still think the NHS has a long way to go to live up to the whole team work ethos and that we as the younger, idealist generation of future healthcare professionals should make this one of our key aims for our future careers. When we finally become senior health care professionals we should try our best to make all clinical encounters an MDT approach.
almost 7 years ago
In which John discusses the complicated reasons why the United States spends so much more on health care than any other country in the world, and along the way reveals some surprising information, including that Americans spend more of their tax dollars on public health care than people in Canada, the UK, or Australia. Who's at fault? Insurance companies? Drug companies? Malpractice lawyers? Hospitals? Or is it more complicated than a simple blame game? (Hint: It's that one.) For a much more thorough examination of health care expenses in America, I recommend this series at The Incidental Economist: http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-introduction/ The Commonwealth Fund's Study of Health Care Prices in the US: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/May/1595_Squires_explaining_high_hlt_care_spending_intl_brief.pdf Some of the stats in this video also come from this New York Times story: http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html?pagewanted=all This is the first part in what will be a periodic series on health care costs and reforms leading up to the introduction of the Affordable Care Act, aka Obamacare, in 2014.
over 6 years ago
http://www.handwrittentutorials.com - This tutorial takes a look at the production of thyroid hormones in the Thyroid Gland. This includes the transport of i...
about 6 years ago
Introduction Computerised presentations are a part of every medical student's / junior doctor's life. Sometimes we give them, often we sleep through them and occasionally we even listen to them. They are the backbone of medical education besides traditional bed-side teaching, having rapidly replaced the now extinct OHR (Over Head Projector) acetate-sheet presentations of years gone-by. The problem is that Doctors and medical students often struggle with creating and presenting coherent slides. This is most probably due to the general apathy most have for actually talking in front of an audience, or because those asked to present are often taken unawares, and therefore have little time to prepare. In these times of avolition or last-minute hurriedness, people often reach out for the industry standard of presentation production: PowerPoint. PowerPoint is the most commonly used tool for making presentations because it is simple to use and comes with a whole load of free templates. Unfortunately, most of these templates look disgusting. If a template doesn't look disgusting, then it is most certainly overused and you run the risk of having a presentation that looks identical to the student before you at the weekly seminar teaching - a scenario that can be easily likened to turning up to a lecture wearing exactly the same clothes as another person in the room, which would just be awkward. Another problem with PowerPoint is the phenomenon of 'Death By Powerpoint,' which refers to the general boredom and apathy experienced by those who have received way too much information in way too short a space of time via a series of over-cramped, poorly stylised slides. But why on earth do you care? People should care about 'Death By Powerpoint' because if your presentations cause people to zone out, then you are not getting your message across. And if you aren't getting your message across then you. are. not. presenting. at. all. (take a moment to reflect on that particularly Zen statement). Let me explain using a metaphor, if I am a sales person and I present my talk with well-designed slides, in an enthusiastic and well-rehersed manner to an appropriate audience I will make more sales than if I present using poorly designed slides at the last minute. Similarly, in Medicine if I present well designed, aesthetic slides I am more likely to convey accurate information to my colleagues that may very well be retained and enjoyed by all involved. Of course, this blog assumes a degree of presentation-related Altruism. The recommendations I am about to make require you to 'step out of the mould' and say 'no' to poor presentations. They require you to forgive others for the presentations they have inflicted on you in the past. You will 'lead by example'. Unfortunately I am not capable (or qualified) to make you an excellent designer, nor can I give you the motivation to feel as passionately about design aesthetics as i do when all you've got to do is slam some slides together for your monthly journal club. But what I can do is present to you a series of resources that might tempt you away from the horrific PowerPoint templates that currently infest medical student seminars and young doctors presentations. If you really couldn't care less, then I suggest using Prezi, a website where you can make quite eccentric looking presentations rapidly and for free. The only problem is that Prezi became cliched even before its debut and you risk inflicting travel sickness on your poor audience, what with all the funky zooming in and out of slides that occurs during a typical Prezi presentation (you will know what I mean if you've ever seen one). So, without further ado, here are my top 5 tips for making your presentations look smoother and more polished... Irrespective of whether the contents of your talk are any good. Step One: Typography Get yourself a good font. Typography is really important, when you speak to someone you use a variety of tones and gestures to convey the meaning of the words you are using. Fonts are effectively the printed version of your tone and gestures. Good font choice can help give 'umph' to a particular point in your presentation and help give character to what you are saying. Of course, it's important to remain professional so 'Wingbats' might not be your first choice, but anything that you could envisage on a nice business card is probably a good shout. Fonts are usually something you have to pay for if you want anything beyond the set given to you when you download Microsoft Word (for example). However, there are whole hosts of free fonts available from sites like [dafont])(http://www.dafont.com). The key is to be willing to trawl through these sites to find fonts that are actually useful! Beware those fancy fonts unless you know your audience can take it! If you are stuck on choosing a font, which is a common complaint, then maybe this flow diagram will help! Oh yeah, and never ever use Comic Sans. Ever. Step Two: Colour A good font isn't going to get you very far on its own. You need a solid colour scheme to bring your presentation alive. It seems blunt to say, but some people are not very good at picking colours that go well with one another. This is well evidenced in PowerPoint presentations where the yellow-text-on-blue-background is far too common. I mean yeah, in theory blue and yellow 'compliment' each other, but thats where the relationship between blue and yellow should stay... in theory. Luckily there are some useful colour palette websites available out there, which will match colours for you... Step Three: Structure After you've picked a sensible font and a suitable colour scheme, it's time to think about the structure or layout of your slides. It's absolutely crucial that you avoid putting too much information on your slides even if you are giving an academic presentation. An overloaded slide is about as useful as a dead cat. At this point, some of you may be tempted to resort to those dodgy PowerPoint default templates but there is another way! There are sites out there that have some pretty fresh templates you can use and they are completely free! They are sure to add a bit of spice to your slide's aesthetic. There will probably be a separate tutorial on this in the future, but basic principles apply. As a general rule stick to Left Alignment *and avoid *Central Alignment like the plague. Step Four: Imagery Images help to spice up a presentation, but try and keep them related to the topic. Google Images is a great resource but remember that most images will be a low resolution and will be poorly suited to being shown blown up full-size on a presentation screen. Low resolution images are a presentation killer and should be avoided at all costs. For high-quality images try sites like Flikr or ShutterStock. Step Five: Consider Software The interface of Powerpoint does not lend itself well to having images dropped in and played with to make nice looking layouts. I would recommend Adobe Photoshop for this kind of work, but not everyone will have access to such expensive software. Cheap alternatives include Photoshop Elements amongst others. Once you have created slides in Photoshop it is quick and easy to save them as JPEG files and drag and drop them into PowePoint. Perhaps that can be a tutorial for another time... Step 5: Additional Stuff Presentations typically lack significance, structure, simplicity and rehearsal. Always check over your presentation and ask 'is this significant to my audience?' Always structure your presentation in a logical manner and (it is recommended you) include a contents slide and summary slide to tie things together. Keep your verbal commentary simple and keep the slides themselves even more simple than that. Simplicity is crucial. Once you have produced your beautiful slides with wonderful content you will want to practice them. Practice, Practice, Practice. Rehearsing even just once can make a good presentation even better. Conclusion: This blog entry has covered some basic points on how to improve your medical presentations and has given a series of useful online resources. Putting effort into designing a presentation takes time and motivation, for those without these vital ingredients we recommend Prezi (whilst it is still relatively new and fresh). Perhaps the rest of you will only use these tips for the occasional important presentation. However, I hope that soon after you start approaching presentations with a little more respect for their importance and potential, you too will find a desire to produce high-quality, aesthetically pleasing talks. LARF - Mood: damn tired and feeling guilty that I just wrote this blog instead of revising haematology notes. Follow me on Twitter. Follow the Occipital Designs original blog. Check out my Arterial Schematic.
Dr. Luke Farmery
over 7 years ago
The Health Service Journal have announced this week that medical students could be given a license to practice medicine in the NHS as soon as they graduate. What do we know? The proposal comes from Health Education England. Students would qualify by taking an additional exam when applying for the Foundation Programme. The aim is to improve the standard of medics joining the NHS. Another driving force is to reduce the rising number of med students applying for the two-year Foundation Programme (currently the only way for junior doctors to achieve a full license to practice). Last year there were 297 more applicants than places. If approved the plan would require changes to the Medical Act. Statement from the BMA Dr Andrew Collier, Co-Chair of the BMA’s Junior Doctor Committee said: “We do not feel the case has yet been made for a wholesale change in foundation programme selection process, especially as the system was significantly overhauled and implemented only one year ago. There is little evidence that another new national exam over and above current medical school assessment methods will add any benefit either for graduating students or the NHS as a whole. It is also unlikely to solve the ongoing oversubscription to the foundation programme which will only be addressed by well thought out workforce planning.” Will it work? This proposal has certainly come as a surprise to me so soon after recent changes to the Foundation Programme selection process. I would love to know what you think about it. Do you agree with Dr Collier’s statement? If the plan goes ahead do you think it will be effective in achieving the desired outcomes? Please post your comments and thoughts. Nicole Read more: http://www.hsj.co.uk/news/exclusive-medical-students-face-new-nhs-entry-exam/5066640.article#.UrbyS2RdVaE
over 6 years ago
Ministry of Ethics.co.uk is a non-commercial student-run project aiming to bring learning about Medical Ethics and Law (MEL) into the Web 2.0 era. The website has revision notes, MCQs & EMQs, case videos and scenarios, and allows discussions with other students and professors or lecturers from across the UK and beyond. The website is the perfect revision resource for medical students, clinical students and juniors doctors to learn more about MEL. Doctors are so much more than walking books of facts; they are faced with ethically and legally challenging situations throughout their professional lives. Medical ethics education helps make students aware of the situations that they will face in the clinical setting and suggests appropriate ways of approaching them. In the long term, it aids the development of moral and ethical reasoning that will allow student doctors to understand other people's views, helping them to become more empathetic and caring clinicians. Since it's creation, our website has won a number of prizes including: - Winning Presentation at the 2011 Fifth Conference on Medical Ethics and Law - 2011 BMA Book Awards Highly Commended - 2011 BMJ onExamination Best National E-Learning Resource Prize We hope you enjoy looking at our site and in particular the case scenarios and interactive question bank.
almost 8 years ago