Objectives — Knowledge

Explanation:

Core I have given you the core cases that I expect you to know. You don't need to go and memorize what Nelson's Textbook of Pediatrics has to say about each one. You should spend 10-15 minutes reviewing each case and do a little background reading from a textbook. The best way to learn is to study in groups and break up the cases. Please share resources with each other. The idea is not to compete but to have every student learn about the core cases. We will discuss each case in seminar, but if you come prepared, the level of discussion can be higher.

You should also buy a board review book with questions and do about 10 questions a night. If you try to cram at the end, you won't learn the material as well. Don't spend more than 30 minutes on any one topic. You just won't have the time to read about one case for four hours, even if it is the most interesting case in the world.

Depth The goal is to learn how to develop depth of knowledge quickly. The first step in achieving this is to ask focused and pertinent questions about your patient. That way you will know where to focus your reading. I expect that you will need to do some background reading on the different diseases, but if you spend all night doing background reading you'll never get to the questions that the patient wants answered, such as, "What therapy should I be using?" Depth of knowledge is a very difficult skill and I don't expect that you will be doing much more than background reading for the first 3.5 weeks of the rotation. By the end of the fourth week, it should be clear that your knowledge about a given disease has depth to it. In order to figure out what questions you need to consider when reading for depth, consider what questions you would want answered if you were the patient. The two questions that come up most often are "Is this therapy really the best?" and "Do I really need this test?"

As a third year medical student, it is imperative that you use your downtime effectively. In order to achieve depth of knowledge quickly, you want to use search engines such as:

MD Consult - This costs $100 per year at the student rate, but it is a great tool and it has a full text version of Nelson's Textbook of Pediatrics online. It is a very user friendly search engine.

Medline - It is really hard to do a Medline search well because you frequently wind up with a search that is too general. Once during your five weeks, you should go to a librarian and ask for tips on how to do a focused Medline search. You can find tips on how to do a good Medline search at the web sites listed on the Web Resources page.

PubMed - This search engine has an option called "Clinical Queries" which is found in the menu on the left side of the page. You can also get there by clicking here. It is helpful because it allows you to categorize the search based on therapy, etiology, diagnosis, or prognosis and you can also specify if you want the emphasis to be on sensitivity (picking up all possible relevant articles) or specificity (picking only the most relevant but potentially missing a few).

Cochrane Database - An incredible database that takes all of the knowledge about a given disease or therapy and does a meta-analysis to assess the validity of the interventions. For example, it will compare the efficacy of coronary bypass surgery to medical management in patients with coronary artery disease.