IMreasoning - Clinical reasoning for Doctors and Students artwork

IMreasoning - Clinical reasoning for Doctors and Students

75 episodes - English - Latest episode: almost 3 years ago - ★★★★★ - 83 ratings

Welcome to IM Reasoning with your hosts Dr. Art Nahill and Dr. Nic Szecket, two general internists with a passion for teaching clinical reasoning. Join us for case discussions, conversations and interviews that explore issues important to clinicians and students, with a special focus on clinical reasoning, the once-mysterious process behind the remarkable abilities of the master clinician.

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Episodes

Our final episode

March 31, 2021 07:55 - 55 minutes - 101 MB

We cannot put this off any longer.  IMreasoning has reached the end of its road.  We had a great 5 years.  We both learned so much, about medicine, about cognition, about the art of teaching, about each other, and about ourselves. Thank you once again to all of you, our listeners, for sticking with us.  Thank you especially to those who got in touch, and gave us encouragement to continue this project over the past 5 years. Thank you as well to all of you who appeared and participated in ...

69: STC with Alec Rezigh

February 03, 2021 01:25 - 56 minutes - 103 MB

Join us for another instalment of Stump the Chumps. This time our case comes from Baylor University presented by Alec Rezigh, a friend of the podcast. Enjoy!

Epilette January 2021

January 11, 2021 08:15 - 1 minute - 2.36 MB

Just a quick inbetweenisode to let you all know we will be back with another instalment of STC in early February.  Enjoy a Southern Hemisphere summer, wherever you are.

68: STC with Ramey Bajwa

November 29, 2020 00:09 - 1 hour - 135 MB

Join us for another installation of STC (technically international) with Ramey Bajwa.  Play along and see if you can guess the diagnosis any earlier than we did (or did not).

67: MAID with Stefanie Green

October 28, 2020 18:56 - 1 hour - 169 MB

Join us for our conversation with Stefanie Green, the director of CAMAP (Canadian Association of MAID Assessors and Providers) where we hear about the lessons learned from the Canadian experience over the past four years since it has been legal for doctors to provide medical assistance in dying.

66: STC with Human Dx and reverse STC

October 12, 2020 08:12 - 46 minutes - 85.9 MB

Join us for another instalment of STC (Stump the Chumps) where we tackle another case from HumanDx Global Morning Report. But first, try your hand at solving a case that Art brought along from his recent ward round.  Good luck!

65: STC at the Royal Adelaide with Josh and Toby

September 13, 2020 09:15 - 1 hour - 133 MB

Join us for another instalment of STC, presented at grand rounds at the Royal Adelaide Hospital. Unfortunately we had to stay at home in Auckland and do it over Zoom... (because COVID). Josh Inglis and Toby Gilbert gave us a real challenge.

64: Memory - Daniel Kilov

August 05, 2020 00:41 - 1 hour - 169 MB

Join us for a fascinating conversation with Daniel Kilov, philosopher and memory athlete, about memory.  Find out about techniques that we can each learn to help us to memorise...anything. Click on Daniel Kilov TedX talk to here more And if you're interested here is the link to Joshua Foer Ted Talk, author of "Moonwalking with Einstein":  

63: STC with Human Dx

July 08, 2020 18:17 - 47 minutes - 86.5 MB

We are thrilled to launch our 1st collaboration with HumanDx. "a worldwide effort, created with and led by the global medical community, to build an open intelligence system that maps the steps to help any patient" There is a key image associated with the case which you should inspect before starting.  Go to our website IMreasoning.com. You can try to solve thousands of interesting cases at HumanDx in an interactive, engaging platform, and can add your own cases too.

62: The Chang, and musings on Artificial Intelligence

June 25, 2020 08:22 - 1 hour - 129 MB

Chang is back people.  Hope you enjoy our conversation over a pint at Galbraith's in Auckland.  Chang helps us understand what machine learning actually means.  It's all about matrices apparently.  Easy...

61: Cognitive Autopsy

May 31, 2020 04:15 - 49 minutes - 91.1 MB

Once again we dissect a diagnosis-gone-wrong from the records of the Health and Disability Commissioner.  Can we learn something to take away and avoid making the same mistake ourselves?

60: STC with Josh Inglis

April 19, 2020 04:17 - 1 hour - 142 MB

Welcome to another STC where friend of the podcast, Josh Inglis, challenges us with a case from Australia.  Play along with us and try to get the diagnosis as early as possible. As an aside, our update regarding COVID19 in NZ is already a bit out date.  Time move quickly during a pandemic!  NZ has not only managed to "flatten the curve"; we have completely squashed it.  For each of the last 4 days we have had less than 15 new confirmed and probable cases.  Now we have to figure out how to ...

Episode 60: STC with Josh Inglis

April 19, 2020 04:17 - 1 hour - 142 MB

Welcome to another STC where friend of the podcast, Josh Inglis, challenges us with a case from Australia.  Play along with us and try to get the diagnosis as early as possible. As an aside, our update regarding COVID19 in NZ is already a bit out date.  Time move quickly during a pandemic!  NZ has not only managed to "flatten the curve"; we have completely squashed it.  For each of the last 4 days we have had less than 15 new confirmed and probable cases.  Now we have to figure out how to ...

59: Coronavirus

March 20, 2020 05:50 - 1 hour - 113 MB

First, welcome to Madison and Steven who have joined the IMreasoning team! Like everyone else, we're talking about the Coronavirus.  Its hard not to when it has taken over essentially every aspect of our daily lives, both at work and at home. We talk about what makes the situation difficult for human minds to grasp the reality of this pandemic; the concept of exponential growth, denial in hard times, and the counterfactual. And we have the rare treat of chatting with our good friend Jo...

58: STC - Human Dx Global Morning Report

March 05, 2020 04:19 - 36 minutes - 67.1 MB

Another instalment of STC, this time using a Global Morning Report case from HumanDx.  We hope to do more of these as we initiate a collaboration with the Human Dx team. Big news! We have launched our Patreon page.  Listen to this episode to hear more about how you can support the podcast. You can use the link below to visit our Patreon page: https://www.patreon.com/imreasoning We appreciate your support.

57: Bayesian Reasoning

February 09, 2020 05:34 - 46 minutes - 84.2 MB

In this episode we review Bayesian Reasoning in general, and Nic get's the opportunity to geek out on talking stats.  We cover likelihood ratios, positive and negative predictive values, sensitivity and specificity, and pre- and post-test probabilities.  Hopefully, we used examples that will help you understand and remember these concepts.

56: We're back!

January 13, 2020 09:13 - 37 minutes - 68.6 MB

Well folks, we are finally ready to re-launch with "season 2".  During our break we have been making plans to continue bringing you new material.  But most importantly we've decided to launch a new podcast called "Diagnostica" which aims to bridge the gap between the culture of medicine and the "public".  We'll keep you updated on this new project. For now, enjoy a short cognitive autopsy.  Next episode, more Bayesian math!

We'll be back soon!

August 14, 2019 04:04 - 2 minutes - 3.82 MB

After a season 1 that has dragged on for 4 years, we've decided to have a publishing break so we can work on more episodes.  Thanks to all our listeners for your feedback and encouragement.  We will be back soon!

55: STC live at AusDEM 2019 - Melbourne

July 10, 2019 22:35 - 51 minutes - 93.6 MB

Apologies for the delay in getting this next episode out to you.  Play along with us on this very challenging case. Schadenfreude (/ˈʃɑːdənfrɔɪdə/; German: [ˈʃaːdn̩ˌfʁɔʏ̯də] (listen); lit. 'harm-joy') is the experience of pleasure, joy, or self-satisfaction that comes from learning of or witnessing the troubles, failures, or humiliation of another.  

54: STC with Gurpreet Dhaliwal

May 28, 2019 16:00 - 49 minutes - 91.5 MB

A special edition of STC!  This time our good friend of the podcast Gurpreet Dhaliwal, master diagnostician, works through a case with Nic.  The case was originally presented to Art at morning report by one of our registrars Luke Sutherland.

53: The Medical Futurist - Bertalan Mesko

May 07, 2019 09:51 - 45 minutes - 83.5 MB

Enjoy part 2 of our conversation with Bertalan Mesko, the Medical Futurist.  Apparently in 20 years when we're ready to retire, work will be so satisfying we won't want to leave!  I hope Bertalan's optimism turns out to be prophetic...

52: The Medical Futurist - Bertalan Mesko

April 22, 2019 03:54 - 26 minutes - 49.1 MB

Join us for part 1 of our conversation with Bertalan Mesko, also known as The Medical Futurist.  Bertalan is helping the medical world integrate and adopt technologies that are helping humans deliver better healthcare.  Enjoy!

51: STC International FLIPPED - The Answer...

March 26, 2019 00:07 - 19 minutes - 35.5 MB

Hopefully you had a chance to mull over the case we published in the last episode about Peggy from Australia who was experiencing fatigue and weight loss.  In this episode we review some of your responses and give you the final diagnosis.

50: STC internation - FLIPPED

March 14, 2019 09:01 - 8 minutes - 16.3 MB

Please join the IMreasoning community and try to solve this case!  Art and Nic had a cognitive/technical failure and messed up the sound files when they tried to solve this case.  So this time, you get to be the chump. Good luck!

49: The Racist Patient - Part 2

February 12, 2019 07:31 - 50 minutes - 93 MB

Enjoy part 2 of our conversations about the racist patient.  In this episode we have a conversation with professor of medical ethics, Dr. Phillipa Malpas from the University of Auckland.

48: The Racist Patient

January 15, 2019 23:47 - 48 minutes - 89.2 MB

Join Art and Nic for a discussion about our experiences with patients who hold bigoted, intolerant, racist, and judgmental opinions about their providers and people in general.

47: Compassion - Tony Fernando - Rebroadcast

December 14, 2018 07:44 - 1 hour - 119 MB

This is one of favourite episodes of all time.  "All time" being since August 2015...  Have we really produced enough episodes to justify a "rebroadcast"? possibly not, but we're doing it anyway. We're working on a couple of episodes that we'll have out in the new year, but we didn't want to let so much time pass without seeing you all again. Enjoy!

46: STC International - Wisconsin

November 24, 2018 19:40 - 52 minutes - 95.4 MB

Join us for another installation of STC international, this time with a case from Adam Clements from Wisconsin.

45: A Cognitive Autopsy of a case of back pain

October 11, 2018 01:16 - 50 minutes - 93.2 MB

This is by listener request! Art and Nic analyse what went wrong in the case of man who presented with sudden onset back pain. 

44: Swiss Ruminations

September 14, 2018 20:05 - 45 minutes - 84.1 MB

An "In-between-isode".  Art and Nic discuss lessons from the conferences in Switzerland, Association of Medical Educators of Europe (AMEE) and the European Diagnostic Error in Medicine Conference (EuroDEM).  We also discuss Argentinian Parrilla's...

43: STC live in Perth

August 01, 2018 01:23 - 47 minutes - 86.2 MB

Back with another instalment of STC live, this time from Perth, Australia.  The Australian Medical Student Association put on a fantastic conference with truly inspiring speakers.  We had so much fun sharing the stage with Michelle Johnston, ED doctor and author, who brought the humour and the grace to our session. Play along as the case evolves and see if you can do better than us!

42: Becoming an Expert Diagnostician

July 03, 2018 00:24 - 54 minutes - 99.1 MB

We chat once again with Gurpreet Dhaliwal, this time about what it takes to become a master diagnostician.  We discuss the main strategies; seeing many cases, deliberate training, getting feedback, closing the loop, and others.

41: Words

May 23, 2018 08:45 - 42 minutes - 77.9 MB

We discuss the importance of the words that we choose to use in our medical documentation.  Words matter! They can generate stigma, and they can bias the decisions we subsequently make as practitioners.

40: Stump the Chumps International - Rahul Gandhi

April 06, 2018 21:55 - 58 minutes - 106 MB

It was a pleasure to finally get back to case-solving! Enjoy another interesting case of STC with our friend and colleague Rahul Gandhi, who is galavanting around the world getting super smart, so he can fix everything.

40: Stump the Chumps International - Rahul Gandhi

April 06, 2018 21:55

It was a pleasure to finally get back to case-solving! Enjoy another interesting case of STC with our friend and colleague Rahul Gandhi, who is galavanting around the world getting super smart, so he can fix everything.

39: The Case of Dr. Hadiza Bawa-Garba

March 14, 2018 03:59 - 1 hour - 117 MB

Some of you may have heard of the double tragedy involving Jack Adcock, a six year old who died from sepsis and Dr. Bawa-Garba, a pediatric trainee in the UK convicted of manslaughter in relation to his death and prevented from ever working again. Justice or a clear case of scapegoating? Listen as we discuss this troubling case and its far-reaching implications for transparency, honest reflection, and patient safety.

38: Uncertainty in Medicine

February 21, 2018 03:09 - 52 minutes - 96.3 MB

We're back after a long summer break.  Enjoy this episode on uncertainty in medicine.  We talk to Arabella Simpkin, an English paediatrician, working in Boston, who spends a lot of time thinking and writing about uncertainty and our need to embrace it, or at the very least, tolerate it graciously.

37: STC International Live on Facebook

December 14, 2017 20:23 - 1 hour - 59.8 MB

If you missed us live on Facebook last week, here's you chance to catch up.  Enjoy our STC session.  The case is from Australia, sent to us by Elise Perger (Allan) and Alison Miller... and we invited Chang as a guest host, back by popular demand. Or, you can still watch the Facebook video at the link below. https://www.facebook.com/IMreasoning/videos/1974175999573953/ Let us know if you liked the Facebook live event.  We can do it again!

36: Live STC at MMC

November 14, 2017 18:22 - 46 minutes - 42.8 MB

Enjoy our live Stump the Chumps at Main Medical Centre.  We were honoured to be invited by Bob Trowbridge and it was a pleasure to visit Portland, Maine.

35: Turning the Wheel 2

October 29, 2017 00:37 - 1 hour - 58.3 MB

Part two of our exploration of the connections between art, artistic thinking, creativity, with clinical reasoning and diagnosis. We speak to Alexa Miller, a medical educator who uses arts-based learning and visual thinking skills to train students and seasoned professionals alike to better observe, describe, communicate, and to tolerate uncertainty. We also speak with Jay Baruch, a writer, medical educator, and emergency doctor who is also the director the clinical arts and humanities a...

34: Tackling the drivers that lead to diagnostic error

October 17, 2017 18:03 - 35 minutes - 32.4 MB

Another enjoyable Diagnostic Error in Medicine conference, this time in Art's home town of Boston (actually, Newton...).  In this episode we discuss our thoughts inspired by one of the sessions, run by Doug Salvador and Harry Hoar from Baystate Medical Centre. They addressed how to get one's own hospital administration to engage in Diagnostic Error.  Remember to check the website IMreasoning.com for the attachment so you can follow along while you listen.

33: Turning the Wheel

October 06, 2017 20:08 - 36 minutes - 33.3 MB

This is part one of a two-part series exploring the deep connections between creative thinking and clinical reasoning.  We discuss Art's and Glenn's work as poets and physicians, and how each endeavour enriches the other.

32: STC with Chang

September 11, 2017 04:03 - 57 minutes - 53.1 MB

Enjoy an episode of STC.  This time WE weren't in the hot seat!  Humbling to see an excellent trainee in action.

31: STC International with Genevieve Yates

August 08, 2017 23:25 - 1 hour - 55 MB

We finally got the chance to collaborate with Genevieve on her case for STC.  And we were keen to get this out just before GPTEC. Enjoy!

30: Diagnostic Uncertainty

July 27, 2017 11:08 - 48 minutes - 44.1 MB

We were privileged to speak to one of our patients, recently treated by our service, about her experience while her doctors struggled with diagnostic uncertainty.  The usual suspects were at play; uncommon diagnoses, uncommon presentations, cognitive biases, systems issues, etc. Check out the new look to our website! www.imreasoning.com 

29: STC live! at the Australian DEM

June 22, 2017 06:24 - 49 minutes - 45.5 MB

This time, we did not have a pause button! and we could not edit out all the times we sounded a little thick.  So enjoy the raw experience.  We did!

28: Donald Redelmeier

May 17, 2017 09:26 - 48 minutes - 44.7 MB

Coined by the New York Times as the "leading debunker of preconceived notions in the medical world", Don Redelmeier is an award winning researcher, teacher, and clinician.  Enjoy our conversation with Dr. Redelmeier where we discuss pitfalls in clinical reasoning...as well as New Zealand idioms... Tell us what you think on: www.imreasoning.com www.facebook.com/imreasoning Twitter, @IMreasoning or email us at [email protected]  

27: STC International with Casey Parker

April 17, 2017 10:28 - 49 minutes - 45.2 MB

Finally, our first STC International.  An interesting case from Broome, Western Australia.  Thanks Casey Parker.

26: STC from the Clinical Problem-Solving series in NEJM

March 15, 2017 22:56 - 40 minutes - 36.9 MB

While waiting for another of our home-grown cases we decided to do a STC using a published case from the Clinical Problem-Solving series of the New England Journal of Medicine. Let us know what you think of this format! www.imreasoning.com www.facebook.com/imreasoning or now you can make noise at us on Twitter.  Our handle is @IMreasoning  

25: Revisiting Dual Process Thinking

February 20, 2017 19:44 - 34 minutes - 31.8 MB

Do all diagnostic errors occur because we're rushing, and prematurely jumping to conclusions? Can we course-correct by simply slowing down and by being mindful of our own inherent biases? Geoff Norman and his colleagues review the literature to try to answer these and other questions about where errors in clinical reasoning come from. The Causes of Errors in Clinical Reasoning: Cognitive Biases, Knowledge Deficits, and Dual Process Thinking And get your own Cognitive Bias Codex poster...