Flashback Friday: #Meded #DoNoHarm

(I have an awesome problem. I’m on a two-month mini-sabbatical.  Let’s all pretend that I’m buried in a research library, but the truth… well… for the sake of plausible deniability with my boss… let’s just stop here.

Here’s the problem, editing the ICE blog will be tricky for March and April. To accommodate a “skeleton staff” for the next two months, we are highlighting previous posts.  Tuesdays will continue to be new, thought provoking, practical material.  Friday’s will be a remix of our greatest hits.

If you want to nominate a past post for Flashback Friday’s drop us a line at ice@royalcollege.ca



Originally posted July 21, 2015.

By Damian Roland

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Medicine involves providing compassionate care to patients.  Health care students are introduced to an education culture of ‘doing’ good.  However, as students progress through training they realise that some diseases can’t be cured and that not all patients can be healed. Later still, they may discover the very interventions they’ve prescribed do more harm than good.

A famous medical mantra (perhaps ascribed to Syndenham) is Primum non nocere (‘First, do no harm”). This imperative against actions that harm a patient does not help distinguish which interventions should be avoided. Only in the last decade has guidance on “what not to do” taken shape. In the United States and Canada, Choosing Wisely (US site: www.choosingwisely.org & Canadian site: www.choosingwiselycanada.org) is a campaign to aid and inform doctors about presumably appropriate interventions that, in fact, are not supported by evidence and may cause harm. In the United Kingdom, the National Institute for Health and Care Excellence (NICE) have a database of “do not do” recommendations.

In a similar vein, Jonathan recently discussed practical (but evidence based) teaching that doesn’t suck. At the end of the blog is a list of things to avoid (i.e. do not do).

What are the other things that Clinician Educators should avoid to #DoNoHarm? Finding the evidence on this isn’t easy but there are some topics that do spring to mind. For example, if you are a Twitter aficionado, you will be aware of the mass movement away from complex, busy slides often found in large group presentations.  Presentations should use simple slides (only for emphasis) that help with a clear narrative. What about bullet points? Obviously a huge list of text is not helpful, but a blanket ban might not be welcome by everyone. (I know a colleague who suggests that bullet points help in signposting key points.)

So, lets start a meme for Clinician Educators that describes things to avoid in our education practice.

I’d be interested in hearing your #Meded #DoNoHarm.

Image via blog.newswhip.com