MEM Cast Episode 146: Evidence Based History & Examination
4 snips
Jan 20, 2023 
Nicola Cooper, an expert in medical education, dives into the pitfalls of traditional teaching methods for history and examination skills. She highlights how these outdated practices can lead to diagnostic errors. The discussion centers on the importance of understanding likelihood ratios and evidence-based approaches to improve accuracy in patient assessments. With critiques of conventional textbooks, they advocate for a shift towards teaching that emphasizes probabilities and real-world evidence to foster better diagnostic skills in future medical professionals.
AI Snips
Chapters
Books
Transcript
Episode notes
Textbooks Teach Outdated Prototypes
- Medical textbooks teach prototypical disease presentations that no longer reflect current patient realities.
- This causes cognitive bias, diagnostic errors, and overconfidence in clinicians.
Belching as Heart Attack Symptom
- Dr Cooper recalls not recognizing belching as a symptom of inferior myocardial ischemia as a junior doctor.
- This reflects how classic chest pain teaching misses presentations, especially in women.
Limited Value of Neck Stiffness
- Neck stiffness appears in only one-third of meningitis patients and has a likelihood ratio near one.
- This makes it a poor standalone diagnostic sign, contrary to common teaching.
