Over the last year new LitFL posts have been dominated by things we call ‘Case-based Q&As‘ — you may wondering whats going on.
Don’t worry, LitFL is going to stay true to its quirky and eccentric medical blogging roots…
- Updates and interpretation of the latest in Web 2.0/3.0/4.0… and social medicine,
- UCEM will continue its quest for world domination/ salvation,
- The odd philosophical aside will still spring up,
- Poetical bastardisation will march onwards,
- Neologisms will be created,
- Whimsical human encounters will be de-identified, further fictionalised and shared,
- …and the case-based Q&As are going to keep on cranking too.
Personally, I like to learn by a problem-based approach using the Socratic Method (or positive pimping if you prefer), where an experienced learner/ teacher helps others through guided questioning and explanation. The Case-based Q&As are an attempt to extract the precious bodily fluids from this approach and distill them into an open-source and easily retrieved bottle of port (i.e. something that tastes good and is easy to swallow)… The emphasis on cases, though tenuous and borderline farcical at times, attempts to keep it real, relevant, interactive and interesting.
The question/answer show/hide format makes for easy revision, provides an easily comprehensible structure and allows readers to come back, revise and test their knowledge. Questions and answers can be easily cut-and-pasted into personal notes, edited and modified, or turned into flashcards for using spaced-repetition programs like Mnemosyne for those so inclined. Many of the answers are in two stages — a brief to-the-point bare bones answer, followed by a deeper explanation. In general, the focus is on what the clinician needs to know to take care of their patient and pass their exams — thus extraneous epidemiology and molecular underpinnings tend to be limited. Of course, we have an unabashed predilection for breaking our own rules…
The Case-based Q&As are ever growing, and the index is intermittently updated in a searchable table on the Clinical Cases page. The cases vary from core emergency medicine and critical care subjects that practitioners need to know like the backs of their hands, to more obscure and ‘out there’ topics — but why not? We see it all in this business.
The best case-based Q&As are those like Paul Young’s Pulmonary Puzzle 002 – Not just a PE; as the case evolves an incredible amount of diverse medical terrain is traversed, but the questions focus on the key messages and important learning points.
Many cases, like Laboratory Tester 003 – Seizures, hyponatremia and ADH, evolve from our own learning needs and differences of opinion at work, the clinical questions that arise as we try to do what is best for our patients and the controversies we encounter.
Other cases, like Trauma Tribulation 005 – Releasing the Roman Breastplate, are more conventional and designed to cover core knowledge requirements. Where possible the posts are referenced, usually with at least one of the ACEM or CICM Fellowship exam recommended texts (typically Rosen’s or Oh’s, respectively), unearthed gems from the primary literature and recent review articles, and/or the best online and open-source resources we can find on the web.
Oh, you have another question do you — what’s with the naming of the posts?
Well, we’ve finally settled on a system of giving each post a category name, like ‘Neurological Mind-boggler‘, and most posts will have another more post-specific name to keep things interesting. Some readers get upset when post titles give away the diagnosis and others are irritated by the formulaic category names.
The current system promises to annoy both parties in equal measure…
Finally, what’s the ultimate goal of all these ‘Case-based Q&As’ I hear you ask?
Well, the master plan is to build up an entire case-based curriculum for emergency medicine and intensive care catering for all levels of training. A ‘big ask’ I know, but hopefully in a few years we’ll be able to say, “Well, we knocked the bastard off”, just like New Zealand’s most famous bee-keeper once did. But, we’re not kidding ourselves — we know this is a task that will never end. I’d be disappointed if it did.
And now a postscript, a request. If you use these Case-based Q&A’s fire some feedback our way (even better if its constructive!). We want these resources to be useful and as good as anything out there — open-source or otherwise. If you want to submit a guest Case-based Q&A post having done some research on a relevant EM/ICU topic we will be happy to consider it if its quality stuff (contact the team here), and we’ll credit you as the author. For instance, you might want to create a revision aid for a teaching talk you’re going to give. Feel free to copy, re-use, modify and improve anything on LitFL for your own learning and teaching needs and do Hippocrates proud.
“To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art — if they desire to learn it — without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken the oath according to medical law, but to no one else.”
— from the Hippocratic Oath
Of course, if you learn something from these cases you may hear a knock on your door if we ever find ourselves totally skint… and feel free to ignore the ‘no one else’ part.