EMT CIty Book Club

[hammerpcp]

Awesome!

[chbare]

I agree with Ridryder 911 on Critical Care Paramedic. I think this book sets a new standard and covers material in much more depth. Another book I love is Rosen and Barkin's 5-Minute Emergency Medicine Consult . Very well designed and easy to read. The diagnoses are presented in column format starting with S/S, clinical features, and physiology. Prehospital considerations all the way to admit criteria are covered as well.

Take care,

chbare

[Ridryder 911]

I agree the 5 minute emergenc medicine consultant is another good one. It does appear at first to be like a "cook-book" but; one has to have a good H & P tool to use it...

R/r 911

[Ace844]

Here's a review of a book from the NEJM. I haven't read it but it is on an oft discussed topic here and thought you all may be interested. It is on my list to read an purchase, when i am done I will comment on it.

Measuring Medical Professionalism

Edited by David Thomas Stern. 311 pp. New York, Oxford University Press, 2006. $49.50. ISBN 0-19-517226-4.

This book on the multifaceted problem of measuring medical professionalism is interesting and valuable. It has something for any reader seeking to understand whether, why, or how professionalism in medicine might be evaluated.

The editor, David Thomas Stern, asks whether the concept of "professionalism" is like the concept of "obscenity" — something hard to define but recognizable when observed. Stern, along with Louise Arnold, rejects this glib definition in a very thoughtful essay the two contributed to this book identifying the central qualities of professionalism as excellence, humanism, accountability, and altruism. Predictably, the many other contributors to the book perceive professionalism and its assessment or measurement in many different ways.

Jon Veloski and Mohammadreza Hojat, in their chapter entitled "Measuring Specific Elements of Professionalism: Empathy, Teamwork, and Lifelong Learning," apply systems theory to the assessment of professionalism. On the basis of the assumption that empathy, teamwork, and a commitment to lifelong learning are important components of professionalism, they have developed questionnaires to assess each of these qualities. These assessments may be thought of as global, quantitative assessments of specific properties that define professionalism. The authors suggest that the evaluations are important tools for testing hypotheses concerning the admission of students to medical school, studying changes in the attitudes of students as they progress from preclinical to clinical studies, predicting performance in the training of house staff, and evaluating changes in medical school curricula.

Maxine Papadakis and Helen Loeser, in their chapter entitled "Using Critical Incident Reports and Longitudinal Observations to Assess Professionalism," address the measurement of professionalism not as a continuous quantitative function but as a binary function — pass or fail — akin to a driving test. Critical incident reports, which are faculty reports of students' behavior that is deemed to be unprofessional, are the initial step in identifying outliers — students or physicians in training who may have special needs, are responding poorly to the stresses of the program or other parts of their lives, and may require counseling or remediation. Papadakis and Loeser describe their experience of assessing professionalism through a physician evaluation system at the University of California, San Francisco (UCSF), and they point to the need for faculty to understand and actively participate in the on-site evaluation of student and house staff behaviors. They acknowledge that "single events do not necessarily define professionalism." They also provide data on the number and types of unprofessional behaviors identified since the inception of the system at UCSF in 1995, describe the distribution of critical incidents among the clinical services, and outline the process and legal issues associated with remediation. Shiphra Ginsberg and Lorelei Lingard, in their chapter entitled "Using Reflection and Rhetoric to Understand Professional Behaviors," suggest that critical incidents, serving as topics for reflective essays or small group discussions, have the potential for stimulating students to examine their own reasoning and behavior.

Debra Klamen and Reed Williams, in a chapter entitled "Using Standardized Clinical Encounters to Assess Physician Communication," address the important issue of standardization in evaluation and the increasing dependence on "standardized patients," who they define succinctly as "nonphysicians carefully trained to perform in multiple roles of patient, teacher, and evaluator while realistically replicating a patient encounter." They present data on the reliability and validity of standardized patient examinations, whether evaluated by the "standardized" patient or a third-party observer.

Although this mode of evaluation has the advantages of standardization and the generation of reproducible data, many medical educators and clinical teachers (this reviewer among them) question the technique. When students know they are examining a standardized patient, is their behavior representative of their usual behavior? Students have a remarkable ability to show the side of themselves that they perceive as desirable; why else would virtually every applicant for internship appear in a trim, ultraconservative dark suit? Most of clinical medicine is taught by careful history taking, examination of real patients, and discussions of differential diagnosis, pathophysiology, or disease management. Students' behavior and their ability to elicit relevant information and demonstrate critical assessment of data are easily observed during such clinical teaching sessions. In my view, the advantages of assessment during contact with real patients — a situation that is not a one-time experience, is not perceived as a "test," and fits the medical model — outweigh the lack of "standardization."

Even though readers may quarrel with some of the views expressed in this book, the editor should be praised for bringing together this talented group of medical educators. In his acknowledgments, Stern writes, "These authors are more than expert researchers or physicians, they demonstrate the highest degree of collegiality, intellectual integrity, compassion, and teamwork — they practice what they preach." This book suggests that they also preach what they practice.

Jerome Lowenstein, M.D.

New York University School of Medicine

New York, NY 10016

[JPINFV]

Yes, this is a 1.5 year bump....

Book:The House of God: The Classic Novel of Life and Death in an American Hospital

Author: Samuel Shem

Publisher: Dell

Cost: $10-15

ISBN-10: 0385337388

Discussion:

It's a satire on hospital residencies, but several of the terms and "Laws of the House of God" have made their way into EMS usage [LOL in NAD, Gomer, the first thing to do at a cardiac arrest is to take your own pulse]. Similarly, the picture of interns starting off fresh out of class with little to no experience providing patient care seemed eerily similar to starting off fresh out of Basic class. While definitely not for novice providers [the cynicism could be a turn off], it should be a must read at some point for all providers.

I give it 7/10 stars of life.

[Ridryder 911]

One of most favorite books. I used to require all my EMT students to read "House of God.

It is responsible for t.v. shows such as St. Elsewhere, E.R., and of course Scrubs.

They made a movie based upon the novel, but AMA had bought the rights and refused to produce but decades later finally was released on VHS. Not as good as the book though...

R/r 911

[Scaramedic]

Good luck finding a copy but I feel the best book ever written about EMS was Street Dancer by Keith Neely (not the Keith Neely that writes childrens books). It is out of print, it was published by JEMS, ISBN #978-9993966357.

It is the story of a rookie Medic at Denver General in the seventies. A great read if you can find it.

[DwayneEMTP]

Good luck finding a copy but I feel the best book ever written about EMS was Street Dancer by Keith Neely (not the Keith Neely that writes childrens books). It is out of print, it was published by JEMS, ISBN #978-9993966357.

It is the story of a rookie Medic at Denver General in the seventies. A great read if you can find it.

http://www.biblio.com/details.php?dcx=15766108&aid=frg

[Scaramedic]

http://www.biblio.com/details.php?dcx=15766108&aid=frg

$75!!!!!!!

It's a paperback, damn I wonder what a used ones going for?

[frontcrawl]

That is a used one.