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 the podcast, to present stump the chumps cases, or to share your expertise in conversation with us.

A special thank you to Steve and Madi who navigated the tech and the socials for us in the final leg of this adventure.  We couldn't have done this without you.

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!

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?

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 stay COVID-free until the vaccine...

Remember you can view our medical student teaching events on our Facebook page.

You can support our efforts to continue producing this podcast at https://www.patreon.com/imreasoning

Thanks!

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 Jorge Valbuena-Balbas who is living and working in Bilbao, Spain, and is currently sitting (metophorically-speaking) at the bottom of what appears to be an exponential trajectory in Spain.

For those keen to support our efforts please visit: https://www.patreon.com/imreasoning

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.

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.

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!

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!

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.

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.

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...

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.

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!

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.

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!

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.

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.

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!

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

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

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...

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!

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).

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.

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.

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.

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.

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.

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!

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.

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 at Brown Medical School.

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.

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.

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.

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

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!

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 

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!

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 imreasoning@gmail.com

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

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

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 here: Cognitive Bias Codex

Please write us with comments and feedback on Facebook at https://www.facebook.com/IMreasoning

or on our webpage at www.IMreasoning.com

and send us your STC cases to imreasoning@gmail.com

Doctors should always strive to present themselves as unbreakable to their patients...  All doctors are smart...  All patients have a definitive diagnosis...

Believe it or not, versions of these ideas, and many others, are pervasive in our medical education institutions, and to varying degrees are believed and practiced by doctors everywhere.

In this episode, we debunk and discuss our favourite myths. Enjoy!

Don't forget to write us with feedback on our Facebook page at https://www.facebook.com/IMreasoning

or on our webpage at www.imreasoning.com

and write to us with your STC cases to imreasoning@gmail.com

Transillumination of the sinuses? shifting dullness? the puddle sign?

In this episode we poke fun and debunk our favourite "useless" physical exam manoeuvres that we continue to teach our medical students.  We couldn't cover all of them in one go, so stay tuned for more...

Try the app DxLogic on the iPhone to have a quick reference to the utility of many studied history features and physical exam manoeuvres.

Also, check out JAMA's series of articles entitled "The Rational Clinical Exam".

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!

Enjoy a short episode where we bring you our highlights of the DEM2016 conference in Hollywood, Los Angeles.

This is a very well-organised, relevant, and creative conference, and it just gets better every year.  Consider attending the next DEM conference.  Either in Boston in one year, or come to visit our neck of woods for the first Australasian DEM in Melbourne in May! You can get more information on the SIDM website:

http://www.improvediagnosis.org

Enjoy another instalment of Stump the Chumps.  Friend and colleague Anthony Jordan presents a case of angio-edema...and other symptoms.

Be the next one to present a STC case!  If you're willing to record your voice, write to imreasoning@gmail.com with a snippet of your case, and we will be in touch.

Remember to comment on this episode either on our Facebook page www.facebook.com/IMreasoning or on our webpage www.imreasoning.com

Also, if you have a chance you could rate us on iTunes to help spread the good word...

As promised, today's episode brings you an interview with Dr. Larry Weed.  We hear from the man himself about his vision for a healthcare revolution.

We would love to hear from you about this episode.  Do you think we are doing things right? Or do you think the way we go about diagnosis is fundamentally wrong?

This is part 1 of 2 where we explore the work of Dr. Lawrence Weed.  If you haven't already, before you listen to this episode, have a look at his 1971 Grand Rounds lecture to an audience at Emory University.

https://www.youtube.com/watch?v=qMsPXSMTpFI