Archive for the ‘Presentations’ Category
Poster Presentation Night
Posted on: May 22, 2010
On Wednesday, we travelled to Vancouver for the annual BC Residency Poster Presentation Night. During the afternoon, the evaluators came around to each our posters to ask questions. In the evening, we did a quick 5 minute Powerpoint presentation for pharmacists.
It was a long day but my poster turned out really well. I had some great discussions with renal pharmacists who showed up to the event.
Although, we did have some glitches and issues with the printing services department along the way. Everything worked out in the end. My poster is currently on display in the Renal Unit at RJH.
Here is a copy of my poster: HChui poster
I just finished off my last day of my “outpatient clinic” rotation. Overall, I learned a lot during the last few weeks.
Pain Clinic
- I did 4 full patient work ups. Some of the patients were very complicated but it was nice to have time to sit down and do a full work up without being pressed for time. The staff at the Pain Clinic were also very welcoming and appreciated having us around so it was a nice environment to work in. patient1 patient2 patient3
- Instead of doing a case presentation, I did an in-service for the staff. The topic I presented on was a new patch that is soon to be released by Purdue Pharmaceuticals. I did review some of the evidence but geared it more toward a non-pharmacy audience (which was a challenge because all the presentations I have done up to this point have been for pharmacists). I did not get a very good turn out unfortunately but I left some handouts for the staff and my email if they had any questions. Here is a copy of the presentation slides: bupherenorphinepatchslides
Anticoagulation Clinic
- I had a variety of different preceptors because my primary preceptor was away on vacation for part of the rotation. The first week I felt pretty uncomfortable because I felt like I had no idea what was going on. But once I got the process down and figured out how to organized the patients I slowly got the hang out it. I think I could handle covering it next year if they needed me to. I am also more comfortable with increasing and decreasing doses of warfarin, which I admit prior to this rotation I was not that skilled at.
- I also taught the Warfarin Classes twice a week on Tuesday and Thursdays. I really enjoyed the experience and most of the patients came out of the class saying they learned many things and they also had numerous questions.
- Lastly, I did photocopy some of my work ups and dosage adjustments which I’ve attached here: documentation
Pain clinic Journal Club
Posted on: April 15, 2010
Yesterday, I presented a JC at Pain Clinic rounds yesterday with Amrit Mann, a UBC pharmacy student, 4th year. We got good response from all the pain clinic staff. Here’s a copy: painclinicJChandout
Nephrology rotation…wrap up
Posted on: April 3, 2010
The last two weeks of my renal rotation were busy. I got to meet most of the nephrologists and participated in rounds with a couple of them. Some of the patient work ups presented to be a challenge as many patients have no idea what they are taking or live in a care home so it was a matter of tracking down their MARs.
One thing I liked about the rotation was I able to easily follow up on interventions I made because patients returned to the renal unit three times a week. For example, I suggested stopping a PPI in a patient who really had no indication for the drug and I was able to follow up, in person, to see if the patient started having any issues with GERD or dyspepsia the next week.
One of my goals for the rotation was to learn about calcium and phosphate metabolism in renal patients and how to manage patients with pharmacotherapy. Most of the patients had some issues with their phosphate and PTH so I had a lot of practice in terms recommending changes to vitamin D analogues and phosphate binders. Of course by now, I’ve become pretty comfortable with anemia management so I recommended a lot of loading doses for IV iron!
I’ve attached copies my journal club and case presentation handouts below:
Journal club handout: JChandoutrenal
Case presentation handout: renalpresentationhandouts
ICU Journal Club
Posted on: March 6, 2010
I had a great turnout for my journal club! It was a paper comparing the use of Vancomycin plus rifampin plus vancomycin alone for the treatment of nosocomial MRSA pneumonia. Here is a copy of my handout: JChandoutICU
Pediatrics Rotation – Wrapup!
Posted on: November 20, 2009
Last day on Pediatrics today! The rotation seemed to fly by. I really enjoyed working with the team of residents, MSIs and nurses. I had a lot of questions dosing and choice of drug therapy and it was nice to give my input. I ended up looking up most of the questions because I didn’t know a lot of answers. Here are a few things I took away from the rotation:
1) A lot of therapies are initiated without any real evidence. Unfortunately, there aren’t a lot of well done RCTs in the pediatric population so we have to work with what we have. An example is giving PPIs for pediatric GERD.
2) Getting children to take meds can be a challenge. I had multiple encounters where I had to convince patients to take their liquid antibiotics. Cefuroxime suspension is very bitter and most children don’t like it. The taste of it is also difficult to mask in yogurt or apple sauce.
3) Meticulously checking all doses! Normally I am able to look at a drug regimen (in adults) and know whether it’s an “appropriate” dose or not but with pediatrics you have to checking all doses based on mg/kg dosing.
I also presented a case on a contreversial topic: the use of prophylactic antibiotics in children. I had a hard time putting it together and worked really hard to make it interesting for the audience. Afterward, I got some great feedback so the hard work paid off I guess! Here is a copy of my slides: pedscasepresentation
Journal Club – Pediatrics
Posted on: November 3, 2009
Today I lead a journal club on the use of lansoprazole vs placebo in the treatment of symptomatic GERD in infants. Interestly enough, the study showed that there was no difference in “crying episodes” post feedings. Apparently, it is common practice to prescribe PPIs in infants who have regurgitation/crying/fussiness even though there is no evidence of benefit! Here is a copy of my one page summary: Pediatric Journal Club Handout
Internal Medicine – Final Week
Posted on: October 16, 2009
On Wednesday, I faciliated a journal club on an article which compared varenicline to transdermal NRT for smoking cessation. We had VGH teleconference but we were having technical difficulties and unfortuantely the JC did not flow quite as well as I would have liked. They were having trouble hearing our discussion so we ended up repeating comments multiple times. Here is a copy of my handout: JChandout.
An interesting patient I had this week was a 69 year old patient admitted with acute HF exacerbation. He also had atrial fibrillation and is on warfarin for stroke prophylaxis. His INR was 5 on admission (but was not bleeding) and is also taking clopidogrel due to a history of TIAs. The senior resident wanted to continue dalteparin 5000 units daily for VTE prophylaxis. But I was concerned with an increased bleeding risk and the patient was technically already protected from VTE due to his “supra-therapeutic INR”. After a long discussion, the resident reluctantly agreed to stop the dalteparin. I have had doctors refuse to take my recommendations in the past but I was genuinely concerned that the patient would have a severe bleed if we did not intervene.
Five weeks goes by fast! Friday was my last day. I do admit I was getting a bit overwhelmed with the number of patients I had to cover but I made it through. A few things I have taken away from the past five weeks:
1) Developing a relationship with other health care professionals is really important. I had the opportunity to work with one geriatrician who was very appreciative of my suggestions and often came to ask my input. The same relationship is also very important with nurses too. I got to know a few of them and they would often ask me questions about what was on the formulary and this is where my experience in the dispensary came in handy! Nurses are also a great source of information because they interact with the patients so much more than we do and have great insight into things such as pain control, bowels, mood, etc.
2) Learning to juggle your patients. I had up to fourteen patients I think at one point and toward the end I admit that I got a bit overwhelmed as it was my first rotation. I developed a word document to help me keep track of progress and basically updated it with relevant information.
3) Backing up your recommendation is very important. This is something I struggle with when I write my SOAP notes. I know what I’m going to recommend most of the time but giving concrete reasons is something I am having difficultly with for some reason. This is something I really need to work on over the next couple of months.
Lastly, I’ve attached a copy of my slides for my case presentation. Geriatrics case presentation
Journal Club – HORIZON trial
Posted on: August 25, 2009
Today I facilitated my first journal club as a resident! I was a bit nervous because I haven’t done a journal club since 4th year but there was a good turnout. I tried as much as I could not to “lecture” and attempted to ask the group questions and people participated so it was good. I was scared that I would ask questions, no one would answer and I would be the only one talking! Here is a copy of the one page summary I prepared (HORIZON summary).
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