Cardiovascular

Today’s inane image of the day:

Lilly’s Pathophysiology of Heart Disease was the textbook most, if not all of us used for the Cardiovascular block. I personally thought that this was one of the best textbooks I have ever read [and likely one of the only textbooks I truly read from cover to cover].

Block 1 [Neuroscience] was somewhat of a disappointment, so it seemed that it could only get better from there. And it did with our Cardiovascular system block.

Preface
I want to preface this post by noting that even if Neuroscience went relatively well, I believe that I would have still written a positive review of Cardio — lectures and assessments were as organized as they could be for a first run-through and every lecturer has been enthusiastic and extremely approachable. Not to say that there weren’t bumps in the road, but looking back, they were all minor and overshadowed by how smoothly everything else went.

How the block was organized
We had ~6 very packed weeks of lectures then an Anatomy practical and final NBME exam to wrap things up. Each week featured a “theme” — for example, one week we discussed acute coronary syndromes and everything related to them [i.e. atherosclerosis, hypertension, heart attacks, pharmacology, etc] then ended most weeks with a Clinical Case Study [more on this later]. We only had one TBL during the block, but I definitely preferred the Case Studies as the main form of active learning. Finally, each weekend a 10-question quiz opened up on our online course management site that was worth a couple of points [we had unlimited tries and the grade was whatever our highest scored quiz was].

As with previous courses, we still had Anatomy lab each week and in lieu of Radiology lectures we had Cardiac Imaging labs. Basically they were similar to what a Radiology lecture would be like, but since much of cardiac imaging can be done by Cardiologists now, it makes sense that they would teach us the material.

What I loved
The textbook. For most of the year, I have been learning primarily from lectures and Powerpoint slides and only referencing the textbook when I felt like something wasn’t clear. This seemed to be the most efficient way to study because most of our textbooks are really quite monstrous in size and some tend to have convoluted explanations. But when one of my classmates pointed out how clear and concise Lilly was, I decided to try it out… and was pleasantly surprised. There are a bunch of extremely helpful figures and tables nestled into each chapter and the text is really very readable. Furthermore, it’s compact… so it’s manageable to read and portable [I took it with me to California over Spring Break without breaking my back!].

Clinical Case Studies. I wasn’t sure what to expect from these, but was very satisfied with how they turned out. Basically, we are given a short Powerpoint file with a history of present illness, past medical history and pertinent information from the physical exam and are expected to come to the session with a problem list, differential diagnosis and an idea of where to go from there [i.e. what labs/tests/imaging studies to order]. During every session, there were a ton of Cardiology fellows around [so many that each group had one!] to guide us through the process. We would start with discussing what we prepared and our thoughts then the fellow leading the case would ask the whole group what to order next. The complete Powerpoint file for each case contains links to the results of various tests [or to a slide that says a test isn’t indicated] as well as further information. Finally, every case had some sort of twist so we had to try to put the clinical picture together and determine what might have gone wrong [we’re basically pretending to be doctors on a case in slow motion]. Overall, I definitely learned a lot from these sessions — passive listening to lectures can only get you so far [and that’s not very far when you’re sleep deprived] so this form of active learning was definitely welcome.

The organization. I really cannot stress the importance of this enough. The week’s lectures were opened up ~1 week in advance. Only minor modifications were made [for the most part — there were maybe a few lecturers that made significant changes to the presentation, but that’s bound to happen]. The schedule did not suddenly change on us. For the most part, we knew what to expect and how to prepare for it.

The weekly quizzes. Since we had as many tries as we wanted and only the highest grade counted… this was an extremely low-stress way to force us to review material. Even if I didn’t want to take my notes, it forced me to at least think about the material, even if I was guessing on some. [I think I racked up something like 20 tries on one quiz because I refused to flip through my notes…heh!]

Weekly lunch/review. At the end of each week the lecturers came in to answer any of our questions from past material and also brought pizza/salad with them. Even though it felt kind of wrong eating cheesy, buttery goodness while discussing atherosclerosis… well… everything in moderation, I guess.

Final exam. Although things were different this time around, in retrospect, I loved the changes. Not only did we get an NBME exam that was taken using their USMLE examination interface [that’s right! we’re getting experience now with that rather minimalist interface! I’ve become a computer-strikeout-answer pro — yes, it actually takes skill to learn how to strike an answer out…], but we also have the whole weekend off. Yes. All 2.5ish days of the weekend are free! Woohoo! So, although I have no idea if I passed this exam… at least the weight of it has been lifted and I have a glorious weekend of decompressing ahead!

What could be improved
Lack of suggested reading assignments. [This is a minor point.] For the most part, Lilly’s chapters correlated with the week materials [e.g. during our valvular week, I read the valvular heart disease chapter], but sometimes I wished the lecturers would point out important pages to preview or review. Not all of the professors used images from the textbook, but for the ones that did, it would have been easier to keep up earlier on [I figured it out within a couple of weeks, but still…].

Communication. Everyone working in a group setting could work on this [myself included!] and I think that you can always fall back on this as an area of improvement. Specifically, I thought that although I really enjoyed hearing certain things over and over again, that sometimes the redundancy was a bit too much. For the most part, each lecturer knew what the other lecturers discussed, but there were still some times when I heard the same concept repeated almost the same way and I didn’t think it really helped much. This is most likely a preference thing, though.

Consistency in quality of lecture slides. As with any academic institution, some Powerpoint presentations are formed better than others. Truly, I think it’s an art — being able to cram a ton of important information into slides and keep it interesting? Well, that’s quite difficult and I don’t claim to know the secret to doing this well, but with how many slides I’ve seen in my years… I have an idea of what I like. For example, placing images on a slide without labels doesn’t really help us when we go back to review the slide: Is that little black thing the problem? Or is it that white stuff? Or maybe that growing thing off the side? Wait, is that normal? Or, putting a couple of words on a slide: Mitral valve, stenosis, regurgitation. So I just used up 1/6 of my page to print 4 words? I’m trying to be environmentally-friendly here! 

For the most part, this wasn’t a problem, but hey, it doesn’t hurt to mention it.

Time in lecture. Being the person in charge of turning on the recording equipment and assisting the lecturers with their education technology needs [i.e. where did my Powerpoint file go? how do I go back? why did the screen go black!? *throws hands in the air*], I need to be at every lecture. Of course, I could have someone cover for me… but I’m pretty proud to be one of the few ridiculously dedicated lecture-attending-students [you know who you are!]. Anyway, we spend a lot of time in lecture and sometimes I find that it is more detrimental than helpful to sit in our rather uncomfortable lecture hall chairs [future classes, you are so lucky]. There are definitely some places that could be shaved down as to reduce a couple of hours each week of lecture-time, but I understand that with the first run-through that everything has to be as complete as possible.

Final thoughts
Dr. Goldstein and Dr. Augustyniak [I couldn’t find a link for him anywhere…] really did a wonderful job with this course and overall, I’m extremely satisfied. Our Respiratory block is starting off strong on Monday… but it’s Friday now so I’ll worry about that stuff come Sunday evening.

Have a wonderful, relaxing weekend everyone!