Friday, September 03, 2010
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"Case reports in morning report style"


8/17/2010 : Per rectum

61 yo wm with hx of metastatic leiyomyosarcoma (lung, liver mets) and stage IV CKD presents to ICU from RHI rehab facility with nonspecific complaints of illness, headache, and diarrhea. He had been at RHI rehab facility for the past 2 weeks for PT/OT/memory ...


Jennifer Shoreman, Rohit Devnani : Indiana University School of Medicine


8/12/2010 : A case of One too many

51 year old white gentleman w/ h/o MI 2002, COPD presents with  acute LE edema and stomach swelling. Pt with 2 wk h/o LLE pretibial edema and 1 wk RLE pretibia edema and 1 day stomach swellling, associated with increased SOB  not relieved with combivent, + orthopnea...


Eric Benson : Indiana University School of Medicine


8/12/2010 : Unique Anatomy

Chief Complaint:  Chest Pain

Pt is a 49 yo male who presents with substernal chest pain that came on while he was sitting on the couch.  He described the pain as pressure-like with radiation to his arm that lasted about 30 minutes and was relieved with ASA and sublingual nitro h...


Nargiz Ruzmetova : Indiana University School of Medicine


8/12/2010 : The difficult diagnosis

66 yers old female transferred from OSH. Patient had history of gradually progressive Lt sided weakness, unstable gait, imbalance, falls, slower comprehension and responses o...


M Rizwan Khawaja : Indiana University School of Medicine


8/7/2010 : Always Thirsty

This is a 71yo WM with history of dementia, schizoaffective disorder, DM Type II, Depression, and CKD stage III who presented to the ER with weakness.  The patient has been seen in the VA ER 3 times in the past 3 weeks in addition to an OSH ER 1 time in the same time period with the same com...


Joseph Smith : Indiana University School of Medicine


8/5/2010 : We all need Structure.

The patient is a 70 F with pmh sig for chronic bronchitis and sputum cultures persistently positive with mutliple strains of pseudomonas. She had completed several courses of various PO antibiotics, most of which helped initially, but symptoms always rec...


Adam Mattox, DO : Indiana University School of Medicine


8/3/2010 : Bloated Belly

41 y/o male with h/o CF, pancreatic insufficiency, osteopenia that was on vancomycin and meropenem for 2 1/2 weeks in June, 2010 for a CF exacerbation, that presented with abdominal pain.  Onset of diffuse abdominal pain was 72 hours prior to admission, and p...


Christopher Chiu : Indiana University School of Medicine


8/2/2010 : Save the kidneys

52yo wm with h/o HCV/EtOH cirrhosis complicated by ascites and hepatic hydrothorax (MELD 25, Childs Class C) transferred from OSH with worsening pleural effusion and AKI. Hospitalized from 4/27-5/13/10 due to hypoten...


Chad Zarse : Indiana University School of Medicine


7/22/2010 : Solve the puzzle...

Renal team was consulted on 33yo WM with PMH of HIV and Crohn’s disease with multiple recent hospitalizations and complicated hospital course who had new onset Ac...


Vikas Kalra : Indiana University School of Medicine


7/19/2010 : my bloody nose...

63 yo wm with htn presented with sob, dizziness and fatigue which have been going on for the last 6-7 months, with progressive worsening. He also reports about 20 ...


Sausan Abouharb : Indiana University School of Medicine

he who studies medicine...

MORNING REPORT :

The morning report is a staple didactic session in graduate medical education. It dates back to the earliest training programs, particularly in large academic institutions. Despite variation over the years, it remains a fundamental venue of medical education as a problem solving exercise derived from an actual clinical case allowing for multiple learners to experience and work through challenging situations that colleagues have encountered. This group training imparts valuable lessons that are then applied broadly at patients' bedsides.

Due to increasing demands on residents schedules with decreased work hours and elevated patient loads, education has been forced into smaller timeframes and must be delivered in a more efficient manner. With the majority of time being spent during morning report on data reporting and not data synthesis, the ability to concentrate learning into a 30-60 minute time frame is hampered.

Further education is also lost when the board is erased as the knowledge of the presented case is lost to chalk dust. Because of this problem, many have used PowerPoint presentations as a way to display the initial history and data, but this has failed due to limited interactivity and inability to standardize these presentations.

The Internet has revolutionized medical education. With testing, text books, journals, and other educational material available online, it is the natural progression that day-to-day medical education will follow. We have devised a secure, online, interactive database-driven website which can simulate the process of morning report.

WHY FROMTHECASEFILES :

FromtheCaseFiles.com is a web based, interactive, database driven solution to years of frustration from chief residents. The web site allows for residents to place in the history, physical exam, labs, images, and a presentation that is able to be viewed during morning report as a projection and allows for the history to be presented quickly and labs/images to be viewed without switching to other systems.

The information is stored in an online database that can be searched in the future so that the interesting cases and their learning points can be shared with future generations of residents.

No programming knowledge is required to enter a case as simple forms guide through the process. Privacy is maintained with user restriction of data until verified by an administrator for general viewing.

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