A good pair of trousers can't be bested but they can be worsted.
Rhea Liang
@liangrhea.bsky.social
General + breast surgeon, MedEd, DiversityAndInclusion, #KnittingLady (IT'S CROCHET). Bond University Clinical Curriculum Lead. Posts own opinion.
We've reached the point where caring is radical. #auspol
Bravo to the year 11 students doing hospitality cert III prac from a commercial kitchen. As one of the 'guests', I reckon this would hold up pretty well on Masterchef! 👏😋
Indeed. I have cared for “monsters”… but I have cared for them as I would any other patient. Because I don’t want the darkness to enter my heart. I have my own accounts with my conscience to keep straight.
I used to go to a practice that had all male doctors - over 10 of them but not one woman. The misogyny oozes from the corridors as all the nurses and admin assistants are women. A lot of work required for doctors still - surprised my sister made it to a specialist 30 years ago
This is great article. One of the great myths about assessment is putting people under pressure is a good thing. It's not. Pressure whilst managing a medical emergency is different and distinct to the pressure on feels in an exam. Pretending the two are the same really is absurd.
Rhea Liang@liangrhea.bsky.social · 2d agoUn-patient centred doctors? Maybe it's how we assess #MedEd. 'when we design assessments prioritising speed, we may reproduce... constant urgency, rapid task switching and unilateral decision making [and]... unintentionally equate speed with competence.'
Remember a colleague telling me their kid broke their arm in the US and needed a cast. Prescribed oxycodone for home. He chucked the prescription and bought some paracetamol. Kids was absolutely fine.
'Humanism always sounded like it should be soft and easy.' A hard-hitting read. How do you meet your professional duty and practice humanism when the patient has participated in violence, even mass crimes, perhaps directly harming a member of your family? 💔 #MedEd
Human first
Editor’s Note: Names and other details have been changed to protect the privacy of the individuals described.
academic.oup.com
Oh my goodness 😅 No significant correlations between perceived and measured competence in 29 [trauma surgery] procedures. By practising surgeons! Participants overestimated their abilities for ALL procedures. 😱🔪 #DunningKruger #MedEd www.sciencedirect.com/science/arti...
Discordance Between Perceived and Measured Procedural Competence in Trauma Surgery
The Dunning-Kruger effect is a well-researched influence on the abilities of individuals to accurately estimate their competence in any given domain, …
sciencedirect.com
In a world that rewards speed over competence (hello AI 👀)... go slower, go better.
Dark Matter Zine@darkmatterzine.bsky.social · 2d agoYep. In hubby’s first job post-uni, he wrote the fewest lines of code per hour BUT he was the most productive programmer, because his code had fewer errors AND he documented the code inside the code as he went, so editing was easier for everyone. Less haste, more speed.
Un-patient centred doctors? Maybe it's how we assess #MedEd. 'when we design assessments prioritising speed, we may reproduce... constant urgency, rapid task switching and unilateral decision making [and]... unintentionally equate speed with competence.'
Validity for whom? Unpacking assessment validity from an inclusion perspective
Click on the article title to read more.
asmepublications.onlinelibrary.wiley.com
Un-patient centred doctors? Maybe it's how we assess #MedEd. 'when we design assessments prioritising speed, we may reproduce... constant urgency, rapid task switching and unilateral decision making [and]... unintentionally equate speed with competence.'
Validity for whom? Unpacking assessment validity from an inclusion perspective
Click on the article title to read more.
asmepublications.onlinelibrary.wiley.com
It's a bit of a thump coming back to earth after the trip to Uluṛu. Will channel the energy of this ant I photographed making its way across a vast expanse of red dirt, grain by grain. 😅
Opioid use postop in the US is wild to me. Rest of the world: PROSPECT guidelines. Opioids as rescue analgesia only US: 90% of postop pts fill opioid prescriptions Also US: oh look, a small proportion get regional anaesthesia and require less opioids! 🤦🏻♀️ www.sciencedirect.com/science/arti...
Association of Regional Anesthesia With Reduced Post-discharge Opioid Prescriptions Following Immediate Autologous Breast Reconstruction: An ACS-NSQIP Analysis
Postoperative pain may be significant following mastectomy and immediate autologous breast reconstruction, and pain management regimens must be balanc…
sciencedirect.com
Proud owner of a masectomy scar here (plus survived a post-op bout of golden staph)! Very glad to be alive!
Male #BreastCancer is rare- 1,542 males (0.6%) vs 256,704 females over ~20 yrs in this study. But it's shocking there has been just one significant change in management in that time (de-escalation of axillary surgery) compared to the multitude of treatment advances for women.
Evolution of male breast cancer treatment: Results from twenty years of BreastSurgANZ Quality Audit data
Treatment of breast cancer in female patients has evolved over the past 20 years to improve outcomes, however it is unclear to what extent treatment h…
sciencedirect.com
Thoroughly enjoyable #MedEd gem from Dr Tasha Wyatt- could the solution to workforce distress and burnout be a (controlled) collapse of institutional norms, de-centreing assessments of 'success' for a professional identity that embraces mess and 'wildness'?
‘Still standing, quietly decaying’: How professional legitimacy in medical education creates trainee harm
Introduction For nearly a century, medical education has operated in a self-proclaimed state of crisis. Contemporary issues heavily focus on the escalating rates of trainee burnout, moral distress a...
asmepublications.onlinelibrary.wiley.com
Flying back the other way, the flight captain told us it's the fullest it's been since the 1970s! 💦🤯
Rhea Liang@liangrhea.bsky.social · last wk.Lake Eyre has water in it! Such a treat to be flying over this part of the country today, it's sooooo beautiful. We must look after it. 😍
Can't get over the whiteness of the bark of the ghost gums. Magnificent. 😍
Omg. I crochet during talks all the time. It's the only way I can focus. I love this
Thank you for sharing that! Beautifully written, calm and succinct. “…truth-telling is not betrayal—it is often the deepest form of compassion.” 💜
The sunrise this morning over the Cammeraygal Land wasn't bad either
The Uluṛu Field of Lights is huuuuuge! A 360 degree spin in it-
Amazing #MedEd quick read. 'I have found a new pedagogy—one that measures its success not only in cycles of chemo or exams passed, but in the courage to speak truth, the grace to relinquish control, and the humility to recognize that sometimes, the most healing thing we can teach is how to let go.'
Beneath the white coat: from hope to truth
Editor’s Note: Names and other details have been changed to protect the privacy of the individuals described.
academic.oup.com
Rhea Liang@liangrhea.bsky.social · last wk.35.4% of pts with very high risk died within 48 hours of surgery, and 77.2% of those changed to end-of-life/comfort care in that time. This is clearly nonbeneficial. We all (pts and relatives included) need to get better at deciding when *not* to operate. jamanetwork.com/journals/jam...