Background: With the increasing use of diagnostic imaging modalities, incidental findings (IFs) are a common occurrence in hospitalized patients. They present a unique challenge to hospitalists treating patients admitted for chest pain because of the ever shorter hospital length of stay. Very few studies have focused on describing the characteristics of patient with IFs. A […]

Background: Despite a commitment to high-quality medical education, diagnostic errors continue to be pervasive. Clinical presentations with nonspecific symptoms and diagnoses with wide differentials are prone to diagnostic errors; dizziness may be the epitome of this conundrum. Dizziness is a common symptom, costly to assess, and frequently misdiagnosed. Diagnostic decisions have high stakes, given the […]

Case Presentation: A 68‐year‐old woman presented to our hospital with worsening orthopnea 3 times during 1 month. On her first hospitalization, she was diagnosed with diastolic heart failure in the setting of a normal B‐type natriuretic peptide (BNP) and echocardiogram. Shortly after discharge she developed sudden‐onset dysarthria which resolved over several hours. The subsequent re‐admission […]

Background: Teaching trainees clinical reasoning is a critical skill for clinical teachers. Advances in the fields of cognitive science and educational theory have provided a conceptual framework of core concepts in clinical reasoning: problem representation, illness scripts, treatment thresholds, and test-treatment thresholds. Purpose: We designed a one-hour workshop to teach interns core concepts in clinical […]

Background: Developing contextualized curricula in diagnostic reasoning and clinical decision-making is crucial to improve medical education (1,2). Barriers to transition from classroom-based to workplace curricula include workflow constraints, the absence of standardized tools to assess clinical reasoning, the complexity of decision making, and outdated teaching methods (3,5). Aimed to bridge these gaps, we developed the […]

Case Presentation: A 57‐year‐old man with HIV (CD4 count of 7), not currently on antiretroviral treatment, presented with 2 days of fever and cough. On physical exam, he was found to have fever, tachycardia, and tachypnea with diffuse right lung rhonchii on auscultation. Chest imaging showed dense consolidation of the right upper, middle, and lower […]

Case Presentation: A 62‐year‐old man with diabetes and recent subdural hematoma presented from another hospital with lethargy. At transfer, he was afebrile, hypertensive, disoriented to time and place but able to follow instructions. He had a sixth cranial nerve palsy and anasarca. White blood cell count was 7500, urea nitrogen 48, creatinine 2.1, and albumin […]

Background: Clinical reasoning is a core component of medical training yet learners receive very little formative feedback on their clinical reasoning documentation. We hypothesize that this is related to the lack of a shared assessment rubric and faculty time constraints. Purpose: Here we describe the process of developing a machine learning algorithm for feedback on […]

Case Presentation: A 50 year-old African American male with type 2 diabetes requiring insulin, end stage renal disease on peritoneal dialysis, coronary artery disease, infertility, chronic pancreatitis, alcohol use disorder, and recent influenza presented with fever and cough. He was afebrile, hypotensive, tachycardic, and tachypneic with a leukocytosis and bibasilar consolidations on chest x-ray. He […]

Case Presentation: A 22 year old gentleman with no past medical problem presented with a gradually increasing swelling of his right forehead. He had a minor bump on a car door in the same area 2 weeks ago. He was evaluated in an urgent care & sent home on analgesic. As the swelling continued to […]