The Facts Karla M. Ku - The Methodist Hospital

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We Welcome your questions a nd comments inquiries and letters to the editor can be directed to jmdhc@tmh.tmc.edu. William l. Winters, Jr., Md Editor-in-chief Journal of the Methodist DeBakey Heart Center Journal of the me thodist deBake y he art center Volume 2, numBer 1 William L. Winters, Jr., M.D. Editor-in-Chief Sheshe Giddens Managing Editor John K. Dietrich Assistant Editor Advisory Board: Christie Ballantyne, M.D. Stan Duchman, M.D. Raphael Espada, M.D. Robert Hust, M.D. Karla Kurrelmeyer, M.D. Mike Reardon, M.D. JMDHC provides an update from Methodist DeBakey Heart Center specialists about leading edge research, diagnosis and treatment. U.S.News & World Report ranks the Methodist DeBakey Heart Center’s cardiology, cardiothoracic and vascular surgery programs number 16 in the nation. JMDHC is written for physicians and should be relied upon for medical education purposes only. It does not provide a complete overview of the topics covered and should not replace the independent judgment of a physician about the appropriateness or risks of a procedure or treatment for a given patient. © 2006 The Methodist Hospital Houston, Texas Methodist DeBakey Heart Center 6565 Fannin Houston, Texas 77030 Telephone: 713-DEBAKEY debakeyheartcenter.com
TO T E AC H I S TO L E A R N W i l l i a m L . W i n t e r s F r o m M e t h o d i s t D e B a k e y H e a r t C e n t e r a n d B a y l o r C o l l e g e o f M e d i c i n e , H o u s t o n , Te x a s How often have you heard someone say, “I learn more from preparing a lesson than my class will ever learn from listening to me deliver it”? It’s no secret that sharing personal experiences with others who have had similar experiences reinforces the message shared. Teaching and learning may be delivered in a variety of formats, especially in the field of medicine. I recently attended a superb conference structured around the discipline of echocardiography. As a disclaimer, I do admit to some bias toward echocardiography, having been seduced by the potential by-product of cardiac ultrasound some 40 years ago and then befriended by Drs. Inge Edler and Helmuth Hertz, whose fairly simple idea has blossomed into an extraordinary science. The message delivered at this conference was well prepared and presented. Some information was new, some old and revisited with new perspective, but when delivered expertly it is always worth hearing again. What has stuck with me after leaving that conference has been the message from the many case reports — including a brief clinical review and reports of the laboratory, ECG, X-ray and echocardiography findings — that were presented each morning. Echocardiography provided the opportunity to visualize the problem, discuss the pathophysiology, make differential diagnoses and highlight the important features. Each report was followed by a brief discussion directed by the case presenter and the moderator. The experience was absolutely spellbinding and guaranteed to have everyone awake and eager for the first lecturer. Upon my return, I came across an editorial by Dr. C. Richard Conti, editor-in-chief of Clinical Cardiology. 1 For those of you who enjoy reading editorials, I believe his are among the most interesting and informative around. His topic is case-based teaching and learning. He and I are of an era when presentations of clinical cases by students to mentors, followed by brief discussions by all involved, was a major modus operandi for teaching clinical sciences. That put the onus on all parties to be prepared. Over the years, as the sheer volume and complexity of medical information has increased, not to mention the array of diagnostic capabilities and therapeutic options, it is my perception that didactic lectures are now the standard when planning educational programs — albeit with fascinating technical computer tricks to keep attention focused. In years past, medical grand rounds at The Methodist Hospital was a major weekly event where physicians vied for the opportunity to participate. Slide lectures were important, but the really entertaining and educational programs were those in which clinical cases were presented and discussed. I don’t believe that has occurred for the past 20 years. Roughly 35 years ago, in an attempt to stimulate an educational collegial spark among those interested in cardiovascular education, a small group of us from the American Heart Association’s Physicians’ Education Committee formed the Houston Society of Cardiology. The format required participation on a rotating basis of physicians interested in cardiovascular medicine. Physicians, students and trainees from each major hospital in the city, most of which were in the Texas Medical Center at that time, were all invited to participate. Attendance at those monthly meetings often exceeded 100 individuals — far exceeding our expectations. Most presentations involved case reports, and it proved to be one of the most exciting and interesting educational enterprises I’ve ever been associated with. Prominent physicians joined in, among them cardiologists, cardiovascular surgeons, radiologists and pathologists. Rather than lectures, the cardiovascular surgeons presented fascinating surgical problems, the radiologists some unbelievable X-ray problems, and the pathologists those beguiling things we often overlooked as clinicians. On one occasion, Dr. Miguel Quiñones and I presented a town-meeting-type program around the discipline of echocardiography. We each stood at one side of a large screen and presented echocardiographic cases to each other with audience participation. It was a howling success, being entertaining as well as educational. Then a funny thing began to happen. After a number of years, respected guest lecturers began to appear in place of case reports. The requirement for program presentation by participating hospitals was dropped, and soon attendance at the meetings declined to the point where the American Heart Association lost interest and ultimately declined further support — ironic, given that the idea was originally conceived in the AHA Physicians’ Education Committee. I have always believed that a major culprit in the Houston Cardiology Society’s demise was the loss of local physician participation from the major hospital groups and the case-based teaching and discussion. As I read the editorial by Dr. Conti, I was reminded how echocardiography is the heart of cardiovascular imaging. Continued on page 28 JMDHC | II (1) 2006 1
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The Facts Karla M. Ku - The Methodist Hospital

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