Page 6 - COM Outlook - Spring 2013

6 COM Outlook . Spring 2013
By OMS-IV Lauren Westafer
and publication process can take years and lack transparency.
Consensus guidelines? It can take hours for a group to agree on a
lunch order, let alone medical standards. Thus, guidelines often do
not reflect the current best practice.
In addition, much of keeping up in medicine exists in the process
of unlearning. It takes decades for the medical community to unlearn
a practice. Examples include the use of lidocaine with epinephrine
in digits (it’s safe), a cross-reactivity of 10 percent between penicillin
and cephalosporins (it’s 1 or 2 percent), and the notion that ketamine
should not be used in head trauma due to increases in intracranial
pressure (it’s now recommended in these cases).
Continuing medical education (CME) has traditionally filled the
role of educating physicians in a longitudinal fashion. Yet, CME often
comes at an extraordinary expense because it’s outdated, pricey,
and inconvenient. Physicians committed to a lifetime of learning pay
“Half of what we are going to teach you is wrong, and half of it
is right. Our problem is that we don’t know which half is which,” said
Charles Sidney Burwell, former dean of Harvard Medical School.
As my classmates and I prepare for graduation, I find Dr. Bur-
well’s words frightening. They highlight the gap in medicine between
when the best knowledge and evidence become accepted and
when that knowledge reaches the bedside. This gap, the knowledge
translation window, is estimated to be about 10 years. Thus, as
we embark on our lives as physicians, my peers and I are already
practicing in the past, circa 2003.
Why is this knowledge translation gap so lengthy? Physicians
and trainees are busy. It is difficult to maintain the fund of knowledge
acquired in medical school, clinical encounters, and journals, let
alone build on it. Furthermore, even recent journal articles and emi-
nent textbooks contain old information. The submission, peer-review,
A Look at Social Media in
Medical Education and CME