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Professionalism and Presenting Yourself in Social Media Carisa Champion-Lippmann Danielle Maholtz.

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Presentation on theme: "Professionalism and Presenting Yourself in Social Media Carisa Champion-Lippmann Danielle Maholtz."— Presentation transcript:

1 Professionalism and Presenting Yourself in Social Media Carisa Champion-Lippmann Danielle Maholtz

2 AUB  Nml cycle – bleeding every 28 days lasting 3-5 days 30-50 mL of blood loss  AUB is any departure from norm (too much, too little, inappropriate schedule)  DUB – idiopathic heavy and/or irregular bleeding that cannot be attributed to another cause (anovulation or oligoovulation)

3 Patterns of AUB PALM-COEIN classification system of AUB PALM-COEIN classification system of AUB PALM (structural causes) – Polyps, Adenomyosis, Leiomyomas, Malignancy/hyperplasia PALM (structural causes) – Polyps, Adenomyosis, Leiomyomas, Malignancy/hyperplasia COEIN (nonstructural causes) – Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not Yet Classified COEIN (nonstructural causes) – Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not Yet Classified

4 MENORRHAGIA  Excessive flw in duration (>7 days) or volume (>80 mL)  Caused by uterine fidrobids, adenomyosis, endometrial polyps; less endometrial hyperplasia or cancer or cervical polyyps  Teans should be tested for primary bleeding d/o (von Willebrand dz, ITP, platelet disfunction, thrombocytopenia from malignancy)  Test for CBC, platelet count, PT/PTT, factor VIII, von Willebrand factor antigen and activity

5 Cryptorchidism 1% 1 y/o boys Complete or incomplete failure of the intra-abdominal testes to descend into the scrotal sac U/l in most cases Characterized by an arrest in development of germ cells associated with marked hyalinization and thickening of the BM of the spermatic tubules In most patients the undescended testis is palpable in the inguinal canal Condition is completely asymptomatic, found by patient or the examining physiian only when scrotal sac is discovered not to contain the testis

6 * Regularly timed menses with light flow * Caused by hypogonadotropic hypogonadism (anorexic pts and athletes); Asherman’s syndrome (intrauterine adhesions), congenital malformations, infection, intrauterine trauma, OCPs/depo/progestin IUDs, endometrial ablation all have atrophic endometrium; outlet obstruction secondary to cervical stenosis or congenital abn

7  Metrrrorrrrhagia – bleeding between regular periods (less than normal)  Caused by cervical lesions, endometrial polyps, carcinoma  Menometrrrorrrrhagia – excessive (>80 mL) or prolonged bleeding at irregular intervals  Caused by uterine fibroids, adenomyosis, endometrial polyps, hypereplasia, cancer Metrorrhagia and Menometrorrhagia

8 Oligomenorrhea Periods > 35 days apart Caused by disruption of hypothalamic- pituitary-gonadal axis or systemic dz (hyperprolactinemia and thyroid d/o); PCOS, chronic anovulation, pregnancy, thyroid dz

9 Polymenorrhea Periods <21 days apart Usually caused by anovulation

10 Evaluation  History – timing of bleeding, quantity, menstrual hx/menarche, associated symptoms, family hx  Physical – rectal, urethral, vaginal and cervical causes r/o; PCOS symptoms (hirsutisum, acne, truncal obesity, acanthosis nigricans); thyroid dz (thromegaly, skin changes, diaphoresis, increased pulse); bleeding d/o (bruising, petechiae); PAP smear for cervical dysplasia and cancer; cervical cultures for infection  Lab eval (tailored)  Light skipped cycles – preg test, TSH, PRL, FSH (menopaus/POI)  Heavy/frequent/prolonged – preg test, TSH, CBC  F >45 with AUB needs endometrial biopsy to r/o endometrial hyperplasia and cancer (or obese if <45 – peripheral conversion of androgens into estrogens in adipose cells)  Pelvic US for endometrial polyps, fibroids, hyperplasia, cancers, adnexal masses  Sonohysterogram to see intrauterine defects if pathology on pelvic US  MRI to distinguish adenomyosis from uterine fibroids  Hysteroscopy to visualize intrauterine cavity  D&C provides tissue for diagnosis

11 Depends on underlying etiology Sypmtomatic fibroids/polyps – resection/removal Adenomyosis – hormonal regulation (OCPs, Mirena), endometrial ablation (done bearing children)/resection, hysterectomy Cervical polyps – polypectomy Endometrial polyps – Hysteroscopy, polypectomy +/- D&C, endometrial ablation, hysterectomy Endometrial hyperplasia – progestin therapy, D&C, hysterectomy Endometrial Cancer – Hysterectomy, BSO, radiation Hormonal Problems Anovulation – menstrual regulation with estrogens/progestins and weight loss Hypothyroidism – thyroid hormone replacement Hyperprolactinemia – DA agonists TREATMENT

12 DUB No pathologic cause of AUB identified Most pts with are anovulatory (ovary produces estrogen but no corpus luteum is formed and no progesterone is produced); continuous estrogenic stimulation of the endometrium without the usual progesterone-induced bleeding – endometrium continues to proliferate until it outgrows its blood supply, breaks down, sloughs of in irregular fashion Occurs in hypothyroidism, hyperprolactinemia, hyperandrogenism, POI/PMOF, adolescence, perimenopause, lactation, pregnancy Determine if pt is ovulating by basal body temp OR 21-23 serum progesterone Tx – NSAIDs for chronic, hormonal therapy (OCPs, OrthoEvra Patch, Nuva Ring) If estrogen CI (HTN, thrombophilias, hx DVT/PE, >35 y/o and smoke) can use progestin only options (depo, Mirena, Implanon) D&C, hysterectomy

13 Most Common Power Point Mistakes

14 Objectives Learn how to structure and give a strong presentation Learn some techniques that will allow you to communicate effectively Learn some personal etiquette rules to follow

15 Power Point Structure IntroductionContentConclusion

16 Introduction ObjectivesMotivation Prerequisite knowledge Agenda

17 Content Overview/Advanced Organizer Content matches stated learning objectives Skills/tasks to be learned were demonstrated effectively Current guidelines, recommendations, or studies incorporated

18 Conclusion SummaryReferences

19 Slides Easily digestible portions of information Directed attention at important information Font size/style made easily readable Color scheme/background appealing and not distracting Images/charts large enough to read easily

20 Delivery Room and materials set up according to needs of lesson Speak and enunciate well Body language should convey meaning and should not be distracting

21 Personal Presentation SpeechAppearanceTone

22 Tone Monotone vs. Emotion Should match your speech and body language

23 Speech Filler Words SpeedPronunciationEnunciation

24 Appearance Body language Stance Eye Contact Gestures

25 Etiquette Fun Facts At social events, keep right hand free for shaking hands Always say your full name Always stand when being introduced Handshake (practice) 10 second Elevator Speech about yourself and why you are at an event If you are at the dinner table you drop anything, don’t pick it up Business Cards

26 Dinner Etiquette B and D Fingers Turn cup over if you don’t want coffee or tea Fork and knife at end of meal Bread and Butter Passing around the table Fold napkin on chair when leaving table Place hand bags on the floor Cut food as you eat it Don’t drink while your mouth is full of food Don’t hand your plate to the waiter

27 Summary Keep your presentation simple and well organized Start practicing how you present yourself NOW, however often you want! Keep in mind there are some rules of etiquette for different situations and try to follow them. We gave you some but there are plenty of resources to continue learning from!

28 Professionalism “Professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served.” Representing one’s profession by encouraging trust from patients in their physicians.

29 Inter-professionalism The first priority of inter- professional education is to create an inter-professional team approach to healthcare and overall health care delivery. This is theorized to help increase communication, bring a better understanding of individual professional roles, decrease duplication, and improve patient care and outcomes.

30 Social Media/Electronic Information

31 Emails and Texts Professional Communication Err on the side of formality. Read/Edit/Spell-check Avoid excessive formatting. Forward with caution. Responding to sensitive or emotionally charged emails Rotations!

32 Social Media Who is your audience?

33 Legal Precedent/Guidelines Slow but evolving Based on jurisdiction Free speech?

34 School Policies 10% of LCME medical schools have policies in their student handbooks. Cyber bullying/stalking

35 Hospitals/Health Networks Many large hospitals and networks have media policies that tend to be more strict then schools.

36 Organizations/Profession COSGP “I do hereby affirm that I will represent and serve my fellow students in good judgment and diligence, always striving to uphold the principles of the osteopathic oath, so entrusted to me as a future physician.” Profession You represent yourself AND the organizations/groups/communities that you are affiliated with. Your professional status is reaffirmed daily. You are responsible for protecting that professional reputation.

37 What is concrete?

38 Tough Call A patient friend requests a medical student. o This is almost always inappropriate unless the Dr./medical student- pt relationship has ended. Even after the Dr. pt relationship has ended it would be inappropriate to discuss health related info. A medical student tweets that he just finished rounds with the residents on a pt and describes the clinical findings of that patient. - It’s difficult to be certain that info disclosed on twitter is not identifiable to that particular patent. The best types of posting would include very general information. Other posts by the same student could have indicated their medical school and current rotations leading to circumstances that indirectly indentify the pt. such as by naming a distinct disease or symptom.

39 Tough Call A med student writes in her blog naming an attending who did minimal teaching on rounds and recommending that other students not take clinical electives with that physician OR Med student posts to wall that half the class slept during student doctor Liu’s lecture. Legitimate critique of an education activity is appropriate so long as professionalism is maintained. There are ore effective and less public mechanisms for relaying this type of info and the student may be counseled accordingly. Med student posts photo of patient with good intentions and receiving the patients’ verbal ok. Without written consent this is a clear violation of patient confidentiality even if the pt is not named and no other identifiable info is used.

40 Tough Call Med student posts about how the hospital’s equipment they are rotating at should have been replaced years ago and is unreliable. The public disclosure of such info increases the liability for the hospital health system and is clearly unprofessional. There are legitimate and confidential mechanisms for improving quality at the hospital. Medical student posts that her teacher/attending wears too much cologne, has bad taste in clothes, has a gross mustache, and takes overly long lunch breaks. Inappropriate forum and set of comments and demonstrates unprofessional behavior by the student. There are legitimate and confidential mechanisms for addressing valid concerns in schools and the workplace. Medical student wearing a Mayo Clinic Tee-shirt has a picture posted of them at a bar clearly inebriated. 1) Hospital logo indentifies the affiliation to the institution and 2) The unprofessional behavior of the student is available for all to see, including future employers and patients. The med student did not post the photo but should do everything possible to have the photo removed and remove the tagging link to the students own Facebook page.

41 Ten Recommendations 1)Use good judgment. Think about how you want the public to view you as a person and as a medical professional since you represent your profession at all times. Don’t want to undermine your credibility or the reputation of your colleagues and affiliations. Think before you post if there are people you wouldn’t want to see what you are posting, liking, photos, etc. 2) Privacy Settings Many can view your Facebook so go to settings and click view as to see your profile as a random non-friend individual. 3) Check your school’s policy and that of the hospitals you rotate at. 4) Seek expert guidance. Some schools have a specific person to contact if you have any question about what is allowed and what is not. 5) Protect patient privacy.

42 Ten Recommendations 6) Respect work commitments (make sure not interfering with work commitments). 7) False and unsubstantiated claims and inaccurate or inflammatory postings may create liability for you. 8) Consider using a disclaimer such as the views expressed on this {post, blog, etc} are my own and do not reflect the views of my {school, rotation site, etc}. However this is not fool proof. 9) Respect copyright and fair use laws. 10) Protect propriety information.

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