1. Teaching first year medical students together
Mr. Huub Kooijman
Dr. Marlies Wijsenbeek
Getting prepared before the lecture

2. Differential diagnosis
Symptom
The patient:
Mr Kooijman
The doctors:
the students
History
Physical examination
Problem
Differential diagnosis
Additional tests
Working diagnosis
Treatment
Disease course

3. Story and symptoms Shortness of breath 2012
After 5 months refered to hospital

4. We ask the students: What investigations do you need?

5. HRCT-scan
Normal lungs
My fibrotic lungs
Fibrosis

6. Letting the students know the impact of telling a patient that he or she has a deadly disease
Survival in IPF is worse than in many cancers.
Vancheri ERJ 2010

7. No medication that cures IPF
Screening longtransplantation
Shortage of donor organs
Long waiting time
People die while on the waiting list
Inmense uncertainty

8. Lung function went down and down over time
Normal lung function range

9. On the heart-lung machine
Telling student what this does to a patient to be completely depend for your life on a machine and many people

10. 4 june 2015 lung transplantation!!
new lung
old lung

11. Lung function after transplantation
Lungtransplantation

12. Why patients should tell their story
Appearance may be misleading
Impact leads to remembering
Improved recognition of (rare) diseases
Emotional side of having a deadly disease
Impact on family
Also acknowledging emotions of the doctor

13. Let patients speak THANK YOU Together looking back at a lecture
And looking forward to many more to come
THANK YOU