The Spiderman Ride.... at Disney???

It appears that Disney has bought Marvel... Does this mean there could be a Spiderman ride at Disney and Universal?

Cardio test is done, and it wasn't too bad. Now I have to blitz to get ready for Heme/Onc, which should be the harder of the two by far. Only two days left.

The end of an Era

No I'm not talking about Ted Kennedy. The PBS show Reading Rainbow is going off the air after 26 years, which is longer than I have been alive. A sad day for us all.

Moving Along

My first "mini" block is almost over and I am gearing up for tests next Monday and Wednesday. Cardio has been a great course, mainly because our instructor is excellent. Heme/onc... well lets just say it is hard.

One year into medical school, I have essentially become a professional multiple choice test taker. One thing you must learn is how to grind through, and exploit, poorly written test questions. In medical school, most of the professors are NOT full time teachers. They come in for a month or two out of the year and teach their material. The questions they come up with have taught me that multiple choice test writing is a skill that comes to some naturally, and others not so much.

My friend Patrick found this sarcastic quiz online that highlights what I mean.

Can you answer these 6 questions about multiple-choice questions?

Posted in Instructional design, Writing tips by Cathy Moore on 27 August 2007

1. I opened a course on a topic I know nothing about, clicked through without reading anything, and took the assessment. I passed! What does that suggest?

1. I am a genius!
2. The assessment was too easy.
3. Maybe the course was too easy, too.
4. Maybe the course didn’t even need to be written.
5. b, c, and d

2. In a multiple-choice question, when is the longest answer the correct answer?

1. Rarely
2. Sometimes
3. It’s almost always the correct answer, and it’s often stuffed with new information that should have gone in the main part of the course but we forgot so now we’re putting it in the quiz because we can’t possibly leave out the tiniest detail
4. Occasionally

3. When is “All of the above” the correct answer?

1. With alarming regularity
2. When we try to cover too much in one question
3. When we use a question to teach instead of assess
4. All of the above

4. When is it NOT a good idea to avoid negative questions?

1. Never
2. Sometimes
3. Always
4. What?

5. How often is the correct answer a?

1. Usually
2. Frequently
3. Often
4. Almost never, because if a is the right answer, then the learner doesn’t have to read all the other options we spent so much time writing and revising, and where’s the ROI in that?

6. We can confuse learners when we:

1. fail to actually complete the sentence we started in the question.
2. inconsistent grammar in the options.
3. sometimes we veer off into another idea entirely.
4. wombats.

My tests are filled with questions like these, where half the battle is making sure you understand what it is you are being asked. Oh well... 4 months to go!

Source: http://blog.cathy-moore.com/2007/08/can-you-answer-these-6-questions-about-multiple-choice-questions/

Back to Work

As most of the people who read this blog know, Lisa and I were back in Michigan for almost all of the month of July. We spent half the time with Lisa's family, including a week at a cottage in Holland on Lake MI. The other half of the time we spent with my family, including a week in Disney World. Lisa and I had tons of fun back home and were happy to get out of the Houston heat for a while. The best part of the trip was getting to see family and friends, since we haven't had many chances to get back to Michigan since we moved down a year ago.

Unfortunately, my break came to a quick end. The Monday after we got back I started Block 7, which for right now involves Cardiology and Hematology/Oncology. One good thing about school this fall is that they have changed our test schedule in a way that I think will be less stressful. Baylor classes in previous years have had 10 weeks of classes in block 7; the first four weeks were dedicated to cardio and heme/onc as I have right now, with the remaining time mostly devoted to respiratory and renal. Then they would have a big week of exams over all of the subjects after the 10 weeks. This was hard because you finished taking cardio and heme/onc classes a full 6 weeks before the tests, and then you had to dig that information back up and get ready for a test in a very short period of time. The same thing would happen again in block 8, except it was even worse because the block ended with 10 exams over the course of 3 weeks, including the big end of basic sciences exam which you had to pass to move on to clinics (and several people did fail every year).

So, because of the wonderful complaining of the students above us, they changed it so that we have a test after each individual class, instead of just at the end of each block. So my cardio and heme/onc exams will be at the end of August, instead of mid October. I think this will encourage us to work at a more consistent pace and relieve stress during exam periods, even if there will be many more of them.

My new preceptorship for this fall is actually in the hospitals instead of at the Baylor clinic. While the cystic fibrosis patients I saw last year were very interesting, being in the inpatient setting is a good change. In the first week I saw a patient with diffuse/systemic scleroderma, and a very sick patient with newly diagnosed HIV/AIDS. The emphasis for this fall is to make sure we are comfortable enough with the physical exam to be somewhat useful on rotations and learn more of the abnormal findings that we should be looking for.

I think that this semester will be challenging but fun, and with only about four months to go before rotations, the light is visible at the end of the tunnel.

Lisa has one more week of break before going back, and I think she is excited for this coming year. Her program has been completely restructured, so instead of having a big group all at once for several hours a day, she will be pulling kids out one at a time or even going into the gen ed class rooms to work one on one.

Sorry for the long post!

Catch Up

Sorry about the long delay since the last post! I am playing catch up in school and my exams start in less than a week. This will be the end of block 6, my 11th straight month of medical school with only 2 weeks off for Christmas. Needless to say, I am ready for a break and thankfully it is coming up soon. For the month of July Lisa and I will be flying back to MI on the 6th, leaving with my family for Disney World from the 11th until the 19th, and then staying around until we head back to Texas on the 1st of August.

Besides the fact that vacation time is almost here, some other good news is that I just found out yesterday I was chosen for a spot on Baylor's Curriculum Committee. This is a group of administrators at the school who consider changes to the curriculum, organize feedback from students, and sometimes even advise the AAMC on what should be required course work for pre-medical students. There are two student representatives from each class, and I was picked out of the maybe 14 students who applied. It should be a fun thing to do, and the time requirement is really not too bad.

I also have posted some albums to my picasa site (click the my photos link on the right). There are a bunch of pictures from the graduations and a few shots of when Lisa's parents came down to visit.

One thing I discovered when we went to Galveston is that the octopus water slide thing at Moody Gardens is gone! This was one of the highlights of visiting Houston each summer growing up. Some of its arms were stairs leading up to its head, and others were water slides. Underneeth there was a sub marine with cool stuff inside. Now they have replaced it with a silly, generic looking water slide. Sad.

Paying for Health Care

I just read an excellent article in the New Yorker by Atul Gawande, one of my favorite doctor/writers (his previous two books, Complications and Better are both fantastic). He explains that the question that is being debated right now in Washington, who should pay for health care, is the wrong one. Whether a public plan exists or not does not solve the real problem, the ballooning cost of delivering medical care. An expanded medicare-type system might save some money through administrative efficiencies, but the real problem, as Gawande outlines, is over-utilization of services by patients and doctors.

Gawande shows in his article why McAllen, Texas has one of the highest per-capita spending rates in the nation, but doesn't necessarily deliver higher quality care. It turns out that the doctors in that area have developed a culture that creates high volume, high profit practices that generate much of their income from ancillary services. When doctors own testing facilities and equipment, they tend to order more tests and recommend more surgery because it augments their income. Plus, most patients still believe more is better when it comes to health care, so they agree to whatever battery of tests their physician orders (and their insurance pays for all of it too).

I agree that reducing health care consumption by restructuring the way physicians get compensated would do more than anything else to reduce health care costs. However, Gawande didn't really outline a detailed way in which this might work. Defining what a successful outcome is for a given patient and then coming up with a way to compensate appropriately is a very difficult thing to do. The team model, where a group of doctors is held accountable for the quality of their work and given a portion of the money they save by reducing over treatment would probably save lots of money, but who wants to go see a doctor who makes more money by giving you less care? The pendulum would swing towards under treatment, which Americans would never tolerate.

It is a very complicated topic and it will be interesting to see what Obama's health care bill will look like once it is done.

San Antonio

Lisa and I celebrated our first wedding anniversary last weekend (May 24th) in San Antonio. We decided we needed to get out of Houston and see some of the rest of Texas. We drove over to San Marcos first on Saturday, where we went to an outlet mall that was unbelievably huge. We both needed clothes and Lisa likes to shop, so it seemed like the thing to do. We then spent the rest of Saturday and Sunday and part of Monday in the city. Some highlights of the trip included the Mexican market, exploring the river walk and taking a boat tour, and stopping by the Alamo just to say we had been there. Our hotel was a Westin on the river walk and was the room was nice. Mom and Dad spoiled us with flowers and treats too!



The Mexican market was interesting because Mom and Dad apparently took a trip San Antonio about 20 years ago, where they bought some home decorations that I remember dusting many times during my stint as "key-tay." I saw the exact same vegetable hanging thing that is still in my parents kitchen (the one with the corn). Lisa and I bought a pepper one of our own for our kitchen.


You can check out all of the pictures from the trip by clicking the my photos link off to the right and looking at the San Antonio album. I apologize in advance for the quality of the photos. We forgot all of our cameras, so my cell phone's horrible camera had to record all of the memories for this trip.