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pathrat

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So I've been handed the job of arranging our conference schedule for the next year (hooray!) and I'm looking for some new ideas for the schedule.

How do your programs do unknowns?

Do you have any conferences that people really enjoy?

What about CPC conferences? Any good formats that your program uses?

I appreciate the input, as our conferences are sometimes, frankly, quite sucky.
 

MirkoCrocop

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Whatever you do, don't do what I did and stop scheduling them lol
 

mlw03

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the best conference when i trained was one led by a really, really good old-school surg path guy. it was not done as an unknown, rather a benign type of pimping at the multi-head scope. residents were encouraged to give recuts of their good cases, whether they were zebras or nice examples of classics. questions were pgy dependent, so the first years were asked about the warthin tumor, while the seniors were asked about the small round blue cell tumors of the sino-nasal tract. these conferences were voluntary, and still got better attendance than many of our required conferences.

another good one we had was a gross path conference. residents submitted good examples of gross findings, and a faculty member or resident tried to get the diagnosis via a 20 questions type of format. it was generally pretty low-key and fun.
 
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pathrat

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I like the idea of a twenty questions format.

Right now our gross conference is extremely painful. Bad, old pictures with one attending who, while admittedly VERY good at gross diagnostic skills, is hard of hearing so every time you offer an observation or answer, he can't hear you and just repeats it again, or will fuss at everyone for not knowing the answer, even though someone just said it. It's a little monotonous.
 

Napoleon1801

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We started doing clinical pathology unknowns, ie micro plates, Hb electrophoresis, and flow unknowns. It's just a trial right now, but so far people here have liked them.

There are also a fair amount of webinars and podcasts out there via CAP and other organizations.
 

Euchromatin

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We have some very good conferences, although a lot of the more popular ones are fairly dependent upon having attendings who are good teachers/willing to put in some extra time.
I'm not sure what you mean by a "CPC" conference...

For AP we have two types of "unknowns" - once a month we have a more formal conference that all of the attendings and residents attend. The attendings take turns selecting cases for this conference, which we usually get 1-2 weeks prior. During the session we have to show the slides ourselves, describe the features, give a differential and also discuss what additional studies/stains we would want and be prepared for additional pimping.

Many attendings will also give us "unknown" slides to review a day or two prior if they will be using them for a multi-headed scope-based lecture. Those are usually easier to prepare for because we all know what the topic/organ system is and the pimping during lecture is usually pretty benign (and PGY appropriate).

We have CP "unknowns" twice a month - one session is hemepath and the other alternates between the other fields (chemistry, molecular, blood bank, micro, etc.). These are usually pretty useful, depending upon what the attending running the conference decides to do. Hemepath staff usually give us slides of PB, BM, LN or body fluids. The other attendings usually give us some sort of practice questions/cases which they may or may not hand out ahead of time. A lot of the residents particularly like it when the blood bank director uses questions to make a Jeopardy game.

Once a month our program director does a board review conference which is excellent. It is run like a mini-test and she usually shows images (gross, micro, EM, etc.) and the questions are a mix of primary "what is the diagnosis" and secondary/tertiary-type questions. We then immediately go over the answers during the second half of the conference. She'll occasionally make up a slide-based quiz too.

Another conference that we don't have very often, but people really like, is an attendings vs. residents Jeopardy game (called the "Gross Bowl") that the chief resident(s) make up once or twice a year.

I'm not sure about other topics, but I would NOT recommend the CAP lab admin/management online webinars/VMCs. We did those my first year and the vast majority (all except for one or two) sucked. They were a complete waste of time and were often not geared towards residents/M.D.s and/or the speaker was mind-numbingly boring. Our head of CP decided to start doing a lab admin curriculum with us instead, which is much better.
 

Torsed

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We started doing clinical pathology unknowns, ie micro plates, Hb electrophoresis, and flow unknowns. It's just a trial right now, but so far people here have liked them.

There are also a fair amount of webinars and podcasts out there via CAP and other organizations.

These would have helped me a lot in residency training rather than suffering through them by oneself as I did.
 

KCShaw

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One of our senior residents did a sort of RISE/board questions jeopardy-type conference for a while, but it was a lot of work and had to be held early in the morning -- and despite people liking it, we didn't have many "morning people" at the time. I like the idea of doing gross conference with good images (nothing beats the real thing, but there's a lot of surrounding work to preparing & washing specimens prior and putting them away after), although not every place regularly photographs their gross specimens to begin with.

Personally I liked a conference we did in which 1 or 2 residents would be expected to bring some slides and do a short teaching session at the scope, rotating the responsibility every week -- total 30 min to an hour. It was pretty low pressure -- the leading resident had plenty of time to prepare, and everyone else was mainly there to learn rather than be tested, although I seem to remember most of the time the slides were available to preview ahead of time. People seemed a lot more free to chat about what they found useful or difficult to remember, and seemed to share their approaches more freely in the absence of a grizzled attending (although occasionally an attending would sit in, they were good about sitting back and only piping in if things got stale or someone went way down the wrong track).

Also, personally.. be wary about how many teaching conferences you have. If they're all good and everyone gets something out of them every time, great, but there can be such a thing as too many conferences, just as there can be too few. I would much prefer having a couple of high yield conferences every week than one every single day that required preparation time I already didn't have or during which my only focus was to try to stay awake. Some conferences can be held every other week or even monthly -- just depends.

On the CP side, we had a CP call-review conference each week which was usually pretty useful and low stress, during which the week's calls were used for teaching points and everyone got to hear/learn how they were handled (or should have been handled).
 

Euchromatin

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On the CP side, we had a CP call-review conference each week which was usually pretty useful and low stress, during which the week's calls were used for teaching points and everyone got to hear/learn how they were handled (or should have been handled).

We do CP call review as well (although only once/month). From your description it sounds very similar to what we do - go over the calls and how they were handled. Unfortunately, I feel that our conference is not particularly educational. Probably because I think most of the crap that we get saddled with as part of our resident CP call is not very educational. The vast majority of calls are 1) nurses/phlebotomy calling to ask "Can we draw an aPTT through a line that is running heparin because the patient has no other access?" and 2) calls at 1-2 am from our outreach lab client services department dumping the responsibility for critical lab values on us when the clinician who ordered the test cannot be reached.

Occasionally some discussion of how a new acute leukemia or blood banking/transfusion issue was worked up might be slightly educational, but no one brings slides/takes pictures or anything (and they tend to be less common calls).
 

KCShaw

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The vast majority of our calls were blood bank/transfusion related, our attendings were generally good about finding teaching points, and our residents were actually pretty decent about asking questions or presenting a case with a question or issue rolled into it. That said, these were often not 1 full hour of just conference time (more like half that) and I seem to remember a lot of sandwiches, so we must've either had them with breakfast or lunch; food tends to make a lot of things better.

We got a few of the "critical value dumps" for a while for outpatients as they tended to be batched during night shifts, but I tended to rant about how idiotic that was and either policy changed or the techs got scared enough to substantially slow the rate of such things. I don't remember exactly the outcome, but there was also some talk about an additional form for doctors of outpatients regarding critical values to absolve the lab for not contacting them, which wasn't so much driven by annoyed pathology residents but by some of the physicians of outpatients who didn't want to be called at 2 AM about out of whack electrolytes or whatever in their outpatient chronic/cancer/dialysis/hospice patients. If anything, they were louder and used naughtier words about being contacted than I did about the dumps.

We did -not- get very many other CP related calls during the middle of the night -- occasionally during the day, but most of those questions were funneled through the relevant lab directors (micro, chem, etc.) and any resident on those services, rather than going to the "CP call" pager.
 
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