Friday, November 7, 2014

Leading an Online Journal Club in Palliative Medicine #hpmJC

by Ollie Minton

Having come to the end of a medical education certificate I now know the value of reflection to consolidate the learning. However in the chaos of the real world and work and other things weeks go by without any chance to do so. One of the reasons I like using Twitter so much is the speed at which it moves and the diversity but it does not give you a chance to delve more deeply into any given theme. I am however committed and passionate about what I do as a consultant in palliative medicine both clinically, academically (when the chance arises) and through teaching (part of my day job).

I had the pleasure of being asked to host the September palliative medicine journal club (@hpmjc) run by Katherine Sleeman (@kesleeman) of the Cicely Saunders Institute London UK (@CSI_KCL). On this occasion, we had hijacked the very well established #hpmglobal slot hosted by Jim Cleary (@jfclearywisc). Despite printing off and yes actually reading in depth my chosen paper "Diagnosing Dying - an integrative literature review" – open access so everyone could read the full text – I felt suitably under-prepared.

"Piled Higher and Deeper" by Jorge Cham
www.phdcomics.com
I had organised my day and ward round to be able to do this but knew I was relying on a National Health Service computer (not the most up to date in the world) and was denied access to Tweetdeck or any other service that would screen and automatically hashtag my tweets. My efforts to produce multiple drafts had also been defeated by a recent twitter software upgrade. Nevertheless I felt I could be in charge for the hour (or at least direct the flow).

I was really pleased to see the global nature of the chat rapidly develop. There were inputs from people I followed and know in real life but also so many others I could not have predicted from across the world. In addition, there were also contributions from relatives and patient groups.

The discussion focused on the complicated areas of diagnosing dying and highlighted some cultural differences. We all agreed on the more active dying phase but it was the preceding areas that were trickier to judge. There was no overall agreement other than the need to educate other professionals on illness trajectory, communicate clearly with everyone involved and acknowledge uncertainty. While we as palliative care professionals are familiar with that – involving others may not be straightforward. I think we all felt that the review did not offer specific guidance on how to move forward.

Afterwards I was exhausted – the level of concentration required, not being face to face and avoiding the temptation to be too school-master like - not that I had any tools to use beyond the obvious. While perhaps not surprisingly more questions than answers were generated and the ubiquitous “more research is needed” formed a part of the conclusions it was a great discussion. I felt the best conclusion I could ask for was in this tweet:
A complete summary of our chat is here hosted by Symplur.

No doubt there is another journal club planned –  "Identifying changes in the support networks of end-of-life carers using social network analysis." on Monday November 17th 12n GMT; 11p SYD; 7a NYC -  I will be taking part. I am just glad that is all I will be doing….

Dr Ollie Minton, PhD, FRCP is a locum consultant and honorary senior lecturer in palliative medicine. Outnumbered 3:1 by ladies at home and by a worse ratio at work I survive as a consultant in palliative medicine research cancer, survivorship, and fatigue

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Image credit: Jorge Cham Reprinted with permission All rights reserved 

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