Another day in paradise

Once again, I spent much of the day in a case-based review course, this one on interventional radiology. In my practice, we have one real interventional radiologist and two pseudo-interventionalists. The prime difference being that a real interventional radiologist knows what he's doing. The other big difference is an IR enjoys what he is doing.

A PIR lives in fear of the next case. The interventionalist's job is complex, integrating modern diagnostics, direct clinical care, and rapidly changing tools. The PIR's goal in life is simple - try not to kill anyone on the IR's day off.

These case-based courses are very good. They use an electronic Audience Response System to foster audience participation in the class. It is harder, though not impossible, to fall asleep if you have to answer a question every two or three minutes.

About a thousand handheld gizmos are given out in the class. With each case, a series of multiple choice questions are asked. The audience has 15 seconds to choose an answer by pushing the corresponding number on their gizmo.

Once the votes were in, a bar graph of the tallies was immediately displayed. Most questions get a few hundred responses, which means half the class was asleep or too stupid to figure out their gizmo.

Each time I voted there were four possible outcomes:

1. Everyone in the class got the right answer. If my choice was not a guess, I could feel good that I was on par with my peers.

2. The answers are spread like shotgun pellets across the graph, but I got the right answer. If my choice was not a guess, I could feel even better knowing I was a little above average.

3. The answers are spread like shotgun pellets, and I got the wrong answer. Whether or not my choice was a guess, I feel stupid and hope the guys next to me didn't see me vote.

4. Almost everyone in the room got the right answer, but I did not. If my choice was not a guess, it should have been.

Unfortunately, this is pretty much how my day-to-day practice works, too.

It is supposed to snow here tonight, so I had to leave the meeting a little early to finish my Christmas shopping. Life is full of tough decisions.