SPIT to teach in the ED

by Sonny Tat
Children's National

Teaching at the bedside in the ED can be challenging. We're often pressed for time and its hard to gauge the level of your learner. Maneesha Agarwal, a 3rd year PEM fellow in Charlotte, NC suggests in a recent post on the PEMNetwork blog that one approach might be to broaden the differential and SPIT.

Serious
Probable
Interesting
Treatable

According to Maneesha, here's how the technique works:

• The learner comes up with at least one unique diagnostic possibility for each letter of SPIT for the patient in question.
• You can discuss it as part of the patient presentation or even after reviewing the triage summary before seeing the patient.
• It can vary depending on your learner and personal style.
• Some even have learners write down their responses on an index card prior to discussion!

SPIT is a quick, interactive way to help the learner to get into the PEM mindset by thinking broadly and specifically. Check out the post, read the example, and see if SPIT works for you and your learners.