C3.5 R2: Prepare and deliver educational seminar to pharmacists

During my ICU rotation, I presented on the management and use of fibrinolytics in submassive and massive PEs. The evidence regarding this topic is not very clear-cut and it was a great learning experience to try to figure out what I can help my audience take away from the available evidence and implement in their clinical practice.

Things that went well:

  • Flow of the presentation was fairly easy to follow and organized
    • Placed title slides for each section and provided and outline
    • Slides were generally not too text heavy
  • Paused at each section to check in with my audience and to see if there were any questions

Things I could improve on:

  • Continue to practice, practice and practice for my future presentations…I definitely still get very nervous and stumble during my presentation, but overall, I still feel that my delivery skills are improving with each presentation
  • Thinking back to my presentation… I realized that I had my back faced to a few of my audience members (whoops) and only turned back occasionally to ask if there were any questions.
    • For future presentations, I will try to position myself in a way that I’m not blocking the presentation and am able to observe most of my audience to better gauge their understanding

My preceptor kindly helped me prepare for my presentation and provided me with lots of pearls to keep in mind for future presentations:

  • Provide your own critique for each of the studies you present
    • Use the risk of bias domain tool to help present on the quality of the evidence (including internal and external validity)
    • Strength of a DB RCT shouldn’t be that it is randomized and double-blinded
    • Provide your own summary of each trial and your own conclusion
      • Consider the inclusion and exclusion criteria
      • Consider the type of patient population that was eventually randomized
      • Highlight benefits and risks
      • Consider what the audience can or can’t take away from the slide
  • Provide NNT/H only when results are statistically significant
  • When going over goals of therapy and whether the evidence supports it or not, provide more concrete support (e.g. NNH, NNT, citation)
  • When providing comparisons of drugs, include pharmaokinetic information:
    • Also consider: are doses equivalent between options
    • Think about how the drugs are used for other indications
  • Consider my audience and provide some practical application points/pearls
    • For instance, for this topic – providing information on whether or not anticoagulation can be started concomitantly with fibrinolytics and if not, how to decide when to start it? As well as answering what type of PE requires more monitoring and what kind of monitoring?
    • Also for submassive PEs, being able to justify whether you would lyse right away or wait for hemodynamic decompensation before lysing
      • An interesting analogy that my preceptor provided was that if a patient was pre-diabetic, would you prevent them from getting diabetes by giving them the treatment for diabetes?
    • Being able to explain the clinical significance of outcomes studied (e.g. hemodynamic decompensation)
  • If there is a lot of information to cover for trials, place them in the appendix at the end of your presentation
  • Where the evidence is more grey
    • Be able to justify whether you woud lyse or wait until you lyse
  • Studies using ICD-9 codes: good for information where disease states are very uncommon or outcomes are very uncommon

My presentation handout: Submassive+Massive+PE+Final