Planner? I Barely Know 'Er! Also, Teleguided Training...

I am physically/emotionally/spiritually incapable of keeping a planner. When I was in grade school we were required to keep one and got graded on it. Mine was blank all week until about 10 minutes before it was checked off - I would frantically fill out what we did that week from memory. I’ve probably spent hundreds of dollars on blank planners, each one a false promise to myself, a check I can’t cash. Perhaps we will be judged when our earthly lives are through and I imagine being brought to account by being forced to fill out all those blank planners in retrospect. So, since my inability to plan/schedule haunts my every waking hour I have resolved to attack this problem in an unorthodox way that suits my established habits - I’m filling out my planner at the end of the day, listing the stuff I did. I’m gonna trick myself into a habit that’s easier to keep and eventually work it into a long con whereby I become organized [mostly] by accident.

If you zoom in at the bottom you might be able to read dating advice from a pharmaceutics professor.

Cal EM, Gunnell E, Olinger K, et al. Utility of tele-guidance for point-of-care ultrasound: a single center prospective diagnostic study. J Ultrasound. Published online February 10, 2024. doi:10.1007/s40477-023-00860-x

Permit me some brevity here. This was a prospective diagnostic study with healthy volunteers and ultrasound novices doing mock exams. Experts evaluated whether the images obtained would be diagnostic (using binary scale - useful (1) or not (0)) - for the heart, kidney, and gallbladder. The ultrasound newbies (at least 1 semester of human anatomy at some point and no ultrasound training) watched a video series on ultrasound basics and using the Butterfly iQ, then they each had 4 minutes to collect images from a standardized patient and submit. 15 of the newbs had no assistance (control) and 15 had assistance from a radiologist with 3 years ultrasound experience using the Butterfly teleguidance feature. I have used the Butterfly a lot (all of fellowship year and quite a bit before that when I was still a novice), but I have never used the teleguidance feature and it seems really cool. The person assisting via teleguidance can view patient and probe as well as the ultrasound views. They can also remotely adjust things like depth, gain, and scanning mode, as well as freeze the image, speak with the scanner, and DRAW ON THE SCANNER’S SCREEN IN REAL TIME. Haha, when I’m there in person I just use a laser pointer to indicate stuff on the screen (used to use my finger) and recently a group of residents expressed relief that I hadn’t brought it that day because apparently it’s so powerful the beam splashes off the screen and blinds them. I have since purchased a weaker laser. Anyway, no surprise here, the group with teleguidance help did better. Outcomes were image quality, diagnostic quality, and time to image acquisition.

The group with teleguidance found and submitted images faster (cardiac 35 vs 134 seconds, kidney 55 vs 149, GB 48 vs 169), scored better on a 5-point image quality scale (cardiac 3.46 vs 1.86, kidney 4.49 vs 1.58, GB 3.93 vs 1.50), and were way higher on the ‘ol diagnostic quality binary (cardiac 0.745 vs 0.198, kidney 0.968 vs 0.117, and GB 0.796 vs 0.058).

Taking advantage of some kind of teleguidance feature is a goal of mine for the upcoming year. If you have folks familiar with the software it’s no worse than having someone in person and it’s way better than having no one to guide you at all. The only thorny issue is patient privacy, so before you go off broadcasting yourself into random patient rooms to peep an LV or two run it by the risk folks.

I leave you with this ominously positive affirmation: “Everything will turn out fine. You cannot stop it.”