Ray and Tom Malioczi, better known as "Click and Clack, Tappet Brothers," stopped recording new episodes of NPR Car Talk in 201
Tom died shortly after that, in 2014. But the spirit of the show continues to live. And if you visit the doctor's office, you just win from her.
As it turned out, step by step the method of diagnosing injuries Ray and Tom can be applied to more than just a broken old wasp. Several doctors use the show to train medical students to diagnose the disease.
"I use clips Car Talk when I teach first-year students," says Dr. Gurpret Dhavaliv, a professor of medicine at the University of California-San Francisco. "I tell them that they are looking for key parts of the problem-solving process."
Dhaliwal is a lifetime fan of cars. In one of his favorite episodes, a surprised woman calls to complain that she gets shock every time she kisses her husband in a car. Ray did not take much time to poke on the decision – new tires that created static electricity.
– I listened to An Automotive Conversation when I grew up in my father's car in childhood, – recalls Dhavaliv. "I did not know mechanics, but recognized two people who had a good time when they laughed."
But when he entered the world of professional medicine, the show got a new meaning.
every weekend will listen to their podcasts, – explains Dhavaliv. "Once I said to myself:" My God, these guys are doing the same job that I have. They collect data, determine the problem and choose from several solutions. This is essentially what the doctor does. "
Since then, Dhaliwal has played segments of the show in his classes, he uses clips to study clinical reasoning – a process that doctors use to diagnose. He even published an essay on his approach to JAMA A few years ago
Clinical considerations may be difficult for young students, says Dhavilav, as doctors often receive information about their patient. If you are a beginner, it can be difficult to decide what is important and what no.
Dhaliwal illustrates how clips work in class
First, the subscriber describes his problems with the car. Dhaliwal will ask the students: "What is the main problem they are trying to solve?" Dhaliwal explains.
In one case of Car Discussion, "the problem was 1994 Chevy Lumina is making a chugging sound going uphill.
Then, Ray and Tom take a story.
"This is an old car with 150,000 miles on it," explains Dhaliwal. "The main problem when you spoil the slope is that you do not get enough fuel at very high demand."
Finally, the brethren represent a potential correction.
"They understand that there are only two plausible solutions," says Dhavilav. "Or there is a dirty fuel filter, or there are some bad spark plugs."
Identify the brand and model, that is, the main problem: take a story. plausible hypotheses for a solution.
Dhavaliv explains how he can work with a person.
"It looks like a healthy 25-year-old man with a cough," he says. "They should trigger possible solutions for this. Could it be pneumonia? Could it be a simple virus? Could it be something as serious as tuberculosis? And since they receive more data, they ultimately have to make a call and say which of these things is likely to be. "
Dhavaliv admires not only the mental skills of Ray and Tom. One more thing that he teaches to beginners is to imitate – their ability to build relationships with cheerfulness, kindness and humility.
And Dhaliw is not the only one who sees the parallel between the two worlds. Dr. Eric Goldstein is an honorary professor at the University of Washington School of Medicine. At the beginning of his career, Goldstein was trying to find an effective way to teach clinical considerations to new students. "I listened to the guy's car [Ray and Tom] to analyze the problem, the reason for this, and to come up with a diagnosis. I did not know anything about cars, but I could follow what they were talking about."
It was 90s, before Automotive Conversation was readily available on the Internet. So Goldstein began to manually fix the segments from the radio and play them during their lectures.
Many students in the first year of medicine are full of medical school, says Goldstein, and they are afraid to make mistakes. This hesitation can be on the way to learning. But diagnosing the problems of the car allows students to think about the process in a less stressful environment.
"This reduces the intimidation factor," Goldstein said. "None of them should be a car mechanic, so they are not afraid to make mistakes when they talk about cars." communicate with your patients. Dhaliwal addresses to a colleague, Dr. Gregory E. Brisson, who wrote an essay in May 2018 Family Medicine explaining how he uses a car metaphor to discuss sensitive topics
In an article, Brisson mentions one conversation. with a middle-aged patient who had a problem with sexual activity.
The patient, writes Brisson, described his problems as "not in fact the problem. ] … but not so when I was younger."
"He could not say this, so I helped him, "continues Brisson. "You do not need to go from zero to sixty. You are looking to go from thirty to sixty and stay on cruise control for a little longer. Is it so?"
Although Goldstein believes that Ray and Tom would be excellent physicians, there is one habit that students may not want to emulate: their bedding style. will die! "Said Goldstein. "You do not want to say such things when you meet your patients." He is on Twitter for @PaulJChisholm .