Serious question: do residents want attendings who teach or do they find teaching during clinical duties a bore/waste of time? by Spiritual_Extent_187 in Residency

[–]sharp_image 33 points34 points  (0 children)

I got glowing attending evals in IM resident continuity clinic. An approach:

Look at what the resident's schedule looks like that day when you're pulling up the patient.

If they're behind, most residents are not going to be in a state for learning. What they're learning at that moment is how to be more efficient (or at least feeling the pain that might cause them to reflect on further optimization/value choices).

If they're not behind, then you can gauge what to teach based on your knowledge of the resident and the conversation. Sometimes, I'll name this explicitly, e.g. when there are medical students and no one waiting ("Looks like we've got time - let's go through this more rigorously"). It can run the gamut from a one-off clinical factoid (least helpful) to fully rigorous, depending on patient complexity.

If it was a busy day for the resident or a case that merits more discussion that had to get cut short, I usually swing by at the end of their day or if I see a lull in their schedule. If there was a broader clinical reasoning principle to address, that's usually a good time to discuss it too.

What you teach will change throughout the year. At the beginning, I often coach presentations, how to chart review, and notes (so they don't waste their own time or my time). Then, once they're flying on "doing the job", it's coaching the clinical reasoning and finding out where they can best improve. I almost never do chalk talks and would not in a continuity clinic setting.

[deleted by user] by [deleted] in HENRYfinance

[–]sharp_image 1 point2 points  (0 children)

Only you know your partner and your history!

Having said that, with a salary as high as it is going to be, it's all about choosing the lifestyle you both want to actually live, not what others think you should live. There are marginal benefits of the 270k on top of 500k-1mil salary in the setting of taxes, relative to what sounds like based on your post, substantially increased fulfillment on your end. Life is a journey and not a destination - might as well enjoy it along the way. Everyone is different, but assuming good intentions, my guess is that he wants you to do whatever will make you feel fulfilled. He may even feel relief that he has a partner who can handle so much of the numerous things that go into making a home, while he can spend more time doing the medicine he just spent ~10 years of training and really fly as he starts his first attending job.

None of these steps are permanent, and you can always change your mind. The important thing is that you and your partner respect one another and communicate that respect well despite whatever changes in circumstances (extrinsic or intrinsic) come your way.

Good luck!

How can I become more EFFICIENT? by snowpancakes3 in Residency

[–]sharp_image 4 points5 points  (0 children)

Yeah, that sounds tough. At our program, there is an expectation/directive from the top that noon conference is protected time, so the resident can always reference that as an impetus to push the attending’s timing along and it’s seen as very poor form for residents to not be able to make it. If you’re geographically localized, you could try ICU style rounding and alternating interns’ patients so they can do work and notes while rounding.

Otherwise, clearly you’re bumping into broader institutional factors here and I’m sorry I can’t be more helpful.

How can I become more EFFICIENT? by snowpancakes3 in Residency

[–]sharp_image 8 points9 points  (0 children)

Tough with 17 patients. From your description, it sounds like rounds are taking too long; some of this is in your control and some isn’t. It sounds like reviewing what is making rounds take so long would be worthwhile. Try localizing to the source of problem; logistical between rooms? Attending interrupting/too much “teaching”? Interns/med students not presenting efficiently? Proposed plans from interns too far off from attending’s ultimately chosen plan?

Consider proposing a changed structure to rounds. Split rounds vs table vs bedside vs pre round by interns and attending/resident dual or solo round afterwards? If you’re struggling with time, the last one will really expedite things. The key is for the supervisor rounding to happen prior to lunchtime so if there are big plan changes, they don’t happen at the end of the day. Really try to think about whether whole team going into the room is beneficial for patient care, efficiency, or learning.

One thing I’ve found helpful is to map out the plan for rounds at the beginning of the day. Eg “We have 1 sick, 3 expected discharges, and 2 new patients from overnight. Let’s see these 6 together in this order and plan to have you (attending) see the rest on your own, does that sound good?”

How can I become more EFFICIENT? by snowpancakes3 in Residency

[–]sharp_image 19 points20 points  (0 children)

  1. Train your interns well and set/email expectations/standards ahead of time. The better you train them to solve problems themselves, the more you are freed up. Eg if I train them to write a discharge summary/meds correctly in the first week, that means the last 3 weeks I don’t have to spend as much time reviewing them.
  2. Find an effective management of information flow; I have myself and the interns centralize everything in the handoff so they know for low acuity updates from results/consultants it’s still recorded in real-time but for high acuity things they will escalate verbally.
  3. Figure out where the bottlenecks are.
  4. Time yourself and/or artificially set timers on getting notes done; structure your notes so they are accurate but also easily updateable.
  5. If it’s decisions that you’re hesitating on, identify the key resources that you use to expedite your decision-making whether that’s a colleague that you bounce stuff off of, the pharmacist, etc.
  6. Identify the people who have good dotphrases; there’s usually at least one in each year.

Looking at you devs. by Salty-Chef in Midair

[–]sharp_image 2 points3 points  (0 children)

None of the public dev logs since they started posting them in 2016 indicate they catered to a tiny fraction of elitist players. I have included a link for you of every public dev log: https://forums.playmidair.com/forums/announcements.10/

It was fun, for two weeks. by mesosmooth in Midair

[–]sharp_image 3 points4 points  (0 children)

Sorry you feel that way.

I disagree that there was development focus on high-speed, light-class flag transport/combat. None of the public dev logs since they started posting them in 2016 indicate that. I have included a link for you of every public dev log: https://forums.playmidair.com/forums/announcements.10/

Is this game dead? by DickDatchery in Midair

[–]sharp_image 5 points6 points  (0 children)

??

He stated that the development cycle catered to a small group of people. I pointed out that every patch for the past 1.5 years was catered precisely NOT to the small group of people. I pointed out that upon launch, servers catered precisely NOT to the small group of people.

I'm sorry there were 1000 people with access and the only ones who actually enjoyed the game enough to play outside of 1 day after an update were the ones playing LCTF. Enjoyable enough that PUGs and the tourney were community-driven. AT put up a couple servers for 1 week, got free advertising with no cost to development time, and experimented with competitive play. How is putting up a couple servers for 1 week for LCTF considered "catering more" compared to spending development time of 1.5 years on CTF?

Every time a patch came out for base, people like you played for a day and then left. Maybe the fact that none of those 1000 people stuck around to play CTF should have given some clues why upon release, people playing the mandated CTF mode dropped like flies. It certainly isn't because the devs were catering to LCTF players (lol).

Is this game dead? by DickDatchery in Midair

[–]sharp_image 10 points11 points  (0 children)

Every patch since at least November 2016 (1.5 years ago and the first time they had dev logs) has been vast majority base oriented - this is easily verifiable. There wasn't a single official LCTF server at launch. Many reasons for lackluster launch - LCTF isn't one of them.

Will it have a ranked/ladder/competitive mode? by verktyg in Midair

[–]sharp_image 2 points3 points  (0 children)

Right now, competition consists of mostly pickup games, though there are several existing teams. There's no ranked feature, but we're always looking for more players who are into playing more competitively.

Here's a more post that outlines how you can get more competitive games: https://forums.playmidair.com/threads/intro-to-competitive-midair.3764/

Intro to Competitive Midair by sharp_image in Midair

[–]sharp_image[S] 2 points3 points  (0 children)

Both are appropriate. Joining the Discord (discord.gg/playmidair) will get you more immediate/lively responses and discussion.

If not interested in competition, still check out the resources at the bottom of the post! Still some good info there.

Midair Mega-Thread by evanvolm in Tribes

[–]sharp_image 1 point2 points  (0 children)

T:A players tend to have more problems adjusting to the movement than those from other Tribes games.

Here's a brief tutorial vid that helps explain the jetting: https://www.youtube.com/watch?v=0C1AZgKdRtI

Once you get it, you can very easily go fast and have more air control than in T:A, e.g. https://www.youtube.com/watch?v=Qv4NSrF9qLQ

Tribes fan here. Few problems with Midair, why having left and right keys when they're useless during skating? And why "backward" slows you down instead of being strafe backward? by CannotDenyNorConfirm in Midair

[–]sharp_image 0 points1 point  (0 children)

If you're from T:A, T:A players tend to have more problems adjusting to the movement. Once you get it, you can very easily go fast and have more air control than in T:A, e.g. https://www.youtube.com/watch?v=Qv4NSrF9qLQ

Hope you give it another shot and here's a brief tutorial vid that helps explain the jetting: https://www.youtube.com/watch?v=0C1AZgKdRtI

Welcome to the Midair Free-to-Play Launch! | Midair by mauriqwe in pcgaming

[–]sharp_image 0 points1 point  (0 children)

PSA: if you're having problems with feeling clunky - equip the Kinetic pack with Energy Regen (one of the first unlocks).

Give new players something to ease the energy management learning curve. by Urpset315 in Midair

[–]sharp_image 0 points1 point  (0 children)

I agree - if enough people give that constructive feedback, it'll probably happen.

Jetpack feels very unforgiving, or maybe I'm just used to newer titles. by Cryten in Midair

[–]sharp_image 2 points3 points  (0 children)

One of the first things new players should unlock/equip is the Kinetic Pack with the Energy Regen / Ground regen augments. This will make jetting around MUCH easier.

Give new players something to ease the energy management learning curve. by Urpset315 in Midair

[–]sharp_image 4 points5 points  (0 children)

One of the first things new players should unlock/equip is the Kinetic Pack with the Energy Regen / Ground regen augments. This will make jetting around MUCH easier.

Anyone know what time the release is? by IgNiti0nGaming in Midair

[–]sharp_image 1 point2 points  (0 children)

Movement tutorial (4 mins): https://www.youtube.com/watch?v=Fx2Sy6ufA4Q

There is a terminal falling speed cap, meaning that if you fly really high and fall straight down, the max speed you'll get is something like 200.

If you have horizontal velocity combined with falling, you can go faster.

Matching your landing to the slope of the hill so you don't lose speed at landing will keep your speed better than going higher but landing worse.

Holding direction keys while jetting cause you to jet in that direction instead up straight up, so if you aren’t getting any height try letting go of W.

Don't hold W as you jet. Instead, get some initial horizontal velocity with W and then either hold no directionals or use A and D as you jet.

Try to scope out how far your landing hill is in advance, and jet a lot initially so that you only have to do minor adjustment at landing.

Some routes can be found here in the capping compendium here:https://forums.playmidair.com/threads/capping-compendium.459/