scholarly journals P087: Pilot project: Implementation of a peer support network for geographically distributed learners in the NOSM family medicine/emergency medicine residency program

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S95
Author(s):  
T. Lyon ◽  
R. Ohle
Keyword(s):  
Emergency Medicine ◽  
Family Medicine ◽  
Peer Support ◽  
Residency Program ◽  
Medical Training ◽  
Pilot Project ◽  
Support Network ◽  
Difficult Patient ◽  
Formal Services ◽  
The Face

Innovation Concept: Residents bear an enormous burden of responsibility for patient care which can lead to stress and mental exhaustion, especially in the face-paced and acute environment of emergency medicine (EM). In addition to numerous demands faced by EM residents, being a member of a geographically distributive residency program presents many unique challenges from a support and wellness perspective. To address these issues we sought to implement a video conferenced peer support network in hopes to foster wellness in the NOSM Family Medicine/EM program, where learners are commonly separated for training. Methods: Participants completed a pre-pilot questionnaire that strongly showed interest for this type of novel network. Furthermore residents conveyed that they are reluctant to access formal services and commonly rely on co-residents for support. This pilot program intends to decrease barriers that geography and stigma create that negatively hinder seeking support throughout medical training. Keeping the network small, consisting of only co-residents maintains a collegial and confidential environment that enables colleagues to provide relevant help to one another. Offering this outlet allows the opportunity to debrief and share unique experiences, which can lead to improved knowledge and wellbeing. Curriculum, Tool or Material: Informal, co-resident run and easy to access sessions are held twice monthly and average one hour in length. Discussion topics commonly include residency issues, difficult patient encounters and challenging situations. These sessions are conducted via video conferencing making them easily accessible from a distance and also from a comfortable and convenient environment of the participants choosing. Residents have commented that this is a helpful platform to discuss important issues while providing and safe and confidential resource to help cope with residency challenges. Conclusion: Further data analysis is underway as we are in the initial stages of implementing the program. In the final stages (April 2018) a pending post-pilot questionnaire will be interpreted to explore barriers, limitations and to determine the role of the network going forward. If found to be effective it is something that can be implemented and adapted for future residents. Other programs can use this feasible model to increase wellness and foster the same supportive environment among residents, especially those separated geographically from peers who may benefit most.

scholarly journals LO42: Ice Cream Rounds: the adaptation and implementation of a peer-support wellness rounds in an emergency medicine residency training program

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S42
Author(s):  
S.M. Calder-Sprackman ◽  
T. Kumar ◽  
K. Sampsel ◽  
C. Gerin-Lajoie
Keyword(s):  
Emergency Medicine ◽  
Training Program ◽  
Peer Support ◽  
Ethical Issues ◽  
Ice Cream ◽  
Residency Training Program ◽  
Wellness Program ◽  
Difficult Patient ◽  
Protected Time ◽  
Poor Patient

Introduction/Innovation Concept: Emergency Medicine (EM) is a specialty that requires physicians to deal with acutely ill patients in a fast-paced environment, which can create stress, mental exhaustion and burnout. Continually changing working teams in the Emergency Department does not always allow appropriate debriefing for difficult patient encounters and outcomes on shift. To address these challenges, we sought to adapt and implement a peer-support rounds called ‘Ice Cream Rounds’ used in some Pediatric training programs for an EM training program. Methods: CCFP and Royal College EM residents were surveyed to determine interest and need for Ice Cream Rounds. Of the 31/50 respondents, 87% (26/31) identified their co-residents as their main source of support after difficult patient encounters and 71% (22/31) felt that current opportunities to debrief after difficult experiences were only “sometimes” or “rarely” adequate. Overall, 84% (26/31) were interested in attending Ice Cream Rounds. Residents expressed that they did not want staff present for Ice Cream Rounds so two residents (SCS and TK) obtained training to lead peer-support sessions from The Faculty of Medicine Wellness Program. Attendance at rounds was voluntary and the EM program provided funding for refreshments. Two Ice Cream Rounds were piloted. Attendance and feedback was recorded from pilot sessions. Curriculum, Tool, or Material: Resident-only, peer-run confidential debriefing sessions. Sessions were voluntary and lasted one hour. Approximately 20-30/50 residents attended each Ice Cream Rounds. Discussions were confidential but include topics such as difficult patient encounters, poor patient outcomes, challenges in residency, and ethical issues. In response to positive attendance and feedback, the EM program provided 3-4 one-hour protected time slots with a stipend for refreshments for future academic years. Comments from residents consistently reaffirmed that Ice Cream Rounds was a helpful forum to discuss important issues with colleagues and provided a safe and confidential resource to help cope with residency challenges. Conclusion: We adapted, implemented, and evaluated a novel Peer-Support Wellness Rounds for debriefing resident issues and difficult patient encounters in a EM training program. To our knowledge this is the first Canadian initiative to implement such rounds in an EM training program. We believe that this template can be easily adopted by any EM training program and will effectively address wellness challenges faced by residents during their training.

scholarly journals Ice cream rounds: The adaptation, implementation, and evaluation of a peer-support wellness rounds in an emergency medicine resident training program

CJEM ◽  
2018 ◽  
Vol 20 (5) ◽  
pp. 777-780 ◽  
Author(s):  
Samantha Calder-Sprackman ◽  
Thara Kumar ◽  
Caroline Gerin-Lajoie ◽  
Megan Kilvert ◽  
Kari Sampsel
Keyword(s):  
Emergency Medicine ◽  
Training Program ◽  
Peer Support ◽  
Ethical Issues ◽  
Dynamic Environment ◽  
Ice Cream ◽  
Resident Training ◽  
Wellness Program ◽  
Difficult Patient ◽  
Emergency Medicine Resident

AbstractIntroduction/Innovation ConceptEmergency medicine (EM) requires physicians to deal with acutely ill patients in a fast-paced and dynamic environment, which creates a barrier to debriefing after critical events. These unique challenges can negatively impact wellness. We sought to adapt and implement a peer-support wellness program called ‘Ice Cream Rounds’ in an EM residency setting.MethodsA needs assessment survey was conducted among EM residents at The University of Ottawa to gauge interest and obtain resident input regarding program design. The structure of the sessions was adapted from similar initiatives in Canadian Pediatric Residency programs.Curriculum, Tool or MaterialConfidential peer-support sessions were created and piloted. Residents preferred peer facilitators, rather than staff, so two residents obtained training the Faculty of Medicine’s Wellness Program to lead sessions. Attendance at rounds was voluntary; however, overall attendance was recorded along with feedback from pilot sessions. Discussion topics included difficult patient encounters, poor patient outcomes, challenges in residency, and ethical issues. Post implementation feedback demonstrated that Ice Cream Rounds was a helpful forum for residents to discuss important issues with colleagues.ConclusionsThis is the first Canadian EM training program to adapt, implement, and evaluate peer-support wellness rounds for debriefing, and this initiative can be easily adopted by any EM training program.

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

Exploring the Differences in Macrocognition Between Experts and Non-CHD Experts Managing Congenital Heart Disease (CHD)

2021 ◽  
Vol 10 (1) ◽  
pp. 335-339
Author(s):  
Azadeh Assadi ◽  
Peter C. Laussen ◽  
Patricia Trbovich
Keyword(s):  
Decision Making ◽  
Emergency Medicine ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pediatric Emergency ◽  
Acute Management ◽  
Naturalistic Decision Making ◽  
The Face

Background and aims: Children with congenital heart disease (CHD) are at risk of deterioration in the face of common childhood illnesses, and their resuscitation and acute management is often best achieved with the guidance of CHD experts. Access to such expertise may be limited outside specialty heart centers and the fragility of these patients is cause for discomfort among many emergency medicine physicians. An understanding of the differences in macrocognition of these clinicians could shed light on some of the causes of discomfort and facilitate the development of a sociotechnological solution to this problem. Methods: Cardiac intensivists (CHD experts) and pediatric emergency medicine physicians (non-CHD experts) in a major academic cardiac center were interviewed using the critical decision method. Interview transcripts were coded deductively based on Klein’s macrocognitive framework and inductively to allow for new or modified characterization of dimensions. Results: While both CHD-experts and non-CHD experts relied on the macrocognitive functions of sensemaking, naturalistic decision making and detecting problems, the specific data and mental models used to understand the patients and course of therapy differed between CHD-experts and non-CHD experts. Conclusion: Characterization of differences between the macrocognitive processes of CHD experts and non-CHD experts can inform development of sociotechnological solutions to augment decision making pertaining to the acute management of pediatric CHD patients.

scholarly journals Face, Content, and Construct Validity of a Virtual Reality Otoscopy Simulator and Applicability to Medical Training

2021 ◽  
pp. 019459982110328
Author(s):  
Tobias Albrecht ◽  
Christoph Nikendei ◽  
Mark Praetorius
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Construct Validity ◽  
Content Validity ◽  
Medical Training ◽  
Controlled Trial ◽  
Correct Diagnosis ◽  
Age Groups ◽  
Tertiary Referral Center ◽  
The Face

Objective Otologic diseases are common in all age groups and can significantly impair the function of this important sensory organ. To make a correct diagnosis, the correct handling of the otoscope and a correctly performed examination are essential. A virtual reality simulator could make it easier to teach this difficult-to-teach skill. The aim of this study was to assess the face, content, and construct validity of the novel virtual reality otoscopy simulator and the applicability to otologic training. Study Design Face and content validity was assessed with a questionnaire. Construct validity was assessed in a prospectively designed controlled trial. Setting Training for medical students at a tertiary referral center. Method The questionnaire used a 6-point Likert scale. The otoscopy was rated with a modified Objective Structured Assessment of Technical Skills. Time to complete the task and the percentage of the assessed eardrum surface were recorded. Results The realism of the simulator and the applicability to medical training were assessed across several items. The ratings suggested good face and content validity as well as usefulness and functionality of the simulator. The otolaryngologists significantly outperformed the student group in all categories measured (P < .0001), suggesting construct validity of the simulator. Conclusion In this study, we could demonstrate face, content, and construct validity for a novel high-fidelity virtual reality otoscopy simulator. The results encourage the use of the otoscopy simulator as a complementary tool to traditional teaching methods in a curriculum for medical students.

scholarly journals P026: Need for training in medical education: staff emergency physician perspectives

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S86
Author(s):  
J. Bryan ◽  
F. Al Rawi ◽  
T. Bhandari ◽  
J. Chu ◽  
S. Hansen ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Adult Education ◽  
Family Medicine ◽  
Graduate Training ◽  
Formal Training ◽  
Emergency Physicians ◽  
Allied Health Professionals ◽  
Evaluation Time ◽  
Post Graduate Training

Introduction: Emergency medicine physicians in our urban/suburban area have a range of training in medical education; some have no formal training in medical education, whereas others have completed Master’s level training in adult education. Not all staff have a university appointment; of those who are affiliated with our university, 87 have appointments through the Department of Medicine, 21 through the Department of Pediatrics, and 117 through the Department of Family Medicine. Emergency physicians in our area are a diverse group of physicians in terms of both formal training in adult education and in the variety of settings in which we work. The purpose of this study was to gauge interest in formal training in adult education among emergency medicine physicians. Methods: With research ethics board approval, we created and sent a 10-item electronic questionnaire to emergency medicine staff in our area. The questionnaire included items on demographics, experience in emergency medicine, additional post-graduate training, current teaching activities and interest in short (30-60 minute) adult education sessions. Results: Of a potential 360 active emergency physicians in our area, 120 responded to the questionnaire (33.3%), representing 12 area hospitals. Nearly half of respondents had been in practice over 10 years (48.44%). Respondents were mainly FRCP (50%) or CCFP-EM (47.50%) trained. 33.3% of respondents had masters degrees, of which 15% were MEd. Most physicians were involved in teaching medical students (98.33%), FRCP residents (80%) and family medicine residents (88.3%), though many were also teaching off-service residents, and allied health professionals. More than half of respondents (60%) were interested in attending short sessions to improve their skills as adult educators. The topics of most interest were feedback and evaluation, time-efficient teaching, the learner in difficulty, case-based teaching and bedside teaching. Conclusion: Emergency physicians in our area have a wide variety of experience and training in medical education. They are involved in teaching learners from a range of training levels and backgrounds. Physicians who responded to our survey expressed an interest in additional formal teaching on adult education topics geared toward emergency medicine.

What gets resident physicians stressed and how would they prefer to be supported? A best–worst scaling study

2021 ◽  
pp. postgradmedj-2021-140719
Author(s):  
Andrew Wu ◽  
Ritika S Parris ◽  
Timothy M Scarella ◽  
Carrie D Tibbles ◽  
John Torous ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Peer Support ◽  
Well Being ◽  
Specific Information ◽  
Choice Modelling ◽  
Work Stressors ◽  
Cross Sectional ◽  
Academic Medical Centre ◽  
Best Worst Scaling

IntroductionPhysician burnout has severe consequences on clinician well-being. Residents face numerous work-stressors that can contribute to burnout; however, given specialty variation in work-stress, it is difficult to identify systemic stressors and implement effective burnout interventions on an institutional level. Assessing resident preferences by specialty for common wellness interventions could also contribute to improved efficacy.MethodsThis cross-sectional study used best–worst scaling (BWS), a type of discrete choice modelling, to explore how 267 residents across nine specialties (anaesthesiology, emergency medicine, internal medicine, neurology, obstetrics and gynaecology, pathology, psychiatry, radiology and surgery) prioritised 16 work-stressors and 4 wellness interventions at a large academic medical centre during the COVID-19 pandemic (December 2020).ResultsTop-ranked stressors were work-life integration and electronic health record documentation. Therapy (63%, selected as ‘would realistically consider intervention’) and coaching (58%) were the most preferred wellness supports in comparison to group-based peer support (20%) and individual peer support (22%). Pathology, psychiatry and OBGYN specialties were most willing to consider all intervention options, with emergency medicine and internal medicine specialties least willing to consider intervention options.ConclusionBWS can identify relative differences in surveyed stressors, allowing for the generation of specialty-specific stressor rankings and preferences for specific wellness interventions that can be used to drive institution-wide changes to improve clinician wellness. BWS surveys are a potential methodology for clinician wellness programmes to gather specific information on preferences to determine best practices for resident wellness.

scholarly journals Emergency medicine as a career choice: a descriptive study of Canadian medical students

CJEM ◽  
2009 ◽  
Vol 11 (03) ◽  
pp. 196-206 ◽  
Author(s):  
Ian M. Scott ◽  
Riyad B. Abu-Laban ◽  
Margot C. Gowans ◽  
Bruce J. Wright ◽  
Fraser R. Brenneis
Keyword(s):  
Emergency Medicine ◽  
Family Medicine ◽  
Medical School ◽  
Career Choice ◽  
Demographic Data ◽  
School Entry ◽  
Social Orientation ◽  
Scope Of Practice ◽  
Medical Specialties ◽  
Hospital Orientation

ABSTRACTBackground:Studies indicate that a student's career interest at medical school entry is related to his or her ultimate career. We sought to determine the level of interest in emergency medicine among students at the time of medical school entry, and to describe characteristics associated with students primarily interested in emergency medicine.Methods:We surveyed students in 18 medical school classes from 8 Canadian universities between 2001 and 2004 at the commencement of their studies. Participants listed their top career choice and the degree to which a series of variables influenced their choices. We also collected demographic data.Results:Of 2420 surveys distributed, 2168 (89.6%) were completed. A total of 6.1% (95% confidence interval 5.1%–7.1%) of respondents cited emergency medicine as their first career choice. When compared with students primarily interested in family medicine, those primarily interested in emergency medicine reported a greater influence of hospital orientation and a lesser influence of social orientation on their career choice. When compared with students primarily interested in the surgical specialties, those primarily interested in emergency medicine were more likely to report medical lifestyle and varied scope of practice as important influences. When compared with students primarily interested in the medical specialties, those who reported interest in emergency medicine were more likely to report that a hospital orientation and varied scope of practice were important influences, and less likely to report that social orientation was important.Conclusion:Students primarily interested in emergency medicine at medical school entry have attributes that differentiate them from students primarily interested in family medicine, the surgical specialties or the medical specialties. These findings may help guide future initiatives regarding emergency medicine education.

scholarly journals Emergency medicine training demographics of physicians working in rural and regional southwestern Ontario emergency departments

CJEM ◽  
2007 ◽  
Vol 9 (06) ◽  
pp. 449-452 ◽  
Author(s):  
Munsif Bhimani ◽  
Gordon Dickie ◽  
Shelley McLeod ◽  
Daniel Kim
Keyword(s):  
Emergency Medicine ◽  
Family Medicine ◽  
Residency Training ◽  
Emergency Departments ◽  
Training Programs ◽  
Family Physicians ◽  
Demographic Information ◽  
Trauma Resuscitation ◽  
Curriculum Content

ABSTRACT Objectives: We sought to determine the emergency medicine training demographics of physicians working in rural and regional emergency departments (EDs) in southwestern Ontario. Methods: A confidential 8-item survey was mailed to ED chiefs in 32 community EDs in southwestern Ontario during the month of March 2005. This study was limited to nonacademic centres. Results: Responses were received from 25 (78.1%) of the surveyed EDs, and demographic information on 256 physicians working in those EDs was obtained. Of this total, 181 (70.1%) physicians had no formal emergency medicine (EM) training. Most were members of the College of Family Physicians of Canada (CCFPs). The minimum qualification to work in the surveyed EDs was a CCFP in 8 EDs (32.0%) and a CCFP with Advanced Cardiac and Trauma Resuscitation Courses (ACLS and ATLS) in 17 EDs (68.0%). None of the surveyed EDs required a CCFP(EM) or FRCP(EM) certification, even in population centres larger than 50 000. Conclusion: The majority of physicians working in southwestern Ontario community EDs graduated from family medicine residencies, and most have no formal EM training or certification. This information is of relevance to both family medicine and emergency medicine residency training programs. It should be considered in the determination of curriculum content and the appropriate number of residency positions.

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