scholarly journals Intern Orthopedic Rotation Versus Emergency Medicine Procedure Month: Which one Derives More Opportunity?

2021 ◽  
Vol 8 ◽  
pp. 238212052110446
Author(s):  
Blake Chandler Briggs ◽  
David Martin Cline ◽  
Kendall Lynn Stewardson ◽  
Jordan Alexis Kugler ◽  
Cedric Lefebvre
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Medical Education ◽  
Standard Deviation ◽  
Graduate Medical Education ◽  
Statistical Difference ◽  
Orthopedic Procedures ◽  
Self Directed Learning ◽  
Residency Programs ◽  
Directed Learning

INTRODUCTION The American College of Graduate Medical Education (ACGME) defines 18 “key procedures” as requirements in emergency medicine (EM) residency programs. The post-graduate year-1 (PGY-1) curriculum provides an early foundation for EM trainees to gain procedural experience, but traditional PGY-1 rotations may not provide robust procedural opportunities. Our objective was to replace a traditional orthopedic rotation with a 4-week rotation that emphasized EM procedure acquisition and comprehension. Although all residents met ACGME procedural requirements before the curricular modification, the purpose of this month was to increase overall procedure numbers. The block contained dedicated procedure shifts in the emergency department as well as an asynchronous, self-directed learning course. We sought to compare the number of procedures performed by PGY-1 residents during their orthopedic rotation (the year before implementation), to the number of procedures performed during their procedure rotation (the year after implementation). METHODS The total number of procedures performed and logged by PGY-1 residents during the traditional orthopedic rotation (during the year prior to implementation of the new procedure rotation) were compared to the total number of procedures by the first class to undergo the new procedure rotation the following year. Thirty resident logs were reviewed (15 per class). Data were analyzed using SAS NPAR1WAY; Z < 0.05 was considered significant. RESULTS When compared to the orthopedic rotation, the procedure rotation had statistically significant higher numbers of procedures per resident (22, standard deviation [SD] 12, vs 11.4, SD 7.6; Z = 0.0177). A wide variety of nonorthopedic procedures accounted for the increased numbers, (13.6, SD 10.3, vs 0.9, SD 0.9; Z < 0.001). While the average number of orthopedic procedures was slightly less on the procedure rotation, there was no statistical difference (orthopedic rotation 10.13, procedure rotation 8.26; Z = 0.4605). Notably, fewer procedures were performed when 2 residents were on the procedure rotation at the same time (21 vs 10.1). CONCLUSION This analysis demonstrated a larger number and a wider variety of procedures performed by PGY-1 residents during a dedicated procedure rotation compared to a traditional orthopedic rotation. Furthermore, exposure to orthopedic procedures did not decline significantly. Limitations of the study include a modest number of subjects. Data may be limited by the consistency of procedure logging by individual residents. Further studies may assess procedural competency after PGY-1 year of training.

scholarly journals Radiology Education Among Emergency Medicine Residencies: A National Needs Assessment

2021 ◽  
Vol 22 (5) ◽  
pp. 1110-1116
Author(s):  
Stephen Villa ◽  
Natasha Wheaton ◽  
Steven Lai ◽  
Jaime Jordan
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Needs Assessment ◽  
Graduate Medical Education ◽  
Central Region ◽  
The United States ◽  
Residency Programs ◽  
Radiology Education ◽  
Graduate Medical ◽  
Program Leadership

Introduction: Radiology training is an important component of emergency medicine (EM) education, but its delivery has been variable. Program directors have reported a lack of radiology skills in incoming interns. A needs assessment is a crucial first step toward improving radiology education among EM residencies. Our objective was to explore the current state of radiology education in EM residency programs. Methods: This was a cross-sectional survey study of all Accreditation Council for Graduate Medical Education-accredited EM programs in the United States. Program leadership completed an online survey consisting of multiple choice, Likert scale, and free-response items. We calculated and reported descriptive statistics. Results: Of eligible EM programs, 142/252 (56%) completed the survey including 105 postgraduate year (PGY) 1-3 and 36 PGY 1-4 programs. One respondent opted out of answering demographic questions. 23/141 (16%) were from the Western region, 29/141 (21%) were from the North Central region, 14/141 (10%) were from the South-Central region, 28/141 (20%) were from the Southeast region, and 47/141 (33%) were from the Northeast region. A total of 88/142 (62%) of responding programs did not have formal radiology instruction. Of the education that is provided, 127/142 (89%) provide it via didactics/lectures and 115/142 (81%) rely on instruction during clinical shifts. Only 51/142 (36%) provide asynchronous opportunities, and 23/142 (16%) have a dedicated radiology rotation. The majority of respondents reported spending 0-2 hours per month on radiology instruction (108/142; 76%); 95/141 (67%) reported that EM faculty “often” or “always” provide radiology instruction; 134/142 (95%), felt that it was “extremely” or “very important” for ED providers to be able to independently interpret radiograph results; and 129/142 (90.84%) either “sometimes” or “always” rely on their independent radiograph interpretations to make clinical decisions. The radiology studies identified as most important to be able to independently interpret were radiographs obtained for lines/tubes, chest radiographs, and radiographs obtained for musculoskeletal-related complaints. Conclusion: A minority of EM residency programs have formal instruction in radiology despite the majority of responding program leadership believing that these are important skills. The most important curricular areas were identified. These results may inform the development of formal radiology curricula in EM graduate medical education.

scholarly journals Educating Emergency Medicine Residents in Emergency Department Administration and Operations: Needs and Current Practice

2014 ◽  
Vol 6 (4) ◽  
pp. 770-773 ◽  
Author(s):  
Taketo Watase ◽  
Lalena M. Yarris ◽  
Rongwei Fu ◽  
Daniel A. Handel
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Medical Education ◽  
Logistic Regression ◽  
Current Practice ◽  
Cross Sectional ◽  
Web Based ◽  
Residency Programs ◽  
Program Characteristics ◽  
Ed Operations

Abstract Background Emergency medicine (EM) residents are expected to develop competence in emergency department (ED) administration and operations. Objectives We assessed current needs and educational practices related to preparing EM residents for their role in ED operations, and explored whether there was an association between program characteristics and the presence of ED operations education in US EM residency programs. Methods We conducted a cross-sectional needs assessment, using a web-based survey sent to all US EM residency programs to assess program characteristics, provision of ED operations-related lectures, availability of an ED administrative fellowship, and presence of a formal ED operations curriculum. Logistic regression was used to determine if any program characteristics were associated with the presence of lectures and a formal operations curriculum. Results Of the 158 Accreditation Council for Graduate Medical Education–accredited EM programs, 117 (74%) responded. Of these, 109 (93%) respondents had at least 1 lecture on ED operational topics. Sixty programs (54%) measured resident productivity. Knowledge of Centers for Medicaid & Medicare Services reimbursement guidelines was significantly positively associated with presence of an ED operations curriculum (OR, 3.52, P  =  .009) and with lectures on patient satisfaction (OR, 3.99, P  =  .006). Measuring resident productivity was positively associated with having lectures on productivity (OR, 2.50, P  =  .02) and with ED throughput (OR, 2.32, P  =  .03). No 2 variables were simultaneously significant in the model. Conclusions Most EM programs had at least 1 lecture on ED operations topics. Roughly half of the programs measured resident productivity and half had a formal ED operations curriculum.

scholarly journals Women in Emergency Medicine Residency Programs: An Analysis of Data From Accreditation Council for Graduate Medical Education-approved Residency Programs

2017 ◽  
Vol 1 (3) ◽  
pp. 175-178 ◽  
Author(s):  
Christian R. DeFazio ◽  
Samuel D. Cloud ◽  
Christine M. Verni ◽  
Jessica M. Strauss ◽  
Karen M. Yun ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Graduate Medical Education ◽  
Residency Programs ◽  
Accreditation Council ◽  
Graduate Medical

scholarly journals Effect of Changes in Graduate Medical Education Funding on Emergency Medicine Residency Programs

2001 ◽  
Vol 8 (6) ◽  
pp. 642-647 ◽  
Author(s):  
Latha Stead ◽  
Robert W. Schafermeyer ◽  
Francis L. Counselman ◽  
Paul Blackburn ◽  
Debra Perina
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Graduate Medical Education ◽  
Education Funding ◽  
Residency Programs ◽  
Graduate Medical

scholarly journals Empathy Can Be Taught, and Patients Teach it Best

2021 ◽  
Vol 8 ◽  
pp. 238212052110003
Author(s):  
Sudhagar Thangarasu ◽  
Gowri Renganathan ◽  
Piruthiviraj Natarajan
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Core Competencies ◽  
Core Competency ◽  
Role Modeling ◽  
Residency Programs ◽  
Graduate Medical ◽  
Mixed Messages ◽  
Attending Physicians ◽  
Medical Education Curriculum

Empathy toward patients is an essential skill for a physician to deliver the best care for any patient. Empathy also protects the physician from moral injury and decreases the chances for malpractice litigations. The current graduate medical education curriculum allows trainees to graduate without getting focused training to develop empathy as a core competency domain. The tools to measure empathy inherently lack validity. The accurate measure of the provider’s empathy comes from the patient’s perspectives of their experience and their feedback, which is rarely reaching the trainee. The hidden curriculum in residency programs gives mixed messages to trainees due to inadequate role modeling by attending physicians. This narrative style manuscript portrays a teachable moment at the bedside vividly. The teaching team together reflected upon the lack of empathy, took steps to resolve the issue. The attending demonstrated role modeling as an authentic and impactful technique to teach empathy. The conclusion includes a proposal to include the patient’s real-time feedback to trainees as an essential domain under Graduate Medical Education core competencies of professionalism and patient care.

Current Models for Inpatient and Emergency Room Ophthalmology Consultation in U.S. Residency Programs

2020 ◽  
Vol 12 (02) ◽  
pp. e171-e174
Author(s):  
Donna H. Kim ◽  
Dongseok Choi ◽  
Thomas S. Hwang
Keyword(s):  
Emergency Department ◽  
Medical Education ◽  
Emergency Room ◽  
Program Directors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Direct Supervision ◽  
Residency Programs ◽  
Residency Program Directors ◽  
Competency Assessments

Abstract Objective This article examines models of patient care and supervision for hospital-based ophthalmology consultation in teaching institutions. Design This is a cross-sectional survey. Methods An anonymous survey was distributed to residency program directors at 119 Accreditation Council for Graduated Medical Education accredited U.S. ophthalmology programs in the spring of 2018. Survey questions covered consult volume, rotational schedules of staffing providers, methods of supervision (direct vs. indirect), and utilization of consult-dedicated didactics and resident competency assessments. Results Of the 119 program directors, 48 (41%) completed the survey. Programs most frequently reported receiving 4 to 6 consults per day from the emergency department (27, 55.1%) and 4 to 6 consults per day from inpatient services (26, 53.1%). Forty-seven percent of programs reported that postgraduate year one (PGY-1) or PGY-2 residents on a dedicated consult rotation initially evaluate patients. Supervising faculty backgrounds included neuro-ophthalmology, cornea, comprehensive, or a designated chief of service. Staffing responsibility is typically shared by multiple faculty on a daily or weekly rotation. Direct supervision was provided for fewer of emergency room consults (1–30%) than for inpatient consults (71–99%). The majority of programs reported no dedicated didactics for consultation activities (27, 55.1%) or formal assessment for proficiency (33, 67.4%) prior to the initiation of call-related activities without direct supervision. Billing submission for consults was inconsistent and many consults may go financially uncompensated (18, 36.7%). Conclusion The majority of hospital-based ophthalmic consultation at academic centers is provided by a rotating pool of physicians supervising a lower level resident. Few programs validate increased levels of graduated independence using specific assessments.

scholarly journals ‘Flipped Learning’ in Disaster Triage – Polarising Medical Student Attainment?

2020 ◽  
pp. 1-3
Author(s):  
Anthony Mark Monaghan ◽  
Jake Hudson ◽  
Arion Romanos Alexopoulos
Keyword(s):  
Medical Education ◽  
Medical Student ◽  
Flipped Classroom ◽  
Independent Learning ◽  
Flipped Learning ◽  
Potential Utility ◽  
Self Directed Learning ◽  
Learning Skills ◽  
Directed Learning

Abstract ‘Flipped learning’ has become increasingly popular in medical education as a means of developing independent learning skills in students. The article by Zheng at al. (2020) highlights the potential utility of this approach in disaster triage training. However, the article also highlights to us some concerns regarding how ‘flipped learning’ may favour certain learners over others in the provision of disaster triage education. Specifically, the article demonstrates the necessity for increased pre-classroom preparation when a ‘flipped classroom’ model is employed which inevitably privileges those with a higher ability to engage with self-directed learning. Whilst such a skill is important to develop in medical education, we fear it may lead to polarised student attainment rather than ensuring a maximum number of students achieve the requisite standard required. More research is consequently needed to inform the most efficacious means of facilitating disaster triage training that supports all students sufficiently whilst also helping to nurture their independent learning skills.

scholarly journals A Descriptive Analysis of the Use of Twitter by Emergency Medicine Residency Programs

2018 ◽  
Vol 10 (1) ◽  
pp. 51-55 ◽  
Author(s):  
David Diller ◽  
Lalena M. Yarris
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Descriptive Analysis ◽  
Descriptive Statistics ◽  
Mixed Methods Study ◽  
Instructional Tool ◽  
Residency Programs ◽  
The Public ◽  
Twitter Account ◽  
E Mail

ABSTRACT Background  Twitter is increasingly recognized as an instructional tool by the emergency medicine (EM) community. In 2012, the Council of Residency Directors in Emergency Medicine (CORD) recommended that EM residency programs' Twitter accounts be managed solely by faculty. To date, little has been published regarding the patterns of Twitter use by EM residency programs. Objective  We analyzed current patterns in Twitter use among EM residency programs with accounts and assessed conformance with CORD recommendations. Methods  In this mixed methods study, a 6-question, anonymous survey was distributed via e-mail using SurveyMonkey. In addition, a Twitter-based search was conducted, and the public profiles of EM residency programs' Twitter accounts were analyzed. We calculated descriptive statistics and performed a qualitative analysis on the data. Results  Of 168 Accreditation Council for Graduate Medical Education–accredited EM programs, 88 programs (52%) responded. Of those programs, 58% (51 of 88) reported having a program-level Twitter account. Residents served as content managers for those accounts in the majority of survey respondents (61%, 28 of 46). Most programs did not publicly disclose the identity or position of their Twitter content manager. We found a wide variety of applications for Twitter, with EM programs most frequently using Twitter for educational and promotional purposes. There is significant variability in the numbers of followers for EM programs' Twitter accounts. Conclusions  Applications and usage among EM residency programs are varied, and are frequently not consistent with current CORD recommendations.

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