Yuabrams0985
Medical students transition to intern year with significant variability in prior clinical experience depending on their medical school education. This leads to notable differences in the interns' ability to perform focused histories and physical exams, develop reasoned differentials, and maximize care plans. Providing a foundational experience for these essential skills will help to establish standardized expectations despite variable medical school experiences.
During an orientation block, interns participated in a standardized patient experience. Interns were presented with three common chief complaints abdominal pain; chest pain; and headache. Faculty observed the three patient encounters and provided immediate verbal and written feedback to the interns based on a standardized grading rubric.
All residents that participated "agreed" or "strongly agreed" that the experience was a meaningful educational experience. 90% of the interns reported the experience would change their clinical practice. Additionally, 75% of residents survyed one year after the experience felt the experience changed their clinical practice. ENOblock inhibitor Faculty felt the learning experience allowed them to address knowledge gaps early and provide early guidance where needed.
This article describes an emergency medicine residency program's effort to provide a foundational experience for interns in evaluating emergency department patients. The intent was to "level the playing field" and establish "good habits" early in intern year with the realization that prior experiences vary significantly in July of intern year.
This article describes an emergency medicine residency program's effort to provide a foundational experience for interns in evaluating emergency department patients. The intent was to "level the playing field" and establish "good habits" early in intern year with the realization that prior experiences vary significantly in July of intern year.
The focus of residency training is to ensure that graduates attain a minimum level of skills and knowledge in order to be able to practice independently. While there are multiple formal methods to evaluate a resident, there is a paucity of literature that describes whether programs have residents perform individual self-assessment (ISA) with the development of individualized learning plans (ILP) to better themselves. We sought to investigate the current state of emergency medicine (EM) residency programs using ISA and determine whether these assessments are used to develop an ILP for each resident.
An electronic survey was developed by educators at our institution and sent to all program leaders of United States EM residencies approved by the Accreditation Council for Graduate Medical Education. An individualized email request was sent to non-responders. Results were obtained from February-May 2019.
Of 240 programs we contacted, 119 (49.5%) completed the survey. Seventy-nine percent of programs reported that they had all residents perform an ISA. These were completed semiannually in 69% of the programs surveyed, annually in 19%, less than annually in 8%, and quarterly or more frequently in 4%. Of those programs requiring a resident ISA, only 21% required that all residents develop an ILP; 79% had only those residents requiring additional help or no residents develop an ILP.
Most programs that completed the survey reported having residents complete an individual self-assessment, but there was variation in the areas assessed. The majority of programs had only lower performing, or no residents, develop an ILP based on this.
Most programs that completed the survey reported having residents complete an individual self-assessment, but there was variation in the areas assessed. The majority of programs had only lower performing, or no residents, develop an ILP based on this.
Educational podcasts are used by emergency medicine (EM) trainees to supplement clinical learning and to foster a sense of connection to broader physician communities. Yet residents report difficulties remembering what they learned from listening, and the features of podcasts that residents find most effective for learning remain poorly understood. Therefore, we sought to explore residents' perceptions of the design features of educational podcasts that they felt most effectively promoted learning.
We used a qualitative approach to explore EM trainees' experiences with educational podcasts, focusing on design features that they found beneficial to their learning. We conducted 16 semi-structured interviews with residents from three institutions from March 2016-August 2017. Interview transcripts were analyzed line-by-line using constant comparison and organized into focused codes, conceptual categories, and then key themes.
The five canons of classical rhetoric provided a framework for thematically grouping the disparate features of podcasts that residents reported enhanced their learning. Specifically, they reported valuing the following 1) Invention clinically relevant material presented from multiple perspectives with explicit learning points; 2) Arrangement efficient communication; 3) Style narrative incorporating humor and storytelling; 4) Memory repetition of key content; and 5) Delivery short episodes with good production quality.
This exploratory study describes features that residents perceived as effective for learning from educational podcasts and provides foundational guidance for ongoing research into the most effective ways to structure medical education podcasts.
This exploratory study describes features that residents perceived as effective for learning from educational podcasts and provides foundational guidance for ongoing research into the most effective ways to structure medical education podcasts.
Medical students pursuing an emergency medicine (EM) residency are advised to obtain at least two Standardized Letters of Evaluation (SLOE). Students often complete one rotation at their home institution and at least one "away" rotation at a program separate from their home institution. The SLOE was introduced as an objective evaluation tool. The aim of this study was to determine whether there was a difference in scores between home rotation and away rotation SLOEs.
We retrospectively reviewed the SLOEs of all applicants to an urban, academic EM residency program. For each SLOE, we calculated a composite score from rankings in seven "Qualifications for EM" (CS7), and converted comparative rank score (CRS) and estimated rank list position (ERP) to percentile scores. The CS7, CRS, and ERP on the home rotation SLOE were compared to those of the away SLOE using a paired t-test.
An evaluation of 721 applicants with at least one home SLOE and one away SLOE demonstrated a significant increase in the ERP of home rotators (P = 0.003). The data did not demonstrate a statistically significant difference in the CS7 (P = 0.69), or CRS (P = 0.97).
Our study demonstrated that the only difference in SLOEs is that students are likely to be given a slightly higher estimated placement on the rank order list on a home SLOE. We hope this will help residency leadership with reviewing applications.
Our study demonstrated that the only difference in SLOEs is that students are likely to be given a slightly higher estimated placement on the rank order list on a home SLOE. We hope this will help residency leadership with reviewing applications.
Clinical rotations in emergency medicine (EM) can be challenging for medical students because of the lack of continuity with attending physicians. To overcome this challenge, institutions have started to match a student's schedule with that of a resident, referred to as "paired shifts." We sought to pilot and compare two schedule formats for fourth-year medical students (MS4) - a resident-paired shifts (RPS) and a traditional resident-unpaired shifts (RUS) schedule.
This prospective, crossover trial included MS4s rotating in the emergency department over four consecutive four-week blocks. Each MS4 was assigned two weeks using the RUS schedule and two weeks with the RPS schedule, alternating the format order each month. link2 At the end of the rotation students were anonymously surveyed regarding the differences in learning experience, their ability to showcase their knowledge and clinical skills, and familiarity with the residency program with the two formats.
The response rate was 47 of 58 students (84%). Respondents indicated that RPS resulted in more teaching time (64.6% RPS vs 8.3% RUS), a better overall educational experience (68.8% RPS vs 8.3% RUS), and a greater ability to showcase their medical knowledge (52.1% RPS vs 6.3% RUS). Additionally, students felt that the program was better able to evaluate them (66.7% RPS vs 10.4% RUS) and they were better able to better evaluate the program (66.7% RPS vs 6.3% RUS) in the RPS format.
When compared to traditional RUS during an MS4 rotation, a RPS format provided students with the perception of an improved learning experience, ability to showcase knowledge, and familiarity with the residency program without sacrificing teaching from attending physicians.
When compared to traditional RUS during an MS4 rotation, a RPS format provided students with the perception of an improved learning experience, ability to showcase knowledge, and familiarity with the residency program without sacrificing teaching from attending physicians.
Recent research demonstrates burnout prevalence rates as high as 76% in emergency medicine (EM) residents. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) required that all training programs provide dedicated wellness education for their trainees as a requirement for accreditation. We aimed to conduct a systematic review of published wellness interventions conducted in EM residency programs following the implementation of the 2017 ACGME Common Program Requirements change in order to characterized published intervention and evaluate their effectiveness.
We applied a published approach to conducting systematic reviews of the medical education literature. We performed a search of the literature from January 1, 2017-February 1, 2020. Studies were included for final review if they described a specific intervention and reported outcomes with the primary goal of improving EM resident wellness. Outcomes were characterized using the Kirkpatrick training evaluation model.
Eight of 35 idenentions designed to improve EM resident wellness. Furthermore, the studies we identified are narrow in scope, involve relatively few participants, and describe programmatic changes of limited variety. link3 Future directions include an increase and emphasis on multi-institutional studies, randomized controlled trials, qualitative methodology, and opportunities for funded research.The rising numbers of residency applications along with fears of a constrained graduate medical education environment have created pressures on residency applicants. Anecdotal evidence suggests substantial challenges with the process of offering residency interviews. This narrative review is designed to identify and propose solutions for the current problems in the process of offering residency interviews. We used PubMed and web browser searches to identify relevant studies and reports. Materials were assessed for relevance to the current process of distributing residency interviews. There is limited relevant literature and the quality is poor overall. We were able to identify several key problem areas including uncertain timing of interview offers; disruption caused by the timing of interview offers; imbalance of interview offers and available positions; and a lack of clarity around waitlist and rejection status. In addition, the couples match and need for coordination of interviews creates a special case. Many of the problems related to residency interview offers are amenable to program-level interventions, which may serve as best practices for residency programs, focusing on clear communication of processes as well as attention to factors such as offer-timing and numbers.
