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Western Journal of Emergency Medicine

Carmen N Spalding, Sherri L Rudinsky
Introduction: Emergency Medicine (EM) is a unique clinical learning environment. The American College of Graduate Medical Education Clinical Learning Environment Review Pathways to Excellence calls for "hands-on training" of disclosure of medical error (DME) during residency. Training and practicing key elements of DME using standardized patients (SP) may enhance preparedness among EM residents in performing this crucial skill in a clinical setting. Methods: This training was developed to improve resident preparedness in DME in the clinical setting...
January 2018: Western Journal of Emergency Medicine
Jessica R Parsons, Amanda Crichlow, Srikala Ponnuru, Patricia A Shewokis, Varsha Goswami, Sharon Griswold
Introduction: In today's team-oriented healthcare environment, high-quality patient care requires physicians to possess not only medical knowledge and technical skills but also crisis resource management (CRM) skills. In emergency medicine (EM), the high acuity and dynamic environment makes CRM skills of physicians particularly critical to healthcare team success. The Accreditation Council of Graduate Medicine Education Core Competencies that guide residency program curriculums include CRM skills; however, EM residency programs are not given specific instructions as to how to teach these skills to their trainees...
January 2018: Western Journal of Emergency Medicine
Chris Merritt, Michelle Daniel, Brendan W Munzer, Mariann Nocera, Joshua C Ross, Sally A Santen
In just a few years of preparation, emergency medicine (EM) trainees must achieve expertise across the broad spectrum of skills critical to the practice of the specialty. Though education occurs in many contexts, much learning occurs on the job, caring for patients under the guidance of clinical educators. The cognitive apprenticeship framework, originally described in primary and secondary education, has been applied to workplace-based medical training. The framework includes a variety of teaching methods: scaffolding, modeling, articulation, reflection, and exploration, applied in a safe learning environment...
January 2018: Western Journal of Emergency Medicine
Joshua Jauregui, Steven Bright, Jared Strote, Jamie Shandro
Introduction: Peer-assisted learning (PAL) is the development of new knowledge and skills through active learning support from peers. Benefits of PAL include introduction of teaching skills for students, creation of a safe learning environment, and efficient use of faculty time. We present a novel approach to PAL in an emergency medicine (EM) clerkship curriculum using an inexpensive, tablet-based app for students to cooperatively present and perform low-fidelity, case-based simulations that promotes accountability for student learning, fosters teaching skills, and economizes faculty presence...
January 2018: Western Journal of Emergency Medicine
Dorothea Eisenmann, Fabian Stroben, Jan D Gerken, Aristomenis K Exadaktylos, Mareen Machner, Wolf E Hautz
Introduction: Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED) is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care...
January 2018: Western Journal of Emergency Medicine
Regina Royan, Christine Wu, Nik Theyyunni, Sacha Montas, James A Cranford, Joseph B House, Michael P Lukela, Sally A Santen
Introduction: Transitioning from the pre-clinical environment to clerkships poses a challenge to students and educators alike. Students along with faculty developed the Clinical Reasoning Elective (CRE) to provide pre-clinical students exposure to patients in the emergency department and the opportunity to build illness scripts and practice clinical skills with longitudinal mentorship in a low-stakes environment before entering clerkships. It is a voluntary program. Each year, the CRE has received overwhelming positive feedback from students...
January 2018: Western Journal of Emergency Medicine
Vivienne Ng, Jennifer Plitt, David Biffar
Introduction: Peritonsillar abscess (PTA) is the most common deep space infection of the head and neck presenting to emergency departments.1 No commercial PTA task trainer exists for simulation training. Thus, resident physicians often perform their first PTA needle aspiration in the clinical setting, knowing that carotid artery puncture and hemorrhage are serious and devastating complications. While several low-fidelity PTA task trainers have been previously described, none allow for ultrasound image acquisition...
January 2018: Western Journal of Emergency Medicine
Gita Pensa, Jessica Smith, Kristina McAteer
With the increasing influence of the "Free Open Access Medical Education" (FOAM or FOAMed) movement, it is critical that medical educators be engaged with FOAM in order to better inform and direct their learners, who likely regularly consume these materials. In 2012, the Accreditation Council for Graduate Medical Education (ACGME)/Residency Review Committee (RRC) began to permit 20% of emergency medicine (EM) residents' didactics hours to be earned outside of weekly conference, as "Individualized Interactive Instruction" (III) credits...
January 2018: Western Journal of Emergency Medicine
Daniel R Martin, Felix Ankel, Robin R Hemphill, Sheryl Heron, Sorabh Khandelwal, Chris Merritt, Mary Westergaard, Sally A Santen
No abstract text is available yet for this article.
January 2018: Western Journal of Emergency Medicine
Leo Kobayashi, Xiao Chi Zhang, Scott A Collins, Naz Karim, Derek L Merck
Introduction: Augmented reality (AR), mixed reality (MR), and virtual reality devices are enabling technologies that may facilitate effective communication in healthcare between those with information and knowledge (clinician/specialist; expert; educator) and those seeking understanding and insight (patient/family; non-expert; learner). Investigators initiated an exploratory program to enable the study of AR/MR use-cases in acute care clinical and instructional settings. Methods: Academic clinician educators, computer scientists, and diagnostic imaging specialists conducted a proof-of-concept project to 1) implement a core holoimaging pipeline infrastructure and open-access repository at the study institution, and 2) use novel AR/MR techniques on off-the-shelf devices with holoimages generated by the infrastructure to demonstrate their potential role in the instructive communication of complex medical information...
January 2018: Western Journal of Emergency Medicine
Michael W Manning, Eric W Bean, Andrew C Miller, Suzanne J Templer, Richard S Mackenzie, David M Richardson, Kristin A Bresnan, Marna R Greenberg
Introduction: The Association of American Medical Colleges' (AAMC) initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to "identify system failures and contribute to a culture of safety and improvement." We set out to determine the feasibility of using medical students' action learning projects (ALPs) to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED) setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism)...
January 2018: Western Journal of Emergency Medicine
Michael G Barrie, Christopher Amick, Jennifer Mitzman, David P Way, Andrew M King
Most emergency medicine (EM) residency programs provide an orientation program for their incoming interns, with the lecture being the most common education activity during this period. Our orientation program is designed to bridge the gap between undergraduate and graduate medical education by ensuring that all learners demonstrate competency on Level 1 Milestones, including medical knowledge (MK). To teach interns core medical knowledge in EM, we reformulated orientation using the flipped-classroom model by replacing lectures with small group, case-based discussions...
January 2018: Western Journal of Emergency Medicine
Timothy Fallon, Tania D Strout
Although Free Open Access Medical Education (FOAM) has become popular within emergency medicine, concerns exist regarding its role in resident education. We sought to develop an educational intervention whereby residents could review FOAM resources while maintaining faculty oversight. We created a novel curriculum pairing FOAM from the Academic Life in Emergence Medicine (ALiEM) Approved Instructional Resources (Air) series with a team-based learning (TBL) format. Residents have an opportunity to engage with FOAM in a structured setting with faculty input on possible practice changes...
January 2018: Western Journal of Emergency Medicine
Anne M Messman, Ian Walker
Textbook reading plays a foundational role in a resident's knowledge base. Many residency programs place residents on identical reading schedules, regardless of the clinical work or rotation the resident is doing. We sought to develop a reading curriculum that takes into account the clinical work a resident is doing so their reading curriculum corresponds with their clinical work. Preliminary data suggests an increased amount of resident reading and an increased interest in reading as a result of this change to their reading curriculum...
January 2018: Western Journal of Emergency Medicine
Matthew Tews, Robert W Treat
No abstract text is available yet for this article.
January 2018: Western Journal of Emergency Medicine
Emily S Miller, Corey Heitz, Linette Ross, Michael S Beeson
No abstract text is available yet for this article.
January 2018: Western Journal of Emergency Medicine
Joshua W Joseph, David T Chiu, Matthew L Wong, Carlo L Rosen, Larry A Nathanson, Leon D Sanchez
Introduction: Resident productivity is an important educational and operational measure in emergency medicine (EM). The ability to continue effectively seeing new patients throughout a shift is fundamental to an emergency physician's development, and residents are integral to the workforce of many academic emergency departments (ED). Our previous work has demonstrated that residents make gains in productivity over the course of intern year; however, it is unclear whether this is from experience as a physician in general on all rotations, or specific to experience in the ED...
January 2018: Western Journal of Emergency Medicine
Linda Regan, Leslie Cope, Rodney Omron, Leah Bright, Jamil D Bayram
Introduction: Clinical Competency Committees (CCC) require reliable, objective data to inform decisions regarding assignment of milestone proficiency levels, which must be reported to the Accreditation Council for Graduate Medical Education. After the development of two new assessment methods, the end-of-shift (EOS) assessment and the end-of-rotation (EOR) assessment, we sought to evaluate their performance. We report data on the concordance between these assessments, as well as how each informs the final proficiency level determined in biannual CCC meetings...
January 2018: Western Journal of Emergency Medicine
Amish Aghera, Matt Emery, Richard Bounds, Colleen Bush, R Brent Stansfield, Brian Gillett, Sally A Santen
Introduction: Goal setting is used in education to promote learning and performance. Debriefing after clinical scenario-based simulation is a well-established practice that provides learners a defined structure to review and improve performance. Our objective was to integrate formal learning goal generation, using the SMART framework (Specific, Measurable, Attainable, Realistic, and Time-bound), into standard debriefing processes (i.e., "SMART Goal Enhanced Debriefing") and subsequently measure the impact on the development of learning goals and execution of educational actions...
January 2018: Western Journal of Emergency Medicine
Jesse Bohrer-Clancy, Leslie Lukowski, Lisa Turner, Ilene Staff, Shawn London
Introduction: Negative outcomes in emergency medicine (EM) programs use a disproportionate amount of educational resources to the detriment of other residents. We sought to determine if any applicant characteristics identifiable during the selection process are associated with negative outcomes during residency. Methods: Primary analysis consisted of looking at the association of each of the descriptors including resident characteristics and events during residency with a composite measure of negative outcomes...
January 2018: Western Journal of Emergency Medicine
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