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Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. As a result, the experiences of these residents in the ED tend to vary during their rotations. The resulting program encompasses clinical experience and didactic sessions through which residents are trained in core topics and skills. This knowledge will be applicable in the clinical settings in which residents will continue to train and ultimately practice their specialty.
It is flexible enough to be applicable and implementable without being limited by resource availability or faculty strengths. Emergency medicine EM offers a unique perspective to residents of all specialties through its broad spectrum of patient presentations. The goal of this Academic Affairs Committee was to create a working, practical curriculum that residency programs across the country could implement.
The six steps are 1 problem identification and general needs assessment, 2 needs assessment of targeted learners, 3 goals and objectives, 4 educational strategies, 5 implementation, and 6 evaluation and feedback. This knowledge and experience could subsequently be applied to different settings for the care of acutely ill patients. A focused needs assessment of internal medicine residents rotating through the ED was performed in early unpublished data.
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Results indicated a significant lack of preparation for certain critical issues and identified gaps in their medical education. The largest perceived gaps between importance and preparedness were in the areas of airway management, ophthalmology, and orthopedics. Moreover, internal medicine residents and attending physicians felt that knowledge in many of these areas is extremely important in becoming a complete internist.
In addition, the Academic Affairs Committee used an informal, targeted needs assessment—informal interviews of resident physicians and program directors—to identify specific needs of residents from surgery and the surgical subspecialties, as well as family practice, pediatrics, and psychiatry. Emergency medicine is different from most other specialties in that it involves the evaluation and care of patients with acute illness and injury in a very specific, often limited, time frame.
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Moreover, residents learn about the constraints that drive this different approach and the strategies emergency physicians use to provide excellent patient care. Educational strategies are at the core of the curriculum and include both content specific material and methods how it is taught.
The content and methods will guide learners and faculty members toward the implementation stage of the curriculum. This focus allows the physician trainee to identify and appropriately manage similar cases that will present in other settings with the resources available in those environments.
Rotating residents should develop a skill set that is integral to EM, but that can also be applied to their own disciplines, in any setting, whether in the intensive care unit, in an outpatient clinic, or on a soccer field. It is important that residents demonstrate procedural competency, including familiarity with the indications, contraindications, potential complications, and steps involved in key procedures. Appropriate supervision is required to determine the procedural competency and comfort level of the individual learner.
Several texts describe procedures commonly performed in the ED. The procedures are derived from previous EM curricula, consensus opinion, and informal evaluation of procedures currently performed on rotations.
As an adjunct to the clinical ED experience, we recommend a list of selected clinical articles in EM. The majority of learning is experiential through bedside teaching with direct supervision.
Emergency medicine procedures reichman pdf writer
Didactic teaching enhances learning in a different mode; the structure of this component will vary based on resources and local academic structure. This can be accomplished by investing time in learning about the resident or the group, including prior experience, current postgraduate year level, expectations about the rotation, and career aspirations.
Many delivery methods are used for curriculum implementation and are based on available resources. Conferences are essential to building a large bank of EM knowledge. This can take many forms, including brief didactic lectures in the department during a shift and combining targeted lectures with rotating medical students. Residents should be encouraged to present a topic of their own choosing. Each residency program has its own unique resources and faculty availability. If time permits, a prerotational interview with a faculty preceptor can determine goals and objectives for each resident for the month.
Feedback and evaluation are essential components of education to help the learner improve his or her clinical performance on the rotation and to assist in his or her professional growth. Quality feedback depends on setting clear expectations with the learner, effective communication, and documentation of the encounter.
At the end of each shift, residents should be encouraged to ask for specific comments on their performance and areas to improve. The final grade is generally a global rating pass or fail and is based on evaluations written on a standardized form and collated by the faculty responsible for the final evaluation.
Feedback and objective appraisal must be tied closely to the prerotation objectives set by the resident or group, in concert with his or her mentor or the director of the rotation, resulting in directed, effective feedback that will ensure a focused learning experience.
Evaluations need to be well structured and should contain both summative and formative components.
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We suggest the use of the shift evaluation cards used by medical student educators. The suggested curriculum is not intended as a rigid, mandated format, but rather is meant to be adapted to the specific environment in which it is to be applied.
This curriculum should benefit both the rotating residents and the residency program by offering a set of guiding principles by which to structure the rotation. In addition, it will add uniformity and standardization to instruction and assessment in rotations across the country. We view this curriculum as a dynamic, interactive, process that never really ends, but evolves as learners and educators evolve, through evaluation and feedback and identification of new learning needs and advances in EM.
The manuscript was copyedited by Linda J. Data Supplement S1.
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Critical thinking: an approach to the undifferentiated and emergently ill patient. Data Supplement S2. Please note: Wiley Periodicals Inc. Any queries other than missing material should be directed to the corresponding author for the article. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors.
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Academic Emergency Medicine. Chad S. Search for more papers by this author. Evie G. Charles J. Catherine A. David E. Bradley N. Peter E. Address for correspondence and reprints: Chad S.
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Please review our Terms and Conditions of Use and check box below to share full-text version of article. Core Optional Basic airway management Electrocardiogram interpretation Foley catheter placement Intravenous access peripheral and central Venous blood draws Wound management Ultrasound use and interpretation Endotracheal intubation Joint reduction Lumbar puncture Tube thoracostomy Arterial blood gas acquisition and interpretation Thoracentesis Paracentesis Procedural sedation.
Emergency Medicine Procedures 2nd Edition (2013) (PDF) Eric Reichman
Acknowledgments The manuscript was copyedited by Linda J. Supporting Information. Educating internists in emergency medicine: medical education. West J Med. Google Scholar. Crossref PubMed Google Scholar. Wiley Online Library Google Scholar.
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Myths in Emergency Medicine - EM & Acute Care Course
Forgot your username? Enter your email address below and we will send you your username. Basic airway management Electrocardiogram interpretation Foley catheter placement Intravenous access peripheral and central Venous blood draws Wound management Ultrasound use and interpretation.