An Asynchronous Curriculum for Teaching Practical Interpretation Skills of Clinical Images to Residents in Emergency Medicine

Birth of a Social Mediatrician: Adopting Slack, Twitter, and Instagram for Residents

Introduction Physicians have increasingly used social media platforms to review new research, expand networks, and communicate. However, few studies have evaluated how the integration of social media into residency programs affects training. This is relevant during the COVID-19 pandemic, with a shift towards virtual formats for medical education, community building, and recruitment. Objective The objective of this study was to evaluate how the integration of social media platforms, including Slack, Twitter, and Instagram, influences education, social connectedness, and recruitment within a residency program. Methods In 2020, pediatric residents at one institution were encouraged to create personal Twitter and Instagram accounts if they did not already have one and follow the residency program's Twitter and Instagram accounts. Residents were also encouraged to enroll in a private Slack network within the residency program. We surveyed residents in May and June 2020 (pre-intervention) and March 2021 (post-intervention). Analytics from the residency program's social media accounts and Slack were recorded. Data were analyzed using a mixed-methods approach. Results Response rates from residents regarding the impact of social media interventions on education, connectedness, and recruitment were 98% (100/102) pre-intervention and 74.5% (76/102) post-intervention. During the study period from May 2020 to March 2021, chief resident posts on the residency program's Twitter and Instagram accounts garnered 447,467 and 151,341 impressions, respectively. Posts with the highest average impressions were those related to advocacy. After the intervention, residents reported increased connectedness to residents in other classes and increased usage of their personal Twitter and Slack accounts for learning and education. Residents rated the program's Instagram account as a useful recruitment tool. Feasibility of posting was assessed by the number of posts by chief residents during the study period (Twitter n=806, Instagram n=67). There were no costs. Conclusion Our data shows that social media in residency is feasible, cost-effective, and valuable for education, connectedness, and recruitment. We outlined specific ways social media was feasible and useful in these domains.

Performance of PBL-Based Image Teaching in Clinical Emergency Teaching

At present, with the rapid increase of emergency knowledge and the improvement of people’s requirements for medical quality, the traditional teaching mode cannot fully meet the needs of emergency teaching in the new era. This paper is aimed at improving the clinical emergency teaching mode by problem based learning (PBL) teaching method and improving the comprehensive ability of clinical emergency of medical students. This article proposes a problem-based PBL imaging teaching method, combining the characteristics and content of clinical emergency courses, focusing on students, highlighting the problem-solving process, and improving students’ creative thinking ability. To cultivate students’ interest in clinical learning, develop their self-learning ability, train their teamwork and communication skills, and cultivate their ability to set, question, and solve questions, so as to promote medical students’ overall comprehensive ability to integrate specialized knowledge and clinical practice. In this paper, the PBL teaching method and the traditional teaching method of comparative experiments show that the PBL teaching method can more effectively highlight the characteristics of clinical emergency medicine teaching mode and make full use of the limited emergency teaching resources, so as to improve the quality of clinical emergency teaching. Compared with the traditional teaching mode, the theoretical knowledge and clinical operation skills of medical students under the PBL teaching mode are improved by 13%. Autonomous learning ability, communication ability, and creative thinking ability have also been relatively improved.

Performance of Problem-Based Learning Based Image Teaching in Clinical Emergency Teaching

At present, with the rapid increase of emergency knowledge and the improvement of people’s requirements for medical quality, the traditional teaching mode cannot fully meet the needs of emergency teaching in the new era. PBL is a project-based teaching that allows students to have a deeper understanding of content knowledge and to better apply what they have learned to their lives. This paper aims to improve the clinical emergency teaching mode by PBL teaching method, and improve the comprehensive ability of clinical emergency of medical students. This article proposes a problem-based PBL imaging teaching method, combining the characteristics and content of clinical emergency courses, focusing on students, highlighting the problem-solving process, and improving students’ creative thinking ability. To cultivate students’ interest in clinical learning, develop their self-learning ability, train their teamwork and communication skills, and cultivate their ability to set, question and solve questions, so as to promote medical students’ overall comprehensive ability to integrate specialized knowledge and clinical practice. In this paper, the PBL teaching method and the traditional teaching method of comparative experiments show that the PBL teaching method can more effectively highlight the characteristics of clinical emergency medicine teaching mode, and make full use of the limited emergency teaching resources, so as to improve the quality of clinical emergency teaching. Compared with the traditional teaching mode, the theoretical knowledge and clinical operation skills of medical students under the PBL teaching mode are improved by 13%, Autonomous learning ability, communication ability and creative thinking ability have also been relatively improved.

UME-to-GME PandEMonium in COVID-19: Large-Scale Implementation of a Virtual ACGME Milestone-Based Curriculum for Senior Medical Students Matched Into Emergency Medicine

BACKGROUND

The COVID-19 pandemic displaced newly matched emergency medicine "pre-interns" from in-person educational experiences at the end of medical school. This called for novel remote teaching modalities.

OBJECTIVE

This study assesses effectiveness of a multisite Accreditation Council for Graduate Medical Education (ACGME) sub-competency-based curricular implementation on Slack during the first wave of the COVID-19 pandemic in the United States.

METHODS

Emergency medicine residency programs were recruited via national organization listservs. Programs designated instructors to manage communications and teaching for the senior medical students who had matched to their programs (pre-interns) in spring/summer 2020. Pre- and post-surveys of trainees and instructors assessed perceived preparedness for residency, perceived effectiveness of common virtual educational modalities, and concern for the pandemic's effects on medical education utilizing a Likert scale of 1 (very unconcerned) to 5 (very concerned). Data were analyzed using descriptive statistics and the t test.

RESULTS

Of 276 possible residency programs, 28 enrolled. Of 324 possible pre-interns, 297 (91.7%) completed pre-surveys in April/May and 249 (76.9%) completed post-surveys in June/July. The median weeks since performing a physical examination was 8 (IQR 7-12), since attending in-person didactics was 10 (IQR 8-15) and of rotation displacement was 4 (IQR 2-6). Perceived preparedness increased both overall and for 14 of 21 ACGME Milestone topics taught. Instructors reported higher mean concern (4.32, 95% CI 4.23-4.41) than pre-interns (2.88, 95% CI 2.74-3.02) regarding the pandemic's negative effects on medical education.

CONCLUSIONS

Pre-interns reported improvements in residency preparedness after participating in this ACGME sub-competency-based curriculum on Slack.

Planning Engaging, Remote, Synchronous Didactics in the COVID-19 Pandemic Era

As part of the Accreditation Council for Graduate Medical Education requirements, residents must participate in structured didactic activities. Traditional didactics include lectures, grand rounds, simulations, case discussions, and other forms of in-person synchronous learning. The COVID-19 pandemic has made in-person activities less feasible, as many programs have been forced to transition to remote didactics. Educators must still achieve the goals and objectives of their didactic curriculum despite the new limitations on instructional strategies. There are several strategies that may be useful for organizing and creating a remote residency didactic curriculum. Educators must master new technology, be flexible and creative, and set rules of engagement for instructors and learners. Establishing best practices for remote didactics will result in successful, remote, synchronous didactics; reduce the impact of transitioning to a remote learning environment; and keep educators and learners safe as shelter-at-home orders remain in place.

Social Media Bridges the Training Gap Between Match Day and Internship With ACGME Milestone-based Clinical Case Curriculum

OBJECTIVES

The objective was to bridge the relative educational gap for newly matched emergency medicine preinterns between Match Day and the start of internship by implementing an Accreditation Council for Graduate Medical Education Milestone (ACGME)-based virtual case curriculum over the social media platform Slack.

METHODS

We designed a Milestone-based curriculum of 10 emergency department clinical cases and used Slack to implement it. An instructor was appointed for each participating institution to lead the discussion and encourage collaboration among preinterns. Pre- and postcurriculum surveys utilized 20 statements adapted from the eight applicable Milestones to measure the evolution of preintern self-reported perceived preparedness (PP) as well as actual clinical knowledge (CK) performance on a case-based examination.

RESULTS

A total of 11 institutions collaborated and 151 preinterns were contacted, 127 of whom participated. After participating in the Slack intern curriculum (SIC), preinterns reported significant improvements in PP regarding multiple Milestone topics. They also showed improved CK regarding the airway management Milestone based on examination performance.

CONCLUSIONS

Implementation of our SIC may ease the difficult transition between medical school and internship for emergency medicine preinterns. Residency leadership and medical school faculty will benefit from knowledge of preintern PP, specifically of their perceived strengths and weaknesses, because this information can guide curricular focus at the end of medical school and beginning of internship. Limitations of this study include variable participation and a high attrition rate. Further studies will address the utility of such a virtual curriculum for preinterns and for rotating medical students who have been displaced from clinical rotations during the novel coronavirus pandemic.

Converting to Connect: A Rapid RE-AIM Evaluation of the Digital Conversion of a Clerkship Curriculum in the Age of COVID-19

BACKGROUND

With the advent of the 2019 coronavirus pandemic, a decision was made to remove medical students from clinical rotations for their own safety. This forced students on a core emergency medicine (EM) rotation at McMaster University to immediately cease all in-person activities. An urgent need for a virtual curriculum emerged.

METHODS

A virtual curriculum consisting of asynchronous case-based learning on Slack, ask-me-anything webinars, and online e-modules was created to fill the need. We describe a program evaluation using the RE-AIM framework and a social networking analysis of participants.

RESULTS

Medical students (n = 23) and 11 facilitators (five residents, six faculty members) participated in this pilot study. Faculty members sent a mean (±SD) of 115 (±117) messages (n = 6), and mean (±SD) message counts for students and residents were 49.96 (±25; n = 23) and 39 (±38; n = 5), respectively. A total of 62,237 words were written by the participants, with a mean of 1,831 per person. Each message consisted of a mean (±SD) of 25 words (±29). Students rapidly acquitted themselves to digital technology. Using the RE-AIM framework we highlight the feasibility of a virtual curriculum, discuss demands on faculty time, and reflect on strategies to engage learners.

CONCLUSIONS

The use of asynchronous digital curricula creates opportunities for faculty-resident interaction and engagement. We report the successful deployment of a viable model for undergraduate EM training for senior medical students in the COVID-19 era of physical distancing.