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Cevik AA, Cakal ED, Kwan J, Chu S, Mtombeni S, Anantharaman V, Jouriles N, Peng DTK, Singer A, Cameron P, Ducharme J, Wai A, Manthey DE, Hobgood C, Mulligan T, Menendez E, Jakubaszko J. IFEM model curriculum: emergency medicine learning outcomes for undergraduate medical education. Int J Emerg Med 2024; 17:98. [PMID: 39103797 DOI: 10.1186/s12245-024-00671-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/04/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND The International Federation for Emergency Medicine (IFEM) published its model curriculum for medical student education in emergency medicine in 2009. Because of the evolving principles of emergency medicine and medical education, driven by societal, professional, and educational developments, there was a need for an update on IFEM recommendations. The main objective of the update process was creating Intended Learning Outcomes (ILOs) and providing tier-based recommendations. METHOD A consensus methodology combining nominal group and modified Delphi methods was used. The nominal group had 15 members representing eight countries in six regions. The process began with a review of the 2009 curriculum by IFEM Core Curriculum and Education Committee (CCEC) members, followed by a three-phase update process involving survey creation [The final survey document included 55 items in 4 sections, namely, participant & context information (16 items), intended learning outcomes (6 items), principles unique to emergency medicine (20 items), and content unique to emergency medicine (13 items)], participant selection from IFEM member countries and survey implementation, and data analysis to create the recommendations. RESULTS Out of 112 invitees (CCEC members and IFEM member country nominees), 57 (50.9%) participants from 27 countries participated. Eighteen (31.6%) participants were from LMICs, while 39 (68.4%) were from HICs. Forty-four (77.2%) participants have been involved with medical students' emergency medicine training for more than five years in their careers, and 56 (98.2%) have been involved with medical students' training in the last five years. Thirty-five (61.4%) participants have completed a form of training in medical education. The exercise resulted in the formulation of tiered ILO recommendations. Tier 1 ILOs are recommended for all medical schools, Tier 2 ILOs are recommended for medical schools based on perceived local healthcare system needs and/or adequate resources, and Tier 3 ILOs should be considered for medical schools based on perceived local healthcare system needs and/or adequate resources. CONCLUSION The updated IFEM ILO recommendations are designed to be applicable across diverse educational and healthcare settings. These recommendations aim to provide a clear framework for medical schools to prepare graduates with essential emergency care capabilities immediately after completing medical school. The successful distribution and implementation of these recommendations hinge on support from faculty and administrators, ensuring that future healthcare professionals are well-prepared for emergency medical care.
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Affiliation(s)
- Arif Alper Cevik
- Emergency Medicine Section, Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
- Department of Emergency Medicine, Tawam Hospital, Al Ain, UAE.
| | - Elif Dilek Cakal
- Emergency Department, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - James Kwan
- Department of Emergency Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Simon Chu
- University of Adelaide, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia
| | - Sithembile Mtombeni
- Department of Emergency Medicine, University of Namibia, Northern Campus, Oshakati, Namibia
| | | | - Nicholas Jouriles
- Department of Emergency Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA
| | | | - Andrew Singer
- Australian Government Department of Health and Aged Care, Canberra, ACT, Australia
- Australian National University Medical School, Acton, ACT, Australia
| | - Peter Cameron
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
- The Alfred Hospital, Emergency and Trauma Centre, Melbourne, Australia
| | | | - Abraham Wai
- Department of Emergency Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - David Edwin Manthey
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Cherri Hobgood
- Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Terrence Mulligan
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Edgardo Menendez
- Department of Emergency Medicine, Churruca Hospital UBA, Buenos Aires, Argentina
| | - Juliusz Jakubaszko
- Department of Emergency Medicine, Wroclaw University of Medicine, Wroclaw, Poland
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Kumar S, Jensen EH, Watts S, Parsa M. Assessing Individual Competency Differences Between Third- and Fourth-Year Medical Students Using the National Clinical Assessment Tool for Medical Students in the Emergency Department. Cureus 2024; 16:e56486. [PMID: 38638768 PMCID: PMC11024878 DOI: 10.7759/cureus.56486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Medical students rotating through emergency departments as part of their clinical education are typically evaluated using an on-shift evaluation tool. The National Clinical Assessment Tool for Medical Students in the Emergency Department (NCAT-EM) is the current standard of evaluation for medical students in the emergency department, regardless of level of training. This study aims to evaluate whether the NCAT-EM can detect differences in skill levels between third-year medical students (MS3s) and fourth-year medical students (MS4s) rotating at a level 1 trauma center and teaching institution. These authors hypothesized that MS4s should outperform MS3s across all assessment domains given their additional training. A total of 930 performance evaluations were gathered for MS3 and MS4 rotating between May 2022 and June 2023. There were 321 evaluations of MS3s and 609 evaluations of MS4s. Across the six assessment domains, MS4s had statistically significant higher performances in two domains - namely emergency recognition and management (fully entrustable: 37.4% vs. 23.8% (p = 0.03)) and communication (fully entrustable: 46.2% vs. 33.6% (p = 0.03)). These findings indicate that the use of the NCAT-EM at this institution reliably differentiated between MS3s and MS4s in these two assessment domains. There were trends suggesting MS4s outperform MS3s in the other four domains, which did not rise to the level of statistical significance, but are consistent with prior validation studies of the NCAT.
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Affiliation(s)
- Siddhant Kumar
- Emergency Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Elizabeth H Jensen
- Emergency Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Susan Watts
- Emergency Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Michael Parsa
- Emergency Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
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Hoxha I, Hekman DJ, Schnapp B. Second- and third-year medical students' clinical encounters in the emergency department. AEM EDUCATION AND TRAINING 2024; 8:e10937. [PMID: 38504802 PMCID: PMC10950016 DOI: 10.1002/aet2.10937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/08/2023] [Accepted: 11/23/2023] [Indexed: 03/21/2024]
Abstract
Background Experiential learning theory suggests that direct clinical experiences facilitate learning. Previous literature has focused primarily on the experiences of fourth-year medical students. As more students gain early clinical exposure, it is important to understand the types of patients seen by junior students. Objectives This study aims to categorize the clinical experiences of early (M2 and M3) students in the emergency department (ED). Methods A retrospective review of the electronic health record of patients seen by M2s and M3s on a 2-week emergency medicine rotation at a single urban academic ED in the Midwest was performed. Data elements extracted included total number of patients seen, Emergency Severity Index (ESI), disposition, and chief complaint. Students were not mandated to see any particular patients. Results Medical students (248) saw 2994 total patients from 2018 to 2022. The median number of patients seen by each student was 12.0 (range 1-32). Pediatric patients made up 6.5% (n = 194) of total patients. Encounters were primarily ESI 2 or 3, which accounted for 89.4% of all patients (n = 2676). The most encountered complaints were abdominal pain, chest pain, and dyspnea, making up 15.6% (n = 467), 8.7% (n = 260), and 5.5% (n = 165), respectively, of total cases. Obstetrics/gynecology, hematologic, and environmental disorders were the least frequently encountered domains. No students saw all Clerkship Directors in Emergency Medicine (CDEM)-recommended complaints. Conclusions There is significant variability in the ED encounters of M2s and M3s, with wide ranges of patient volume and presentations. This study provides some evidence that early students may not be meeting CDEM recommendations.
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Affiliation(s)
- Ines Hoxha
- University of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Daniel J. Hekman
- Department of Emergency MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Benjamin Schnapp
- Department of Emergency MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
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Murray C, Stauffer-Macdowell C, Shenvi C. Medical Student Learning Experience With Attending or Resident Preceptors in the Emergency Department. Cureus 2023; 15:e47285. [PMID: 38021862 PMCID: PMC10656126 DOI: 10.7759/cureus.47285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives The emergency department (ED) provides a unique learning environment for medical students. However, environment, patient, and preceptor factors limit standardized teaching. We explored the most effective educational interactions for fourth-year medical students during an emergency medicine (EM) clerkship designed to allow clinical interaction with both residents and faculty. Methods This is an exploratory, prospective, needs assessment study of objective cards and surveys submitted by medical students as part of their month-long fourth-year clinical rotation at a tertiary care academic ED. Students marked which topics or procedures they had reviewed, and who had precepted them. In an exit survey, students were asked to rate how often they received individualized teaching and whether their educational goals were met when working with residents and attendings. Qualitative and quantitative data were collected anonymously with institutional review board (IRB) exemption. Results Shift card data was collected from 69 of the rotating students. Attendings tended to precept visual diagnostics while residents tended to teach technical procedures. Forty-four students completed the exit survey. Results showed that students felt they received individualized teaching from both attendings and residents (7.9 and 8.0 respectively, p = 0.059). Students felt their goals were met more when reporting to the residents than the attendings but not significantly so (8.6 and 8.0, respectively, p = 0.088). Additional themes were that students wanted more individualized experiences with the attendings and requested more dedicated teaching shifts. Conclusions Fourth-year medical students in the ED felt they received individualized teaching on most shifts. They reported their education goals were met as often when working with residents as with attendings; however, interactions feature different educational content. Clerkship curricula design would benefit from resident and attending-directed teaching experiences to optimize the educational experience in the ED.
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Affiliation(s)
- Collyn Murray
- Emergency Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA
| | | | - Christina Shenvi
- Emergency Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA
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Zemel R. A COVID-19 Call to Action: Psychological First Aid Training for Medical Professionals and Trainees. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:769-773. [PMID: 35585429 DOI: 10.1007/s40596-022-01645-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Rachel Zemel
- MedStar Georgetown University Hospital, Georgetown University, Washington, D.C., USA.
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Cevik AA, Cakal ED, Alao D, Elzubeir M, Shaban S, Abu-Zidan F. Self-efficacy beliefs and expectations during an Emergency Medicine Clerkship. Int J Emerg Med 2022; 15:4. [PMID: 35065608 PMCID: PMC8903584 DOI: 10.1186/s12245-021-00406-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background Undergraduate emergency medicine (EM) training is important because all medical graduates are expected to have basic emergency knowledge and skills regardless of their future speciality. EM clerkship should provide opportunities to improve not only knowledge and skills but also the self-efficacy of learners. This study aims to evaluate the expectations, opinions, and self-efficacy beliefs of medical students during a 4-week mandatory EM clerkship. Methods This study used a prospective longitudinal design with quantitative and qualitative survey methods. It includes final year medical students of the 2015–2016 academic year. Voluntary de-identified pre- and post-clerkship surveys included 25 statements. The post-clerkship survey included two open-ended questions asking participants to identify the best and worst three aspects of EM clerkship. Responses were analysed to determine themes or commonalities in participant comments indicative of the EM clerkship learning experiences and environment. Results Sixty-seven out of seventy-nine (85%) students responded to both pre- and post-clerkship surveys. Medical students’ expectations of EM clerkships’ effect on knowledge and skill acquisition were high, and a 4-week mandatory EM clerkship was able to meet their expectations. Medical students had very high expectations of EM clerkships’ educational environment. In most aspects, their experiences significantly exceeded their expectations (p value < 0.001). The only exception was the duration of clerkship, which was deemed insufficient both at the beginning and at the end (p value: 0.92). The students perceived that their self-efficacy improved significantly in the majority of basic EM skills and procedures (p value < 0.001). Emergent qualitative themes in the study also supported these results. Conclusion This study showed that a 4-week mandatory EM clerkship increased medical students' perceived self-efficacy in basic emergency management skills. The EM clerkship met students' expectations on knowledge and skill acquisition, and exceeded students’ expectations on educational environment.
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Müller A, Wagner FM, Schuster AK, Günal B, Pfeiffer N, Schmidt F, Prokosch V. [Ophthalmic emergencies: training via interactive key feature cases for medical students]. Ophthalmologe 2022; 119:48-55. [PMID: 34057586 PMCID: PMC8763746 DOI: 10.1007/s00347-021-01409-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/13/2021] [Accepted: 04/27/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Autonomous diagnosis and assessment of medical emergencies are important skills to acquire for medical students. Ophthalmology features certain specialty-specific "red flag" signs and symptoms, which pose a challenge for educators in ophthalmology. To support medical students in identifying those "red flags" we developed and implemented interactive cases for our e‑learning platform. MATERIAL AND METHODS A total of seven interactive cases with key feature problems regarding potentially dangerous signs and symptoms, such as painless loss of vision or red eye were developed. Medical students were guided through a case and performed formative assessments. The interactive cases were created with e‑learning authoring software and were available on the learning management system presence of the department of ophthalmology. They were mandatory for medical students in the ophthalmology course. Students evaluated the cases after the course. RESULTS The interactive cases were rated on average at 1.51 ± 0.68 (mean ± standard deviation; n = 163) on a grade scale (1 = best, 6 = worst). On a Likert scale they were perceived as helpful for individual learning at 1.60 ± 0.81 (1 = very helpful, 7 = not helpful at all; n = 164). The information provided on the cases and selection of scenarios was positively evaluated. CONCLUSION To support students in identifying and managing ophthalmic emergencies in the context of limited time in tightly packed curricula, interactive key feature cases can be part of corresponding e‑learning resources. An integration of such cases was evaluated as desirable.
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Affiliation(s)
- Andreas Müller
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - Felix M Wagner
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Alexander K Schuster
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Betül Günal
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Norbert Pfeiffer
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Franziska Schmidt
- Zentrum für Qualitätssicherung und -entwicklung, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Verena Prokosch
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
- Zentrum für Augenheilkunde, Uniklinik Köln, Köln, Deutschland
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Lucas R, Dandar V, Scott J. Engagement and Workplace Satisfaction of Emergency Medicine Faculty in the United States. AEM EDUCATION AND TRAINING 2021; 5:e10474. [PMID: 33842803 PMCID: PMC8019150 DOI: 10.1002/aet2.10474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The objective was to determine the drivers of workplace satisfaction and attrition for emergency medicine (EM) faculty in U.S. medical schools. METHODS Dimensions of workplace satisfaction measured in the Association of American Medical Colleges StandPoint Faculty Engagement Survey from 36 U.S. Liaison Committee on Medical Accreditation-accredited medical schools were analyzed by multiple regression analysis to determine the factors associated with overall workplace satisfaction and intention to leave. These were compared to faculty from non-EM clinical departments. RESULTS In total, 737 EM faculty (response rate 66%) completed the survey. Over 50% of EM faculty are less than 45 years old, of junior rank, and on a nontenure track, different than non-EM colleagues. Overall satisfaction with one's department as a place to work was 76% and one's medical school as a place to work was 69%, similar to other clinical faculty. Overall satisfaction is 87% for EM faculty with a formal mentor compared to 68% for those who do not. One's nature of work, departmental governance, collegiality and collaboration, and the clinical practice environment are significant factors in overall workplace satisfaction. EM faculty spend significantly more time on teaching and administrative tasks and less time on research than non-EM faculty. Overall functioning of the ED and ability to provide high-quality care in their practice environment is lower for EM than non-EM faculty. Survey dimensions were poor predictors of intention to leave. CONCLUSIONS Overall EM faculty have high workplace satisfaction similar to other specialties. Ensuring strong departmental leadership, improving the clinical practice environment, and increasing access to a formal mentor may be effective strategies to improve workplace satisfaction for EM faculty.
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Affiliation(s)
- Raymond Lucas
- From theDepartment of Emergency MedicineGeorge Washington UniversityWashingtonDCUSA
| | - Valerie Dandar
- and theAssociation of American Medical CollegesWashingtonDCUSA
| | - James Scott
- From theDepartment of Emergency MedicineGeorge Washington UniversityWashingtonDCUSA
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Guth TA, Overbeck MC, Roswell K, Vu TT, Williamson KM, Yi Y, Hilty W, Druck J. Impact of a Dedicated Teaching Attending Experience on a Required Emergency Medicine Clerkship. West J Emerg Med 2019; 21:58-64. [PMID: 31913820 PMCID: PMC6948705 DOI: 10.5811/westjem.2019.11.44399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/13/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction One published strategy for improving educational experiences for medical students in the emergency department (ED) while maintaining patient care has been the implementation of dedicated teaching attending shifts. To leverage the advantages of the ED as an exceptional clinical educational environment and to address the challenges posed by the rapid pace and high volume of the ED, our institution developed a clerkship curriculum that incorporates a dedicated clinical educator role – the teaching attending – to deliver quality bedside teaching experiences for students in a required third-year clerkship. The purpose of this educational innovation was to determine whether a dedicated teaching attending experience on a third-year required emergency medicine (EM) clerkship would improve student-reported clinical teaching evaluations and student-reported satisfaction with the overall quality of the EM clerkship. Methods Using a five-point Likert-type scale (1 - poor to 5 - excellent), student-reported evaluation ratings and the numbers of graduating students matching into EM were trended for 10 years retrospectively from the inception of the clerkship for the graduating class of 2009 through and including the graduating class of 2019. We used multinomial logistic regression to evaluate whether the presence of a teaching attending during the EM clerkship improved student-reported evaluation ratings for the EM clerkship. We used sample proportion tests to assess the differences between top-box (4 or 5 rating) proportions between years when the teaching attending experience was present and when it was not. Results For clinical teaching quality, when the teaching attending is present the estimated odds of receiving a rating of 5 is 77.2 times greater (p <0.001) than when the teaching attending is not present and a rating of 4 is 27.5 times greater (p =0.0017). For overall clerkship quality, when the teaching attending is present, the estimated odds of receiving a rating of 5 is 13 times greater (p <0.001) and a rating of 4 is 5.2 times greater (p=0.0086) than when the teaching attending is not present. Conclusion The use of a dedicated teaching attending shift is a successful educational innovation for improving student self-reported evaluation items in a third-year required EM clerkship.
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Affiliation(s)
- Todd A Guth
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Michael C Overbeck
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Kelley Roswell
- University of Colorado School of Medicine, Department of Pediatrics, Aurora, Colorado
| | - Tien T Vu
- University of Colorado School of Medicine, Department of Pediatrics, Aurora, Colorado
| | - Kayla M Williamson
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Yeonjoo Yi
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - William Hilty
- Saint Mary's Medical Center, Department of Emergency Medicine, Grand Junction, Colorado
| | - Jeff Druck
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
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Berger-Estilita J, Nabecker S, Greif R. A Delphi consensus study for teaching "Basic Trauma Management" to third-year medical students. Scand J Trauma Resusc Emerg Med 2019; 27:91. [PMID: 31623634 PMCID: PMC6798469 DOI: 10.1186/s13049-019-0675-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/30/2019] [Indexed: 11/22/2022] Open
Abstract
Background The Basic-Trauma Management (BTM) course has been taught to third-year medical students in small groups for many years without substantial changes. With the introduction of a new curriculum for Swiss medical students, it was necessary to revise the BTM content and re-align it. Our aim was to identify core competencies for the revised BTM course. Methods We applied a three-round step-wise Delphi consensus. First, we asked open-ended questions on what were the most important competencies to be taught for BTM; the second round used Likert scales to ensure agreement on the competencies; and the final round reached out for consensus on these BTM competencies. Stakeholders were selected based on their long-standing experience in teaching BTM and in managing trauma patients. Results Consensus was found on 29 competencies out of an initial 130 proposals. “Human Factors”, which had not been taught previously, scored relatively high, at 22%. The sole specific trauma skill agreed upon was the use of tourniquets. Conclusions This is an example of curricular revision of a clinical skills course after the introduction of a regulatory framework for undergraduate medical education. The revised course curriculum tailors the concepts and skills in trauma that fulfill stakeholder needs, and are in agreement with the new Swiss learning outcomes.
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Affiliation(s)
- Joana Berger-Estilita
- Department of Anaesthesiology and Pain Therapy, Inselspital, Bern University Hospital, Freiburgstrasse 8-10, 8010, Bern, Switzerland.
| | - Sabine Nabecker
- Department of Anaesthesiology and Pain Therapy, Inselspital, Bern University Hospital, Freiburgstrasse 8-10, 8010, Bern, Switzerland
| | - Robert Greif
- Department of Anaesthesiology and Pain Therapy, Inselspital, Bern University Hospital, Freiburgstrasse 8-10, 8010, Bern, Switzerland
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Royan R, Wu C, Theyyunni N, Montas S, Cranford JA, House JB, Lukela MP, Santen SA. Anything but Shadowing! Early Clinical Reasoning in Emergency Department Improves Clinical Skills. West J Emerg Med 2017; 19:177-184. [PMID: 29383078 PMCID: PMC5785190 DOI: 10.5811/westjem.2017.10.36691] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 10/23/2017] [Accepted: 10/18/2017] [Indexed: 12/03/2022] Open
Abstract
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. The objective of this study is to determine if the CRE improved students’ clinical skills and reported comfort in their skills. Methods We examined the relationships between students’ self-reported participation in the CRE and their individual scores on a comprehensive clinical assessment (CCA) at the end of the pre-clerkship period. A total of 178 students took the CCA exam in 2016. Of these, 113 participated in the CRE and 65 did not. Seven students who participated in CRE did not complete the exit survey and were omitted from analysis. We performed regression analysis and dichotomous (participants/nonparticipants) comparisons of means with t-tests. Survey of student reactions was collected. Results Participants completed an average of 10 sessions over the course of the program (range=1–20). Involvement in the CRE was associated with significantly increased scores on Abdominal History; Pulmonary Physical Exam; Overall History-Taking; Overall Communication; and Overall Physical Exam (p<0.05). Nearly all students (97%) reported that the program offered opportunities to enhance clinical skills, increased their comfort with patients, and better prepared them for their clinical years. Conclusion There were measurable improvements in clinical skills performance for students who participated in CRE. As many schools seek to incorporate early clinical exposure to their curricula, this program provides a successful framework to provide meaningful clinical exposure to real patients that also shows objective benefits to students’ clinical skills.
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Affiliation(s)
- Regina Royan
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Christine Wu
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Nik Theyyunni
- Michigan Medicine, Department of Emergency Medicine, Ann Arbor, Michigan
| | - Sacha Montas
- Michigan Medicine, Department of Emergency Medicine, Ann Arbor, Michigan
| | - James A Cranford
- Michigan Medicine, Department of Emergency Medicine, Ann Arbor, Michigan
| | - Joseph B House
- Michigan Medicine, Department of Emergency Medicine, Ann Arbor, Michigan
| | - Michael P Lukela
- Michigan Medicine, Department of Internal Medicine and Pediatrics, Ann Arbor, Michigan
| | - Sally A Santen
- Michigan Medicine, Department of Emergency Medicine, Ann Arbor, Michigan.,Virginia Commonwealth University School of Medicine, Richmond, Virginia
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Dang TT, Wong C, Bistritz L. Gastroenterology Curriculum in the Canadian Medical School System. Can J Gastroenterol Hepatol 2017; 2017:8538974. [PMID: 28484687 PMCID: PMC5397633 DOI: 10.1155/2017/8538974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 02/22/2017] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose. Gastroenterology is a diverse subspecialty that covers a wide array of topics. The preclinical gastroenterology curriculum is often the only formal training that medical students receive prior to becoming residents. There is no Canadian consensus on learning objectives or instructional methods and a general lack of awareness of curriculum at other institutions. This results in variable background knowledge for residents and lack of guidance for course development. Objectives. (1) Elucidate gastroenterology topics being taught at the preclinical level. (2) Determine instructional methods employed to teach gastroenterology content. Results. A curriculum map of gastroenterology topics was constructed from 10 of the medical schools that responded. Topics often not taught included pediatric GI diseases, surgery and trauma, food allergies/intolerances, and obesity. Gastroenterology was taught primarily by gastroenterologists and surgeons. Didactic and small group teaching was the most employed teaching method. Conclusion. This study is the first step in examining the Canadian gastroenterology curriculum at a preclinical level. The data can be used to inform curriculum development so that topics generally lacking are better incorporated in the curriculum. The study can also be used as a guide for further curriculum design and alignment across the country.
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Affiliation(s)
- ThucNhi Tran Dang
- Faculty of Dentistry and Medicine, University of Alberta, Edmonton, AB, Canada
| | - Clarence Wong
- Faculty of Dentistry and Medicine, University of Alberta, Edmonton, AB, Canada
| | - Lana Bistritz
- Faculty of Dentistry and Medicine, University of Alberta, Edmonton, AB, Canada
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Fielder EK, Lemke DS, Doughty CB, Hsu DC, Middleman AB. Development and assessment of a pediatric emergency medicine simulation and skills rotation: meeting the demands of a large pediatric clerkship. MEDICAL EDUCATION ONLINE 2015; 20:29618. [PMID: 26626927 PMCID: PMC4666893 DOI: 10.3402/meo.v20.29618] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 10/19/2015] [Accepted: 10/30/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To implement a curriculum using simulation and skills training to augment a Pediatric Emergency Medicine (PEM) rotation within a pediatric clerkship. BACKGROUND PEM faculty are often challenged with a high learner to teacher ratio in a chaotic clinical setting. This challenge was heightened when our pediatric clerkship's traditional 1-week PEM rotation (consisting of 4 students completing four 8-hour ED shifts/week) expanded to 8 students every 2 weeks. We sought to meet this challenge by integrating simulation-based education into the rotation. METHODS Clerkship students from March to June 2012 completed our traditional rotation. Students between July and October 2012 completed the new PEM-SIM curriculum with 19 hours ED shifts/week and 16 hours/week of simulation/skills training. Pre/post-tests evaluated 1) medical management/procedural comfort (five-point Likert scale); and 2) PEM knowledge (15 multiple-choice questions). RESULTS One hundred and nine students completed the study (48 traditional, 61 PEM-SIM). Improvement in comfort was significantly higher for the PEM-SIM group than the traditional group for 6 of 8 (75%) medical management items (p<0.05) and 3 of 7 (43%) procedures, including fracture splinting, lumbar puncture, and abscess incision/drainage (p<0.05). PEM-SIM students had significantly more improvement in mean knowledge compared to the traditional group (p<0.001). CONCLUSIONS We have successfully integrated 16 hours/week of faculty-facilitated simulation-based education into a PEM rotation within our clerkship. This curriculum is beneficial in clinical settings with high learner to teacher ratios and when patient care experiences alone are insufficient for all students to meet rotation objectives.
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Affiliation(s)
- Elaine K Fielder
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA;
| | - Daniel S Lemke
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Cara B Doughty
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Deborah C Hsu
- Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Amy B Middleman
- Section of Adolescent Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Pek JH, Lim SH, Ho HF, Ramakrishnan TV, Jamaluddin SF, Mesa-Gaerlan FJC, Tiru M, Hwang SO, Choi WM, Kanchanasut S, Khruekarnchana P, Avsarogullari L, Shimazu T, Hori S. Emergency medicine as a specialty in Asia. Acute Med Surg 2015; 3:65-73. [PMID: 29123755 DOI: 10.1002/ams2.154] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 07/02/2015] [Indexed: 11/07/2022] Open
Abstract
Aim We aim to examine the similarities and differences in areas of EM development, workload, workforce, and capabilities and support in the Asia region. Emerging challenges faced by our EM community are also discussed. Methods The National Societies for Emergency Medicine of Hong Kong, India, Japan, Malaysia, Philippines, Singapore, South Korea, Taiwan, Thailand and Turkey participated in the joint Japanese Association of Acute Medicine (JAAM) and Asian Conference of Emergency Medicine (ACEM) Special Symposium held in October 2013 at Tokyo, Japan. The findings are reviewed in this paper. Results Emergency medicine (EM) has over the years evolved into a distinct and recognized medical discipline requiring a unique set of cognitive, administrative and technical skills for managing all types of patients with acute illness or injury. EM has contributed to healthcare by providing effective, safe, efficient and cost-effective patient care. Integrated systems have developed to allow continuity of emergency care from the community into emergency departments. Structured training curriculum for undergraduates, and specialty training programs for postgraduates are in place to equip trainees with the knowledge and skills required for the unique practice of EM. Conclusion The practice of EM still varies among the Asian countries. However, as a region, we strive to continue in our efforts to develop the specialty and improve the delivery of EM.
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Affiliation(s)
- Jen Heng Pek
- Department of Emergency Medicine Singapore General Hospital Singapore
| | - Swee Han Lim
- Department of Emergency Medicine Singapore General Hospital Singapore
| | - Hiu Fai Ho
- Accident and Emergency Department Queen Elizabeth Hospital Hong Kong
| | - T V Ramakrishnan
- Department of Accident and Emergency Medicine Sri Ramachandra Medical College and Research Institute Chennai India
| | | | | | - Mohan Tiru
- Department of Emergency Medicine Changi General Hospital Singapore
| | - Sung Oh Hwang
- Department of Emergency Medicine Wonju College of Medicine Yonsei University Seoul Korea
| | - Wai-Mau Choi
- Department of Emergency Medicine Mackay Memorial Hospital Hsinchu Taiwan
| | | | | | - Levent Avsarogullari
- Department of Emergency Medicine Erciyes University Medical School Kayseri Turkey
| | - Takeshi Shimazu
- Department of Traumatology and Acute Critical Medicine Faculty of Medicine Osaka University Osaka Japan
| | - Shingo Hori
- Emergency and Critical Care Medicine School of Medicine Keio University Tokyo Japan
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15
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Osborne R. Should emergency medicine registrars focus on seeing patients and leave the teaching of medical students to others? No. Emerg Med Australas 2015; 27:78-9. [DOI: 10.1111/1742-6723.12351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Ruth Osborne
- Emergency Department; Austin Hospital; Melbourne Victoria Australia
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16
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Robinson D, Chin D, Kong A. Debunking myths and enhancing medical student learning within the emergency department. Emerg Med Australas 2015; 27:72-4. [PMID: 25586745 DOI: 10.1111/1742-6723.12354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Danielle Robinson
- Austin Clinical School, The University of Melbourne, Austin Health, Melbourne, Victoria, Australia
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17
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Cox M, Chandra A. Undergraduate emergency medicine in an African medical school – Experiences from Botswana. Afr J Emerg Med 2013. [DOI: 10.1016/j.afjem.2013.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Cochran Ward E, Kwan J, Garlan K, Bassett E, Klein L. ‘To teach or not to teach?’ Factors that motivate and constrain Australian emergency medicine physicians to teach medical students. Emerg Med Australas 2013; 25:353-8. [DOI: 10.1111/1742-6723.12104] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | - James Kwan
- Emergency Medicine; Sydney Medical School-Western; Sydney; New South Wales; Australia
| | - Karen Garlan
- Office of Medical Education; Sydney Medical School; Sydney; New South Wales; Australia
| | - Elizabeth Bassett
- Western Clinical School; Sydney Medical School; Sydney; New South Wales; Australia
| | - Linda Klein
- Office of Medical Education; Sydney Medical School; Sydney; New South Wales; Australia
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Tews MC, Hamilton GC. Integrating emergency medicine principles and experience throughout the medical school curriculum: why and how. Acad Emerg Med 2011; 18:1072-80. [PMID: 21996073 DOI: 10.1111/j.1553-2712.2011.01168.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The management of acutely ill and injured patients is an essential component of medical student education, yet the formal integration of emergency medicine (EM) into the medical school curriculum has progressed slowly since the inception of the specialty. Medical student interest and the number of resident positions in the National Resident Matching Program are higher than any time in the past, yet students often find access to EM faculty and clinical experience limited to a fourth-year rotation. Incorporating EM into all years of the undergraduate medical student curriculum can offer unique educational experiences and enhance exposure to the necessary and recommended knowledge and skills students must attain prior to graduation. Academic emergency physicians (EPs) should advocate our specialty's importance in their medical school curricula using a proactive approach and actively involve themselves in medical student education at all stages of training. The goals of this article are to describe several approaches for EM faculty to expand medical student exposure to the specialty and enhance student experiences in the core principles of EM throughout the undergraduate medical curriculum.
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Affiliation(s)
- Matthew C Tews
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, USA.
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