220TF A Didactic Curriculum for the Emergency Medicine Sub-internship, Designed to Be Delivered by Residents

Abstract

The emergency medicine (EM) sub-internship at OHSU is a popular and well-established four-week elective rotation for fourth-year medical students. The students are largely taught both on-shift and in didactic sessions by a third year EM resident on their “teach rotation,” which is also an educational experience for the residents. We aimed to create a didactic curriculum for the medical student rotation that provides an improved didactic experience for the medical students while still being feasible for the residents to facilitate. We sought to develop a curriculum that would prepare the students to: 1) demonstrate knowledge of introductory clinical concepts of EM; and 2) perform basic emergency department procedures under direct supervision. A secondary aim was to incorporate residents in small group didactic session and interactive workshop facilitation as part of our resident-as-teacher curriculum. We used Kern’s six-step approach to curriculum development. We started by reviewing the existing didactic material to identify opportunities for improvement and to develop strategies to optimize the materials for student learning (problem identification and targeted needs assessment). We tailored the material to meet the stated goals and objectives of the course; namely, to introduce basic clinical concepts of EM, and to teach suture, splint, and ultrasound skills. For our educational strategies, we combined a skills workshop with small group learning sessions. The workshop occurs on the first day of the clerkship and covers suture, splint, and ultrasound skills. We provide the teach resident with a PowerPoint that intersperses lecture-based teaching with opportunities for students to practice each skill. We also provide the resident with an outline of suggested teaching points that complements the slides and helps to ensure students are getting a consistent and comprehensive experience each time. After the workshop, students have a total of four two-hour didactic sessions led by the teach resident. We provide the teach resident with a repository of one-hour PowerPoint-based lectures from which they and students can choose based on interest and gaps of knowledge in the group. The expectation is that the resident will teach most, though not necessarily all, of the lectures included. The lectures are designed to be interactive in the small group setting, with many including a “pass the pointer” component to encourage student participation. We designed the slides to be self-explanatory with additional information provided in the “presenter’s comments” section so minimal advance preparation is required by the resident. The new curriculum was implemented in January 2020, and has been feasible to implement and acceptable to the learners. Student learning will be assessed on the clerkship final exam and in their shift assessment forms. Curriculum evaluation will be performed by collecting anonymous feedback from students using surveys distributed to students after they complete the clerkship, and the curriculum will be iteratively revised based on learner assessment and program evaluation data. This didactic curriculum developed for the EM sub-internship provides a consistent didactic experience for the medical students while being feasible to implement for the teach residents who are delivering the content.