Good Saves: How Emergency Medicine Residents are Learning From Success.

Abstract

The practice of learning from medical errors is well-established and well-researched in the literature on morbidity and mortality conferences. However, durable learning from case-based education occurs not only through the analysis of medical errors but also through the evaluation of how critical decisions were made to result in a positive clinical outcome, what we will call a "good save." The aim of the current study is to provide an overview of how US-based emergency medicine residencies are teaching using "good saves." A national survey of emergency medicine (EM) residency leadership was distributed through the Council of Residency Directors (CORD) and the Society of Academic Emergency Medicine (SAEM) listservs. A descriptive analysis of the results was undertaken. Residency leadership representing 67 different US EM training programs participated in our survey. Of these, only 19 programs use formal learning objectives and dedicated education time to teach from "good saves." Thirty-six programs provide informal recognition, often in the form of a "shout-out." Residency leadership is motivated to provide this recognition and learning through efforts to promote wellness and resiliency among EM residents. Notably, the use of prizes and awards is not necessary. Some EM residencies in the United States are making targeted efforts to promote the recognition of successful clinical care. This recognition and education are being used as tools both to promote wellness and to teach resiliency. However, there is wide heterogeneity in approaches. Our survey provides examples of the many ways that "good saves" can be incorporated into any EM residency curriculum with the potential for significant impact.