Emergency Medicine Residency Curriculum Research Articles

Bringing competency-based communication training to scale: A multi-institutional virtual simulation-based mastery learning curriculum for Emergency Medicine residents

Purpose Serious illness communication skills are essential for physicians, yet competency-based training is lacking. We address scalability barriers to competency-based communication skills training by assessing the feasibility of a multi-center, virtual simulation-based mastery learning (vSBML) curriculum on breaking bad news (BBN). Methods First-year emergency medicine residents at three academic medical centers participated in the virtual curriculum. Participants completed a pretest with a standardized patient (SP), a workshop with didactics and small group roleplay with SPs, a posttest with an SP, and additional deliberate practice sessions if needed to achieve the minimum passing standard (MPS). Participants were assessed using a previously published BBN assessment tool that included a checklist and scaled items. Authors compared pre- and posttests to evaluate the impact of the curriculum. Results Twenty-eight (90%) of 31 eligible residents completed the curriculum. Eighty-nine percent of participants did not meet the MPS at pretest. Post-intervention, there was a statistically significant improvement in checklist performance (Median= 93% vs. 53%, p < 0.001) and on all scaled items assessing quality of communication. All participants ultimately achieved the MPS. Conclusions A multi-site vSBML curriculum brought all participants to mastery in the core communication skill of BBN and represents a feasible, scalable model to incorporate competency-based communication skills education in a widespread manner.

Building, Delivering, and Evaluating a Longitudinal Global Health Curriculum for Emergency Medicine Residents

Building, Delivering, and Evaluating a Longitudinal Global Health Curriculum for Emergency Medicine Residents

Documentation Curriculum for Emergency Medicine Residents

Documentation Curriculum for Emergency Medicine Residents

Development of a Social Determinants of Health Curriculum for Emergency Medicine Residents

Development of a Social Determinants of Health Curriculum for Emergency Medicine Residents

Safer Stimulant Use: Harm Reduction Curriculum for Emergency Medicine (EM) Residents and Faculty

Safer Stimulant Use: Harm Reduction Curriculum for Emergency Medicine (EM) Residents and Faculty

Trauma-Informed Verbal De-escalation Curriculum for Emergency Medicine Residents

Trauma-Informed Verbal De-escalation Curriculum for Emergency Medicine Residents

A Novel REBOA Training Curriculum for Emergency Medicine Residents: A Pilot Study

A Novel REBOA Training Curriculum for Emergency Medicine Residents: A Pilot Study

Simulation Improves Emergency Medicine Residents' Clinical Performance of Aorta Point-of-Care Ultrasound.

Using point-of-care ultrasound (POCUS) to diagnose abdominal aortic aneurysm (AAA) is an essential skill in emergency medicine (EM). While simulation-based POCUS education is commonly used, the translation to performance in the emergency department (ED) is unknown. We investigated whether adding case-based simulation to an EM residency curriculum was associated with changes in the quantity and quality of aorta POCUS performed by residents in the ED. A case-based simulation was introduced to resident didactics at our academic, Level I trauma center. A case of undifferentiated abdominal pain was presented, which required examination of an ultrasound phantom to diagnose an AAA, with a hands-on didactic. We compared the quantity, quality, and descriptive analyses of aorta POCUS performed in the ED during the four months before and after the simulation. For participating residents (17/32), there was an 86% increase in total studies and an 80% increase in clinical studies. On an opportunity-adjusted, per-resident basis, there was no significant difference in median total scans per 100 shifts (4.4 [interquartile range (IQR) 0-15.8 vs 8.3 [IQR] 3.3-23.6, P = 0.21) or average total quality scores (3.2 ± 0.6 vs 3.2 ± 0.5, P = 0.92). The total number of limited or inadequate studies decreased (43% vs 19%, P = 0.02), and the proportion of scans submitted by interns increased (7% vs 54%, P = < .001). After simulation training, aorta POCUS was performed more frequently, and ED interns contributed a higher proportion of scans. While there was no improvement in quantity or quality scores on a per-resident basis, there were significantly fewer incomplete or limited scans.

(O-D2) Needs Assessment Tool for Global Emergency Medicine Residency Curriculum Modification

(O-D2) Needs Assessment Tool for Global Emergency Medicine Residency Curriculum Modification

A Novel Leadership Curriculum for Emergency Medicine Residents.

This longitudinal leadership curriculum is designed for emergency medicine residents at all levels, with individual sessions designed for each residency year. This curriculum runs once annually over three to four years of emergency medicine residency. Leadership is a vital skill for emergency physicians but is often passively taught during residency training. Strong leadership skills can lead to improved patient outcomes, but very few residency programs in any specialty and no emergency medicine residency programs have published comprehensive leadership training curricula. The goals of this curriculum are to expose Emergency Medicine residents to the basics of leadership, to provide a graduated series of interactive, psychologically safe environments to explore individual leadership styles, to review interesting relevant literature, and to discuss leadership principles and experiences with senior leaders in our Emergency Department. The educational strategies used in this curriculum include: brief lecture-style seminars, small group discussion and reflection, and a panel-style discussion. The educational content of this curriculum was evaluated by learners via feedback surveys after each session. Course evaluations conducted in both 2017 and 2020 showed that more than 89% of resident participants found these sessions "useful" or "very useful." All residents surveyed agreed that leadership is an important topic for emergency medicine residency, and 76% felt that the inclusion of leadership content strengthened the residency's curriculum. Suggestions for future topics included handling personal conflict and discussing transitions in leadership during yearly residency promotions. The curriculum has been successfully implemented for seven years. It has proven to be sustainable and requires minimal resources. The residents report high satisfaction with the curriculum and agree that formal instruction on the topic of leadership is important to their on-shift performance and careers. Leadership, communication.

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

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.

EMERGENCY MEDICINE IN KINGDOM OF SAUDI ARABIA: AN ERA OF DEVELOPMENT AND A BRIGHT THERAPY FOR THE FUTURE. AN APPRAISAL

Objectives: To identify the intergender variation of on-scenetime (OST) for highly urgent emergency cases conveyed by emergency medical services (EMS) in Saudi Arabia and to assess other predictors of OST and hypothesis for possible factors delaying OST. Design: A retrospective population-based registry study. Setting: Riyadh Province is the largest provincein terms of population and the second in terms ofgeographical area. Participants: All highly urgent transported patients from the scene to emergency departments, be they medical emergencies or trauma emergencies during 2018. Outcome Measure:OST difference between men and women transported by EMS. Although emergency medical services (EMS) and pre-hospital care have existed in the Kingdom of Saudi Arabia (KSA) since 1934, emergency medicine (EM) is a relatively new medical field in the country that was not formally recognized as a medical specialty until 2001. In 2005, the Saudi Board of Emergency Medicine formed to develop, implement, and evaluate a standardized curriculum for EM residents. Since then, EM and the pre-hospital system in the KSA has evolved and grown. This article provides an overview of emergency medicine in Saudi Arabia and the progress it has made in the pre-hospital system, healthcare delivery system, and emergency medicine training. Finally, we will discuss the challenges and opportunities faced as this specialty continues to develop.

Pediatric Emergency Medicine Didactics and Simulation: JumpSTART Secondary Triage for Mass Casualty Incidents.

Mass casualty incidents (MCI), particularly involving pediatric patients, are high-risk, low-frequency occurrences that require exceptional emergency arrangements and advanced preparation. In the aftermath of an MCI, it is essential for medical personnel to accurately and promptly triage patients according to their acuity and urgency for care. As first responders bring patients from the field to the hospital, medical personnel are responsible for prompt secondary triage of these patients to appropriately delegate hospital resources. The JumpSTART triage algorithm (a variation of the Simple Triage and Rapid Treatment, or START, triage system) was originally designed for prehospital triage by prehospital providers but can also be used for secondary triage in the emergency department setting. This technical report describes a novel simulation-based curriculum for pediatric emergency medicine residents, fellows, and attendings involving the secondary triage of patients in the aftermath of an MCI in the emergency department. This curriculum highlights the importance of the JumpSTART triage algorithm and how to effectively implement it in the MCI setting.

A Novel Pediatric Resuscitation Simulation and Procedures Curriculum for Emergency Medicine Residents

A Novel Pediatric Resuscitation Simulation and Procedures Curriculum for Emergency Medicine Residents

The Residency Olympics: A Novel Gamified Curriculum for Emergency Medicine Residents

The Residency Olympics: A Novel Gamified Curriculum for Emergency Medicine Residents

Creation and Implementation of a Novel Asynchronous ECG Curriculum for PGY1 Emergency Medicine Residents

Creation and Implementation of a Novel Asynchronous ECG Curriculum for PGY1 Emergency Medicine Residents

Feasibility of a Multifaceted Social Emergency Medicine Curriculum for Emergency Medicine Residents.

Emergency physicians are in a unique position to impact both individual and population health needs. Despite this, emergency medicine (EM) residency training lacks formalized education n the social determinants of health (SDoH) and integration of patient social risk and need, which are core components of social EM (SEM). The need for such a SEM-based residency curriculum has been previously recognized; however, there is a gap in the literature related to demonstration and feasibility. In this study we sought to address this need by implementing and evaluating a replicable, multifaceted introductory SEM curriculum for EM residents. This curriculum is designed to increase general awareness related to SEM and to increase ability to identify and intervene upon SDoH in clinical practice. A taskforce of EM clinician-educators with expertise in SEM developed a 4.5-hour educational curriculum for use during a single, half-day didactic session for EM residents. The curriculum consisted of asynchronous learning via a podcast, four SEM subtopic lecture didactics, guest speakers from the emergency department (ED) social work team and a community outreach partner, and a poverty simulation with interdisciplinary debrief. We obtained pre- and post- intervention surveys. A total of 35 residents and faculty attended the conference day, with 18 participants completing the immediate post-conference survey and 10 participants completing the two-month delayed, post-conference survey. Post-survey results demonstrated improved awareness of SEM concepts and increased confidence in participants' knowledge of community resources and ability to connect patients to these resources following the curricular intervention (25% pre-conference to 83% post-conference). In addition, post-survey assessment demonstrated significantly heightened awareness and clinical consideration of SDoH among participants (31% pre-conference to 78% post-conference) and increased comfort in identifying social risk in the ED (75% pre-conference to 94% post-conference). Overall, all components of the curriculum were evaluated as meaningful and specifically beneficial for EM training. The ED care coordination, poverty simulation, and the subtopic lectures were rated most meaningful. This pilot curricular integration study demonstrates feasibility and the perceived participant value of incorporating a social EM curriculum into EM residency training.

Using cognitive load theory to develop an emergency airway management curriculum: the Queen's University Mastery Airway Course (QUMAC).

Emergency airway management requires the simultaneous coordination of clinical reasoning and therapeutic interventions in the complex and time-sensitive setting of emergency resuscitation. The cognitive demand associated with these situations is invariably high and must be taken into consideration when designing training programs for this core professional competency. The four-component instructional design model (4C/ID), based on cognitive load theory, was used to develop a 1-year longitudinal airway management curriculum for Emergency Medicine residents. The simulation-based curriculum was designed with the goal of facilitating the construction and automation of schemas by individual residents in preparation for the high cognitive demand associated with emergency airway management in the clinical environment.

Implementation of an Emergency Medicine Palliative Care Curriculum for Emergency Medicine Residents: A Quality Improvement Project (Sch437)

Implementation of an Emergency Medicine Palliative Care Curriculum for Emergency Medicine Residents: A Quality Improvement Project (Sch437)

A Novel Quality Improvement and Patient Safety Curriculum for Emergency Medicine Residents

Quality improvement training during residency is a crucial component of post-graduate medical education and is one of the Association of American Medical Colleges Cross-Continuum Competencies and the six Accreditation Council for Graduate Medical Education domains of clinical competency. No national standard curriculum exists when it comes to training emergency medicine residents. A novel residency-focused QI curriculum was implemented to help emergency medicine residents develop foundational skills in QI and to translate these skills into practical projects that span multiple disciplines. The curriculum was effective, is readily adaptable to the resident physician and medical student levels, and supports the national trend toward implementing education in QI earlier in physician training.