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Didactic Session (didactic + session)
Selected AbstractsEmergency Medicine Crisis Resource Management (EMCRM): Pilot Study of a Simulation-based Crisis Management Course for Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 4 2003Martin Reznek MD Objectives: To determine participant perceptions of Emergency Medicine Crisis Resource Management (EMCRM), a simulation-based crisis management course for emergency medicine. Methods: EMCRM was created using Anesthesia Crisis Resource Management (ACRM) as a template. Thirteen residents participated in one of three pilot courses of EMCRM; following a didactic session on principles of human error and crisis management, the residents participated in simulated emergency department crisis scenarios and instructor-facilitated debriefing. The crisis simulations involved a computer-enhanced mannequin simulator and standardized patients. After finishing the course, study subjects completed a horizontal numerical scale survey (1 = worst rating to 5 = best rating) of their perceptions of EMCRM. Descriptive statistics were calculated to evaluate the data. Results: The study subjects found EMCRM to be enjoyable (4.9 ± 0.3) (mean ± SD) and reported that the knowledge gained from the course would be helpful in their practices (4.5 ± 0.6). The subjects believed that the simulation environment prompted realistic responses (4.6 ± 0.8) and that the scenarios were highly believable (4.8 ± 0.4). The participants reported that EMCRM was best suited for residents (4.9 ± 0.3) but could also benefit students and attending physicians. The subjects believed that the course should be repeated every 8.2 ± 3.3 months. Conclusions: The EMCRM participants rated the course very favorably and believed that the knowledge gained would be beneficial in their practices. The extremely positive response to EMCRM found in this pilot study suggests that this training modality may be valuable in training emergency medicine residents. [source] Effects of a distance learning program on physicians' opioid- and benzodiazepine-prescribing skillsTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2006Deana Midmer BScN Abstract Introduction: Opioid misuse is common among patients with chronic nonmalignant pain. There is a pressing need for physicians to increase their confidence and competence in managing these patients. Methods: A randomized controlled trial of family physicians (N = 88) attending 1 of 4 continuing medical education events helped to determine the effectiveness of e-mail case discussions in changing physician behavior. Before random assignment, participants completed a pretest and attended a 3-hour didactic session on prescribing opioids and benzodiazepines. The intervention group participated in 10 weeks of e-mail case discussions, with designated participants responding to questions on cases. An addictions physician facilitated the discussion. Several months after the e-mail discussion, participants took part in a mock telephone consultation; a blinded researcher posing as a medical colleague asked for advice about 2 cases involving opioid and benzodiazepine prescribing. Using a checklist, the researcher recorded the questions asked and advice given by the physician. Results: On post-testing, both groups expressed greater optimism about treatment outcomes and were more likely to report using a treatment contract and providing advice about sleep hygiene. There were no significant differences between pretesting and post-testing between the groups on the survey. During the telephone consultation, the intervention group asked significantly more questions and offered more advice than the control group (odds ratio for question items, 1.27 [p = .03]; advice items, 1.33 [p = .01). Discussion: Facilitated by electronic mail and a medical expert, case discussion is an effective means of improving physician performance. Telephone consultation holds promise as a method for evaluating physicians' assessment and management skills. [source] Use of Simulation Technology in Forensic Medical EducationACADEMIC EMERGENCY MEDICINE, Issue 2009Heather Rozzi Although the emergency department often provides the first and only opportunity to collect forensic evidence, very few emergency medicine residencies have a forensic medicine curriculum in place. Most of the existing curricula are composed only of traditional didactics. However, as with any lecture-based education, there may be a significant delay between the didactic session and clinical application. In addition, traditional curricula lack the opportunity for residents to practice skills including evidence collection, documentation, and use of a colposcope. At York Hospital, we have developed a forensic curriculum which consists of both traditional lectures and practical experience in our Medical Simulation Center. As part of their educational conference series, residents receive presentations on domestic violence, child abuse, elder abuse, evidence collection, sexual assault, ballistics, pattern injuries, documentation, forensic photography, and court testimony. Following these presentations, residents have the opportunity to apply their knowledge of forensic medicine in the Simulation Center. First, they interview a standardized patient. They then utilize the mannequins in the Simulation Center to practice evidence collection, photo documentation, and use of our specialized forensic medicine charts. After evidence collection and documentation, the residents provide safety planning for the standardized patients. Each portion is videotaped, and each resident is debriefed by victim advocates, experienced sexual assault nurse examiners, and emergency department faculty. The use of simulation technology in resident education provides the opportunity to practice the skills of forensic medicine, ultimately benefiting patients, residents, and law enforcement, and permitting teaching and evaluation in all six core competency areas. [source] Off-service Resident Education in the Emergency Department: Outline of a National Standardized CurriculumACADEMIC EMERGENCY MEDICINE, Issue 12 2009Chad S. Kessler MD Abstract Although many residency programs mandate at least one rotation in emergency medicine (EM), to the best of our knowledge, a standardized curriculum for emergency department (ED) rotations for "off-service" residents has not been developed. As a result, the experiences of these residents in the ED tend to vary during their rotations. To design an off-service EM curriculum, we adopted Kern's six-step approach to curriculum development as a conceptual framework. The resulting program encompasses clinical experience and didactic sessions through which residents are trained in core topics and skills. This knowledge will be applicable in the clinical settings in which residents will continue to train and ultimately practice their specialty. It is flexible enough to be applicable and implementable without being limited by resource availability or faculty strengths. [source] Need for Standardized Sign-out in the Emergency Department: A Survey of Emergency Medicine Residency and Pediatric Emergency Medicine Fellowship Program DirectorsACADEMIC EMERGENCY MEDICINE, Issue 2 2007Madhumita Sinha MD Objectives To determine the existing patterns of sign-out processes prevalent in emergency departments (EDs) nationwide. In addition, to assess whether training programs provide specific guidance to their trainees regarding sign-outs and attitudes of emergency medicine (EM) residency and pediatric EM fellowship program directors toward the need for the development of standardized guidelines relating to sign-outs. Methods A Web-based survey of training program directors of each Accreditation Council for Graduate Medical Education (ACGME),accredited EM residency and pediatric EM fellowship program was conducted in March 2006. Results Overall, 185 (61.1%) program directors responded to the survey. One hundred thirty-six (73.5%) program directors reported that sign-outs at change of shift occurred in a common area within the ED, and 79 (42.7%) respondents indicated combined sign-outs in the presence of both attending and resident physicians. A majority of the programs, 119 (89.5%), stated that there was no uniform written policy regarding patient sign-out in their ED. Half (50.3%) of all those surveyed reported that physicians sign out patient details "verbally only," and 79 (42.9%) noted that transfer of attending responsibility was "rarely documented." Only 34 (25.6%) programs affirmed that they had formal didactic sessions focused on sign-outs. A majority (71.6%) of program directors surveyed agreed that specific practice parameters regarding transfer of care in the ED would improve patient care; 80 (72.3%) agreed that a standardized sign-out system in the ED would improve communication and reduce medical error. Conclusions There is wide variation in the sign-out processes followed by different EDs. A majority of those surveyed expressed the need for standardized sign-out systems. [source] |