On behalf of the AIR Executive Board, we are excited to introduce the Approved Instructional Resources (AIR) series! The AIR series was conceived to provide a credible method by which an U.S. Emergency Medicine resident can receive academic credit for using Free Open Access Meducation (FOAM) resources. The Executive Board will release a list of high-quality FOAM educational posts and podcasts specially selected by our Executive Board, in parallel with the CORD residency training curriculum. We will have an accompanying quiz for each list and track who completes it. EM residents who complete the quiz can hopefully receive credit for Individualized Interactive Instruction (III) from their EM residency for training purposes.
Why do this?
We created this series because we have observed residencies struggle in evaluating which blog posts and podcasts are appropriate and high quality for resident education. Often residents independently access FOAM resources available online, but do not receive training credit for this. We seek to use our expertise to bridge this divide by assisting residency programs to promote asynchronous learning, online education, as well as reward residents who already effectively utilize FOAM resources.
Who is our sponsor?
The Council of EM Residency Directors (CORD), who shares our vision for improving graduate medical education through digital learning platforms, has generously offered to help sponsor our efforts. This helps toward sustaining the ALiEM AIR Series on the blog and eventually making a major move to our custom learning management platform ALiEMU (anticipated starting February-March 2016).
How do we select the articles?
The 9-person Executive Board reviews numerous FOAM resources and scores each on an objective grading system designed for this series. We curate relevant posts from top blogs and podcasts, as graded by the Social Media Index, with the inclusion criteria of publication date within the past 12 months. If this list of posts is insufficient, we broaden to a longer time interval. We do not claim an exhaustively comprehensive search, but feel that we ultimately highlight quality posts for residency education.
The cumulative highest scoring 6-10 posts from each module are selected. To decrease any obvious bias, members of the Executive Board recuse themselves from evaluating posts they wrote or were directly involved in writing. Our scoring tool looks at five measurement outcomes, each using a Likert 7-point scale:
- BEEM Score
- Content Accuracy
- Educational Utility
- Evidence Based Medicine
The actual grading instrument can be viewed in this AIR Series Grading Tool PDF.
What is III?
In 2008, the Residency Review Committee (RRC) in Emergency Medicine as well as the Accreditation Council for Graduate Medical Education (ACGME) endorsed a change in the education hours requirements for residencies. Previously, five hours of educational conference time was required per week. The new recommendation allows residencies to decrease their conference time to four hours per week with an additional one hour of documented asynchronous learning outside the classroom. This series abides by the CORD and ACGME’s requirements for III. Upon request, all EM program directors will have access to our master read-only list of residents who complete the quiz. In addition, faculty on our Executive Board will engage with residents in the blog comment section for questions and comments that arise during reading.
How does this count for III credit?
Per the ACGME and EM RRC [PDF, pg 4-5], III credit depends on fulfilling all 4 of the following criteria, and this is how we address them:
- The program director must monitor resident participation. – We give read-access to PDs.
- There must be an evaluation component. – We have a post-module quiz.
- There must be faculty oversight. – We have faculty not only screening the content for accuracy and value, but also monitoring the blog comments section if there are questions to reply in a timely fashion.
- The activity must be monitored for effectiveness. – We have an internal QI process as well as a post-module survey to incorporate learner feedback.
I am an EM resident desiring III credit
Please speak with your program director about this possibility. If you are told that the AIR series is approved for credit, complete the end-of-module quiz and your participation will be tracked. Of course, you are always welcome to take the quiz for your own learning purposes.
I am an EM residency program interested in implementing this series for III credit
Please contact us for a log-in access to the read-only Google Drive document with all resident participants who have taken the quiz who self identify with your residency program. Please give us the email that is linked to your Google Drive account. This list is sortable by program and date. We recommend that each module of curated posts count for 2 hours of III.
Frequency of AIR series modules
We plan to release new curated lists to correspond with the EM modular curriculum.
|01||July 2014||ID/Heme/Onc Module||2 Hours|
|02||August 2014||HEENT Module||2 Hours|
|03||September 2014||Endocrinology Module||3 Hours|
|04||November 2014||Peripheral Vascular Disease Module||3 Hours|
|05||December 2014||Psychiatry Module||2 Hours|
|06||January 2015||Toxicology Module||4 Hours|
|07||March 2015||Ob/Gyn Module||3 Hours|
|08||April 2015||GU/Renal Module||4 Hours|
|09||May 2015||Respiratory 1 (General) Module||5 Hours|
|10||June 2015||Respiratory 2 (PE) Module||5 Hours|
|11||July 2015||Cardiology 1 (ACS) Module||5 Hours|
|12||August 2015||Cardiology 2 (CHF and others)||4 Hours|
|13||September 2015||Environmental Module (Bites, Temp, Stings)||1 Hour|
|14||November 2015||Environmental Module 2||1 Hour|
|16||February 2016||Neurology 2 (headaches, Seizures, and Other)||6 Hours|
|17||March 2016||Cutaneous||Coming Soon|
|18||April 2016||Ortho (Upper Extremities)||Coming Soon|
|19||May 2016||Ortho (Lower Extremities)||Coming Soon|
Members of AIR Executive Board
- Felix Ankel MD, Vice President and Executive Director of Health Professional Education, HealthPartners Institute for Education and Research; Associate Professor of EM; University of Minnesota
- Jeremy Branzetti MD, Associate Program Director and Assistant Professor of EM; University of Washington Department of EM
- Andrew Grock MD, Associate Director AIR Executive Board, EM Resident at Kings County EM Program
- Nikita Joshi MD, Associate Director AIR Executive Board, ALiEM Associate Editor; Clinical Instructor, Stanford University, Division of EM
- Michelle Lin MD, Associate Director AIR Executive Board, ALiEM Editor-in-Chief, UCSF Associate Professor and Academy Endowed Chair for EM Education, San Francisco General Hospital
- Eric Morley MD, Associate Director AIR Executive Board, Associate Program Director of EM; Stony Brook University
- Anand Swaminathan MD MPH, Assistant Program Director and Assistant Professor of EM, NYU Medical Center; Faculty Reviewer of EMLyceum.com
- Taku Taira MD, Associate Program Director and Assistant Professor of EM, USC School of Medicine
- Lalena Yarris MD MCR, Program Director and Associate Professor of EM; Oregon Health Sciences University
- Mallin M, Schlein S, Doctor S, Stroud S, Dawson M, Fix M. A Survey of the current utilization of asynchronous education among emergency medicine residents in the United States. Acad Med. 2014 Apr;89(4):598-601. PMID: 24556776.
- Reiter DA, Lakoff DJ, Trueger NS, Shah KH. Individual interactive instruction: an innovative enhancement to resident education. Ann Emerg Med. 2013 Jan;61(1):110-3. PMID: 25520994.
Nikita Joshi MD
Michelle Lin MD
Updated 7/25/14: Added the ACGME/RRC criteria for III credit.