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MEdIC Series: The Case of Shifting Expectations – Expert Review and Curated Commentary


The Case of Shifting Expectations outlined a scenario of a junior emergency attending who feels like she has lost control of her department while working with an overconfident senior resident. This month, the MEdIC team (Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, Eve Purdy, John Eicken, Alkarim Velji, and Brent Thoma), hosted a discussion around this case with insights from the ALiEM community. We are proud to present to you the Curated Community Commentary and our expert opinions. Thank-you to all participants for contributing to the very rich discussions surrounding this case!

This follow-up post includes

  • Responses from our solicited experts:
    • Dr. Warren Cheung (@wjcheungem) is an Assistant Professor and holds a Junior Clinical Research Chair in Medical Education in the Department of Emergency Medicine at the University of Ottawa. He is a Senior Clinician Investigator with the Ottawa Hospital Research Institute and a CanMEDS Clinician Educator at The Royal College of Physicians and Surgeons of Canada. His research focuses on improving the quality of trainee assessments within a competency-based framework, with a particular interest in studying workplace-based assessments. His greatest joy is spending time with his wife and son.
    • Dr. James Kimo Takayesu (@kimotakayesu) is the Assistant Residency Director of the Harvard-affiliated Emergency Medicine (EM) Residency at Brigham and Women’s/Massachusetts General Hospitals. Dr. Takayesu also serves as the co-director of the EM clerkship for fourth year medical students, mentoring senior medical students, exposing them to the practice of Emergency Medicine, and providing them with guidance through the application and interview process. As the EM Departmental Simulation Officer, he works in the MGH Learning Lab running a program for individual resident formative assessment based on the current EM Milestones. Dr Takayesu has published on a wide variety of topics including residents-as-teachers, the role of peer-reflection in resident wellness, patient communication strategies, patient satisfaction, predictors of resident burnout, resident competency assessment, and learner-centered seminar teaching.
  • A summary of insights from the ALiEM community derived from the Twitter and blog discussions
  • Freely downloadable PDF versions of the case and expert responses for use in continuing medical education activities
Expert Response 1: Clinical Supervision: To Trust or Not To Trust (Dr. Warren Cheung)
Expert Response 2: Guiding the Performance of our Learners: Appropriate Feedback in the ED (Dr. Kimo Takayesu)
Curated from the Community (Dr. Alkarim Velji)

Case and Responses for Download

Click here (or on the picture below) to download the case and responses as a PDF (192 kb).

Tamara McColl, MD FRCPC

Tamara McColl, MD FRCPC

Associate Editor, ALiEM MEdIC Series
Emergency Physician, St. Boniface Hospital, WRHA
Academic Lead, Educational Scholarship
Department of Emergency Medicine
University of Manitoba