About Geoff Comp, DO

Associate Program Director
Emergency Medicine Residency
Creighton University School of Medicine/Valleywise Health Medical Center(Phoenix)

How I Educate Series: Geoff Comp, DO

This week’s How I Educate post features Dr. Geoff Comp, the Associate Program Director at Creighton University School of Medicine/Valleywise Health Medical Center in Phoenix, Arizona. Dr. Comp spends all of his shifts with learners, including emergency medicine residents, off-service residents, and medical students. He describes his practice environment as a county hospital with a Level 1 Trauma designation that has both an adult and pediatric emergency room. Below he shares with us his approach to teaching learners on shift.

Name 3 words that describe a teaching shift with you.

Innovative, evidenced-based, fun

What delivery methods do use when teaching on shift?

My favorite method of teaching is hands-on bedside describing and demonstrating different ways to complete a task or procedure with the learner. However, during patient presentations, I use a lot of scratch paper to show flow diagrams illustrating how to develop a differential diagnosis or plan from a chief complaint. I also use previously identified articles to help illustrate a point. Frequently I will pull up the resource on a computer, and then send the learner a copy of what we discussed for them to review after shift.

What is one thing (if nothing else) that you hope to instill in those you teach?

Identify the learning opportunity in every encounter you have on shift. Sometimes learning is focused on a specific patient and their chief complaint, but other times it is related to optimizing skills such as team leadership and interpersonal interaction with other staff in the emergency department. If the learner is provided the tools to identify their own learning points their potential is limitless.

How do you balance your flow with on-shift teaching? Does this come at the expense of your documentation?

This is a super hard one to do. Unfortunately, personal documentation usually takes a backseat during many of my clinical shifts so I can spend more time interacting with patients as well as the learners. However, I try to identify my own methods for workflow optimization and explicitly share that with learners. For example, if I’m working through a particularly complex MDM I will include the resident working on the case with me to discuss my thought process. If I’m having a hard time incorporating the completion of different procedures in a workflow on shift, I will share the thought process of my list of things to do in order stratification with a learner as well.

Do you feel departmental flow and metrics adversely affect teaching? What is your approach to excelling at both?

Occasionally, a busy fast paced ER provides an opportunity to teach more than just medical or scientific topics! You can absolutely teach the learner about your thought process and flow as well as different requirements for when they will be working as an attending. Spend the time talking about why you’re documenting the way that you are, talk about how you keep metrics in mind and share with them details on documentation for billing and critical care time. There is also always an opportunity to create a list of the medical topics that you want to make sure you cover after you get through a bit of the rush or after shift over a quick snack, or at an out-of-hospital meet-up!

It can be difficult to sit back and let senior learners struggle what is your approach to not taking over prematurely?

Time, experience, and your own comfort in critical patient care and resuscitation is the key to effective senior learner guidance. We need to know and understand the skills of our senior learners as well as understand when patient safety may be compromised. The true hallmark of a great teacher is to know and understand at what time in each patient case they need to be able to step in. That space between a learner’s knowledge and when you feel like you need to step in is the space for learner growth and allows for optimum learner engagement. The second important component is being intentional with your learner about when you will be taking over because of concern for patient safety. This should always be paired with an active and intentional debrief of the entire patient encounter as soon as the patient has been stabilized. The second step allows for education and learner optimization without compromising patient safety or losing the teaching opportunity.

Do you start a teaching shift with certain objectives or develop them as a shift unfolds?

The teaching goals are pretty individualized. Some learners really respond well to setting the stage at the beginning of the shift and asking what goals they have for learning. Other learners need a little bit of guidance in identifying a tangible goal for the day. Matching the energy and experience level of the learner is important for a successful shift. However, I have my own personal goals when it comes to teaching as well as basic standards that I try to follow for the day. These include making sure that I am constantly intentional about teaching and giving feedback, identifying small pearls in seemingly “easy” cases to advance the learner, and focusing on understanding and patience when I’m working with struggling learners to help them ultimately succeed.

Do you typically see patients before or after they are presented to you?

The timing of when I physically see patients myself is usually tied somehow to the goals of the learner or to help me identify areas of improvement. For new or junior learners I try to sneak in before they present to me to identify key points of the history and physical so I can help guide them in proper presentation style and technique. With more advanced learners I usually see a patient after they present to me to confirm key parts of the history and circle back with them about different components of the case.

How do you boost morale amongst learners on shift?

A positive attitude is a choice and being an example of positivity is the best way to boost morale. Choosing to identify the components of an event that you can modify will allow for a beneficial outcome. By practicing positivity in the face of a challenging shift, departmental pressure, or a difficult case, you are actively demonstrating techniques to the learner. Be the type of attending that you want to learn from. However, I also work to boost morale by doing both individual and group check-ins, as well as debriefing during periods with high patient loads/acuity or after a critical resuscitation. I also work on giving intentional and direct mini-feedback sessions throughout the shift to provide positive encouragement and identify areas for learning.

How do you provide learners feedback?

Feedback should be time sensitive, directed towards a specific action/event, and well defined, and it should be provided with strategies for improvement. I start all feedback sessions by saying very intentionally “I’d like to give you some feedback.” I also work to make sure that I identify some sort of resource to either review or have the student look up. I then close the loop at a later time by asking them about their own personal exploration of the topic after our previous feedback session.

What tips would you give a resident or student to excel on their shift?

Identify a measurable goal that you want to achieve by the end of your shift. If you start your shift with the intention of saying what you would like to accomplish you will be able to strive for that goal throughout the entire experience. Also, loop in your teachers and mentors with this process. Let the attending that you’re working with for the day know what your goal is so they know how to provide appropriate feedback at the end of the shift and know what to be looking for!

What are your three favorite topics to teach during a shift?

Resuscitated procedures/resuscitation mindset as well as team leadership, wilderness and environmental medicine, and orthopedic injuries.

What is your favorite book or article on teaching?

I really like articles that help explicitly identify different on-shift teaching techniques. It’s hard for me to pick one specific one but a couple that I give to residents with a specific interest in medical education include EM Cases Teaching on Shift and EMRA Resident as an Educator.

Who are three other educators you’d like to answer these questions?

Michael Epter, Sara Krzyzaniak, and Stephani Lareau.
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Read other How I Educate posts for more tips on how to approach on-shift teaching.

By |2022-09-04T12:42:52-07:00Sep 7, 2022|How I Educate, Medical Education|

How I Work Smarter: Geoff Comp, DO

Geoff Comp

One word that best describes how you work?


Current mobile device

iPhone 7


MacBook Pro

What is something you are working on now?

I am working on a series of EM department recommendations for the treatment of various environmental conditions, including heat associated injury and hypothermia, with multiple residents interested in wilderness medicine.

How did you come up with this Idea/Project?

Like all great projects, these were developed while chatting about interests over beers! We reviewed current recommendations from various sources during a wilderness medicine interest group meeting and discovered the department does not have official guidelines for these topics.

What’s your office workspace setup like?

Unfortunately, most work is done on the couch. When I need a truly dedicated space, I use my wife’s home office for multiple monitors and a desk.

What’s your best time-saving tip in the office or home?

Rely on a schedule! Be mindful and deliberate with your time so you can focus on a specific project for a shorter period of time in a day and know the boundaries of a new task. My calendar has brief “work periods” of 1.5 hours, where I turn off external alerts/distractions and plug away at a predetermined list of goals for one project. Also, use applications that will communicate with all of your devices seamlessly. If your email, calendar, to-do list, personal finance, etc. don’t play well with all of your devices, you won’t use them.

What’s your best time-saving tip regarding email management?

Don’t use it as a to-do list. I work hard to go through emails in the morning and at night and clear out or address them. If it is a request for a task or a new project/opportunity, I will respond right away with acknowledgment and let the person know I will give a full response before a deadline. Then that task gets added to my own to-do list, rather than the constant reminder and irritation of a positive email balance that continues to spiral out of control.

What apps do you use to keep yourself organized?

Apple Calendar app. My work, personal, and family calendars all get pushed to this. I have sub-calendars for to-do lists, exercise, work meetings, etc. I always open this up and make sure I am available before agreeing to a commitment.

I also recently switched to Microsoft To-Do after the app “Wonderlist” was acquired by the company. It allows me to create a specific “next step” action items for big projects and allows for some success momentum as I see progress. I can make personal deadlines and reminders as well as assign tasks to a daily to-do list.

How do you stay up to date with resources? (FOAMed, CME, Current Events, etc.)

With targeted subscriptions and personal organization. I subscribe to only a handful of resources that are automatically emailed to me or populate my podcasting app. It is very easy to get overwhelmed by all of the incredible resources out there. I use Feedly as my aggregator and will scroll through frequently. After I exhaust my “go-to” resources, I search for Google FOAM.

What’s your best time-saving tip in the ED?

Identify roadblocks to your flow and address them early on to decrease your aggregate cognitive load over the duration of your shift. Procedures and in-depth exams take priority so I can free up that mental space and be ready for more patients. #StopPuttingOffTheLumbarPuncture

ED charting: Macros or no macros?

Absolutely. I use “dot-phrases” when documenting and have a pre-populated chart. If you use macros, make sure you either created them yourself or are very aware of everything included in it and ultimately in your note. You always want to make sure every portion is reviewed to ensure all of the abnormal findings are changed from your prepopulated “normal exam.”


  • What’s the best advice you’ve ever received about work, life, or being efficient? (Give multiple if you have them.)

Have and rely on a family and personal time calendar. I tend to have a self-inflicted busy schedule due to projects and work events, and it is easy for me to see free time and fill it up with work. However, I know it is essential for me to prioritize my family and ensure my wellness. My wife has access to edit my electronic calendar, and we frequently block off and reserve time for date night or time with friends. This helps me turn off “work brain,” as I am forced to complete my daily goals before spending time together, and I am not always thinking of my other projects or work.

Prioritize your work, not someone else’s. It is easy to start the day looking at your email and complete tasks like getting documents signed, responding to requests, and completing EMR training modules (yuck). These are all based on someone else’s timelines rather than your own. It is easy to go through a large chunk of time in your day completing tasks without making progress towards your personal goals and ultimately feel like you were “busy” but not “productive.” I set aside time blocks where I don’t respond to emails/slack/text messages and focus on one of my own projects.

Identify all of the small steps needed to accomplish a big goal and give yourself some wins by completing the tasks. It is sometimes very daunting to think of how to start or end a new project or job. I spend some time being mindful of all of the smaller steps that will need to be completed before finishing a final product. If you set and complete specific, measurable, and time-sensitive goals, you will gain that momentum to finish that fantastic project!

  • What advice would you give other doctors who want to get started, or who are just starting out?

Never stop learning. When you finish residency, continue to take the same advice we give to new residents: read as much as you can, learn something new each day from a patient. We are fortunate to have the best job in the world, and we must continue to grow and learn, allowing us to provide the best care possible throughout our careers.

  • Is there anything else you’d like to add that might be interesting to readers?

Work with a mentor! Find someone you think has a sound system for organization or efficiency and reach out to them to ask what they do.

Who would you love for us to track down to answer these same questions?

  • Mike Gottlieb
  • Drew Kalnow
  • Luz Silverio

Read other How I Work Smarter posts.

By |2020-10-08T16:10:34-07:00Oct 9, 2020|How I Work Smarter, Medical Education|

Teaching in the age of COVID-19: Small group conversations

Although you can still use technologies like Zoom or Webex to conduct small group meetings, residency programs may find it prudent to stick to known platforms rather than trying to upskill a large group of faculty and trainees.  This is where technologies like Skype and Google Meets (which is the reinvented version of Google Hangouts) can come in. Of note, Google has recently announced that they have made their usually paywalled platform (Google Meet) free during the age of coronavirus, as their way of helping those schools and teachers looking to continue their practice during these difficult times.


By |2020-04-02T13:56:26-07:00Mar 18, 2020|Academic, Administrative, COVID19, Medical Education|

Teaching in the age of COVID-19: Real-time video conferencing

video conferencing

As programs face unprecedented pressure to protect learners via social distancing, many will turn to video as their preferred method to continue delivering educational content. The need to do this in “real-time” makes conferencing applications an obvious choice for content delivery. Programs may already be familiar with this technology for conference calls, further lowering the bar for early adoption. Studies demonstrate the educational content via live video is at least as effective as a live lecture [1]. Further, they have been used to deliver additional content, such as small groups and simulation [2]. With current technology, these tools are widely available and easy to use for educators.


By |2020-04-02T13:56:51-07:00Mar 17, 2020|Academic, Administrative, COVID19, Medical Education|

Teaching in the age of COVID-19: Teaching with tech while socially distancing

social distancing

With the arrival of SARS-CoV2 (COVID-19) in North America, programs are facing the need to reconsider how they deliver didactic education to their learners. The ACGME only allows for 20% of the curriculum to be delivered in an asynchronous fashion. The remainder is delivered through traditional didactic means, including “small-group sessions, such as break-out groups, serially repeated conference sessions, practicum sessions, or large-group planned educational activities.” With mandatory social distancing likely to become standard practice, we present multiple solutions to bridge the gap between live, in-person conferences and asynchronous materials.


By |2020-04-02T13:57:06-07:00Mar 17, 2020|Academic, Administrative, COVID19, Medical Education|
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