App review: POC Ultrasound Guide
There is a new free app called POC Ultrasound Guide [iTunes link], created by Wexner Medical Center at Ohio State University.
RIME – Evaluating Learners
Lets talk about an effective evaluation process called RIME developed in 1999 by Pangaro. Not only is the name catchy, but it also makes intuitive sense.
RIME stands for
- R – reporter
- I – interpreter
- M – manager
- E – educator / expert
Lost in translation: What counts as asynchronous learning?
Reiter et al 1 just published a review on Individual Interactive Instruction also known as asynchronous learning in the Annals of Emergency Medicine.
They chronicled the events in 2008 that led CORD (Council of Emergency Medicine Residency Directors) to recommend integration of individual interactive instruction into the residency curriculum. The summary recommendations by Sadosty et al 2 discuss components, strengths, and weakness of both asynchronous and synchronous learning paradigms along with background about Malcolm Knowles and andragogy.
SimWars: A “warring tigers” competition
SimWars
You’ve seen this word on the agenda at the most recent Emergency Medicine conference that you attended. It sounded interesting… but you ended up going to a happy hour and missed out on the event. And so you are left with the burning question, what is SimWars?
I have now heard Dr. Haru Okuda (Director of VA SIMLEARN) introduce SimWars a few times at the start of competitions at conferences. He usually has a photo of two cute little kittens with great big sweet eyes juxtaposed with a photo of two warring tigers fighting each other. He uses this comedic relief to illustrate the difference between a standard simulation session and SimWars competition.
New Years Resolution: More teachable moments please
“The worst thing about busy shifts is that I never learn anything.”
– anonymous resident
A junior resident and I were contemplating the many difficulties of residency, especially when working at a busy urban ED where patients are plenty, but teaching during shifts may be harder to come by. We discussed the importance of coming up with at least one learning point or clinical question during each shift, and making a point of following through and reading up on it after. (That shift we both learned about fat emboli s/p extremity fracture.)
Physical exams: A relic of the past?
Why do most of us dread patients who complain of dizziness in the ED? Because it is so vague, and the differential is so broad from elusive posterior cerebellar strokes to ear wax clogging up our ear canals. And this is one of those diagnoses where the differential really depends upon performing a thorough physical examination.
Think really hard, when is the last time you focused upon getting a complete and accurate physical examination? In medical school, there are courses dedicated to the art. I always laugh when I think of my neurology attending who just loved to bang on different parts of the body with his reflex hammer to elicit cool reflexes.
To debrief or not?
Learners have limited time. Residents have work hours restrictions, practicing physicians have work / life demands, and the list goes on. Time is valuable. Therefore, educational interventions must be hard-hitting, effective, and worthwhile.
We discussed previously “What is debriefing?” Debriefing is a facilitated discussion and reflection about objectives previously chosen by the educator. Dr. Ernest Wang (NorthShore Center for Simulation and Innovation) states that it’s about getting learners to that “aha!” moment.