About Sara Dimeo, MD

Program Director
East Valley Emergency Medicine
Dignity Health- Chandler Regional Medical Center (CRMC)

How I Educate Series: Sara Dimeo, MD

This week’s How I Educate post features Dr. Sara Dimeo, the Program Director at East Valley Emergency Medicine. Dr. Dimeo spends approximately 70% of her shifts with learners which include emergency medicine residents, off-service residents, and medical students. She describes her practice environment as a busy, level 1 trauma center in the East Valley of Phoenix, Arizona with an annual patient volume of ~70K. Our sister hospital Mercy Gilbert has a new Women’s and Children’s pavilion where a pediatric ED will be opening in conjunction with Phoenix Children’s hospital. The program is a community-based EM program with all of the bells and whistles of an academic program, and the culture of the hospital makes it a great place to work. Below she shares with us her approach to teaching learners on shift.

What delivery methods do use when teaching on shift?

“What if”…I like to pose hypothetical situations to mentally prepare learners when a critical patient is arriving. For example, a patient who is in cardiac arrest is due to arrive; “What if they just had an orthopedic surgery recently?” “What if they are in refractory v-fib?” “What if the nurses are struggling to get a line?”

What is your method for reviewing learners’ notes and how do you provide feedback on documentation?

It can be difficult to provide note feedback while on shift, depending on the shift. I like to open an email while I sign my charts and take notes to send to learners; particularly if I notice a pattern of difficulty with documentation.

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

I aim to be somewhere in the upper end of the middle of the pack in regards to patients per hour, etc. I think that choosing opportune times to teach, and running the list with residents frequently to divide and conquer between myself and them which tasks need to be done helps a lot. For example, if we have a sign out list of 3 patients and there are 2 new patients to be seen, I’ll “take” the sign out patients and have the resident go see the 2 new ones.

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

YES- this can be so hard! I was once given the advice that everyone will know you’re an attending if you stand at the foot of the bed to guide the resuscitation. I try to guide my learners to assume this position and encourage them to consciously lead the team. I physically will stand next to them or at the side of the room and put my hands in my pockets. I try to speak up only if I see a patient safety issue or if the learner truly needs help.

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

I think that the entire idea of developing an objective to learn before a shift can be flawed because often you will see very different presentations of patients than what you desire. However, making sure your learners know how you work is important. Also, creating broad objectives such as: “I want to work on completing my notes in real-time”, or “I want to try to see every patient in the pod” is a sure way to go.

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

Depends. If possible, I like to see them before because I can synthesize their presentation and give them better real-time feedback. I also like to directly observe learners because it gives me the best insight into their H&P and decision-making skills, and also kills two birds with one stone (where I don’t have to see the patient later). It also allows you to model certain behaviors or add focused questions, though I think this is best done at the end of the learner’s questioning because otherwise, I’d feel I was interrupting them.

How do you boost morale amongst learners on shift?

Residency is really hard. Medical school is hard but in different ways. For students, involving them as much as possible so they feel they are truly part of the team, and showing them my enthusiasm for learning and discovering is my approach. With residents, I encourage them to get food, coffee, etc. and just try to be a supportive ally in what they’re going through.

How do you provide learners feedback?

I used to struggle a lot with giving feedback, so I made an effort to practice it often and now I don’t think it’s such a big deal. It pains me so much when a resident receives a scathing evaluation and they tell me no one has discussed it with them. It really takes a toll on their mental health. I think the cool thing about residents is that they want to improve, and they usually are the hardest on themselves. I always start with an open-ended question such as “How do you think that went?”, which gives me the opportunity to clarify their thought process about their performance.

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

(1) Put in your orders, then dictate your HPI and PE of your note right after seeing a patient
(2) Run your patient list frequently
(3) Try not to put off procedures or difficult cognitive decisions to the end of your shift….it will just make you stay over!

Are there any resources you use regularly with learners to educate during a shift?

Life in the Fast Lane for EKGs, EMRAP procedural videos, EMRA guides

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

(1) Love eye stuff! it’s an often neglected topic
(2) STEMI equivalents (though now the guidelines are finally catching up!)
(3) How to give a death notification/difficult patient encounter approaches

What is your favorite book or article on teaching?

If you haven’t read the original Dunning-Kruger paper, I found it to be really fascinating.

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

Christina Shenvi, Andy Little, and Molly Estes.

How I Educate Series logo

Read other How I Educate posts for more tips on how to approach on-shift teaching.

By |2023-03-22T07:41:13-07:00Mar 22, 2023|How I Educate, Medical Education|

How I Work Smarter: Sara Dimeo, MD

One word that best describes how you work?


Current mobile device

iPhone 11 Pro


MacBook Pro

What is something you are working on now?

The Impact of Digital Badges on Motivation in Asynchronous Learning

How did you come up with this Idea/Project?

When COVID hit, we had to think creatively on how to engage learners in an online format. Having done a fellowship in Multimedia, Design, Education Technology I was really excited to experiment with different techniques. My main goal is always to create a sense of engagement, even when there is limited ability to do so in a traditional way. One thing I’d seen done in a limited fashion are badges to reward learners, so I decided to explore digital badges and learned they’re becoming increasingly popular in the K-12 literature and other fields. I adopted this to create our own asynchronous curriculum with a badge system to identify learners who were engaging well in the material, and who were performing highly on knowledge-based quizzes.

What’s your office workspace setup like?

I finally have a dedicated office space in my home, which I love! I work best when I’m on my own away from distractions because I’m a typical EM personality. The window in my office looks out into our yard and the front street which is nice for a mental break. I like to keep my desktop clean (clean desk = clean brain) and just have my laptop and a notepad available to jot down quick thoughts or reminders.

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

Blocking off chunks of time to accomplish xyz task is helpful for me, as I often have multiple projects and/or tasks on any one given day. Prioritizing is important. I became pretty good at task-switching during my fellowship when I was juggling a lot of non-clinical projects.

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

I use a delete-flag-archive system, where anything not important in the future is immediately deleted, things that need close follow up are flagged, and everything else is filed into its relevant folder. I have 6-7 folders which I frequently use. One really helpful folder that you don’t always think about is for IDs/passwords!

What apps do you use to keep yourself organized?

I love the Things app for task management. It merges with my Google Calendar and allows you to set due dates for upcoming tasks as well as to documents to-do lists for bigger or more long-term projects. It is my peripheral brain! I also have a whiteboard in my office that displays my big projects. I like checking things off as a sense of accomplishment.

How do you stay up to date with resources?

Twitter is probably my main resource for connecting with colleagues about new ideas…I almost exclusively following folks in medical education. I use Journal Feed for quick synopses of review articles. And of course EMRAP.

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

Try not to delay tough cognitive decision points that will affect the workup/algorithm that you go down. When you are not sure what to do, take a step back to think, call a consultant, or ask the advice of a colleague.

ED charting: Macros or no macros?

Yes! For example, I have an abscess I&D macro that contains less than 5 variables to fill out. Though, I dislike macros for more complicated encounters.


  • What’s the best advice you’ve ever received about work, life, or being efficient?

    [Great creative minds] think like artists but work like accountants. – Cal Newport, “Deep Work”.

    I personally love to think about new ideas or projects, but unfortunately that does not equate to success. Success is the ability to organize yourself to be productive. This is a work in progress for all of us!

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

Get involved in a bigger way. Think about serving on a hospital committee or taking a leadership position. It will give you a new experience and accelerate your growth. For me, that was joining the EMRA Education committee, which ultimately led to me serving as the Director of Education for their Board of Directors. It was and has been a life changing experience.

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

Find mentors that believe in you. I was told by an advisor that if I wanted to do med ed, I had to have my entire career path laid out and was highly discouraged from considering it. A two year fellowship and an (almost completed) masters later, I’m very glad I trusted my instinct and did not listen to their advice. Eventually I looked elsewhere and found mentors who were willing to help me achieve my goals.

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

  • Kat Ogle @DrKittyKat
  • Kristy Schwartz @kaynani32
  • Zach Jarou @zachjarou
  • John Eicken @MedEd_Tech

Read other How I Work Smarter posts, sharing efficiency tips and life advice.

By |2021-04-20T09:12:55-07:00Apr 23, 2021|How I Work Smarter, Medical Education|
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