Article review: EM in medical schools

Similar to JAMA, which publishes an annual publication focusing on Medical Education, the Academic Emergency Medicine (AEM) journal just published a AEM-CORD/CDEM supplement focusing on EM education. I was fortunate to be involved with one of the papers published in this supplement.

This paper, written on behalf of the Clerkship Directors in EM (CDEM) and the Association of Academic Chairs of EM (AACEM), reviews the past, present, and future of EM in the U.S. medical school curriculum.

EM faculty members are playing an increasingly important role in both the preclinical and clinical curriculum. Our specialty teaches skills and knowledge, crucial for all medical students regardless of their eventual career choice. EM educators are a natural fit to teaching topics, such as the following:

Basic life support (BLS)
Advanced cardiac life support (ACLS)
Wound care
Splinting
Basic procedural skills
Simulation-based education
Bedside ultrasonography
Management of common emergencies

Furthermore, as medical schools are looking towards restructuring their overall curriculum to incorporate more clinical exposure from day 1, the diverse, high-volume environment of the Emergency Department (ED) makes it a perfect fit for students. Recall back to when you were a first-year medical student. How amazing would it have been to observe ED patients to reinforce your learning about pharmacology, anatomy, pathology, and heart sounds?

From an institutional standpoint, the EM clerkship fulfills many of the Liaison Committee on Medical Education (LCME) educational requirements. The LCME is the regulatory body that accredits U.S. and Canadian medical schools. The LCME recognizes that the ED provides students with an unparalleled learning opportunity. Consequently, more and more schools are making EM clerkships mandatory. In 2004, about 39% of U.S. medical schools had mandatory EM clerkships for third-year medical students. There’s an ongoing CDEM study to determine the more updated numbers (I’m guessing it’ll be closer to 50%).

Medical schools are increasingly depending on the EM specialty to help with teaching students at all levels of learning. For those of us invested in medical education, this is great news.

Reference
Wald D, Lin M, Manthey D, Rogers R, Zun L, Christopher T. (2010). Emergency Medicine in the Medical School Curriculum. Academic Emergency Medicine, 17 DOI: 10.1111/j.1553-2712.2010.00896.x
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By Michelle Lin, MD|2016-11-11T19:00:24-08:00Oct 25, 2010|Education Articles, Medical Education|

Article review: Importance of first clinical clerkship

What was your first clinical clerkship rotation?

Oddly, I started my third year with a sub-internship rotation on the Burn/Plastics service as my first rotation. Not sure how that happened… I managed my own patients like a 4th year student, did lots of wound care, and even got to harvest a few skin grafts. It was trial by fire.

In a recent JAMA article, 3rd year medical students who started their clinical experiences in an Internal Medicine rotation overall did better on overall clerkship grades, when compared those who started their rotations on the Ob/Gyn, Psychiatry, or Family Medicine service.

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By Michelle Lin, MD|2016-11-11T19:00:25-08:00Oct 4, 2010|Education Articles, Medical Education|

What is "contextualizing" patient care?

Medicine is as much about Science as it is about Art. This is no better illustrated than an educational intervention study about “contextualizing” patient care, published in JAMA.

What is contextualization?

It is the “process of identifying individual patient circumstances (their context) and, if necessary, modifying the plan of care to accommodate those circumstances”. In other words, this is care beyond the evidence-based guidelines, beyond standardized quality measures, and beyond the checklists.

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By Michelle Lin, MD|2016-11-11T19:00:27-08:00Sep 20, 2010|Education Articles, Medical Education|

Do you have medical students rotating in your Emergency Department? Are they allowed to document in the medical record?

Charting in the medical record is the cornerstone of clinical communication. You document your findings, your clinical reasoning, and management plan. The medical record allows communication amongst providers. Chart documentation is a crucial skill that every medical student should know, as stated by the Association of American Medical Colleges (AAMC).

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By Michelle Lin, MD|2016-11-11T19:00:30-08:00Sep 6, 2010|Education Articles, Medical Education|

Article Review: Rethinking the premed requirements

Think back to your college years. Remember those premed courses that you had to take? Biology, chemistry, physics… oh my. How helpful were these in your preparation for medical school and clinical practice?

In 1981, the Association of American Medical Colleges assembled a group, the General Professional Education of the Physician and College Preparation for Medicine (GPEP) to relook at these premed requirements. In 1984, the published a report “Physicians for the Twenty-First Century”. They advocated that the intensive premed requirements overly skews students’ education towards a “narrow objective of medical school admission”. Education is not balanced to include broader liberal arts learning, which may teach students more about humanistic values and communication skills.

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By Michelle Lin, MD|2016-11-11T19:00:31-08:00Aug 30, 2010|Education Articles, Medical Education|

Article Review: Use of Effective Questioning

Asking effective questions is a valuable skill for any teacher. As a junior faculty member working to improve my teaching, I’m often in awe of my more experienced colleagues when I have the chance to watch them teach. At times, it’s quite easy to pick out the skills that they put into action but occasionally, their expertise is much more subtle.

Effective questioning falls into this category.

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By Robert Cooney, MD MSMedEd|2016-11-18T10:05:48-08:00Aug 23, 2010|Education Articles, Medical Education|

Article Review: Premature diagnostic closure

You are taking care of a patient, who frequently presents to the ED for polysubstance use. You are pretty sure his altered mental status is from polysubstance use again. He was found in his home next to drug paraphernalia. He intermittently becomes severely agitated, and so you give him sedatives. He has a low-grade fever, but you attribute that to his psychomotor agitation and likely stimulant use. Because he remains confused and lethargic after 8 hours, you admit him to an inpatient team to await further metabolism of his recreational drugs and your sedation medications.

The next day, you learn that had meningoencephalitis.

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By Michelle Lin, MD|2016-11-11T19:00:36-08:00Jul 26, 2010|Education Articles, Medical Education|

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