IDEA Series: Just-in-Time Training for Diagnostic Paracentesis

AP wrist radiograph

According to the National Health And Nutrition Examination Survey, approximately 630,000 adults in the United States have cirrhosis of the liver, 69% of which are reportedly unaware of having liver disease. A diagnostic paracentesis is a simple procedure for identifying spontaneous bacterial peritonitis in cirrhotic patients with ascites. A just-in-time training (JITT) model incorporating low-fidelity equipment readily available in the ED can facilitate procedural teaching of the diagnostic paracentesis.

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By |2019-12-21T13:00:22-08:00Dec 18, 2019|Academic, Gastrointestinal, IDEA series|

IDEA Series | “Saving Society” Podcast Series Teaches Residents Reflective Practice Through Debriefing

The Problem

Idea Series Logo debriefing

Emergency physicians (EPs) experience professional burnout more than 3 times that of the average physician.​1​ In a recent study, the prevalence of burnout among emergency medicine residents was found to be an astounding 76.1%, suggesting that burnout begins as early as residency training.​2​ The emotional impact of witnessing suffering and death and the high-stakes, stressful environment of the ED likely contribute to burnout among trainees.

One potential protective factor against burnout is the strategic use of debriefing to mitigate work-related stress. Debriefing involves taking the opportunity to discuss and reflect upon a recent experience with a group of peers who share an understanding of the experience’s context. Debriefing can create a space for peers to provide mentorship, support and feedback to each other, thereby reducing work-related stress.​3,4​

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By |2019-07-12T19:59:19-07:00Jul 12, 2019|IDEA series|

IDEA Series: A Workshop to Reflect on Personal Resilience

The Problem

Burnout is a well-known syndrome characterized by poor self-care, dehumanization, exhaustion, and reduced effectiveness. The study of wellness and resilience among emergency medicine (EM) providers and trainees has recently blossomed, largely as a consequence of recent tragedies of physician suicide, provider distress, and an increased awareness the impact burnout has on both personal and professional domains. While there are ongoing discussions on practices to best address burnout, methods have focused on promoting resilience, mindfulness, and provider engagement.1

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By |2019-09-10T14:21:25-07:00Feb 12, 2019|IDEA series, Wellness|

IDEA Series: A Low-fidelity Simulation Workshop for Teaching Cricothyroidotomy

The Problem

idea series teaching residents quality improvement

Cricothyroidotomy is an emergency life-saving procedure that involves surgical placement of a tube through the cricothyroid membrane in order to establish a patent airway for oxygenation and ventilation. The indications for this procedure are when traditional means, such as orotracheal or nasotracheal intubation, are contraindicated or have failed during attempts to establish an emergency airway.1,2 It is a critical skill for emergency physicians but the declining rate of this procedure has resulted in decreased exposure during training.3,4

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By |2019-03-28T21:25:08-07:00Feb 3, 2019|Critical Care/ Resus, IDEA series|

IDEA Series-JETem Innovation: A Low Cost Escharotomy Simulation Model for Residency Education

The Problem

idea series teaching residents quality improvementEmergency Medicine (EM) residents are expected to be familiar with and competent in performing a wide number of procedures, including rare ones such as performing an escharotomy in a patient with severe burns. Unfortunately, there is a paucity of readily available simulation models to facilitate practice of this rare yet potentially life-saving skill.

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By |2019-02-19T18:37:33-08:00Jan 19, 2019|IDEA series, Trauma|

IDEA Series Highlights JETem Innovations: A Low Cost Trainer for Neonatal Umbilical Catheterization

The Problem

Idea Series LogoAlthough umbilical catheterization can be a lifesaving technique in the emergent management of a critically ill neonate, it is performed infrequently in the ED.1 Simulation has emerged as a key teaching modality for residents to gain both proficiency and competency with this important procedure.2,3 Commercially available umbilical catheterization models are available, but costly, and often require an expensive investment (over $1,000 for a single trainer).4 This expense may discourage residency programs from acquiring the trainer and offering it to learners. In an effort to minimize this barrier to learning, a team from Kings County Hospital “home built” their own umbilical catheterization model. Their work was recently published in the Journal of Education and Teaching Emergency Medicine (JETem), and the ALiEM IDEA Series is proud to have recently teamed up with this journal to periodically share their innovations with our readership!

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By |2018-12-14T19:46:41-08:00Dec 15, 2018|IDEA series, Pediatrics|

IDEA Series: Utilizing On-Shift Shared Google Docs as an Interactive Digital Whiteboard

The Problem

Idea Series LogoDespite the importance of on-shift teaching, finding an effective and efficient method can be challenging when juggling the multiple simultaneous demands of the emergency department. Various EM educators have recently shared their innovative methods for on-shift teaching. Dr. Amal Mattu has championed the #WhiteboardTeaching movement on Twitter, and Drs. Michelle Lin and Rob Cooney have championed the use of post-it notes paired with educational pearls.1,2 Computers, however, have become an inescapable part of ED workflow. Physicians may spend more time in front of computers than talking to patients.3 Perhaps computers, which are readily available at most physician work-stations, can be utilized as a clinical teaching tool in order to engage residents and students.
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By |2018-10-01T21:17:37-07:00Oct 2, 2018|IDEA series|