No specialty in medicine requires “efficiency” more than Emergency Medicine (EM). Being able to seamlessly and quickly move between tasks is a necessary skill to function in the Emergency Department (ED). The controlled chaos and many moving parts can be overwhelming to new learners in the department and takes dedicated time and experience to overcome. Along with learning the necessary medical knowledge, efficiency expertise is crucial to becoming a high-performing emergency physician. Unfortunately, there is minimal formal training on how to maximize efficiency skills, leading many new EM learners (e.g. medical students and junior residents) having to troubleshoot and create these skills for themselves.
ED Efficiency Themes
Research and anecdotal tips on being an efficient healthcare provider are sprinkled throughout the literature, but there are no established efficiency guidelines or consensus recommendations. Parsing through all available smattering of information in the literature, we identified 3 distinct “themes”:
- Efficiency in workflow practices: This means learning skills that maximize a practitioner’s ability to see more patients throughout the shift. These skills work to help providers navigate patients quickly through the department, maintaining constant flow and maximizing resource utilization. By improving one’s workflow practices, tasks can be completed quickly and more patient’s can be seen overall.
- Anticipating roadblocks: Situational awareness of potential hurdles allows providers to more easily find workarounds to keep patients on a forward path. Understanding the intricacies of the health system and the functionality of a hospital allows for better anticipation and planning for future impedances to patient care and progress toward disposition.
- Effective team communication: Communication is an integral part of being an EM physician. By improving communication and learning to effectively work in a team, a provider can improve their overall efficiency in the department and can decrease provider mental burden.
The ALiEMU 3-Course Series
As educators, we believe all skills can be taught. This includes efficiency skills. After distilling the available efficiency literature, we designed 3 courses, based on the above themes to best teach efficiency to new EM learners.
- Improving Your ED Efficiency 101: Efficient Workflow Strategies to Up Your Clinical Game
- Improving Your ED Efficiency 102: Anticipating and Surpassing Roadblocks
- Improving Your ED Efficiency 103: Effective Team and Patient Communication
Our FREE curriculum uses the ALiEMU platform to simulate real-world scenarios, integrating the lessons in an interactive and fun way. Learners will discover strategies to optimize their time in the ED and begin their journey toward optimal efficiency.
Examine how your ideas of efficiency fit with the strategies. These concepts may be new, or may already be a part of your EM practice. While operations vary for hospitals and EDs, the content taken as a whole represents the best practices found in the literature. These 3 themes should begin and guide your journey toward efficiency mastery.
What are some of YOUR best tips for efficiency on shift? Contact us on Twitter (Dr. Guy Carmelli @GuyCarmelli) with any suggestions or feedback.
During the pandemic, similar to how a work-from-home mentality has become more accepted, a learn-on-own mentality has arisen for medical students. The success of the 9-part Bridge to Emergency Medicine (EM) self-guided curriculum for senior medical students interested in EM has confirmed this. This was evidenced by over 130,000 page views about the Bridge curriculum since March 2020 and 609 awarded ALiEMU certificates since April 2021 (launched only 2 months ago!).
GroundED in EM: A new curriculum for third-year medical students
We are thrilled to announce a 4-week, self-guided reading/listening curriculum along with choose-your-own-adventure cases paired now with ALiEMU quizzes, certificates, and badges for third-year medical students interested in EM. It’s called GroundED in EM, and created by an all-star team led by GroundED Editor-in-Chief, Dr. Andy Little. Here’s the rest of the team:
- Brian Barbas, MD, FACEP (Associate Professor of Emergency Medicine, Loyola University Chicago – Stritch School of Medicine)
- Carmen J. Martinez, MD MSMEd (Assistant Professor of Emergency Medicine, University of South Alabama)
- Guy Carmelli, MD, MSEd (Assistant Professor of Emergency Medicine, University of Massachusetts)
- Laryssa A. Patti, MD (Assistant Professor of Emergency Medicine, Rutgers Robert Wood Johnson Medical School)
- Kaitlin Bowers, DO (Vice Chair of Emergency Medicine, Campbell University College of Osteopathic Medicine)
- Meenal Sharkey, MD FACEP (Assistant Program Director & Clerkship Director; Department of Emergency Medicine, Doctors Hospital)
GroundED on ALiEMU
Similar to Bridge to EM, reading and listening materials have been identified and curated from external sites. Then come on back to ALiEMU to take self-assessment quizzes to get your certificates and badges.
IDEA Series: Virtual “Faux-tation” Rotation for 4th Year Medical Students Interested in Emergency Medicine
Visiting clerkships have traditionally offered the opportunity for extended contact among medical student applicants and residency program representatives, allowing for enhanced assessment of mutual compatibility. Accordingly, visiting clerkships are consistently rated as an essential consideration among residency program leadership when reviewing applications, and among medical students, as they determine “fit” [1,2]. The COVID-19 pandemic has resulted in institutional restrictions on visiting clerkships. Despite the now limited opportunities for medical students to see residency programs of interest in-person, demand for these experiences remains high. Opportunities that allow for increased interaction among medical student applicants and residency programs that maintain compliance with COVID-19 restrictions are needed to fill this gap. Virtual rotations have previously been described in the literature in multiple other specialties . Several emergency medicine programs have advertised a formal virtual rotation experience via the Council of Residency Directors’ (CORD) listserv that offers course credit to student rotators.
A group of educators from our ALiEM Faculty Incubator 2020 class has created a 4-week virtual introduction to Emergency Medicine curriculum for 3rd-year medical students called Grounded in EM!
Think back, back to March 2020: you were a medical student, happily rotating through core specialties, considering Emergency Medicine, and then WHAM! The coronavirus pandemic pulled the rug out of your regularly scheduled 3rd year. Or, you were a program looking forward to a “business as usual” approach to your 3rd-year EM clerkship. Now, you’ll have limited face to face time, and are wondering “How do we provide the same general em content?”
Are you still considering emergency medicine? Are you worried that your fragmented clinical experience is leaving you unprepared for your rotations in an Emergency Department near you? Are you a program looking for an answer to provide a great EM learning experience? This is the curriculum for you!
Target Audience: Third-year medical students who haven’t committed to Emergency Medicine, but are interested in being introduced to the field AND programs looking to have a comprehensive and ready-made EM related content for MS3’s rotating this academic year.
What: A 4-week completely asynchronous and virtual curriculum containing FOAM resources, including blog posts, podcasts, webpages, and interactive modules, based on the ACGME core competencies. Each module includes a short quiz to test immediate knowledge retention, and the end of the week choose your own adventure case.
Where: Hosted on ALiEM.com
When: Curriculum release on July 1st
Benefits: Walk into your EM rotations feeling confident that you will know how to approach the undifferentiated patient, make a differential, talk to people about it, and write it down, in a compassionate and patient-centered way! Programs can have their students do this curriculum in parallel with their clinical shifts during their 4-week rotation.
Over four weeks, we will cover:
- How to approach undifferentiated and acutely ill adult and pediatric patients (Patient Care and Clinical Reasoning)
- An introduction to the flow and system of the Emergency Department (System Based Practice)
- Communication strategies in Emergency Medicine, both with written and verbal and with EM physicians, consultants, and patients (Interpersonal and Communication Skills)
- Professionalism, medical ethics, and patient-centered issues that arise in the Emergency Department (Professionalism)
- Creating a differential diagnosis for both common and life-threatening patient presentations (Medical Knowledge)
- Exposure to key Emergency Medicine content areas such as resuscitation, evaluation, diagnostics interpretation, and management of common ED presentations (Medical Knowledge, Practice-Based Learning and Improvement)
- Development of procedural skills, including suturing, vascular access, as well as EM tricks of the trade. (Medical Knowledge, Practice-Based Learning and Improvement)
We can’t wait to have you join us on GroundED In EM!