TLDR Book Review: The Culture Code – The Secrets of Highly Successful Groups

culture code

Have you had shifts or worked on committees where everything went smoothly? Closed loop communication happened, there was mutual respect among all the team members, and each individual felt empowered to give input even if it differed from what had already been said or done? You’ve probably also worked on shifts, in meetings, or participated in projects where it seemed like the team was falling apart, communicating on different wavelengths, and failing to have a shared understanding. You may feel like a great leader one day and a failure the next. The difference, according to The Culture Code, has everything to do with the culture of the team. In this 2018 book, Daniel Coyle explains what makes teams successful and how you can help create the culture necessary for all of your teams, committees, and groups to succeed.

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By |2020-01-03T00:12:10-08:00Dec 20, 2019|Book Club, TLDR|

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|

EM Match Advice: Deep Dive into the SLOE

em match advice deep dive sloe

A high-stakes component in a medical student’s application for an emergency medicine (EM) residency is the Standard Letter of Evaluation, or SLOE. This is a standardized templated letter, written by an group (e.g. department) or faculty from an EM-residency program. This episode of EM Match Advice gives a behind-the-scenes peek into what letter writers are thinking and a deeper dive into the mechanics of the SLOE.

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By |2019-12-13T20:23:33-08:00Dec 6, 2019|EM Match Advice|

Making Heads or Tails of the Flipped Classroom: Tips and Tricks for Students

Now more than ever, medical educators are excited about the flipped classroom, defined by Bishop and Verleger as “a new pedagogical method, which employs asynchronous video lectures and practice problems as homework, and active, group-based problem-solving activities in the classroom” [1]. The premise is that students will learn basic concepts during self-study, at their own pace, and come to the classroom ready to dive into small groups and problem-based application [2].

This approach may be unfamiliar and you may find yourself asking: 

  1. Why should I care? 
    and
  2. How do I get the most out of it?

Let’s begin with the first question. Several studies looking at the flipped classroom conclude it is good for your learning. Though it may initially be perceived as extra work, once the student realizes that the work just replaces the after-class homework they used to do, students’ report a generally high satisfaction, and high engagement with the in-class activity [3-6]. The flipped classroom can make you a more effective “lifelong learner.” While assessing learning efficacy is challenging, some studies have shown improvements in analytical and problem-solving skills in students who come prepared and fully engage in the in-class activities [3,7]. 

As for the second question, to ensure that you get the best flipped classroom experience, we compiled a list of must-do steps to engage with this educational strategy successfully.

Tips and Tricks:

Prepare (yes, really)

The proverbial wisdom that “by failing to prepare, you are preparing to fail” holds true with this pedagogy. Don’t walk through the door if you haven’t done the prep work. Assigned videos and podcasts are not just “suggestions,” but rather the building blocks for your in-class time. The point of the flipped classroom is for you to do the “easy stuff” at home and the harder, application-type activities, with your educator present. It’s essential that you complete them prior to class. Think of it as doing the classwork at home, and the homework in class! By reviewing material ahead of time you will be ready to ask clarifying questions and grasp higher-level concepts, in order to make the best use of your teacher’s direct attention.

Don’t skip ahead (or you’ll end up behind)

With access to the learning material online, you may be tempted to “skip ahead” to answers. However, the course will often build on itself and part of the learning process will be to work through application problems with only the information you have at the moment. Future sessions may allow a second-look with a new lens, so staying true to the current schedule is best. Similarly, allowing yourself to fall behind and expecting to catch up later will put you at a disadvantage during the in-person sessions.

Commitment (like any good relationship)

In order to bring a complex topic to a class, there are often multiple moving parts for a flipped classroom activity. If you’re set up in a team, designate 1-2 classmates to hold the rest of your team accountable for the work that you need to get done and the deadlines that you need to complete. Rotating responsibilities part of the way through the course will allow every member to experience different roles. If you’re not working in a team, find an accountability buddy and commit to keeping each other on task and on schedule, so that you can come to your in-class sessions as prepared as you can be.

Feedback (talk to me!)

Let’s face it, you’ve spent a lot of time searching for useful learning resources and have probably found some gems. Instructors may not have known about a great new video or podcast when the material was compiled. Let them know what you’ve found and why you think that it’s a helpful resource for your classmates. Sometimes what you’ve found will help make the next class better, or can be added as supplemental material. Remember that you appreciate high-quality feedback and your instructors aren’t much different.

How do you get to Carnegie Hall? (Answer: practice, practice, practice)

It may be the case that concepts being discussed during a flipped classroom setting seem far removed from clinical practice, especially in the pre-clinical years when you are fully immersed in the basic sciences. The key is practice. In the flipped classroom, the skills acquired through dedicated medical topics, learning how to navigate the vast amount of resources available, working as a team, and dissecting problem-solving challenges will help you in the clinical setting. Be intentional about the skillset you’ve acquired and apply it to past/present/future patients. 

For example, if you learned about risk stratification tools for chest pain during a class, the next time you encounter a virtual case, a standardized patient, or a real patient with chest pain you’ll know if you can apply the TIMI/HEART/Well’s/PERC scores and how to access them online. After calculating the score, you will be able to convey to your attending, admitting team, and consultants your clinical decision-making and application of evidence-based medicine. Bringing your knowledge to the bedside helps solidify the classroom learning and connect it to real live patients which will help you grow as a clinician. 

Want to learn more about the pedagogy of the flipped classroom? And here’s a great example of curated resources for an emergency medicine intern level flipped classroom by @EMFundamentals.

What do you think? Are there other ways that you as a student have made flipped classroom successful for you? Leave us a comment below or @ALiEMFac on Twitter to let us know! 

Blog post edited and curated by:

Mark Ramzy, DO
Faculty Incubator Multimedia and Communications Editor

References

  1. Bishop, J., & Verleger, M. A. (2013). The Flipped Classroom: A Survey of the Research. In 2013 ASEE Annual Conference & Exposition. Atlanta, Georgia. 
  2. Huu Anh Vuong, Nguyen et al. Students’ Perceived Challenges of Attending a Flipped EFL Classroom in Viet Nam. Theory and Practice in Language Studies. 2018.
  3. Sait MS,et al. Advances in medical education and practice: student perceptions of the flipped classroom. Adv Med Educ Pract. Published May 2017; PMID: 28496377
  4. Young TP, et al. The Flipped Classroom: A Modality for Mixed Asynchronous and Synchronous Learning in a Residency Program. West J Emerg Med. 2014. PMID: 25493157
  5. King AM, et al. Flipping the Classroom in Graduate Medical Education: A Systematic Review. J Grad Med Educ. Feb 2019; PMID: 30805092 
  6. Smallhorn, M. The flipped classroom: A learning model to increase student engagement not academic achievement. Student Success, 2017.
  7. White PJ, et al. Student Engagement with a Flipped Classroom Teaching Design Affects Pharmacology Examination Performance in a Manner Dependent on Question Type. Am J Pharm Educ. 2017; PMID: 29302082

By |2019-11-29T18:31:31-08:00Nov 29, 2019|Academic, Incubators, Medical Education|

Is Digital Attendance Enough?

phone

Many medical schools have responded to student requests and begun to record and stream didactic lectures.  Students report watching these lectures can be more convenient and allow them to personalize the time, location, and speed to their specific needs. Meanwhile, faculty are freed up from giving the same Powerpoint lecture every semester and schools can highlight their “digital presence.” It seems to be a win on all sides, except when you look at the outcomes.

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The Leader’s Library: Radical Candor | Curated Summary of the Discussion

radical candor

Welcome back to The Leader’s Library! In our second installment, throughout the week of October 14, 2019, a group of selected learners across the globe tackled Radical Candor by Kim Scott [ALiEM book summary], and generated another fascinating asynchronous dialogue on Slack. This go-round, we had 3 days of discussion with days for reflection in between. Below are the main points that emerged from our robust conversation.

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By |2019-11-10T23:10:07-08:00Nov 18, 2019|Book Club, Leaders Library|

Just-in-Time Training for Emergency Medicine Radial Arterial Line Placement

A 63-year-old male presents for acute onset of headache, neck pain, and altered mental status. He has a prior history of hypertension and hyperlipidemia but recently lost his insurance and has been unable to fill his medications. As a well-informed 2nd year resident, you suspect the presence of a ruptured subarachnoid hemorrhage and arrange an expedited trip to the CT scanner. The patient’s blood pressure continues to remain elevated and you initiate an antihypertensive drip. You decide that in order to have accurate titration, you need more reliable data and decide to place a radial arterial line. However, the last two arterial lines you placed did not go according to plan! Before you start the procedure, you decide to review the procedure and some common pitfalls in placing radial arterial lines. You remember your attendings telling you during prior attempts to do things a certain way and you want to incorporate these in your practice.

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