Expert physicians: These are the ones who effortlessly handle a busy Emergency Department while juggling patient load, learners and consultants.
This article 1 studied macrocognition differences between novices and experts in the Emergency Department. (more…)
Medical education high-fidelity simulation allows for deliberate practice in a safe environment. We are able to miss the intubation repeatedly or botch up the management of aspirin overdose without the demise of the patient. At the end of each session, we gather in a pow wow and debrief….
I have been involved with debriefings, and often wonder what residents are thinking:
What does debriefing even mean?
Seth Godin, a marketing guru, discusses his opinion about “what school is for” in this above video. Although this talk or Seth Godin are not directly related to medical education, this is still related to education and can still be applied to today’s medical education curriculum in many aspects.
Mr. Godin goes on to explain that school was modeled in the industrial age and has changed little ever since. The video covers such concepts as:
One day back in 2005 during my PGY-1 pharmacy practice residency, I remember a conversation with my residency director. He was a Surgical/Trauma ICU pharmacist. There had been a recent article published (I think it may have been one linking ‘tight’ glucose control to decreased mortality in ICU patients). Funny how times change…
Anyway, he mentioned all of the ‘discussion’ surrounding the article in terms of comments submitted to the journal. It was my first introduction to the idea that published literature could be challenged through an avenue provided by the journal.
Just this past week during EM residency journal club, we were discussing the recent Etomidate/Sepsis Meta-Analysis published in Critical Care Medicine (more to come on that soon in another post). I mentioned to my group how one could search for submitted comments. Most seem surprised to learn this trick of the trade.
(more…)
This post is about an editorial comment by Dr. Richard Levitan on an article (1) about pulmonary critical care doctors performing intubations in the ICU (2). The study states that pulmonary critical care doctors can successfully perform this procedure. Dr. Levitan reports that intubation in elective anesthesia has a success rate between 98-99%, but when failure occurs the consequence can be catastrophic. The initial success rate of beginners is usually 50%, and it takes about 50 attempts in elective intubations to be 90% proficient.
“I desire no other epitaph…than the statement that I taught medical students in the wards, as I regard this as by far the most useful and important work I have been called upon to do.” – Sir William Osler, renowned physician and believer in bedside medical education
And with this quotation I would like to introduce a new segment to Academic Life in Emergency Medicine. One of the most important job descriptions we have as physicians is to be a clinical instructor… while simultaneously running cardiac arrest codes, managing agitated altered mental status patients, and avoiding documentation errors.
As active adult learners, we must be conscientious about the what, how, and why we are reading a piece of literature. Being conscientious makes us more efficient, selective, and critical about what we learn. This in turn will help us to provide better care for our patients, which is after all our main goal.
Although mainly used to develop curricula, I believe that understanding Bloom’s taxonomy and applying it to our learning may help us to learn more effectively. Bloom’s taxonomy can help us identify learning objectives that require higher level of cognitive function, which helps us to be better problem solvers.