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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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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2019-03-28T21:25:08-07:00

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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2019-02-19T18:37:33-07:00

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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2018-12-14T19:46:41-07:00

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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2018-10-01T21:17:37-07:00

IDEA Series: Building a High Fidelity Biosimulation Task Trainer for Resuscitative Hysterotomy

The Problem

idea series teaching residents quality improvementThe peri-mortem cesarean section, rebranded in recent years as the “Resuscitative Hysterotomy”, is a potentially lifesaving procedure for both a pregnant mother and her child. It is both daunting and infrequently performed, necessitating frequent review of indications, techniques, and pitfalls to ensure the best possible outcome for mother and baby. The decision to perform this procedure should be made only in pulseless women with a uterine fundus above the umbilicus, which indicates a gestation of >20 weeks.1,2 Prior studies suggest the procedure should be performed within 5 minutes of maternal cardiac arrest in order to maximize the probability of favorable maternal neurologic outcome and the secondary goal of fetal survival.3 Given the paucity of clinical exposure to this potentially-life saving intervention, resuscitative hysterotomy is an ideal candidate for simulation-mediated deliberate practice.

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IDEA Series: Implementing an Integrative Longitudinal Online Ultrasound Curriculum

The Problem

Idea Series LogoEmergency ultrasound (EUS) has quickly become a fundamental aspect of emergency medicine (EM) residency training. While still relatively novel to the field, there has been a significant focus on curriculum development in accordance with the core ultrasound application guidelines set forth by the American College of Emergency Physicians (ACEP).1 Currently, there is no consensus on the optimal approach to EUS education that will provide learners with true clinical competence post-matriculation. Furthermore, a recent survey demonstrated that there is conflict between what ACEP guidelines consider to be competence in EUS and resident opinion on the matter.2 One potential identified issue with our current model is the focus on early ultrasound learning in junior EM residents with a lack of ongoing EUS education in senior years.
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2018-06-06T09:33:25-07:00