This is exemplified in a recent multicenter study, which addresses whether attendance at weekly residency conferences correlates with a better in-service training examination (ITE) score. The ITE score was used as an outcome measure, because it correlates with the resident’s likelihood for passing the official ABEM Board Exams. Both tests draw from questions in the Model of the Clinical Practice of Emergency Medicine.
On Feb 24, 2010, every residency applicant will have a brief moment of panic as their rank list is submitted and officially certified.
Next week, I’ll be joining a group podcast with Dr. Rob Rogers (Maryland) and Dr. Dave Manthey (Wake Forest) for the next installment of EMRAcast. This new podcast series was created by Rob for EMRA for the specific purpose of providing advice to medical students. I still find it fascinating how much you can get done virtually. We’ll all be using Skype from our respective offices and recording our conversation.
It’s a busy day in the Emergency Department and there are 5 new patients to be seen. The waiting room is overflowing. As the attending, you are getting barraged with a million questions to answer and problems to fix.
There is also a case of a full-thickness burn patient going to the OR in the next few minutes. She’d be a perfect teaching case for the residents.
Should I have the residents go see the new patients, or should I pull them all aside to show them the physical findings and teach about burns for 5-10 minutes?
- Is non-judgmental
- Is non-threatening
- Is specific
- Consists of both positive and constructive elements
- Offers alternatives
Medicolegal woes often can be tracked back to poor documentation by the physician.
This article is a retrospective chart review of 384 EM resident charts, focusing on the documentation of the neurologic exam. Charts were selected if their chief complaints were neurologic or psychiatric in nature. A non-validated measurement tool for evaluating a neurologic exam was created based on discussions with attending emergency physicians. I have to agree with the chosen criteria. Documentation in each of the following criterion receives 1 point for a maximum score of 8.
Patient care versus education
This is the tug-of-war struggle that residency programs constantly grapple with. Residents work in an apprenticeship model where they are both patient providers and learners. Both are critical in residency training, but they sometimes negatively impact each other. For instance, EM residents hand-off their patients to covering residents while attending their weekly conference classes. In contrast, residents may skip that day’s board teaching rounds to manage an acutely decompensating patient.
This was the question addressed by the landmark 1910 Flexner Report from the Carnegie Foundation for the Advancement of Teaching. Back in the early 1900’s, residency training did not exist yet, and students entered clinical practice immediately after graduation from medical school. The quality of medical training varied significantly with alarming deficiencies in many medical schools. An independent, nonprofessional organization was commissioned to report about the situation in order to pressure the public to reform medical school education.