CDEM Voice – Member Highlight

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Meigra Chin

Meigra Myers Chin, MD

Assistant Professor

Clerkship Director

Department of Emergency Medicine

Rutgers-Robert Wood Johnson Medical School


 

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  1. What is your most memorable moment of teaching?

I don’t have a single moment, although there are moments that stand out in my mind along the way.  I teach medical students (in various roles) from their first through fourth years, so I get to see quite a few through all the way…and I think that one of the most satisfying, if not memorable, moments in teaching is seeing that evolution from a wobbly first-year to a self-confident, organized fourth-year student.  It is gratifying when you hear back from a student that they remember learning something from you.

  1. Who or what is your biggest influence?

I was very privileged to train under some of the best of the best at Bellevue, not just attending faculty, but residents and fellows as well.  I’d have to say that the true sense of integrity and duty to patients first that I learned there is one of my biggest influences.

  1. Any advice for other clerkship directors?

Get your faculty invested in your students.  There can be a tendency to focus on residents more than students, or EM-bound students more than all students if you have a required clerkship like we do.  Faculty need to remember that these are the kids who will be taking care of our patients (and us!) down the line.  One of my main goals for my clerkship is to give all students a clearer understanding of what EM does, why we are great at what we do, and that in the future, when we wake you up in the middle of the night for a consult, we are doing it for good reason!

  1. What is your favorite part about being an educator/director?

I’ve had a lot of first-year students assigned to follow me in the ED and then come to me down the line to tell me that they’ve decided to pursue EM.  That makes me feel great.

  1. Any interesting factoids you would like to share?

I was an atypical student, back in school as a single parent with an undergrad BFA in theatre and absolutely zero science background when I started my pursuit of medicine.  I think I will always have a soft spot for the outlier students and their individual circumstances because of the way I came up.  “Wanderer, there is no road, the road is made by walking.”—Antonio Machado

CDEM Voice – FOAMonthly

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https://edgeforscholars.org/writing-in-academia-an-interview-with-helen-sword/

Who doesn’t want to be a better writer or publish more frequently? Helen Sword is the author of a new book entitled Air &Light &Time & Space: How Successful Academics Write.  In this interview, she discusses  the process of writing and her insights from writing the book. She provides useful resources to help improve not only your writing but your writing process. You can use the Writer’s Diet website (www.writersdiet.com) to determine if your writing is “flabby or fit.” You can learn why you may not need to write every day. Additionally, the Edge for Scholars blog provides “candid commentary” and “gritty truths” about life in academics and offers a broad range of perspectives from multiple disciplines. The blog has topics ranging from productivity to wellness to negotiation to gender and diversity. It is a great community where you can just read or jump in and share your thoughts and ideas!

Kendra Parekh, MD

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CDEM Voice – Research Column

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Using Surveys in Medical Education Research

Surveys are a common means of acquiring data in medical education research. They can be used to perform needs assessments for curriculum design, evaluate learner and instructor perceptions, or gather information about the attitudes and preferences of individuals in the educational environment.

Surveys are best used to obtain subjective data, such as opinions or attitudes, as these cannot be observed directly. Directly observable data may be gained by various means, such as direct measurement (e.g. using an exam to test content retention), database review (e.g. analyzing student academic records), or third-party observation (e.g. outsourcing analysis of videotaped procedural performance). In contrast, surveys ask respondents to report or recall information, and as such their findings risk being subject to various cognitive biases such as recall bias. For this reason, data should only be obtained by a survey if they are otherwise unavailable due to the impracticality or impossibility of more direct assessment.

When designed and applied properly, surveys can achieve a scientific rigor comparable to psychometric tools. If relevant to the researcher’s questions, previously validated survey tools should be used, as these are more likely to yield high-quality responses and allow for comparison against pre-existing data. Many questions in medical education research may require the construction of new surveys, however, as pre-existing survey questions may not fully capture the information relevant to the study at hand.

Artino et al. describe seven steps in developing a survey tool to maximize its scientific rigor: (1) conduct a literature review to look for pre-existing survey tools or items, and to align the new survey with existing literature; (2) conduct interviews or focus groups to help understand how the population of interest conceptualizes the relevant questions; (3) synthesize the first two steps to ensure that the ideas under investigation a) use language that the population of interest can understand, and b) that these ideas make theoretical sense based on the literature; (4) develop survey items; (5) conduct expert review of these items to assess for content validity; (6) vet these items with members of the respondent population to ensure understanding in the manner that the investigators intend; and (7) run a pilot survey to evaluate response variance and conduct a formal analysis of the content validity of each survey item. While the performance of each of these steps may be too cumbersome for the construction of a given survey, incorporating as many as possible will increase the quality and reproducibility of survey responses and will make the data more reliable for comparison against future studies.

Furthermore, careful design facilitates the reporting of many important survey considerations. A robust evaluation of the study population will enable clearer description of sampling criteria, which will add to a survey’s reproducibility and indicate the generalizability of its results. Content review and item vetting not only improve the quality of data collected by individual questions, but also help identify the best means of response measurement. For example, an opinion question might utilize a Likert scale or free responses, and these two types of data demand very different analyses. Identifying which response type is best suited to gathering the data of interest is crucial for both data acquisition and reporting.

Finally, carefully crafted survey items avoid ambiguity or confusing language. This helps reduce erroneous responses, and thus makes inaccurate conclusions less likely. Clear wording can also improve the response rate, which is a crucial piece of information for any survey study to report. As in all study types, achieving appropriate power helps reduce the risk of type I and type II errors, and in survey methodology power is reflected by the response rate as well as the sample size.

Surveys can be excellent tools for elucidating subjective or otherwise non-observable data. With careful design and appropriate application, they can attain a high degree of scientific rigor.check box

 

Andrew Ketterer, MD

Medical Education Fellow

Beth Israel Deaconess Medical Center/Harvard Medical School

References:

Artino AR, La Rochelle JS, Dezee KJ, et al. Developing questionnaires for educational research. AMEE Guide No. 87. 2014(36):463-74.

Phillips AW. Proper applications for surveys as a study methodology. Brief Educational Advances. December 5, 2016. 18(1).

 

CDEM Voice – FOAMonthly

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A Heaping Spoonful of FOAM Literature Reviews


Site: https://journalfeed.org

Are you tired of hearing about “that cool new study” that your student heard about on a podcast, but can’t cite? Do you find the “why do we do this?” question difficult to answer on shift? Looking to direct your students to landmark EM papers that guide our practice?  This month’s FOAMonthly highlights JournalFeed, formerly EM Topics, which promises to spoon feed us the most important EM literature.

Clay Smith, MD (@spoonfedEM), created JournalFeed to meet the broad needs of novice to advanced learners who need some help staying informed.  Via an almost continuously updating website, daily emails and weekly summary emails, Dr. Smith uses the “spaced repetition” model of learning. After he combs through all of the new EM literature in a month (>1500 articles from 31 journals), Dr. Smith selects articles that seem the most relevant to an EM physician’s practice and posts a summary/emails one reviewed article per day. While each review does link to the primary source, there is also a summary of the highlights, including a single sentence “Spoon Feed” summary, a “why does this matter” section and a brief discussion of the findings and methods of each article.  The website is open access, and daily/weekly emails are via a free subscription.

For our most novice learners, the “Landmark Papers” section will be the most informative. From articles on vent management, stroke care, antibiotic stewardship, to health policy and ED operations, there’s something for every interest.  Best of all, summaries are short, concise and relevant to daily practice.

 

Happy Spoonfeeding,

 

Emily Brumfield MD

@DrSadieHawkins

Assistant Professor

Assistant Director of Undergraduate Medical Education

Vanderbilt University Medical Center

CDEM Voice – Member Highlight

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Lexington

David Story MD, FACEP

B.S., Biochemistry, Louisiana State University & A&M College, 2002

M.D., Louisiana State University Health Sciences Center in New Orleans, 2006

Residency, Emergency Medicine, Duke University Hospital, 2009

Fellowship, Medical Toxicology, NYU/Bellevue/NYC-Poison Control Center, 2010

Physician, Emergency Department, Lower Manhattan Hospital (formerly New York Downtown Hospital), 2009-2011

Assistant Professor, Department of Emergency Medicine, Wake Forest University Medical Center, 2011-present


 

1. What is your most memorable moment of teaching?
There isn’t a specific moment, but I love seeing that point at which a certain idea “clicks” with a student and their eyes light up with the sudden understanding of something that was previously unknown.

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2. Who or what is your biggest influence?
I have been blessed to have been surrounded by several outstanding clinician educators during my training and practice years. Physicians who not only have an extraordinary knowledge base, but are complete practitioners: excellent bedside manner, patient advocates, supporters of ancillary staff, and can disseminate their knowledge to others in a meaningful, respectful, and understandable fashion. A few that come to mind are Josh Broder, Randall Best, Bob Hoffman and David Manthey, but that is far from an exhaustive list!

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3. Any advice for other clerkship directors?
Listen to your students. They are a great resource for what is working, or not working, on the rotation. And don’t be afraid to change things within the clerkship experience. Just because “its always been done this way…” doesn’t mean its the best way!

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4. What is your favorite part about being and educator/director?
My favorite part about working in an academic setting is that we get to wear so many hats: educator, mentor, physician, administrator, advocate. We as EM physicians are often attracted to the specialty because of the breadth of patients and complaints that we see clinically, and academic EM provides the opportunity for variability/versatility adjacent to the clinical realm. In my case, being involved in education (student and/or resident) really inspires me to keep learning so that I can effectively guide and educate the future physicians of the specialty.

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5. Any interesting factoids you would like to share?
imagesMy fourth year of medical school was interrupted when Hurricane Katrina devastated New Orleans in 2005. I spent the next 5 months doing away rotations, allowing me to spend significant time in some of America’s great hospitals and cities. Side note, Katrina was the 3rd of 5 hurricanes to effect me that summer and fall of 2005. You’ve heard of “storm chasers”, well it felt like I was the one being chased!

 

CDEM Voice – FOAMonthly

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http://scienceforwork.com/blog/virtual-teams-trust/

In our academic lives, we constantly work in teams and increasingly, we are working in virtual teams. Would you like to apply the best evidence from the organizational and management literature to make your virtual teams effective? If so, read this post from the website Science for Work to learn how to build trust in your virtual teams—increased trust leads to improved team performance and everyone benefits!

When working in a virtual team, trust takes on even greater importance as there are less social cues, poorer understanding of tasks, and increased risk for conflicts and role ambiguity. Thus, trust becomes more essential to effective team functioning. Here are four tips to improve trust on your virtual team. First, get to know your team. If possible, use social activities to engage each other and build relationships. Second, be trustworthy. Team members trust each other based on three factors: competence, integrity, and benevolence. Therefore, strive to display competence, integrity, and benevolence to increase your trustworthiness. Third, clearly assign roles and tasks. Documenting interactions through the use of recorded videos or chats can help with this. Lastly, work to maintain trust. Once trust is established it is important to maintain trust through frequent team interactions. If you want to learn more about evidence-based management, Science for Work (http://scienceforwork.com/) has ample reading with clearly distilled take away points!

Kendra Parekh, MD

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CDEM Voice – Member Highlight

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Laura Thompson

 

 



Laura Thompson, MD MS

Assistant Professor
Department of Emergency Medicine
OSU Wexner Medical Center



 

  1. What is your most memorable moment of teaching?

I love the moment when you can help a student figure out if a patient is “sick” or “not sick.” It is an incredibly important teaching point, and after a student has 3-4 years of classroom and clinical learning in med school, it is great to see it all come together.

  1. Who or what has been your greatest influence?

My dad believed in a life of service, and I see education and medicine as two fields that intersect with service to students, patients, and society. My mom always juggled work and family, and has been a role model as I’ve started my career.

  1. Any advice for other clerkship directors?

There is a balance to being a clerkship director – being a student advocate and holding your students to high standards to help them become great physicians. It was initially challenging to be the one to call students out when they weren’t performing well in one area. But I think it is perhaps those students we can help the most – if we can identify the gaps in knowledge or in skills, it becomes so much easier to train the next generation of physicians.

  1. What is your favorite part about being and educator/director?

I love clinical teaching and finding the one or two major points per shift that a student can walk away with a have as a new skill or new skills.

  1. Any interesting factoids you would like to share?

I tell my trainees that you never know where you will learn your leadership skills for running a code or an arrest. When I was a resident, I was in the CTICU on an overnight with a patient in extremis. After things were managed, one of the more seasoned nurses turned to me and said “Were you a coxswain or something??” Indeed – I was a coxswain for about 6 years, and those leadership skills have helped me manage many difficult situations. So, I encourage my mentees to work hard in whatever they pursue, and realize the arenas of work and play are not always so different.

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