CDEM Voice – Member Highlight



 Jennifer Avegno, MD MA

Clinical Associate Professor, LSU Emergency Medicine

Community Health Relations and Engagement

Director of Student Rotations


Brief Bio:

Jennifer Avegno currently serves as Associate Program Director and Director of Undergraduate Education for the LSU – New Orleans Section of Emergency Medicine, where she is a Clinical Associate Professor.  A proud New Orleans native, she is a graduate of the University of Notre Dame (go Irish), and has a master’s degree from Tulane University and MD from LSU – New Orleans.  She completed her residency in EM at the famed Charity Hospital in New Orleans in 2005, just months before Katrina unceremoniously destroyed it.  Since then, she has been involved with student and resident education and community health engagement in areas of violence intervention, sexual assault, homelessness and Hotspotting.  Since assuming EM Clerkship Director
duties for both Tulane and LSU Schools of Medicine, she has developed and directs 3 separate rotations in the ED at University Medical Center that serve nearly 400 learners per year. She is active on several local boards and community organizations, 400and though fairly nerdy still gets to ride in the largest all-female Mardi Gras parade during Carnival.  Jennifer and her husband enjoy the adventure that is parenting four children, and she is grateful for the relative calm of her inner-city, urban teaching hospital ED compared to a typical night at home.

What is your most memorable moment of teaching?

I developed a mandatory course for senior students designed to ensure that no matter what their specialty, they had exposure to acutely ill, undifferentiated patients (in the ED), and thus would hopefully not fear the “sick” patients they encountered in residency and beyond.  An intern who had previously completed the course stopped me on the street one day on a visit home and said, “I never would have taken a course that forced me to see really sick patients … but because I did, I was able to know what to do on a crashing patient in the ICU.”  The confidence in her eyes was an honor to see and know our efforts had made a difference.

Who or what is your biggest influence? 

My mother – the most intelligent person I know – was a longtime educator at a local high school.  Every day, she prepared to teach 16-year old girls as if she was about to defend a dissertation or debate a seasoned scholar.  She never made more than the average intern or received much academic praise or advancement; yet she did it with passion and not a month goes by that someone doesn’t tell me “your mother made such an impact on me.”  Education is a job where the rewards are often unseen by the educator, but substantial to the

Any advice for other clerkship directors?

Don’t be afraid to tell it like it is, particularly to those students you are advising on a career in EM.  It took me several years to learn that delivering direct, honest advice or feedback – however painful –  is far better than sparing feelings or always presenting the “best case” scenario.  And – having a supportive residency director makes life easy and the job much more doable.  If anyone knows the headache of scheduling didactics, setting curriculum, and arranging clinical duties while making sure everyone shows up on time, it’s the PD.

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

I love exposing students going into non-EM specialties to what we do.  Before they rotate, they often have jaded or inaccurate ideas about how the ED operates … once they’ve worked a few nights in the trenches, there’s a whole new appreciation that hopefully they’ll bring to their own fields.  Plus, everyone’s best stories as a student come from their EM experience.

Any interesting factoids you would like to share?

I think being a Clerkship Director is the most fun you can have in a residency program.  From the sublime (that visiting student who is so fabulous the nurses beg you to hire them
on the spot) to the ridiculous (the kid who is so disengaged on a night shift that they start reading Harry Potter and instantly incur the collective wrath of your entirharry-pottere residency) – students always keep it interesting.

CDEM Voice – FOAMonthly



Resuscitate your slides!

No more death by PowerPoint. We have all sat through PowerPoint presentations overrun by animations and littered with barely readable text and clip-art. Well, no more. Whether you are guilty of poor slide design yourself or interested in coaching faculty, residents or students on designing powerful slide presentations, the Top 10 Slide Tips from Garr Reynolds is a great place to start. Garr Reynolds is the author of Presentation Zen (an excellent read on slide design) and hosts a blog on professional presentation design. In his easily digestible and immediately applicable Top 10 Tips Garr Reynolds reminds us of the purpose of slides and provides easy-to-follow recommendations on how to make your slides more visually appealing and impactful. Those that resonated most strongly with me were that the audience is there to hear you speak, not read your slides. Your slides should be essentially meaningless without you. To put it another way, if you properly design the slides for the talk, the slides should not be usable as a handout. More is not better so choose your graphics carefully and with purpose. Photographs of people are great to evoke emotion. Fonts and colors impact your message. Use sans serif fonts and whatever font you use, stick with it throughout the entire presentation. Use these tips and share liberally with your faculty, residents, and students to help prevent needless death by PowerPoint and to bring new life to educational talks.

Kendra Parekh, MD


CDEM VOICE – Member Highlight



Melissa C. Janse, MD

Director of Undergraduate Medical Education
Clerkship Director
Department of Emergency Medicine, Greenville Health System
Clinical Assistant Professor
University of South Carolina School of Medicine Greenville
Clemson University School of Health Research


What is your most memorable moment of teaching?

I think that it was walking into our brand new medical school ready to meet my small group students for the first time.  I wanted that teaching position more than anything and was extremely nervous. I had been up late the night before, reviewing the chapter multiple times, taking notes, memorizing my students’ names and faces on the roster, and even stressing about what to wear.  I wasn’t sure if I was up to the task, but as I began to relax, and the students excitedly asked questions (and I actually knew the answers), I realized that I could do this.

Who or what is your biggest influence?

It isn’t any one person/event, but more a composite of what I learned from my emergency medicine residency training. I remember the attending that brought in a dead copperhead that had been run over by a car, just to show us the differences between venomous and non-venomous snakes.  I remember the attending that calmly intubated and saved the life of a patient that had de-saturated to the 50s and was becoming bradycardic after an intern and I (the second year resident) failed to secure the airway.  I remember my mistakes, my “saves,” and how I felt afterwards as well as the mentorship I received from my attendings.  I try to channel this when I teach now so that students know they are not alone.  I figure that they can learn from my past mistakes and successes as well as their own.

Any advice for other clerkship directors?helpsupport

I truthfully had very little idea of what a clerkship director actually did when I jumped on the opportunity. I learned on the job, sought mentors, and reached out to CDEM for advice.  Emergency Medicine is a small, close community.  Take advantage of CDEM and the collective wisdom of your peers.  They want you to succeed.

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

I am excited about my job all over again. After the initial fervor from medical school and residency waned, I grew complacent if not jaded as an attending.  But now I see my job from the perspective of new learners.  Their enthusiasm rejuvenates me.  I find my students’ eagerness to learn a personal challenge, as I am always trying to stay a few steps ahead of them and keep up to date.  Teaching has definitely made me a better, not to mention much happier, Emergency Medicine physician.

Any interesting factoids you would like to share?

I went straight from residency to a private, independent group contracted by a hospital (Greenville Health System) to staff their multiple emergency departments. The compensation was lucrative, but I was working strictly for a paycheck and did not find my job fulfilling. I dropped to half time, working just enough hours to maintain benefits as I tried to balance my role of wife and mother of three with that of a physician. Fifteen years later, as part of its commitment to being an academic health center, Greenville Health System created an independent department of Emergency Medicine making its EM physician employees, started a new medical school (University of South Carolina School of Medicine Greenville), and pledged resources to begin an Emergency Medicine residency program. I got the opportunity to teach at the medical school and be the EM clerkship director, increased my hours, and have never been happier with my career. USCSOMG graduated its first class this past spring, our department just finished hosting our very first visiting student rotations, and our accredited GHS EM residency program will begin next summer.


CDEM VOICE – Research Column






Feeding and weighing rats, changing cages, petri dishes, hours and hours looking through a microscope – these were all concepts I associated with research prior to going to medical school, and honestly even during the beginning of medical school. They were my equivalent of scratching my fingers down a chalkboard; they invoked memories mostly of smells I had hoped to forget. Having done a study during my undergraduate time looking at the sense of taste and its effects of weight gain in albino rats, you may understand why upon getting accepted into medical school I saw research as something I would never again take part in. Then medical school came and went. During this time I was immersed in the study of the form and function of the human body. I was enamored by people, by patients. It was then my thought of research – rats, petri dishes, etc. – was changed. I realized that I really enjoyed asking a relevant question about the patient and finding an answer; ergo I began to enjoy research. I believe many clinicians have similar feelings towards research  and my hope is that we all can change those feelings by following along with this blog.

Now as a practicing Emergency Medicine physician I have found myself with more questions than answers, and I am less and less satisfied with the proverbial “this is how we have always done it.” Which novel approach to a medical query works best? Why does it work in that setting versus this one? How do we as medical educators teach better, give better feedback, or mentor more effectively? I know I am not the only one who has these questions, and I also know not everyone has the tools to go about answering them. Each of you has a question that is worth researching in whatever form you choose.

So why do research? Research is a way to validate our current practices – whether you work at a level 1 academic center or a small critical access hospital; whether you teach students, residents, fellows, or the patient tech helping you with that reduction. It helps the practice and knowledge base of EM grow. It makes ALL of us better at what we love to do. It will empower you to be a better clinician educator and will start you down a road you will not regret. Over the next few months we will be writing other primers on research. We are excited to have you along for the ride, and please, if rat-987c78e8f6d5124306d52a0a978ad8853a9d8988-s300-c85there is a specific topic you want covered let us know in the comments below!

Andy Little, DO

Research Director, Emergency Medicine Residency

Doctors Hospital/Ohio Health



FOAMonthly title.PNG


An online resource worthy of your review –


As clerkship directors (CDs) we are continually providing feedback to our learners and our learners consistently ask for more feedback. A post on The Learning Scientists Blog by Stacey R. Finkelstein entitled “Two Myths about Feedback (and Why the Myths are Wrong)” discusses two common feedback myths. One is that people don’t want to receive negative feedback and two is that people understand the feedback you give. In reflecting on this post, I was struck by the fact that feedback is received differently by novices and experts and that the learner’s motivation matters. Feedback given to early learners considering EM as a specialty needs to be different than the feedback given to visiting students on their third EM rotation. Novices tend to need more positive feedback to support their commitment and motivation to learn the new material. This is compared to “experts” (i.e. the learner on a third EM rotation) who are motivated more by self-improvement and thus are more open to negative feedback. The post also reminded me that I need to be clear in my feedback language. I need to ensure that the learner understands the feedback I am providing and has interpreted the feedback how I intended. Similar to using the teach-back method for patient education, we should check that our learners have understood their feedback. Giving feedback to learners can be difficult and this post provides 2 tips on providing better feedback-try to understand your learner’s motivation and ensure understanding of feedback you have provided!



Kendra Parekh, MD


CDEM VOICE – Member Highlight


                        Where we recognize and and learn from one of our members each month…


Assistant Professor of Emergency Medicine at UMASS Medical School – Baystate Health

  1. What is your most memorable moment in teaching?

Sometimes when you teach routinely -you do something over and over – you have your spiel down and you make the same joke each time. My student procedure lab was like this after just a few months. These labs didn’t stand out to me until I got an email from a former student. He wrote me at the end of a night shift to tell me that the lab saved him and his patient last night. He found himself with a patient needing an LP for possible subarachnoid hemorrhage. He was on with very little staff and no one had the skill or experience to do the LP. He remembered the model, the steps and the keys to success. In the middle of the night he duplicated what we taught and got the LP, and it was a SAH.
My procedure lab isn’t sexy, cutting edge or exciting but this routine teaching experience helped save a life. The impact we have as teachers isn’t always obvious. It is ripples in the water spreading out slowly and these small moments have a huge impact.

  1. Who or what is your biggest influence?

My mother was a high school teacher. She instilled a deep appreciation for learning, integrity and mentorship. She taught by example that a teacher doesn’t teach facts but creates a safe environment where learners and teachers share and grow together. She was the teacher you went to with your secrets, fears, and dreams. She listened and then got you to solve the problem yourself. Fifteen years after retiring, students continue writing, calling, and visiting her. As I began teaching I found myself mirroring her style and quickly evolving from teaching EM to mentoring and guiding learners through their process. momCoffee shops, my kitchen counter and our med rooms are frequent sites for my mentoring. At residency fairs former students and residents will run up to hug me and check on our team at Baystate – this is my mother’s influence.

  1. Any advice for other clerkship directors?

Take the time to work clinically with each student, then sit down with each to give summative feedback and help move them forward. Every student is unique and spending time with each one allows you to see the nuance beyond their grades, scores and personality. Try listening more than talking and use open ended questions just like with patients – it is more efficient and effective.

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

Knowing I’m not just training my residents, nurses, techs, APs, students, but everyone they teach in the future is what keeps me going on the rough days. While the adrenaline rush of doing a procedure is tantalizing, the rush of seeing that joy and accomplishment on another is priceless. Teaching allows for such an enormous impact well beyond what I could ever do as a single doctor. Hearing of my learner’s successes is the best feedback I get.

  1. Any interesting factoids you would like to share?

My first few years I worked in community medicine and developed my areas of greatest weaknesses, filling in my pot holes and developing my teaching style with rotating residents and the local medical school. While this is an unusual path it has given me an enormous advantage in both confidence and dedication.

When you find an area of passion within EM – take time to explore it and learn. This will imbue your teaching, and allow you to shift gears into your niche when the time is right
for you. My niche is airway – while not original it is tremendously rewarding. Hearing scenarios, reviewing literature, and challenging myself to organize that next didactic keeps my creativity going.

Lifeconfusion-311388_960_720 is about the choices you make. I have two amazing children. They inspire and drive me. Balance between home and work is a constant challenge, one solution I’ve come up with is to make them a part of my teaching by having them at student dinners, Journal clubs, and letting them lend their talents to my didactics. My decision to share my teaching with them allows us be a part of each other’s time when we are together and apart.