CDEM Faculty Podcast Episode 11: Residents as Teachers Part 1

Happy summer everyone! This episode is part one of a two part series on residents as teachers. In this episode, we are going to discuss how we prepare our residents to teach.  In part two, we will discuss creating a formal education curriculum for residents. Here to help us navigate these topics are: Page Bridges, MD, Assistant Clerkship Director and Director of Residency Training at the University of South Carolina,  Aaron Kraut MD, Associate Program Director at the University of Wisconsin, and Lauren Wendell, MD, Director of Medical Student Education at Maine Medical Center.

 

 

 

Keep up to date on the latest CDEM Faculty podcast on Libsyn and iTunes.  

 

Suzana Tsao, DO

CDEM Voice – Member Highlight

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Caitlin Bailey MD
Medical Student Clerkship Director
Department of Emergency Medicine
Highland Hospital / Alameda Health System

Fun Facts about Dr. Bailey
Born: Boston, MA
Undergrad: Yale University
Medical School: Harvard University
Residency & Ultrasound Fellowship: Highland Hosp.
Previous Career: “Brief stint as a lab tech, where I was clearly not destined for greatness!”
 

Bailey photo

 

 

What is your most memorable moment of teaching?
The moment that sticks out in my mind the most is actually a small one. When I was an intern in the Emergency Department I was asked to explain the central line kit to a group of fourth-year students. It was one of the first moments in which I felt I had gained important knowledge I could share with learners after me. It helped me solidify my own understanding of the procedure and made me think through how to explain it in an accessible way.

I will also say some of my favorite teaching moments are actually bedside teaching moments with patients and family members, explaining the disease process in the patient and how we will treat it. I think a lot of what we do is medical education for patients.

Who or what is your biggest influence?
My biggest influence is my dad, who is actually a primary care pediatrician. While our specialties are very different, he is my biggest role model for professionalism, work ethic, and true devotion to his patients. Emergency Medicine can be wearing at times; my dad’s example reminds me that we are lucky to have this job caring for patients.

Any advice for other clerkship directors?
Take advantage of your local clerkship director community and the larger CDEM and CORD communities to hear how people running things and responding to common challenges. I could have learned a lot by chatting with other CDs in my area when I first became CD at Highland. Also, if you are affiliated with a medical school but not a primary site, connect with someone at the school of medicine to inquire how issues with “struggling students” are addressed.

What is your favorite part about being and educator/director?
I really enjoy helping students find their independent provider selves over the course of the clerkship– moving them from data-downloaders to managers of their patients. Being a clerkship director helps me clarify my own teaching style and constantly encourages me to focus on teaching.

Any interesting factoids you would like to share?
I was born and raised in Massachusetts, and had never been to California before applying to residency. I fell in love with Highland, came out to train here and never left!

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CDEM Voice – Research Column

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SIMplifying Your SIMulation Research

As medical educators, we all have been involved with simulation during our careers, whether it was during medical school training, residency competency assessment, or leading high-fidelity case scenarios and debriefs with our clerkship students. While it may seem that simulation has effortlessly weaved its way into the threads of undergraduate and graduate medical education, it has required extensive research and external validation in order to gain widespread influence. We understand what makes a simulation case memorable and high yield from a learners’ perspective, but it is much more challenging to translate it into a well-constructed research design. In order to maximize your success with a simulation research project, it is important to understand the unique challenges of this educational research modality.

What is your study question?

The first step is formulating a study question that adds to the existing literature and is testable. Oftentimes, educators attempt to answer too many questions at once and leap to conclusions that are not supported by the results. A specific, testable research question and clear methodology allows for understanding, reproducibility, and implementation by its readers. For instance, instead of posing a broad question such as, “Does simulation improve airway skills?,” an investigator  could better phrase this as “Do dedicated airway simulation sessions using an intubating mannequin decrease the rate of missed intubations in emergency medicine residents compared to a conventional bedside teaching?” which provides a much more a specific objective and measurable outcome.

Can these findings be broadly applied?

A single simulation scenario may not be sufficient to answer an overarching question and may lose its applicability. One must create a diverse portfolio of clinical simulation scenarios if the goal is broad application. After careful literature review, the investigator must identify the deficit in the literature and understand the impact of this research on simulation and medical education. The investigator should identify the learner group under study and use scrutiny when suggesting to whom the results can be applied.

Can your research design be accomplished?

The significant resource utilization associated with a high-fidelity simulation project is often a mitigating factor in pursuing this form of research. If you don’t have access to high fidelity mannequins or commercialized trainers, however, it is still possible to conduct a simulation research project. “Do-it-yourself” or home-made simulation models using inexpensive common materials and some creativity have been well-described in the literature and have demonstrated success. Even when fortunate enough to have sufficient financial resources, time is arguably the other most valuable resource we have and it is difficult to dedicate time from one’s own schedule and gather participants to ensure adequate sample size. Be cognizant of financial, time and participant resources required for your project.

Is your assessment tool valid?

The investigator must understand the details regarding the construct validity of his or her assessment instrument and describe these clearly so others can be sure the data collected is reliable enough to make valid judgments. The use of a control group and details regarding the construct validity of the assessment instrument must be addressed during the development phase of the research project. There are many existing tools in the published literature that have already been externally validated and may be applicable to your project. If designing a new tool for your study, manuscript reviewers will expect that you address issues surrounding validity in its development.

What are the limitations of the research design?

Once the author understands the limitations and challenges of simulation research and their study design, targeted adjustments can mitigate these issues. For example, the ability to test cardiopulmonary physical examination skills may be limited by lack of authenticity. To mitigate these issues, high fidelity mannequins may be utilized and specialized simulation stethoscope to improve auscultation and allow the investigators to hear what the participant hears.

By addressing these questions before initiating a simulation research project, it will increase the chance for success in execution of the design as well as ability to publish this work. The ultimate goal is to increase student and trainee exposure to simulation, improve this educational modality and positively impact future patient care.

 

 

Leslie A. Bilello, MD
Instructor, Harvard Medical School
Assistant Program Director
Department of Emergency Medicine
Beth Israel Deaconess Medical Center

 

Nicole M. Dubosh MD
Assistant Professor, Harvard Medical School
Associate Clerkship Director
Department of Emergency Medicine
Beth Israel Deaconess Medical Center

References

  1. Bond WF, Lammers RL, Spillane LL, et al. The use of simulation in emergency medicine: a research agenda. Acad Emerg Med. 2007;14(4):353-63.
  2. Issenberg SB, Scalese RJ. Five Tips for a Successful Submission on Simulation-Based Medical Education. J Grad Med Educ. 2014;6(4):623-5.
  3. Daly R, Planas JH, Eden MA. Adapting Gel Wax into an Ultrasound-Guided Pericardiocentesis Model at Low Cost. Western J Emerg Med. 2017; 18(1):114-116.
  4. Sullivan GM. A primer on the validity of assessment instruments. J Grad Med Educ. 2011;3(2):119-20.
  5. 5.Warrington SJ, Beeson MS, Fire FL. Are simulation stethoscopes a useful adjunct for emergency residents’ training on high-fidelity mannequins? West J Emerg Med 2013; 14:275.

CDEM Faculty Podcast Episode 8: Bedside Teaching

Happy New Year everyone!  So if one of your New Year’s resolutions is to become a better bedside teacher, then this is the episode for you.  This talk was given by Dr. Francis DeRoos from the University of Pennsylvania’s Perelman School of Medicine at the Philadelphia Education Collaborative.  He discusses the barriers, preparation, setting the stage, and tips and techniques in art of bedside teaching.  I hope this inspires you on your next ED shift.  If you have some great  tips or techniques in bedside teaching please post in the comments section.  I know this is something I struggle with and want to improve on and would love to hear what you all are doing.  In addition, if you want to hear some more great advice on teaching on shift, check out EM Cases episode 98: Teaching on shift.

 

 

 

Keep up to date on the latest CDEM Faculty podcast on Libsyn and iTunes.  

 

Suzana Tsao, DO

 

CDEM Faculty Podcast Episode 6

Episode 6:  National Clinical Assessment Tool for Emergency Medicine (NCAT-EM)

 

Hi everyone!  In this month’s podcast I had the opportunity to talk with Dr. Kathy Hiller about  the recently released National Clinical Assessment Tool for Emergency Medicine (NCAT-EM), which was developed by Jules Jung, Doug Franzen, Kathy Hiller, and Luan Lawson.  We last talked with this group in episode 2 (https://cdemcurriculum.com/2016/03/26/end-of-shift-assessment-of-medical-students/), when they were still in the beginning stages of developing this evaluation tool.  In this interview, Dr. Hiller discusses how you may use the NCAT-EM (see link below) in your clerkship and their current study.  If you are interested in using the NCAT-EM and/or would like to be a part of the study, please email Dr. Hiller at khiller@aemrc.arizona.edu.

NCAT-EM

Keep up to date on the latest CDEM Faculty podcast on SoundCloud, RSS, and iTunes.  

Suzana Tsao, DO

Director Medical Student Clerkship

Perelman School of Medicine