AudienceThis curriculum is designed for emergency medicine residents at all levels of training. The curriculum covers basic foundations in clinical informatics for improving patient care and ...outcomes, utilizing data, and leading improvements in emergency medicine. Length of CurriculumThe curriculum is designed for a four-week rotation. IntroductionThe American College of Graduate Medical Education (ACGME) mandated that all Emergency Medicine (EM) residents receive specific training in the use of information technology.1,2 To our knowledge, a clinical informatics curriculum for EM residents does not exist. We propose the following standardized and reproducible educational curriculum for EM residents. Educational GoalsThe aim of this curriculum is to teach informatics skills to emergency physicians to improve patient care and outcomes, utilize data, and develop projects to lead change.3 These goals will be achieved by providing a foundational informatics elective for EM residents that follows the delineation of practice for Clinical Informatics outlined by the American Medical Informatics Association (AMIA) and the American Board of Preventive Medicine (ABPM).4-6. Educational MethodsThe educational strategies used in this curriculum include asynchronous learning via books, papers, videos, and websites. Residents attend administrative sessions (meetings), develop a project proposal, and participate in small group discussions.The rotation emphasizes the basic concepts surrounding clinical informatics with an emphasis on improving care delivery and outcomes, information systems, data governance and analytics, as well as leadership and professionalism. The course focuses on the practical application of these concepts, including implementation, clinical decision support, workflow analysis, privacy and security, information technology across the patient care continuum, health information exchange, data analytics, and leading change through stakeholder engagement. Research MethodsAn initial version of the curriculum was introduced to two separate institutions and was completed by three rotating resident physicians and one rotating resident pharmacist. A brief course evaluation as well as qualitative feedback was solicited from elective participants by the course director, via email following the completion of the course, regarding the effectiveness of the course content. Learner feedback was used to influence the development of this complete curriculum. ResultsThe curriculum was graded by learners on a 5-point Likert scale (1=strongly disagree, 5 = strongly agree). The mean response to, "This course was a valuable use of my elective time," was 5 (sd=0). The mean response to, "I achieved the learning objectives," and "This rotation helped me understand Clinical Informatics," were both 4.75 (sd=0.5). DiscussionOverall, participants reported that the content was effective for achieving the learning objectives. During initial implementation, we found that the preliminary asynchronous learning component worked less effectively than we anticipated due to a lower volume of content. In response to this, as well as resident feedback, we added significantly more educational content.In conclusion, this model curriculum provides a structured process for an informatics rotation for the emergency medicine resident that utilizes the core competencies established by the governing bodies of the clinical informatics specialty and ACGME. TopicsClinical informatics key concepts, including definitions, fundamental terminology, history, policy and regulations, ethical considerations, clinical decision support, health information systems, data governance and analytics, process improvement, stakeholder engagement and change management.
This study critically examines the K-12 curriculum reform in the Philippines and suggests ways on how it can move forward. Specifically, three recent curriculum guides (i.e., science, mathematics, ...and English) were analysed to determine how they fit with the Education 4.0 milieu. Using a curriculum analysis matrix, the findings indicate that these curricula may require conceptual and pedagogical refinements, particularly in the area of constructive alignment, technology integration, and specificity of its components. Potential implementation challenges in terms of instructional delivery, assessment, lesson preparation, school-based initiatives, and commitment of teachers and school leaders to curriculum reform were also discussed. Recommendations for future design, implementation, and studies are offered.
AudienceThis curriculum is designed for emergency medicine attendings in varying years of community practice to prepare them for Emergency Medicine (EM) residents. Length of Curriculum15 months. ...IntroductionEmergency medicine is a growing field with new residencies approved every year. A strong, competent cadre of clinical educators is essential to the success of any residency, and new programs have the challenge of developing their clinical faculty into outstanding teachers. There is minimal literature guidance for navigating this transition. Our site is a community tertiary care center in the process of applying for an EM residency. We focus on our experience designing a faculty development curriculum to accommodate the needs of a diverse group of physicians in all stages of their careers. We will demonstrate that a curriculum satisfying all stakeholders can easily be implemented in a way that allows for robust participation without excessive additional administrative burden. Educational GoalsOur goal is to prepare community-based EM attendings to be outstanding educators to future residents by augmenting their knowledge of current educational practice and adult learning theory, literature review, and biostatistics. Educational MethodsThe educational strategies used in this curriculum included lectures, guided discussion, small group discussion, and asynchronous learning. Research MethodsThis curriculum was implemented in the Geisinger Wyoming Valley Medical center targeted at staff physicians. This educational study was deemed exempt by the institutional review board (IRB). We electronically collected retrospective survey data using a 5-point Likert scale as well as free text responses. The primary measure was agreement with the statement, "Faculty development time makes me feel more prepared to be a clinical educator." We also surveyed whether this was felt to be an appropriate use of time, self-reported growth in key educational and biostatistical domains, and likeliness to change practice based on the material. ResultsResponses collected from core faculty after the sessions indicated a uniformly positive review of the series itself with the primary outcome receiving a 4.6 rating on a 5-point Likert scale (strong agreement). Faculty reported that these brief sessions improved the quality of the departmental staff meetings (average rating 4.7/5). Journal club sessions were rated as positive (4.7/5) and attendees self-reported growth in statistical literacy and security in clinical practice. DiscussionWe demonstrated successful implementation of a faculty development curriculum that was favorably assessed by all key stakeholders. Faculty self-reported growth in all educational and clinical domains evaluated. It was successfully implemented without substantially increasing the time burden for physicians with robust clinical and administrative schedules. We feel this is generalizable to other sites seeking to start an EM residency and is useful for sites with existing residencies to efficiently deliver content to junior faculty. TopicsEmergency medicine, faculty development, journal club, virtual learning.
AudienceThis curriculum is appropriate for emergency medicine residents PGY 1-3 as a toxicology curriculum. Length of CurriculumThe intent is to run this curriculum over one week. ...IntroductionToxicology is an important part of the emergency medicine (EM) curriculum and defined in the Council of Residency Directors (CORD) 2019 Model of Clinical Practice of Emergency Medicine as a key area of core content expected to be mastered by graduating EM seniors.1 Unfortunately, programs may not have time in their schedules for a dedicated toxicology curriculum, and residents may not have time to learn this important subject outside of conference didactics. Many emergency medicine programs have mandatory toxicology rotations, as many as 66% according to a 2018 study, with an additional 22% of EM programs offering an elective.2 At our institution, we have limited toxicology faculty available for instruction, and until now have only been able to incorporate occasional lectures into regular conference didactics, prompting our development of a new approach. Developing an asynchronous curriculum allows more dedicated time to study toxicology for our learners and allows greater flexibility for our limited toxicology faculty to teach during a synchronous component. Several asynchronous toxicology curricula have been developed previously.3,4 There have also been several novel synchronous toxicology curricular innovations for introduction during regular conference didactics.5,6 While some learners can benefit from asynchronous learning alone, it has been shown that having synchronous components in distance learning can be very important for improving learning experience and improving deep understanding rather than surface learning.7 Here we propose a one-week, blended asynchronous and synchronous rotation in toxicology that aims to give learners a foundation in important core toxicological concepts that they can implement on shift in the Emergency Department. Educational GoalsThe goal of this curriculum is to introduce EM residents to core toxicology concepts and to reinforce toxicology principles through a multimodal approach that leads to increased confidence in the management of poisoned patients on shift. Educational MethodsThe educational strategies used in this curriculum include: 1) Online asynchronous modules for each day of the week consisting of free open access medical education (FOAMed) articles, instruction on core topics, and daily quizzes. The content was created, organized, and published utilizing Articulate Rise 360 8 as a learning management system (LMS) but could easily be adapted to other LMS platforms, such as Google Classroom. The majority of educational content used to build the modules was based on Rosen's Emergency Medicine Concepts and Clinical Practice. (5th editions). 2) A virtual simulation session reviewing toxicology cases with a faculty member. Cases were initially oral boards style cases but were later adapted to independent learning sessions utilizing pre-made Full-Code 9 scenarios. This could likely be adapted to other platforms such as in-person simulation for institutions without Full Code subscriptions. 3) A virtual discussion and question & answer board review session with a staff toxicologist. Research MethodsFollowing completion of the course, residents were encouraged to fill out a survey developed by the writer of the course designed to assess their thoughts about the course, their confidence in recognizing toxidromes as well as their comfort in the medical management of the poisoned patient. This survey was developed in-house and utilized a Likert scale and was administered on Google Forms. In an effort to promote honest feedback, residents were made aware that submissions were anonymous and email information was not collected. ResultsOf the 22 participating residents (PGY1-3), 15 responded to our survey for a response rate of 68%. Overall, resident responses to the course were favorable. All participants except for one answered that they were "satisfied" or "very satisfied" with the course; the respondent who did not mark "satisfied" or "very satisfied" marked the option labeled "neutral." Similarly, 93% (14/15) of respondents "agreed" or "strongly agreed" that they would recommend this course to a colleague, and 86% (13/15) "agreed" or "strongly agreed" that the course was a valuable use of their time.Resident responses also indicated an increased confidence in both the recognition of toxidromes and the management of poisoned patients. The majority of respondents (9/15) indicated that their perceived confidence in recognizing toxidromes improved after completion of the course; the remainder, except for one, remarked the same level of confidence before and after completing the course. The resident who had a decline in their confidence said they were "confident" in recognizing toxidromes prior to the course and "somewhat confident" after the course. Unsurprisingly, perceived confidence in the medical management of toxicology patients improved for 87% (13/15) of respondents after having taken the course, with 2 respondents noting the same level of confidence before and after taking the course.Lastly, multiple residents wrote in the free-response section that the toxicology rotation had been directly helpful to them when managing various toxidromes with real cases in the emergency department. For example, one response noted that they had since managed both a tricyclic antidepressant and a calcium channel blocker overdose, which they felt more comfortable with after completing the course. Another resident wrote about the experience of having a pediatric patient suffering from an ingestion of both acetaminophen and aspirin who was placed on a bicarbonate drip. DiscussionThis blended synchronous and asynchronous approach to a toxicology course was a success with the residents. Based on our survey responses, the majority of the residents felt this was a valuable educational experience. Many of the residents commented on times after the course where they were directly able to apply the knowledge learned from the modules, which was also encouraging. While COVID limitations kept our synchronous aspects virtual, these were also successful with the residents. While we had initially used oral boards style cases for the simulation session, we had found that engagement with learners during these sessions was not as high as we had hoped. We subsequently switched to using the virtual simulation platform Full Code.8 The learners seemed to enjoy these cases much more with having more visual stimulus during the cases. It was also less work on the part of the faculty to have pre-written toxicology cases to use and lab values/imaging results a click away. However, for institutions without a Full Code subscription, oral boards style cases or in person simulation would be a worthwhile alternative. Additionally, video conference sessions with our toxicology faculty members were helpful for the residents to go over the information they had learned in a question-and-answer format.Regarding the synchronous aspect of the course, having written the modules ahead of time, it was very easy to upload into an LMS. We particularly found Articulate Rise7 to be helpful as an LMS, especially with integrating some interactive elements into each module. However, this could easily be adapted into any LMS your institution prefers, or even into slideshow software. TopicsGeneral approach to poisoned patient, gastric decontamination, dialysis in toxicology, acetaminophen overdose (od), salicylate od, carbon monoxide poisoning, pediatric toxicology considerations, alcohol withdrawal, toxic alcohols, beta blocker od, calcium channel blocker od, tca od, serotonin syndrome, opiate od, body packers vs stuffers, marijuana, synthetic cannabinoids, gamma hydroxybutyric acid (ghb) od; cocaine toxicity, inhalant abuse, spider envenomations, snake envenomations, marine envenomations, mushroom toxicities, organophosphate poisoning.
Studies of teachers' use of mathematics curriculum materials are particularly timely given the current availability of reform-inspired curriculum materials and the increasingly widespread practice of ...mandating the use of a single curriculum to regulate mathematics teaching. A review of the research on mathematics curriculum use over the last 25 years reveals significant variation in findings and in theoretical foundations. The aim of this review is to examine the ways that central constructs of this body of research - such as curriculum use, teaching, and curriculum materials - are conceptualized and to consider the impact of various conceptualizations on knowledge in the field. Drawing on the literature, the author offers a framework for characterizing and studying teachers' interactions with curriculum materials. (DIPF/Orig.).
AudienceThe Residents-as-Teachers (RAT) curriculum is designed for emergency medicine (EM) residents of all years (PGY1-4). Length of CurriculumThe curriculum is divided into three hour-long ...sessions. The entire curriculum can be run as a single block or can be spread out over multiple days. IntroductionThe Accreditation Council of Graduate Medical Education (ACGME) and the Liaison Committee on Medical Education (LCME) both require residents to receive training in teaching medical students and junior residents. They also require opportunities for residents to participate in teaching and be assessed on their effectiveness in this role.1,2 However, the ACGME does not provide guidance or require formal curricula on molding residents into effective teachers. Many programs and institutions have incorporated RAT curricula as a solution to provide residents with the skills necessary to create an excellent educational environment for junior learners. These curricula have been embraced by many specialties, including Emergency Medicine (EM).3-6 The effectiveness of the teaching received during the clinical rotations has important long-term effects on medical students, and may impact their future career choices in medicine.6The COVID-19 pandemic has also required education institutions to vastly alter the delivery of their didactics, including moving to a virtual platform. A completely online format has many benefits that extend beyond the pandemic, such as easier access to participants (including those off-service or at remote sites), no requirement for a physical space, and easier recording of sessions. Educational GoalsTo provide residents with an introduction to teaching techniques that can be utilized on-shift to facilitate an excellent educational experience for junior learners while balancing the resident's patient care responsibilities. Educational MethodsThe educational strategies used in this curriculum include PowerPoint (Redmond, WA) slideshows given by a live presenter via the telecommunications platform Zoom (San Jose, CA), viewing of videos demonstrating curriculum topics, simulation-based learning through role-play, and small-group discussions including simulation debriefing. Research MethodsA survey was distributed to residents before and following the completion of the three training sessions to assess resident satisfaction with the delivery of the content and comfort with the teaching tools discussed. Suggestions on potential improvements were also assessed to inform changes to future iterations of the curriculum. Comfort regarding the included teaching tools was assessed using a five-point Likert scale. After completion of the curriculum, rotating medical students were provided with an evaluation form to assess if residents were teaching using the techniques from the course. ResultsBoth the pre-curriculum and post-curriculum surveys had a response rate of 61.1%. Student's t-test showed a statistically significant increase in mean resident comfort level with the teaching strategies post-curriculum (3.05 to 3.83, p < 0.01). Medical student evaluations have shown, overall, that the majority of residents are utilizing the education techniques on-shift. There were no significant differences found in medical student perception of resident use of taught skills between those who had and had not attended the sessions. However, all but one assessed skill showed higher utilization in those who had attended the correlating session. DiscussionThe educational content was effective in improving the residents' comfort with the teaching strategies presented, and residents are utilizing these techniques on-shift. Through implementation, we discovered that presenting a curriculum over video conferencing required additional administrative support to help ensure efficacy of break-out groups. Based on resident feedback after the first session, multiple changes were made, including providing residents with hand-out references for use during the role-playing sessions. The success of this curriculum demonstrated the feasibility and utility of running a RAT curriculum entirely in a virtual format. TopicsResidents-as-teachers, distance learning, role-playing, virtual curriculum, video conferencing, One Minute Preceptor, feedback, "What if?" game, Aunt Minnie, SPIT, activated demonstration, self-directed teaching tools, teaching scripts, Post-It Pearls.
Audience and type of curriculumThis medical education (MedEd) rotation is designed for post graduate year 3 (PGY-3) residents. Length of curriculumThe rotation runs over one month for each PGY-3. ...IntroductionResident physicians have teaching responsibilities during and after training. These responsibilities expand beyond teaching medical students and junior residents to include teaching advanced practice providers, nursing colleagues, and prehospital personnel.1 The need for formal teaching curricula in graduate medical education is recognized, but practical examples are lacking.2. Educational GoalsOur objectives were to provide our senior residents with exposure to various aspects of the field of MedEd, to further develop their teaching skills and to encourage them to consider a career in academic emergency medicine. Educational MethodsThe educational strategies used in this curriculum include: 1) clinical shifts supervising small groups of medical students with dedicated faculty supervision, 2) a structured simulation-based medical student teaching activity where the resident is able to provide feedback and teach medical students, 3) a MedEd project, 4) required readings that cover a variety of topics including education theory, curriculum design, and feedback, 5) case-based didactic presentation at our monthly case conference, and 6) one hour of postgraduate year 1 (PGY-1) small group facilitation focusing on fundamentals of emergency medicine. Research MethodsPGY-3 residents completed an online survey prior to residency graduation. The timing of the survey was purposefully delayed to the end of the academic year to allow the residents time to practice techniques they learned during their MedEd rotation. ResultsThirteen residents (93%) completed a survey. Five residents (38%) reported that the rotation had "some" or more impact on their career decision. The other 8 residents reported "almost no impact" or "a little bit of impact." Ten residents (77%) reported that they would "sometimes," "often," or "almost always" use the teaching techniques they learned during the rotation. The highest rated activities were simulation-based teaching and dedicated clinical teaching shifts. Confidence with bedside teaching improved after the session, with a median confidence before the session of 3/5 (moderately confident; IQR 2-3) and a median confidence after the session of 4/5 (quite confident; IQR 3-4, p=0.006). DiscussionOur MedEd rotation improved teaching confidence but had low impact on career decision. Residents rated the interactive, faculty-supervised components of the rotation highest. We recommend that programs interested in instituting a MedEd rotation first trial the rotation as an elective and utilize established formal teaching activities. TopicsMedical Education, resident physician, medical student teaching, simulation, academic medicine.
AudienceThis simulation-based training focuses on the most common and high risk pediatric prehospital scenarios in low- and middle-income countries (LMIC). The curriculum was developed based on a ...needs assessment to train Ministry of Health and Wellness (MOHW) prehospital providers in Botswana specifically for pediatric resuscitation and could be used for emergency medical services (EMS) providers in other LMIC. After participating in this curriculum, providers should enhance their assessment and interventions in acutely ill pediatric prehospital patients. Length of CurriculumThe entire course was designed to be presented over two days with 6-8 hours of instruction each day. IntroductionIn recent years, prehospital medicine has shown continued growth in LMICs, specifically in Sub-Saharan Africa. As these programs develop focused training for the pediatric population, equipping the workforce with pediatric resuscitation skills is essential. A few years after its inception, the Botswana MOHW identified deficiencies in their current training program and sought external expertise and educational training. We partnered with the MOHW to create and implement a novel, prehospital simulation curriculum to teach pediatric resuscitation to prehospital providers. Our aim was to create a curriculum based on the needs of the community that could also be implemented in other similar resource-limited settings. This course included didactic sessions, five simulation scenarios using low fidelity mannequins and three pediatric-focused skill sessions. This program was found to be effective based on statistically significant improvement in written and simulation post-test scores. Educational GoalsThe objective of this educational project was to design, implement, and evaluate a curriculum relevant to an EMS system based in a LMIC, so that it could be a basis for curricula for use in similar contexts. The educational goal is to improve prehospital providers performance in common pediatric resuscitations. Educational MethodsThe educational methods used in this curriculum included simulation using rapid cycle deliberate practice (RCDP), didactic lectures, and hands on skills training for common pediatric scenarios. Outcomes were measured by comparing performance on written and simulation-based pre-and post-tests. Research MethodsParticipants completed written and simulation-based pre- and post-tests covering the concepts taught in the curriculum. Continuous variables (written and simulation test scores) were compared between two dependent groups (pre- and post-trainings) using paired t-tests. ResultsMean written test scores increased by 11%, from 75% to 86% (p<0.0001), while mean simulated test scores increased by 22% (from 56% to 78 % (p<0.0001). DiscussionThe curriculum we developed focused on high-yield pediatric skills based on the needs of the Botswana MOHW EMS program. We believe simulation training was an excellent and effective method for this type of training. We specifically designed RCDP scenarios for the training, due to the limited experience of the prehospital providers at that time. RCDP offers ample opportunities for feedback with immediate practice and improvement. Trainees demonstrated retention of knowledge and improved performance in simulation-based testing. The overall satisfaction level of the trainees was high and suggests additional training would be beneficial and desired. Additionally, as the results of our needs assessment mirrored common chief complaints in other LMIC countries in Sub-Saharan Africa1,2 we feel that this curriculum can be utilized and adopted with minor modifications in other LMIC settings, particularly where EMS programs are developing and in circumstances where few EMS providers have had extensive field experience. TopicsRespiratory distress, asthma, dehydration, hypovolemic shock, hypoglycemia, seizure, toxic ingestion, newborn resuscitation, precipitous delivery, traumatic injury, EMS, Botswana, global health, collaboration, rapid cycle deliberate practice (RCDP), medical simulation.
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