An interview with student Anne Elizabeth Thaxton is presented. Among other things, Thaxton talks about their grant for their study on Diplocentrus lindo, Vaejovis intermedius, and Centruroides ...vittatus.
Enneagram in EM Cifuni, Megan; Pfennig, Cami; Astemborski, Caroline
Journal of education & teaching in emergency medicine,
10/2023, Letnik:
8, Številka:
4
Journal Article
Recenzirano
Odprti dostop
AudienceThis is a lecture paired with facilitated small group sessions and is targeted towards emergency medicine residents and physicians.BackgroundThe enneagram is a well-established and popular ...personality theory that asserts that there are nine basic personality types, and that each enneagram type, 1-9, operates from a basic fear and a basic desire that produces predictable behavioral patterns and preferences.1-2 The enneagram has long been used as a tool to enhance self-awareness and to better understand internal defenses and reactions,3-5 and as such, it has been increasingly utilized to enhance self-growth and development in the fields of education, parenting, and business.6-7 While some studies have used the enneagram as a tool to predict natural empathy or stress levels of those in the medical field, particularly in nursing and medical school students,8-9 little has been published on the use of the enneagram as a tool to enhance self-awareness, leadership, and teamwork in the medical field. Emergency medicine is a specialty in which residents and physicians must not only be self-aware but must also be attuned to the dynamics of their healthcare team in order to succeed. We believe that the enneagram is the ideal tool to enhance these crucial skills.Educational ObjectivesThe primary aim of this session was to enhance participants' self-awareness by identifying their enneagram type and therefore their predictable behavioral patterns. The secondary aim was to discuss strategies to improve teamwork and physician team leadership by directly addressing the type's strengths and weaknesses in these interactions.By the end of this session, the learner will be able to: 1) Self-identify with a primary enneagram personality type. 2) List the fears, desires, and motivations of the enneagram type. 3) Describe struggles in interacting with other disparate enneagram types. 4) Discuss strategies for success in facing conflict and interacting with other team members.Educational MethodsThis lecture was designed to educate emergency department physicians and residents on the enneagram tool. The introductory lecture takes about 20 minutes, and following this foundational presentation, learners split into small groups. Small group sessions take an additional 20 minutes during which facilitators guide learners through a discussion on their enneagram type and the potential strengths and challenges that each type might face in professional situations. This session was hosted during an Emergency Medicine Resident Education Conference. Due to COVID-19 restrictions, the session was presented virtually on a synchronous video platform with small group breakout rooms.Research MethodsFollowing the session, the educational content was evaluated by our residents and faculty by a Likert reaction survey. The survey assessed both the form and effectiveness of the delivery method and the impact of the content in the session.ResultsA total of 17 responses with a mix of faculty and PGY years were collected after the session. In the post-session survey, 23% (6) of participants reported that the session was "moderately important in better understanding myself," and 38.5% (4) of participants reported that the session was "quite important in better understanding myself." 62% (11) of participants agreed or strongly agreed that the session helped them to understand their peers' personalities and communication preferences.DiscussionOverall, this educational content and delivery in this format was well received and effective in enhancing residents' understanding of themselves and their team's personalities. Our residents and faculty engaged in insightful conversations around their own enneagram type and shared their successes and struggles in interacting with other enneagram types. At the end of the session, our participants left with not only greater self-awareness but also with an appreciation for the preferences and personalities of others on the medical team.TopicsEnneagram, leadership, teamwork, self-awareness, emotional intelligence.
AudienceEmergency medicine residents, pediatric residents on an EM rotation. IntroductionEmergency medicine residents are expected to recognize and treat patients of all ages and diseases of all ...varieties, yet most education and training is focused on the adult patient. Exposure to pediatrics is generally integrated into training across all years of residency, but time spent in the pediatric emergency department is still a small portion of resident education. This module aims to enhance the ability of the emergency medicine residents to recognize and treat respiratory distress in children, one of the most common presenting chief complaints in the pediatric population, by integrating the concepts of case-based learning, self-directed learning and self-testing. Educational ObjectivesBy the end of this module, learners will be able to: 1) recognize the unique pathophysiology for respiratory distress in the pediatric population and formulate a broad differential; 2) understand the treatment principles for the most common causes of respiratory distress in children; 3) navigate and apply validated clinical decision-making tools for treatment of pediatric respiratory illnesses. Educational MethodsA learning module consisting of six clinical vignettes based on the most common causes of respiratory distress in children, with associated self-test questions, and key learning concepts was created for resident education. This module was a self-directed PowerPoint slideshow with embedded questions and links to evidence-based clinical decision-making tools. Research MethodsA survey was created to gauge the residents' perceptions of the learning module and its usefulness in their learning. ResultsTwenty (30%) residents used this module and took the survey. Ninety percent of respondents felt more comfortable managing respiratory distress in children after completing this module. Ninety-five percent of respondents felt they had sufficient knowledge of the topic after completing the module and would like to have more modules such as this one on other topics. DiscussionResidents indicated in the survey that the module enhanced their knowledge and comfort with clinical practice. This unique learning module integrates basic and clinical sciences and utilizes many different learning concepts to engage and motivate the adult learner. The module may also be re-created in order to cover other similar topics as a supplement to resident education. TopicsPediatrics, respiratory, infectious disease, asthma, croup, anaphylaxis, foreign body aspiration, bronchiolitis, laryngomalacia.
AudienceThe lecture and infographic are targeted towards Emergency Medicine physicians and residents. IntroductionPain is the most common presenting symptom in the emergency department.1 Various ...classes of medications are used to treat acute and chronic pain. Specifically, opiate medications are often used to relieve moderate to severe pain. About 20% of patients presenting with the chief complaint of non-cancer pain receive an opioid prescription.2 Since there are many different types of opiates, conversion between one opioid to another has provided a great challenge in terms of addressing the balance between adequately controlling patients' pain and preventing serious adverse effects. The lack of a readily available standard opiate equivalent guide and physicians' limited knowledge base about morphine milligram equivalents may contribute to medication errors, insufficient treatment, addiction, and overdose. Educational ObjectivesThe primary aim of this study was to educate residents and attending physicians about opiate equivalent medications, medication metabolism, provide usual dosages, and to provide a standardized method for converting between various opiate medications in the emergency department (ED). By the end of this session, the learner will be able to: 1) define the term, "morphine milligram equivalents;" 2) describe the relative onset and duration of action of different pain medications often used in the emergency department; and 3) convert one opioid dose to another.Additionally, we aimed to evaluate the efficacy of the lecture and the infographic in increasing physicians' knowledge base of opioid medications and standardize the method of prescribing and converting between opioids in the ED. We designed and placed a simple, eye-catching infographic in the University of California, Irvine Emergency Department that depicted information pertaining to morphine equivalents and pharmacological properties of the opioids. We then presented a lecture on morphine equianalgesic doses, metabolism, and method for conversion between medications. In order to evaluate the functionality of the lecture and chart, we administered multiple surveys to ED providers pre- and post-lecture and placement of the chart in the ED. Our lecture and infographic included up-to-date literature and considered dose reductions, cross tolerance, and patient comorbidities. We designed the infographic to be visually appealing and simple for ease of use in a busy ED environment. Educational MethodsA lecture was designed to educate emergency department physicians and residents on the properties, metabolism and techniques for conversion between various opioid medications. Following the lecture, we walked through an example question with the participants. The lecture was presented at an Emergency Department conference. Research MethodsThis lecture was presented at emergency medicine residency grand rounds. To evaluate the efficacy of our chart and educational lecture, we implemented a pre-presentation survey consisting of questions related to opiate conversions, metabolism, and medication characteristics without the help of the chart. After the presentation participants were once again asked to fill out the same set of questions on a post-presentation survey with the help of the chart. The effectiveness of the lecture and infographic was assessed by comparing participants' scores between the pre-presentation survey and post-presentation survey. A second post-presentation survey with the same set of questions was also sent out about 7 months after the presentation, to assess for retention of the information presented during the lecture. The responses were kept anonymous, though participants were asked for their level of training and four screening questions for the purpose of matching individual responses between the pre-presentation, initial post-presentation, and 7-month post-presentation surveys. ResultsSeven initial post-presentation survey responses were matched to pre-presentation survey responses, while five 7-month post-presentation survey responses were matched to pre-presentation survey responses. Only one participant filled out all three surveys; this participant was found to have increased in score from pre-presentation survey (4/10) to immediate post-presentation survey (10/10), but decreased in score at the 7-month post-presentation survey (8/10). Five of the participants who filled out both the pre- presentation survey and immediate post-presentation survey showed improvement in their scores, one participant received the same score on both surveys, and one participant had a decrease in score. Between the five participants who filled out the pre-presentation survey and the 7-month post-presentation survey, one participant showed an increase in scores, two participants received the same score each time, and two participants decreased in scores. DiscussionOverall, the educational content and infographic allowed for improvement in a majority of the participants' scores between the pre-presentation survey and immediate post-presentation survey. However, it seems that retention of knowledge gained by the presentation waned as time passed, which manifested in most participants showing a decrease or no change in score between the pre-presentation survey and the 7-month post-presentation survey. In other words, through implementation of the infographic in the Emergency Department and educational lecture, we learned that the presentation and the walk-through of an example question contributed to immediate retention of knowledge of morphine equivalents. However, long-term retention of the knowledge about morphine equivalents was lacking. Given the small sample size of eleven participants, we are unable to definitively conclude whether this infographic and lecture are overall effective in improving knowledge, retention of knowledge, and change in clinical management. However, our results suggest that further larger studies could be conducted with the infographic and presentation as useful tools to advance EM physicians' knowledge and awareness of morphine milligram equivalents. Therefore, our hypothesis still stands that this infographic and lecture are useful tools that other EM programs could use and conduct studies to evaluate improvement in their learners' knowledge. The main takeaways are that educational lectures and visually-appealing graphics are able to enhance physicians' understanding of morphine equianalgesic doses in the immediate period after exposure, but must also be conducted with consistent follow-up to improve preservation of knowledge. TopicsMorphine milligram equivalents, morphine equianalgesic doses, opioids, opiates, infographic.
AudienceEmergency medicine interns, medical students, and mid-level providers (physician assistants, nurse practitioners). IntroductionShock is defined as a state of global tissue hypoxia and is ...typically the result of hypotension and circulatory system failure. A variety of disease states may ultimately culminate in hypotensive shock through one or more generally recognized mechanisms - hypovolemic, cardiogenic, obstructive, and/or distributive shock.1 These mechanisms differ significantly in terms of their pathophysiology and requisite treatment. While the effects of hypotensive shock are initially reversible, untreated hypotensive shock may rapidly progress to multiorgan failure and death. Hence, the ability to promptly recognize a state of hypotensive shock, identify the underlying mechanism, and administer appropriate therapies are skills required of those caring for critically ill patients.2The evaluation of hypotensive shock in the Emergency Department is relatively commonplace. Mortality rates associated with shock are high, ranging from 22.6% - 56.2%, depending upon the underlying etiology.3 For these reasons, the authors believe that a web-based learning module addressing topics related to hypotensive shock would be beneficial to healthcare professionals who are likely to encounter it in clinical practice. The web-based nature of the module would lend itself to convenient viewing and would allow for utilization as a just-in-time training modality. Presenting these topics in an animated format may also be a useful way of displaying the complex nature of cardiovascular physiology. Educational ObjectivesBy the end of this module, participants should be able to:Review basic principles of cardiovascular physiologyDescribe the four general pathophysiologic mechanisms of hypotensive shockRecognize various etiologies for each mechanism of hypotensive shockRecognize differences in the clinical presentation of each mechanism of hypotensive shockCite the basic approach to treatment for each mechanism of hypotensive shock. Educational MethodsThis is a video podcast which conveys information through animated content. It is available to learners on demand and just-in-time for practice. It may be used as a stand-alone educational tool, as a primer to other instructional methods (eg, simulation, flipped classroom setting, or case discussions), or a just-in-time training tool. Research MethodsA small-scale study was performed to quantify the efficacy of this module as an educational tool. The learner group was comprised of a convenience sample of third-year medical students in the midst of their core clinical clerkships. All third-year students were eligible to participate, regardless of which core clerkship they were currently engaged in. Third-year students were contacted via email regarding participation. Participation was completely optional - no incentive was offered, and students were informed that participation would not in any way affect their clerkship grades. For these reasons, an Instructional Review Board review was not necessary. Ten third-year medical students volunteered to participate. In the course of a single, hour-long session, learners were administered the attached assessment form as a pre-test, shown the video module, and then asked to immediately retake the assessment as a post-test to assess for improvement. Assessments were graded on a 17-point scale, according to the attached answer key. Learners were also given the opportunity to provide subjective feedback on the quality of the module as an educational tool. ResultsFor this assessment, the maximum possible score was 17 points. The average pre-test score across all learners was 11.75 (69.12%) with a standard deviation of 3.24. The average post-test score across all learners was 15.12 (88.97%) with a standard deviation of 3.31. All learners demonstrated improvement in scores on the post-test, with a maximum and minimum improvement of 6 points and 1 point respectively. On average, learners improved by 3.38 points (p = 0.029, 95% confidence interval, 1.97 to 4.78). Statistical significance was established using a paired student's T-test. All learners agreed with the statement, "This module effectively taught concepts related to hypotensive shock." Learners were also given the opportunity to provide subjective feedback regarding the module and responded with statements like, "comprehensive review of the subject," and "very helpful review for clinical clerkships." DiscussionData from learner assessments suggest that this module is effective in communicating concepts related to hypotensive shock. Learner satisfaction with the module was unanimous. These results suggest that this module would be effective as a standalone educational tool, or as a primer to other instructional methods. Areas of further investigation may include assessment of a larger learner population, assessment of learners at additional stages of clinical training, and assessment of long-term knowledge retention. TopicsShock, hypotension, cardiovascular physiology, pulmonary artery catheterization, flipped classroom, asynchronous learning, emergency medicine.
AudienceThe intended audience of this lecture is emergency medicine residents at all levels of training. It is also appropriate for practicing emergency physicians interested in improving comfort in ...resuscitating sick young infants, ages 0-60 days. IntroductionThe majority of sick and injured children in the United States are seen and treated in general emergency departments.1 This includes very young infants (0-60 days old) in need of immediate resuscitation. Resuscitation of children in this age group involves use of specific knowledge and skills that residents and emergency physicians in general have fewer opportunities to practice.2,3 Emergency medicine residents and practicing emergency physicians often report this as an area of particular discomfort in practice.4,5 It is important that the inconsistent and infrequent opportunities to resuscitate young infants during emergency medicine residency and beyond are supplemented by residency didactics that focus on improving comfort and skills with this population of sick children. This lecture focuses on a practical approach intended to improve the relevant knowledge, skills, and confidence required to stabilize a critically ill young infant in a general emergency department. Educational ObjectivesBy the end of this lecture, participants should be able to:Apply a consistent approach to the initial resuscitation of a critically ill young infant in the emergency department.Select appropriate medications and equipment for use in resuscitation of critically ill young infants.Describe the components of the Pediatric Assessment Triangle,6 which can be used to identify critically ill infants and children.Improve comfort in resuscitating young infants in the emergency department. Educational MethodsThis is a live lecture format using PowerPoint slides. The lecture emphasizes a practical approach to improve the skills and knowledge required for successful young infant resuscitation. It utilizes a case-based approach, and encourages the audience to determine next steps in care to mimic the real time decision-making required for care of critically ill young infants in the ED. Research MethodsLearners were asked to fill out anonymous pre- and post quizzes immediately prior to and directly after the lecture was given. These surveys included questions to assess resident knowledge as well as resident comfort as it pertained to resuscitation of critically ill young infants. ResultsResident comfort with resuscitation of young infants improved with a mean Standard Deviation (SD) pre-lecture rating of 23.1(14.9) on a 100-point visual analog scale and a mean (SD) post lecture rating of 46.7(14.6). Resident performance on all knowledge base questions improved on the post-lecture quiz for all four questions asked. DiscussionThis lecture was effective in improving emergency medicine resident comfort and practical knowledge pertaining to resuscitation of young infants in the emergency department. The emphasis on a practical approach was well received by the resident audience, and they engaged well with audience participation portions of the lecture. The impact of the lecture can be enhanced by having the lecturer share their own real-world experience of resuscitation of young infants in the emergency department during the discussion portions of the lecture. TopicsNeonatal resuscitation, infant resuscitation, pediatric assessment triangle, neonatal sepsis, congenital heart disease, congenital adrenal hyperplasia, non-accidental trauma, malrotation.
AudienceThis content is intended for emergency medicine faculty. IntroductionFaculty at our institution noted that it can be easy to identify and address the knowledge gaps of junior learners. ...However, they often find different skills are needed when precepting senior residents, a sentiment shared by faculty at other institutions.1 To foster the skills needed for lifelong learning and deliberate practice, it is crucial that educators find methods to effectively assess the skills of senior residents and provide them with continued feedback.2 The goal of this faculty development session is to outline methods educators can use with senior residents to support their autonomy and independence while exploring their clinical reasoning, pushing them outside of their comfort zone, and promoting reflective and deliberate practice.2-9. Educational ObjectivesBy the end of the lecture, all faculty will be able to 1) describe how to use the Aunt Minnie method of precepting for senior residents, 2) list examples of ways in which they can probe the clinical reasoning of senior residents, 3) explain how to use reflective feedback techniques with senior residents, and 4) report use of the techniques discussed during this session when precepting senior residents in the emergency department. Educational MethodsThis content is presented as a PowerPoint lecture with subsequent discussion. Research MethodsA post-session survey was distributed to allow participants to evaluate the session. This survey was sent four months after the session to gauge how often participants were using the covered techniques on their clinical shifts in the interim. ResultsThe majority of survey respondents reported that they initially felt that precepting senior learners was "somewhat difficult" and that they found this session "valuable" in helping them address this challenge. Faculty reported using all of the techniques discussed in this session during their clinical shifts, but were more likely to use methods to promote clinical reasoning or reflective feedback than the Aunt Minnie method of precepting. Overall, respondents reported learning new skills during this exercise and appreciated the format which allowed them to share their own experiences of working with the senior residents and brainstorm techniques that might be useful beyond those discussed by the instructors. DiscussionThis faculty development session successfully introduced emergency medicine faculty to techniques that can be used to improve feedback and assessment of senior residents. The lecture format allowed for efficient transmission of material, while several group discussions and a role-play activity allowed for integration of material and sharing of experiences. Overall this exercise was a success with faculty reporting use of several of the techniques discussed. In future iterations, it may be beneficial to integrate more role-play activities to allow participants to practice more of the skills learned in a simulated environment prior to implementing on shifts with learners. TopicsFeedback, deliberate practice, clinical reasoning, precepting.
