Posts Tagged education
The course covers the basics of stroke, pre‐hospital assessment, stroke systems of care, and case studies. EMS educators may also download the slides and use them in their EMS education.
Access the course today at www.EMS4Stroke.com.
(Or: Give Me The Right Answers, ABEM!)Today we residents are post-inservice exam, put together by The American Board of Emergency Medicine, and I can say this about the test: I’m glad I’m not an intern anymore. I’ve obviously still got a lot to learn, but it’s nothing like the feeling of overwhelmth (yes, just made that up) you feel halfway through your internship thinking, “I’m supposed to know the answer to this?”
But today I’m not writing about those mushy-gushy feelings and experiences. No no. Today, I want answers.
I was always annoyed with standardized medical tests (primarily the USMLE) where you left the exam with a) no idea how you performed and b) no real feedback for several months. At this point, I don’t really care if I missed a question about cyclic GMP on USMLE Step I, but for the inservice exam, it’s a different story. This is stuff that I apparently need to know. And so, please, ABEM: I want to know the right answers.
If the point of the inservice and the boards is knowledge and learning and requiring a certain level of competency of emergency physicians, then why not give us feedback so we don’t actually screw something up with an actual patient? What, the answer wasn’t ceftriaxone? Why not? What is it that I’m not understanding about the case that you thought it so important a concept as to test it? If a resident answers that he or she wants to use an ABG to rule out a pulmonary embolism, or decide to get abdominal films as the test of choice for right lower quadrant pain, shouldn’t we be telling that resident (or his or her program) that there’s some serious educating that needs to happen?
ABEM: I want an email with feedback on the questions I missed, or wasn’t sure about. Have me optionally fill out my email address in bubble format, and when you scan through my answers and calculate my percentage, email me the answers. Or, if you don’t want to share the questions because you recycle them, email me the specific topic. Not just “management of status epilepticus,” but “second and third line agents for status epilepticus.” Not just “tick borne disease,” but “treatment of pediatric lyme disease.”
The system is called “Spaced Education,” and it’s based on the theory that adults learn better in short, repeated “doses” rather than in large, intense bouts of studying. The College is testing it on the ACEP PEER VII Sampler and when you sign up, you’ll get one or two questions by e-mail every day. When you answer each question, you’ll get an in-depth discussion of the correct answer. If you miss it, you’ll get it again in about a week. If you get it right, you’ll see it once more in about 2 or 3 weeks.
This method of questioning and reinforcement has been found in randomized, controlled trials to improve knowledge acquisition, increase long-term retention, change behavior, and boost learner’s ability to assess their knowledge. And you get to decide how often you want to get the questions.
Here’s how to sign up:
- Go to http://acep.spaceded.com
- Click on the PEER VII cover image
- Click “Enroll Now for FREE” and choose your delivery options
All ACEP asks is that you provide feedback. About 10 days or 2 weeks after you sign up, one of your questions will include a link to some evaluation questions. And 40 free PEER questions are yours!
For help using SpacedEd, visit www.spaceded.com/info/support
Thanks to Dr. Rob Roger’s podcast on EM-RAP Educator’s Edition series, I learned of one of the funniest publications EVER in a medical journal. It was published on April 1, 2009 in JAMA. The article focuses on teaching medical students the essential skill set — how to survive “pimping”.
Pimping traditionally occurs when an attending physician poses a difficult question to a learner in a public forum, such as board rounds or in the operating room. As a student or resident, you know that this will happen during your training, and you should be prepared. If you think of pimping as a form of battle, you will need a good defense, and you should mix it up to be successful.
Don’t make eye contact with the teacher. Stay very still. Lower your head as if you are deep in thought. But don’t look like you are sleeping and not paying attention. Bottom line is to not draw attention to yourself while appearing to listen. It’s a fine line to walk.
Hold a large muffin in front of your mouth, as if you are going to take a bite. If you don’t know the answer, take a big bite. If you still get called on, pretend to choke. I would go one step further and say – If desperate, syncopize..
The best defense is a good offense. Take a tone and body posture of hostility. Say “I — DON’T — KNOW.” Personally, as a teacher, I’d be afraid of asking this student questions — ever — again.
If asked to contribute to a list of answers, you can repeat a response from earlier pretending that you didn’t hear it, because you were busy with patient care responsibilities (answering pages, working on your medical charting)..
Tell the teacher that you are uncomfortable with the open forum of questioning.
Another version of – the best defense is a good offense. Ask questions in a sub-specialized area which the teacher may not be as familiar with. Careful – this technique may totally backfire, since pimpers often know and don’t appreciate when they are being pimped back.
Don’t Sulk or Cry
Pimpers rarely remember who gave incorrect answers – this happens all the time. But sulkers and weepers definitely are memorable. Whatever you do, don’t be labeled as one who loses composure. I feel like Emergency Medicine trainees do well in this area. We are constantly barraged by stressors, and it takes a lot for us to lose our composure.
Detsky AS. The art of pimping. JAMA. April 1, 2009; 301(13): 1379-81.
- Dr. Deb Diercks discussing pitfalls and standards for chest pain triage
- Dr. Vivek Tayal on ultrasound training standards
Dr. Reynolds and Dr. Newman summarize the June studies, including:
- Failures in patient hand-offs
- Family presence: no impact on efficiency
- A trial of computerized risk assessments in low risk chest pain
- Optic nerve sheath diameter fails to predict ICP in kids
- ED neurocognitive testing may identify mild TBI
- S3 doesn’t help to diagnose CHF
There is lots more, so download the Annals podcast today and every month!
If you haven’t signed up for this year’s ACEP Scientific Assembly in Boston, you should do so today!
The educational programs are awesome – with over 300 sessions covering the latest advances in clinical care, critical management, and health policy issues. The Colin C. Rorrie, Jr., Lecture will feature a discussion on health care reform, one of the year’s hottest topics.
Special sessions such as LLSA article reviews, the New Speakers Forum (which features up and coming presenters), Research Forum, and hands-on skills labs offer a wide variety of learning experiences.
The always popular Exhibit Hall will feature over 300 companies allowing you to meet and discuss new products and technologies with the people who make them.
Finally, don’t forget the social aspects of this meeting! Scientific Assembly gives you the opportunity to meet up and spend time with old friends and colleagues. Make plans before you leave on our Facebook page. And while you’re in Boston, take advantage of the historical sites, and maybe take some time to feast on clam chowder and seafood in the many great local restaurants.
Whether you are a first-time attendee or a seasoned veteran, you are sure to enjoy this spectacular conference. Check out the Scientific Assembly Web site and register today for the courses and social events you want!
Kenneth C. Jackimczyk, Jr., MD, FACEP
Chair, Educational Meetings Committee