Practical Teaching in Emergency Medicine (eBook)

Practical Teaching in Emergency Medicine?????????????????????????????????????????????????????????????????????????????????????????????? 3
Contents?????????????????????????????? 9
Editors and Contributors?????????????????????????????????????????????????????????????? 13
Preface???????????????????????????? 23
Section 1 Background/Introduction 25
Chapter 1 Adult learners in the emergency department?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 27
Learning theories 27
Learning as a child 28
Learning as an adult 28
Learning as an adult—Malcolm Knowles’ theories and the arguments against them 29
Educating adults 30
Adult learning in the emergency department 31
Conclusion 37
References 37
Chapter 2 Obstacles to teaching in the emergency department???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 39
Obstacles inherent in the emergency department 39
Conclusion 46
References 47
Chapter 3 Teaching and patient care in emergency medicine???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 49
Introduction 49
Motivation for teaching emergency medicine 49
The beginning educator 50
The seasoned veteran 50
The master educator 51
The benefits of teaching in emergency medicine 51
Improving patient care and safety 54
Conclusion 55
References 56
Chapter 4 Mentoring in emergency medicine???????????????????????????????????????????????????????????????????????????????????????????????? 59
Mentor and mentoring defined 59
Why mentoring is important 60
Benefits of mentorship 61
The mentoring process 62
Successful mentors and pitfalls of mentoring 65
Role of mentoring in medical education 66
Goals of mentoring 72
Career guidance 72
Summary 76
References 77
Section 2 Teaching in the Emergency Department and Beyond 81
Chapter 5 Bedside teaching in the emergency department?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 83
What is holding us back: barriers to bedside teaching 84
The basics: characteristics of effective bedside teachers 85
The framework: the experience versus explanation cycle 87
Implementation: the art of bedside questioning 89
Closure: effective feedback as it relates to bedside teaching 91
Summary 93
References 94
Chapter 6 Teaching invasive medical procedures?????????????????????????????????????????????????????????????????????????????????????????????????????????? 96
Prepare to teach and learn 96
The process of learning 99
Putting theory into practice 102
Creating a procedural education elective for preclinical medical students 105
Assessing competence 106
References 108
Chapter 7 Providing feedback in the emergency department?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 109
Guidelines for providing effective feedback 110
Additional feedback methods and tools 117
Feedback and the accreditation process 119
Faculty/trainee development 119
Conclusion 120
References 120
Chapter 8 The computer as a teaching tool???????????????????????????????????????????????????????????????????????????????????????????????? 122
Improving patient care by locating and implementing evidence-based clinical guidelines 124
Performing an effective and efficient evidence-based medicine literature search for clinically meaningful answers during a busy shift 124
Improving use and interpretation of diagnostic imaging 126
Enhancing systematic interpretation of electrocardiograms 129
Enhancing understanding of drug toxicity, interactions, and treatment 130
Introducing a systematic approach to describing skin lesions 132
Enhancing the neurologic examination, understanding the NIH Stroke Scale, and knowing the indications/contraindications for tissue plasminogen activator for stroke 132
Enhancing the student’s use of scoring systems, calculators, and decision rules to provide the basis for and documentation of care 133
Preventing medical error 134
Improving the student’s understanding of normal changes in pregnancy, pregnancy complications, radiation risks in pregnancy, and contraindications to medications in pregnancy 135
Reinforcing the importance of clear communication and use of fluent translators for non-English-speaking patients 136
Understanding uncertainty in medicine 136
Using online video in emergency medicine 138
Online spaced education 138
Summary 139
References 140
Chapter 9 Educational technology: Web 2.0???????????????????????????????????????????????????????????????????????????????????????????????? 142
Introduction 142
‘‘Really Simple Syndication’’ or ‘‘Rich Site Summary’’ 144
Wikis 145
Blogs 147
Microblogging 148
Podcasts 149
Social networking 150
Learning management systems 152
Web-based applications 153
Social media risks 154
Conclusions 157
Recommended reading 157
References 158
Chapter 10 Teaching the intangibles: professionalism and interpersonal skills/communication???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 161
Communication and professionalism 161
Recommendation 1: Establish and evaluate explicit standards, beginning with the selection process 163
Recommendation 2: Discuss the benefits of professionalism 163
Recommendation 3: Promote openness to continual growth through feedback 164
Recommendation 4: Observe and discuss negative encounters 165
Recommendation 5: Outline key components of a patient encounter, including the initial introduction, patient-centered interview, and concluding the visit 167
Recommendation 6: Promote effective leadership through positive communication with all members of the health care team 170
Recommendation 7: Communicating clearly, respectfully, and confidently with consultants 171
Recommendation 12: Be the role model of professionalism 171
Remediation of learners having difficulty with professionalism and communication 172
Conclusion 173
References 173
Chapter 11 Teaching lifelong learning skills: journal club and beyond???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 175
Incorporation of research-enhanced practice into graduate medical education 175
Worldwide access to biomedical information via the Internet 176
Characteristics of poor evidence-based medicine/journal club curricula 177
Attributes of the successful evidence-based medicine curriculum and journal club 178
Conclusions 182
References 184
Chapter 12 Medical podcasting 101???????????????????????????????????????????????????????????????????????????????? 187
Summary 200
Further reading 200
Chapter 13 Use of simulation in emergency department education?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 201
History of simulation in education 201
Why use simulation? 202
Basic simulation tools 203
How to set up a simulation program 204
Debriefing 206
Assessment 206
Challenges to simulation 207
Conclusion 208
References 208
Suggested websites 210
Section 3 Teaching Specific Groups 211
Chapter 14 Teaching medical students?????????????????????????????????????????????????????????????????????????????????????? 213
Reasons to teach medical students 213
Unique educational experiences during an emergency medicine rotation 214
Qualities of an effective teacher 216
Adult learner themes 217
Educational curricular components 219
Clinical teaching 221
Techniques for overwhelmed students 223
References 225
Chapter 15 Teaching residents from other services in the emergency department???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 227
Introduction 227
Advantages of having off-service residents in the emergency department 228
Suggested educational goals 229
Models for teaching off-service residents 229
Practical tips to improve models of teaching 233
Conclusion 237
References 238
Chapter 16 The education of resident physicians in emergency medicine???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 240
Emergency medicine residency infrastructure and support 240
The core competencies 244
Paradigms for teaching residents 248
Tailoring the individual resident experience 253
International considerations 256
Conclusion 258
References 258
Chapter 17 Teaching residents how to teach?????????????????????????????????????????????????????????????????????????????????????????????????? 261
Starting the shift: expectations and enthusiasm 262
Assessment 268
Capturing observations and organizing patient care as a teacher 269
Conclusion 270
References 270
Chapter 18 Teaching to an international audience?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 272
Background 272
Technical considerations for teaching international audience 273
Style considerations 280
Thematic considerations 283
Context and content considerations 286
References 290
Chapter 19 The emergency department consultation: teaching physician-physician communication to improve patient outcomes?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 292
Introduction 292
Importance of consultations 293
Taxonomy of consultation 294
Barriers to successful consultations and communication 296
Improving communication in the emergency department 297
Approaches to consultations in the emergency department 299
Future of consultations 301
References 303
Section 4 Improving as an Educator in Emergency Medicine 307
Chapter 20 Characteristics of great teachers?????????????????????????????????????????????????????????????????????????????????????????????????????? 309
What do learners want from their teachers? 310
What do medical educators believe are the characteristics of great teachers? 311
What styles and strategies do great teachers use? 312
What are the barriers to (and the solutions for) successful teaching? 315
Conclusion 316
References 317
Chapter 21 Effective presentation skills?????????????????????????????????????????????????????????????????????????????????????????????? 319
Introduction 319
10 Principles for becoming a memorable speaker 320
Now that you have got it all together: practice, practice, practice 328
Conclusion 329
References 330
Chapter 22 Small-group discussion skills?????????????????????????????????????????????????????????????????????????????????????????????? 331
Opportunities for use of small groups 332
Types of small groups 333
Characteristics and techniques of a good facilitator 335
Starting a small-group discussion 337
Challenges of small-group discussions and their solutions 339
Assessing the discussion 340
Conclusion 341
References 341
Chapter 23 Faculty development as a guide to becoming a better teacher?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 343
Definitions of faculty development 344
Practicing in an academic setting 345
Necessary knowledge and skills 346
Clinicians as teachers 347
Process for faculty development 348
Developing a customized program 349
Finding resources 350
Promotion 357
Conclusions 358
References 358
Section 5 Teaching Techniques and Strategies 361
Chapter 24 Strategies for effective clinical emergency department teaching?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 363
Introduction 363
Strategies versus traits 363
Models to guide emergency department teaching 364
Diagnosing the learner 369
Summary 374
References 375
Chapter 25 Pearls and pitfalls in teaching: what works, what does not??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 376
Introduction 376
Teach for the right reasons 377
Keep it simple 377
Clarify expectations 378
Learn what they need to learn 378
Teach, do not taunt 379
Practice safe learning 379
Engage your learners 380
A little autonomy goes a long way 380
What are you thinking? 381
Food for thought 382
Conclusion 382
Index???????????????????????? 385