Background Leaders in graduate medical education must provide robust clinical and didactic experiences to prepare residents for independent practice. Programs traditionally create didactic experiences individually, requiring tremendous resources with variable content exposure and quality. Objective We sought to create and implement a free, open access, learner-centric, level-specific, emergency medicine (EM) residency curriculum. Methods We developed Foundations of Emergency Medicine (FoEM) Foundations I and II courses using Kern's model of curriculum development. Fundamental topics were identified through content guidelines from the American Board of Emergency Medicine. We incorporated learner-centric strategies into 2 flipped classroom, case-based courses targeting postgraduate year (PGY) 1 and PGY-2 residents. The curriculum was made freely available online in 2016. Faculty and resident users were surveyed annually for feedback, which informed iterative refinement of the curriculum. Results Between 2016 and 2020, registration for FoEM expanded from 2 sites with 36 learners to 154 sites and 4453 learners. In 2019, 98 of 102 (96%) site leaders and 1618 of 2996 (54%) learners completed the evaluative survey. One hundred percent of responding leaders and 93% of learners were “satisfied” or “very satisfied” with FoEM content. Faculty and residents valued FoEM's usability, large volume of content, quality, adaptability, organization, resident-faculty interaction, and resident-as-teacher opportunities. Challenges to implementation included resident attendance, conference structure, technology limitations, and faculty engagement. Conclusions We developed and implemented a learner-centric, level-specific, national EM curriculum that has been widely adopted in the United States.
Objectives The COVID‐19 pandemic continues to impact health systems across the United States and worldwide in an unprecedented way; however, its influence on frontline medical trainees’ educational experiences is unknown. Our objective was to determine the effects of COVID‐19 on emergency medicine (EM) training programs and residents. Methods We performed a mixed‐methods cross‐sectional survey study of faculty and residents at programs registered with Foundations of Emergency Medicine. Participants completed an online survey consisting of closed and open‐ended response items. We reported descriptive statistics for discrete and continuous data. Free‐response data were analyzed qualitatively using a thematic approach. Results Ninety‐two percent of faculty (119/129) and 47% (1,965/4,154) of residents responded to our survey. We identified three major themes related to effects on learning: 1) impact on clinical training, 2) impact on didactic education, and 3) impact on the trainee. Nearly all residencies (96%, 111/116) allowed residents to work with patients suspected of having COVID‐19, although fewer (83%, 96/115) allowed residents to intubate them. We found that 99% (1918/1928) of residents experienced virtual didactics. Faculty and trainees noted multiple educational challenges and strategies for adaptation. Trainees also expressed concerns about stress and safety. Conclusion COVID‐19 has impacted EM education in many ways including clinical training, didactic education, and trainee emotional state and concentration. Challenges and suggested solutions for learning in the virtual environment were also identified. While the pandemic continues to evolve and impact EM residents in various ways, our results may inform strategies to support medical educators and trainees during pandemics or other periods of significant disruption or crisis.
Introduction: Electrocardiogram (EKG) interpretation is integral to emergency medicine (EM).1 In 2003 Ginde et al. found 48% of emergency medicine (EM) residency directors supported creating a national EKG curriculum.2 No formal national curriculum exists, and it is unknown whether residents gain sufficient skill from clinical exposure alone. Methods: The authors sought to assess the value of this EKG curriculum, which provides exposure to critical EKG patterns, a framework for EKG interpretation when the diagnosis is not obvious, and implementation guidelines and open access to any interested residency. The Foundations of Emergency Medicine (FoEM) EKG I course launched in January 2016, followed by EKG II in July 2017; they are benchmarked to post-graduate year 1 (PGY) and PGY2 level learners, respectively. Selected topics included 15 published critical EKG diagnoses and 33 selected by the authors.5 Cases included presenting symptoms, EKGs, and Free Open Access Medical Education (FOAM) links. Full EKG interpretations and question answers were provided. Results: Enrollment during 2017-2018 included 37 EM residencies with 663 learners in EKG I and 22 EM residencies with 438 learners in EKG II. Program leaders and learners were surveyed annually. Leaders indicated that content was appropriate for intended PGY levels. Leaders and learners indicated the curriculum improved the ability of learners to interpret EKGs while working in the emergency department (ED). Conclusion: There is an unmet need for standardization and improvement of EM resident EKG training. Leaders and learners exposed to FoEM EKG courses report improved ability of learners to interpret EKGs in the ED.
Introduction: Online resources are available to enhance emergency medicine training programmes. The aim of this study was to evaluate the feasibility of using online case-based resources created in the United States in a New Zealand emergency medicine training programme.Methods: Evaluation data were collected from junior doctors and educators after they participated in the programme. Data sources included research notes and questionnaire responses. The data were analysed qualitatively using a general inductive approach.Results: Evaluation feedback from 19 junior doctors and 14 educators was interpreted to suggest that the online resource, with minor adaptations, was feasible to use in a New Zealand emergency medicine training programme. Findings indicated that educators were able to modify the materials to modify to meet local requirements, however, the opportunity to include a cultural component was missed. Participants appreciated the case-based format and felt that they established a safe and encouraging learning environment with each other. Participants were able to develop a systematic approach to emergency situations and identify red flags related to deteriorating patients.
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