Faculty‐lead Opinions on Workplace‐based Methods for Graduated Managerial Teaching (FLOW MGMT): A National Cross‐sectional Survey of Canadian Emergency Medicine Lead Educators

Abstract

Objectives Patient volumes are increasing in emergency departments (ED), causing issues with long wait times and overcrowding. One strategy to cope with this phenomenon is to focus on improving patient flow through the ED. Building on earlier work that identified how staff physicians manage flow and what techniques they employ to teach managerial skills to residents, we aimed to determine when it was most appropriate to implement these teaching strategies in a resident’s training. Methods We employed a Canada‐wide cross‐sectional survey of experienced emergency medicine (EM) teaching faculty to determine when they felt our previously identified teaching strategies would be appropriate to implement. The survey was piloted with local educational experts. Results A total of 21 EM (38% female, 62% male) educators from 11 programs responded to the survey. The respondents provided an average of 42.5 endorsements per participant for specific teaching techniques across the stages of training. The core of discipline (35.9%) and transition to practice (39.7%) were the stages of training that received the most endorsement. The top two teaching techniques included the observational teaching technique “attitudinal role modeling (i.e. a strong work ethic)” and the conversational teaching technique “teacher provides clinical pearls, tips, pointers.” The participants showed fairly high agreement, with the advanced in situ techniques showing fairly high reliability as measured by intraclass correlation coefficients ranging from 0.88 to 0.90. Conclusions Our results show a trend toward faculty utilizing more didactic and observational teaching techniques early in residency and then progressing toward more experiential techniques in the senior stages of training. This is consistent with a graduated increase in responsibility as residents demonstrate competency and progress through their training. The results of this study will help inform faculty development around teaching managerial skills in the area of competency‐based medical education.

Feeling the flow with a serious game workshop: GridlockED as Medical Education 2 study (GAME2 study)

“…These findings are promising, since a recent national survey of EM educators highlighted a curricular gap around ED flow. 6 This study highlights the lack of formal curricula for exposing or teaching junior learners about how to lead or manage the ED or more importantly how the ED fits within the greater health system. 6 Our previous research with GridlockED (the Gridlocked as Medical Education, or GAME) was an observational study of more senior learners and EM staff to determine potential teachable moments.…”

“…6 This study highlights the lack of formal curricula for exposing or teaching junior learners about how to lead or manage the ED or more importantly how the ED fits within the greater health system. 6 Our previous research with GridlockED (the Gridlocked as Medical Education, or GAME) was an observational study of more senior learners and EM staff to determine potential teachable moments. 11 From this, we found that GridlockED provided multiple teaching points around ED flow, specifically around patient prioritization and staff deployment.…”

“…1,3,5 Moreover, even if trainees have progressed to a level when they can effectively be given the chance to run the ED, they will have few extraclinical opportunities to have acquired the strategies and knowledge base required to engage in multipatient care. While cognitive apprenticeship 3 and graduated responsibility 1,[4][5][6][7] may hold the key to helping these individuals acquire the crucial skill set of running an ED, our team deemed that it would be prudent to expand upon the types of teaching strategies that are available to EM teachers outside of the clinical space. With a rise in interest for using serious games, we sought to create and test a serious game that would fill this increasing need for health systems education.…”

“…With a rise in interest for using serious games, we sought to create and test a serious game that would fill this increasing need for health systems education. 6,8…”

“…In emergency medicine (EM), we are increasingly aware that our systems have created the need for new competencies including the managing multipatient environments. [1][2][3][4][5][6] The managerial skills of running a busy, high-volume emergency department (ED) are of increasing importance in our specialty, so much so that they are emerging as new entrustable professional activities within the…”