Off‐service Resident Education in the Emergency Department: Outline of a National Standardized Curriculum

Kessler, Chad; Marcolini, Evie G.; Schmitz, Gillian; Gerardo, Charles J.; Burns, Glenn D.; DelliGatti, Brian; Marco, Catherine A.; Manthey, David; Gutman, Deborah; Jobe, Kathleen A.; Younggren, Bradley N.; Stettner, Ted; Sokolove, Peter E.

doi:10.1111/j.1553-2712.2009.00605.x

Cited by 14 publications

(16 citation statements)

References 35 publications

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“…It may also be that supervisors find it challenging to assess off-service trainees because there are often no clear rotation objectives and, when there are, the level of competence expected to be displayed by the offservice resident is not made explicit. [47][48][49] Without a reference standard or set of criteria against which to judge the off-service resident's performance, a supervisor may find it challenging not only to translate his or her judgements into the abstract ordinal categories commonly used on many WBA rating scales (e.g. 'below', 'meets' or 'above' expectations), but they may also have difficulty in providing the sufficiently detailed and meaningful written feedback necessary to produce a high-quality assessment.…”

Section: Mean Performance Ratingmentioning

confidence: 99%

Supervisor-trainee continuity and the quality of work-based assessments

et al. 2017

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Supervisor-trainee continuity did not have an educationally meaningful influence on the quality of assessments documented on DECs. However, resident performance was found to affect assessor behaviours in the On-service group, whereas DEC quality remained poor regardless of performance in the Off-service group. The findings suggest that greater attention should be given to determining ways of improving the quality of assessments reported for off-service residents, as well as for those residents demonstrating appropriate clinical competence progression.

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Section: Mean Performance Ratingmentioning

confidence: 99%

Supervisor-trainee continuity and the quality of work-based assessments

et al. 2017

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“…Rotating residents comprise roughly a quarter of total housestaff in academic EDs 3 . The ED provides a unique training environment to rotating residents by offering them access to patients with undifferentiated medical issues, continuous supervision by attending physicians, and opportunities for improving procedural competency 2,3,6,7 . Additionally, the ED affords rotating residents exposure to unique clinical areas, including resuscitation, emergent airway management, toxicologic and environmental emergencies, and trauma 7 .…”

mentioning

confidence: 99%

A Novel Online Didactic Curriculum Helps Improve Knowledge Acquisition Among Non-Emergency Medicine Rotating Residents

Branzetti¹,

Aldeen²,

Foster³

et al. 2010

Academic Emergency Medicine

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Objectives: Rotating residents represent a significant proportion of housestaff in academic emergency departments (EDs), yet they rarely receive targeted didactic education during their emergency medicine (EM) rotations. The goals of this study were: 1) to determine the effectiveness of an online didactic curriculum in improving EM knowledge among rotating residents and 2) to assess rotating resident satisfaction with this curriculum. Methods:The authors created an online lecture series of six EM subject areas targeted to rotating residents called the Northwestern University Rotating Resident Curriculum (NURRC). All rotating residents at the study site were eligible, written consent was obtained, and the study was approved by the institutional review board. Consenting participants were pretested with a 42-question multiple-choice examination and then randomized to two groups: one with access to the NURRC during the first 2 weeks of the rotation (experimental) and one without (control). Halfway through the rotation, all participants were posttested with a different multiple-choice examination, and the controls were then granted NURRC access. The primary outcome was the difference between pretest and posttest scores (score delta). The t-test was used to compare mean scores, and a linear regression model was used to determine the association of NURRC access on score delta after adjustment for pretest type and resident type. A postintervention survey was administered at the end of the rotation to assess satisfaction with the NURRC and collect suggestions for improvement.Results: Fifty-four rotating residents were enrolled: 29 in the experimental group and 25 in the control group. There was no significant difference in pretest scores between the two groups. Mean score delta was 17.3% in the experimental group and 1.6% in the control group, an absolute difference of 15.7% (95% confidence interval [CI] = 10% to 22%). After adjustment for resident type and pretest type, the only variable positively associated with the primary outcome was NURRC access. Third-year and preliminary-year internal medicine (IM) residents demonstrated the greatest absolute improvement in score delta when granted NURRC access. Eighty percent of the participants responded to the satisfaction survey. Over 80% of the survey respondents approved of each component lecture and of the NURRC overall.Conclusions: After exposure to an online didactic curriculum, rotating residents demonstrated a significant increase in EM knowledge and reported a high level of satisfaction with the didactic program.

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“…Emergency medicine (EM) has traditionally been a rotation where off-service residents gain important clinical experience through month-long rotations (1). However, in the face of declining Medicare reimbursement, graduate medical education funding is struggling to provide for an appropriate physician workforce without bankrupting teaching hospitals (2).…”

Section: Introductionmentioning

confidence: 99%

Increasing Off-Service Resident Productivity while on their Emergency Department Rotation Using Shift Cards

Chakravarthy

Posadas

Ibrahim

et al. 2015

The Journal of Emergency Medicine

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, Abstract-Background: Differences in productivity between off-service residents rotating in the emergency department (ED) and their emergency medicine (EM) resident counterparts have never been directly quantified. Objectives: We sought to quantify the difference between off-service residents rotating in the ED and their EM resident counterparts. We also sought to find whether shift cards could be used to increase the productivity of off-service residents rotating in the ED. Methods: This is a prospective cohort study conducted at an urban, tertiary, Level I trauma center. We implemented the use of shift cards for off-service residents during their EM rotation. Completion of the shift card involved recording patients seen and their dispositions, procedures done, and documenting a learned bedside teaching point from their shift that day. Productivity was measured in terms of patients seen per hour (PPH) and relative value units per hour (RVU/h). Results: Off-service residents showed a productivity of 0.529 PPH (95% confidence interval [CI] 0.493-0.566) and 1.40 RVU/h (95% CI 1.28-1.53) prior to implementation of shift cards. With the introduction of shift cards, productivity increased to 0.623 PPH (95% CI 0.584-0.663, p = 0.001) and 1.77 RVU/ h (95% CI 1.64-1.91, p = 0.001). In comparison, first year EM resident productivity was 0.970 PPH (95% CI 0.918-1.02) and 3.01 RVU/h (95% CI 2.83-3.19). Conclusions: Shift cards can be used to foster motivation for off-service residents rotating in the ED, and is a simple and costeffective method to improve system-based practices and utilization of resources. Ó 2015 Elsevier Inc.

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Off‐service Resident Education in the Emergency Department: Outline of a National Standardized Curriculum

Cited by 14 publications

References 35 publications

Supervisor-trainee continuity and the quality of work-based assessments

Supervisor-trainee continuity and the quality of work-based assessments

A Novel Online Didactic Curriculum Helps Improve Knowledge Acquisition Among Non-Emergency Medicine Rotating Residents

Increasing Off-Service Resident Productivity while on their Emergency Department Rotation Using Shift Cards

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