An Educator''s Guide to Teaching Emergency Medicine to Medical Students

There is a need for every medical school graduate to handle emergencies as they arise in the daily practice of medicine. Emergency medicine (EM) educators are in a unique position to provide students with basic life support skills, guidance in assessing the undifferentiated patient, and exposure to the specialty of EM during all years of medical school. Emergency physicians can become involved in a variety of education experiences that can supplement the preclinical curriculum and provide access to our specialty at an early stage. A well-designed course in the senior year allows students to develop critical thinking and patient management skills that are necessary for any medical career path. It can ensure that all medical students are exposed to the skills essential for evaluating and stabilizing the acutely ill patient. To implement this type of course, learning objectives and evaluation methods must be set when the curriculum is developed. An effective course combines didactic and clinical components that draw on the strengths of the teaching institution and faculty of the department. A structured clerkship orientation session and system for feedback to students are essential in nurturing the development of student learners. This article provides an approach to assist the medical student clerkship director in planning and implementing EM education experiences for students at all levels of training, with an emphasis on the senior-year rotation.     

Clerkship Directors in Emergency Medicine: Statement of Purpose

The Academy of Clerkship Directors in Emergency Medicine (CDEM) provides a forum for the collaborative exchange of ideas among emergency medicine (EM) medical student educators, a platform for the advancement of education, research, and faculty development, and establishes for the first time a national voice for undergraduate medical education within our specialty. CDEM plans to take a leading role in providing medical student educators with additional educational resources and opportunities for faculty development and networking. CDEM will work to foster the professional growth and development of undergraduate medical educators within our specialty. The advancement of undergraduate education within our specialty and beyond will come primarily from the support, hard work, and dedication of the educators. To accomplish our goals, at the departmental, medical school, and national level, we must come together to further promote our specialty across the spectrum of undergraduate medical education. The first step has already been taken with the formation of the Academy of CDEM.     

Emergency Medicine Interest Group Curriculum: Faculty and Preclinical Student Opinions Differ in a Formal Needs Assessment

Background: Medical students and Emergency medicine (EM) faculty may have differing opinions on the ideal curriculum during the preclinical years. Objectives: To assess the perceived needs of preclinical medical students exploring EM and compare them with those of EM faculty regarding appropriate educational interventions. Methods: A survey instrument listing 15 workshops related to EM was administered to preclinical medical students in our Emergency Medicine Interest Group (EMIG), and to EM faculty. Respondents graded the perceived utility of each workshop offered at our medical school and those identified via a web search for EMIG. No recommendations for EMIG curriculum were identified through PubMed. Fisher's exact tests were computed using SPSS (SPSS Inc., Chicago, IL) with α = 0.05. Results: There were 48 medical students and 15 faculty members who completed the survey. Students strongly desired workshops in suturing (48/48; 100%), splinting (47/48; 97.9%), and basic electrocardiogram (ECG) interpretation (47/48; 97.9%). Least desired topics were history of EM (16/48; 33.3%), getting involved in EM organizations (20/48; 41.7%), and wellness (21/48; 43.8%). Women chose the domestic violence workshop more than men (p = 0.036). Faculty strongly supported workshops in conducting focused history and physical examination (14/15; 93.3%), the specialty of EM (14/15; 93.3%), and basic ECG interpretation (12/15; 80.0%). The lowest rated faculty preferences were ultrasound (5/15; 33.3%), history of EM (7/15; 46.7%), and emergency radiology (7/15; 46.7%). Conclusions: Preclinical students and faculty opinions of important educational workshops differed. Faculty favored the approach to the undifferentiated patient and an introduction to the specialty, whereas students preferred hands-on workshops. Both groups agreed that basic ECG interpretation was useful. These data may be useful for designing an educational program that is interesting to preclinical students while still meeting the needs as perceived by medical student educators.     

Emergency Medicine in Undergraduate Education

Abstract. Society has a right to expect that all physicians possess basic knowledge of emergency care and the skills to manage acute problems. Competency in the care of acutely ill and injured patients is one of the fundamental exit goals of most medical schools as mandated by the Liaison Committee on Medical Education. Several groups have called for strengthening the general components of undergraduate medical education, and surveys during the early years of the development of the field of emergency medicine (EM) showed that only a small percentage of schools required significant education in EM. This paper defines the goals and objectives of undergraduate EM education in order to help guide the development of curricular offerings as the role of EM in undergraduate medical school education increases. This paper was developed by the SAEM Education Committee and presents this committee's beliefs on what all graduating medical students should know about assessment and treatment of acutely sick and injured patients. It also suggests methods by which acquisition of this information can occur in medical school education.     

Global Health and Emergency Care: An Undergraduate Medical Education Consensus‐based Research Agenda

Global emergency medicine (EM) is a rapidly growing field within EM, as evidenced by the increasing number of medical students desiring global health and emergency care experiences. Despite this growing popularity, little is known of the effect of undergraduate medical education in global health on learners and patients in the United States and abroad. During the 2013 Academic Emergency Medicine consensus conference, a group of leading medical school educators convened to generate a research agenda on priority questions to be answered in this arena. This consensus‐based research agenda is presented in this article.     

Developing a third-year emergency medicine medical student curriculum: a syllabus of content

Emergency medicine (EM) educators have published several curricular guides designed for medical student rotations and experiences. These guides primarily provided brief overviews of opportunities to incorporate EM into all 4 years of the medical student curriculum, with one specific to the fourth year. However, there are no published guidelines specific to third-year medical students rotating in EM. Given the differences between third-year and fourth-year students in terms of clinical experience, knowledge, and skills, the Clerkship Directors in Emergency Medicine (CDEM) established the Third-year EM Medical Student Curriculum Work Group to create a third-year curriculum. The work group began this process by developing consensus-based recommendations for the content of a third-year medical student EM rotation, which are presented in this syllabus.     

The status of undergraduate palliative medicine education in Canada: a 2001 survey

A survey was conducted in fall 2001/spring 2002 to provide an update on the status of undergraduate palliative medicine education in Canada. The survey identified that the majority of palliative care teaching occurs in the pre-clinical years of medical school, with supervised patient encounters occurring primarily during electives. The coverage of palliative care topics is inconsistent across curricula. Student evaluation methods also vary, with only one school using simulated patients. More than half the schools have an academic division or department of palliative care medicine, although faculty with protected academic time are few in number. A number of barriers to palliative medicine education were identified, including competition for time within the undergraduate curriculum, and lack of resources for curriculum development and teaching. Respondents recommended increased clinical exposure, curriculum development, student assessment and evaluation, faculty development, and improved infrastructure. Following these recommendations, the Undergraduate Palliative Medicine Committee has dedicated itself to developing and fostering a strategic implementation plan to improve palliative medicine education in Canadian medical schools.     

Current state of interprofessional education in Canadian medical schools: Findings from a national survey

Interprofessional education (IPE) is being increasingly recognised and prioritised in undergraduate medical education. While efforts are underway to integrate IPE into health professional curricula across Canada, the state of IPE in Canadian medical schools remains unclear. This study aims to assess the current practice of IPE in Canadian undergraduate medical curricula. An online survey was distributed to IPE directors (or designees) of all Canadian medical schools. The survey gathered details of the IPE experiences offered, curriculum structure, and perceived barriers to the programmes. The survey was completed by 12 of 17 Canadian medical schools and revealed that IPE is generally well represented in Canadian undergraduate medical education curricula. Reported barriers to IPE efforts included scheduling and funding limitations. By comparison, student interest was one of the least commonly cited issues. It would appear that students and faculty are interested in advancing the state of IPE in undergraduate medical education. The results of this study are crucial as IPE continues to evolve as a component of undergraduate medical curricula across the globe.     

Selecting a Medical School Advisor

Having an advisor offers medical students many advantages, including increased likelihood of matching into their top choices. Interestingly, students who choose emergency medicine (EM) as a specialty are more likely to seek advising. However, finding and optimally utilizing an EM faculty advisor is often challenging for the medical student. In this article, we tackle the different ways to seek advising, including the ‘virtual advisor program’ implemented by the Society for Academic Emergency Medicine, the ‘e-Advisor Program’ instigated by the Clerkship Director in EM Group, the ‘member exclusive mentorship program’ of the Emergency Medicine Residency Association, as well as peer-based mentoring. More so, we discuss the consensus recommendations developed by the Student Advising Task Force to guide both students planning to apply to EM and their advisors to ensure high-caliber advising.     

Preparing nursing students for the future: An innovative approach to clinical education

A clinical education model was developed and implemented by nursing faculty in the Oregon Consortium for Nursing Education undergraduate curriculum to improve clinical learning for preparation of nurses to practice in the 21st century. This clinical education model, developed though collaborative work by nursing practice and education representatives throughout the state, moves away from a “random access opportunity” model of clinical education reliant on “total patient care” experiences to an intentional design of clinical learning activities based on course competencies appropriate to student level. Five elements of the model were proposed: case-based, concept-based, intervention skill-based, focused direct client care and integrative experiences. Different elements are dominant in early, middle and late clinical experiences to best support the developmental level of the student. Expectations for faculty, students and clinical staff were also developed to enhance best practices in clinical learning. Preparation of clinical partners for a change in clinical learning and student accountability are essential for optimal learning. This paper provides an overview of the model with clinical application examples for each element with a particular emphasis on case-based, concept-based and integrative clinical experiences.     

A graduate curriculum guided by human becoming: journeying with the possible

Graduate education involves teaching-learning processes and experiences where faculty and students journey with adventure and trepidation all-at-once. In this column, notions regarding graduate education where the educational curriculum is guided by the human becoming school of thought as a conceptual framework are explored. Opportunities and challenges from both faculty and student perspectives are highlighted.     

Undergraduate Curriculum

Abstract. The specialty of emergency medicine (EM) is becoming more and more involved in medical school education. The previous article discusses the integration of EM in medical school curricula. This outline was developed by the SAEM Undergraduate Education Committee to offer specific goals and objectives as well as suggestions for implementation of EM concepts into medical school curricula.     

Emergency Psychiatry Training for Third-Year Medical Students as Reported by Directors of Medical Student Education in Psychiatry

Background: Physicians can expect to confront a variety of psychiatric emergencies during their careers. However, medical schools are not required to teach emergency psychiatry and little is known about the content of existing instruction. Purposes: We conducted this survey to better understand the emergency psychiatry experiences provided to 3rd-year medical students. Methods: Directors of medical student education in psychiatry at U.S. medical schools were mailed a 1-page questionnaire about their school's instruction in emergency psychiatry. Results: We received 74 responses from the 122 U.S. medical schools (61%). All but 4 reported emergency psychiatry instruction. The number of hours and type of settings students were on-call varied greatly from school to school, as did the scope of faculty supervision. Conclusions: Most schools provide emergency psychiatry instruction, but methods vary among institutions. Given its importance, medical schools should work to provide uniformity in the way emergency psychiatry is taught.     

Nursing students' and faculty members' knowledge of, experience with, and attitudes toward complementary and alternative therapies

This study was designed to describe and compare the knowledge, experience, and attitudes of nursing faculty and students (undergraduate and graduate) regarding complementary and alternative therapies (CAT). A cross-sectional survey (N = 153) of undergraduate (n = 41) and graduate (n = 57) students and faculty (n = 55) was conducted in one school of nursing. Most participants were White (87%) and female (78%). More than 70% of the students and faculty agreed that clinical care should integrate the use of CAT. More than 85% desired more education about CAT, especially in undergraduate nursing curricula. More than 65% agreed that the clinical nurse specialist or nurse practitioner role should include the use of CAT in their practice, and more than 50% agreed that they had some knowledge of CAT, but only approximately 30% had some experience with CAT. Faculty and students expressed positive attitudes toward integrating CAT into the undergraduate nursing curriculum and nursing practice. Faculty development and nursing research are needed to facilitate curriculum change and integrate CAT into nursing programs at all levels.     

The Virtual Advisor Program: Linking Students to Mentors via the World Wide Web

BACKGROUND: Emergency medicine (EM) is a popular specialty for medical students choosing a career. Many attend medical schools without an affiliated EM residency and lack both the formal mentorship and informal guidance provided by medical school advisors (or faculty) involved in an accredited EM training program. Others desire specialized advice based on geographic or specific academic interest. OBJECTIVE: The authors describe user characteristics of a Web-based virtual advisor program that paired medical students with EM faculty advisors. METHODS: Prospective users access the system from a link on the Society for Academic Emergency Medicine (SAEM) home page. On the initial visit, demographic information is collected. Faculty and student guidelines are provided. Students desiring individual advice may register for a virtual advisor who can assess career goals and qualifications. Volunteer faculty mentors are assigned on the basis of the student's geographic and demographic preferences and career aspirations. Encounters rely primarily on electronic and/or voice correspondence to suit the needs of the pair. A frequently asked question (FAQ) section provides answers to common questions and does not require registration. RESULTS: Two hundred sixty-four students (183 males, 75 females, 6 unspecified) from North American (87) and international (25) medical schools requested a virtual advisor. One hundred twenty-one faculty advisors from 56 U.S. medical schools participated (86 [71%] males; 35 [29%] females). Students indicated reasons they sought a virtual advisor. Qualitative feedback was generally positive from advisors and advisees. CONCLUSION: The implementation of the virtual advisor program enabled medical students to have access to experienced EM faculty career mentors.     

Clerkships in Emergency Medicine

Planning for clerkships in emergency medicine (EM) can be stressful, prolonged, and challenging. Therefore, medical students should start planning for them early. In this article, we offer guidance regarding several issues pertinent to the EM clerkship, such as the best time to schedule one (or more) during medical school, the most appropriate institution or program to schedule it, the process of selecting and applying for the clerkship, and the number of EM clerkships to consider. We will explain why an EM clerkship should be scheduled between June and October and the reason that 2 EM clerkships at different sites are sufficient for the majority of students. Additionally, we emphasize that clerkships in emergency departments associated with EM residency programs or with reputations for outstanding student teaching tend to be most beneficial. Above all, students interested in EM should attempt to leave a great impression after completing their clerkships by providing stellar patient care, demonstrating enthusiasm at all times, and maintaining professionalism. In turn, they will gain knowledge and clinical experiences that should prove valuable in their future.     

What Experiences in Medical School Trigger Professional Identity Development?

Phenomenon: This qualitative inquiry used conceptual change theory as a theoretical lens to illuminate experiences in medical school that trigger professional identity formation. According to conceptual change theory, changes in personal conceptualizations are initiated when cognitive disequilibrium is introduced. We sought to identify the experiences that trigger cognitive disequilibrium and to subsequently describe students' perceptions of self-in-profession prior to the experience; the nature of the experience; and, when applicable, the outcomes of the experience. Approach: This article summarizes findings from portions of data collected in a larger qualitative study conducted at a new medical school in the United States that utilizes diverse pedagogies and experiences to develop student knowledge, clinical skills, attitudes, and dispositions. Primary data sources included focus groups and individual interviews with students across the 4 years of the curriculum (audio data). Secondary data included students' comments from course and end-of-year evaluations for the 2013–2017 classes (text data). Data treatment tools available in robust qualitative software, NVivo 10, were utilized to expedite coding of both audio and text data. Content analysis was adopted as the analysis method for both audio and text data. Findings: We identified four experiences that triggered cognitive disequilibrium in relationship to students' perceptions of self-in-profession: (a) transition from undergraduate student to medical student, (b) clinical experiences in the preclinical years, (c) exposure to the business of medicine, and (d) exposure to physicians in clinical practice. Insights: We believe these experiences represent vulnerable periods of professional identity formation during medical school. Educators interested in purposefully shaping curriculum to encourage adaptive professional identity development during medical school may find it useful to integrate educational interventions that assist students with navigating the disequilibrium that is introduced during these periods.     

The shadowing experience: valuing the link between faculty practice and student learning.

Nurse faculty members, engaged in active, clinical practice roles, can enhance student learning through a shadowing experience. A shadowing, or observational, experience was designed by the writer to enhance undergraduate student learning, contribute to student socialization to the profession, and assist students to develop career goals. The shadowing experience linked an undergraduate student with the faculty member in a learning partnership in an advanced practice clinical setting. Fifteen undergraduate nursing students participated in a pilot shadowing experience with a faculty member in her private practice. Both the students and faculty reported that the experience was mutually rewarding. Students reported they were able to learn new information, apply theory from the classroom, and develop interest in graduate school. The shadowing experience provided the faculty member with an opportunity to show the value of her clinical practice within a traditional academic environment. The value of the shadowing experience for the faculty member can be enhanced by formal mechanisms that support faculty clinical practice work.