new faculty orientation manual · education service line – primary contacts.....6 . faculty...

1 | P a g e

New Faculty

Orientation Manual

Education Service Line Updated 3/22/16

2 | P a g e

Table of Contents Welcome .......................................................................................................................................... 4 Vision of Emergency Medicine Education ....................................................................................... 5 Education Service Line – Primary Contacts ...................................................................................... 6 Faculty Expectations ........................................................................................................................ 7 Checklist of Activities ..................................................................................................................... 10 Undergraduate Initiatives .............................................................................................................. 11 Medical Students

M1-M2 Overview .............................................................................................................. 12 M3 Overview ..................................................................................................................... 13 M4 Overview ..................................................................................................................... 14 M1-M4 EM Medical Student Comparison Chart .............................................................. 15

Residency Overview and Objectives .................................................................................................. 16 Clinical Rotations............................................................................................................... 16 Assessment Methods ........................................................................................................ 17 Clinical Competency Committee ....................................................................................... 18 Program Evaluation Committee ....................................................................................... 19 Residency Orientation – July ............................................................................................. 20 Faculty Coverage of Residents (Clinical) ........................................................................... 22 Resident Man Down Process ............................................................................................ 23 Non-Emergency Medicine Rotators .................................................................................. 24 Specialty Rotations Global Health Elective ............................................................................. 25 Toxicology Rotation ................................................................................ 25 Ultrasound Rotation ............................................................................... 25 Flight for Life ........................................................................................... 26

Emergency Medical Services (EMS) Fellowship Overview and Objectives .................................................................................................. 27 Assessment Methods ........................................................................................................ 28 Clinical ED Shifts and Moonlighting .................................................................................. 28 Department Educational Activities Emergency Medicine Grand Rounds ................................................................................. 29 Emergency Medical Services (EMS) Grand Rounds .......................................................... 29 Simulation Medical Student ...................................................................................... 30

3 | P a g e

Residency ................................................................................................ 30 Continuing Medical Education (CME) ............................................................................... 30 Journal Club ................................................................................................................ 32 Student Specific Advising ................................................................................................... 32 Observing ................................................................................................ 32 Shadowing............................................................................................... 33 Standard Letter of Evaluation (SLOE) ..................................................... 33 Traditional Student Letter of Recommendation ..................................... 33 Residency Specific Advising ................................................................................................... 34 Resident Letters of Recommendation .................................................... 34 Scholarship ................................................................................................................ 35 Appendix Student Assessment Forms M3 Shift Assessments (electronic) .......................................................... 36 M4 Shift Assessments (electronic ........................................................... 36 Resident Assessment Forms Shift Card Assessments ........................................................................... 37 Annual Program Evaluation .................................................................... 43 Emergency Medicine Research Forum ............................................................................. 45

4 | P a g e

Welcome

The Department of Emergency Medicine at the Medical College of Wisconsin has a strong history of successful educational programs. It is upon this strong foundation that we continue to grow and expand. In recent years, our department has grown in terms of the number of faculty and in respect to the diverse experience and areas of expertise. In addition, the Medical College is growing which has offered many opportunities for our faculty to engage in teaching medical students, being involved in new programs and growing their educators portfolio. There has yet to be a lack of opportunities for faculty to teach and educate a variety of learners in our department and across campus.

As our department expands and our imprint on the care of patients widens, so will our opportunities for EM faculty to impact learners at all levels. Our goal is to educate and develop programs that span the continuum of education, from the college student exploring a career in medicine, to the faculty who is looking to expand their skills and knowledge as a part of their professional development.

The future is filled with opportunities to continue to grow and strengthen our existing programs and branch out into new opportunities. With that in mind, we rely on our faculty to teach learners across the continuum of education, to identify these new opportunities for us to become involved with and to provide feedback to the Education Services team in order to maximize the success of our programs and our learners.

I hope this guide provides you with the information you need to understand our programs, but more importantly, to find an area that interests you as a clinician and educator.

Do not hesitate to contact me or our Education Services team with questions.

Matthew Tews, DO, MS Associate Professor and Director of Education Services, Department of Emergency Medicine Assistant Dean for Clinical Curriculum, Office of Academic Affairs Medical College of Wisconsin

5 | P a g e

Vision of Emergency Medicine Education

The Department of Emergency Medicine will provide exceptional educational programs that foster the professional development of learners along the continuum of each individual’s career

Education Services Line Mission

• To support the spectrum of learners in EM by upholding the Educational Services vision • To promote a collaborative culture of learner success by proving an environment conducive to

teaching, learning and education program expansion • To provide guiding recommendations for the implementation of projects to maximize program

success • To focus on the educational success of all programs • To ensure there are adequate resources to support the success of our programs

6 | P a g e

Education Service Line – Primary Contacts

Service Line Leadership Matthew Tews, DO, MS Director of Education Services [email protected]

Medical Student Team Brady McIntosh, MD M1/2 Clinical Apprenticeship

Director [email protected]

Heidi Ludtke, MD M3 Student Course Director [email protected] Philip Sharpless, MD M4 Student Course Director [email protected]

Emergency Medicine Residency Team Colleen Crowe, MD, MPH Program Director, EM [email protected] Alicia Pilarski, DO Associate Program Director, EM [email protected] Michael O’Connell, MD Assistant Program Director, EM [email protected]

Emergency Medical Services Fellowship Team M. Riccardo Colella, DO, MPH Program Director, EMS [email protected] Timothy Lenz, MD, EMT-P FFL Director [email protected] Jason Liu, MD, MPH Special Operations and Disaster

Medicine [email protected]

Ben Weston, MD, MPH EMS Director [email protected] Specialty Services Teams

Daniel Mielnicki, MD Clinical Services [email protected] Stephen Hargarten, MD, MPH Global Health [email protected] Mark Kostic, MD Toxicology Rotation Director [email protected] Mary Beth Phelan, MD Ultrasound Director [email protected]

Research Team E. Brooke Lerner, PhD Education Scholarship [email protected] Brittany Farrell Research Program Coordinator [email protected]

414-805-0110 Administrative Team

Jill Simonson Education Program Manager [email protected] 414-805-6455

Jennifer Myszkowski Education Program Coordinator [email protected] 414-805-6454

Katherine Murray (Kat)

Education Technology and Social Media

[email protected] 414-805-1101

Stacey Hendricks Grand Rounds/CME Conference Coordinator


Carrie Froemming EMS Coordinator [email protected] 414-805-9923

Chief Residents Chase Deobald, DO Student Education [email protected]

Siarhei Vysotski, MD Resident Education [email protected]

Saada Zegar, DO Scheduling [email protected]

mailto:[email protected]























7 | P a g e

Faculty Educational Expectations

Below are the educational activities that each faculty is expected to complete.

Faculty Development Expectations Activity Requirement Who requires this? Where can I get it? Grand Rounds Attendance

40 hours of Grand Rounds per academic year unless otherwise negotiated with Chair

Department Attendance is tracked by the conference room commander and reported monthly to faculty

• MCW EM Grand Rounds

• MCW EMS Grand Rounds

• See page 20

Continuing Medical Education credit (CME)

30 hours within the 2 calendar years immediately preceding the calendar year for which application for registration is made

State of WI – Medical Examining Board CME credits are tracked in ETHOS and managed by the conference coordinator

• MCW EM Grand Rounds (2 hours certified CME per week)

• Other CME programs (see Ethos) at MCW

• Online courses • Conference

attendance • See page 30

Trauma CME 48 hours of trauma related CME over a 3 year period (16 hrs./year)

Trauma Surgery collects this information for Froedtert Hospital’s Level 1 Trauma Recertification CME credits are maintained in ETHOS and managed by the conference coordinator

• MCW EM Grand Rounds

• Other CME programs (see Ethos) at MCW

• Online courses • Conference

attendance • See page 30

Faculty Teaching Expectations Activity Requirement Who requires this? When do I do it? Grand Rounds Teaching Each faculty is

expected to give 1 Grand Rounds presentation per academic year.

Department Data is tracked by the Residency Office and reported annually to Administration.

• During a Grand Rounds session

• See page 30

8 | P a g e

Faculty Assessment and Evaluation Expectations Activity Requirement Who requires this? When do I do it? Medical Student End-of-Shift Assessment

Each faculty is expected to complete an end of shift assessment and provide verbal feedback to the medical student they worked with Blocks 1-4 – faculty only Block 5-10 – faculty or resident can complete

Department Data is tracked by the student coordinator

• At the end of each shift

• See pages 12-15

Resident End-of-Shift Assessments

Each faculty is expected to complete an end of shift assessment and provide verbal feedback to the primary resident they worked with

Department/ACGME Data is tracked in the Residency Office

• At the end of each shift

• See page 17

Grand Rounds Conference Assessments

Each faculty is expected to complete a conference assessment

Department/ACGME Data is tracked by the conference coordinator

• At the end of each Grand Rounds session

• See page 29 Annual Program Evaluation

Each faculty is asked to complete an assessment and provide feedback regarding the performance of the residency

Department/ACGME Data is tracked in the Residency Office

• Each May

Medical College of Wisconsin Affiliated Hospitals (MCWAH) Annual Faculty Survey

Each faculty is asked to complete an assessment and provide feedback regarding the performance of the residency

Department/ACGME Institution Data is tracked in the Residency Office

• Annual

Accreditation Council for Graduate Medical Education (ACGME) Annual Faculty Survey

Core faculty is asked to complete an assessment and provide feedback regarding the performance of the residency

Department/ACGME Institution Data is tracked in the Residency Office

• Annual

9 | P a g e

Checklist of Activities

Listed below are the regularly recurring educational activities that occur throughout the academic year. It is recommended that new faculty attend the activities at least once (unless otherwise required to attend more) during their first year to gain exposure to our educational environment.

Educational Activities What When Contact Done

EM Grand Rounds • Patient Safety

Conference • Simulation • Visiting Professors • Carrie Falk Memorial

Lecture • Research Forum • Pediatric EM • Resident Care

Conferences for toxicology, ultrasound and critical care

• Mock Oral Board Reviews

Thursday mornings except holidays

Stacey Hendricks [email protected] 414-805-6413

EMS Grand Round (mandatory only for EMS faculty)

Most Thursday afternoons Carrie Froemming [email protected] 414-805-9923

Trauma and Emergency Medicine Disciplinary Conference (will obtain Trauma CME)

Grand Rounds (Second Thursday of each month)

Stacey Hendricks [email protected] 414-805-6413

Additional Recommended Educational Activities What When Contact Done

Journal Club Held 5-6 times per year at various faculty homes

Brittany Farrell [email protected]

M4 Simulation Session 2 Monday per month from 1-4pm


M3 Education Modules Offered 3 times per block 5-10 (schedule varies)


M4 Didactic Lecture Mondays during the block from 8a-12p


MCW Medical Student Teaching Opportunities

Various required courses from September to May

[email protected]







10 | P a g e

Undergraduate Initiatives

University of Wisconsin – Milwaukee and Marquette University: Pre-Medicine Outreach As of 2016, discussions are underway to form a partnership with the two major undergraduate universities in Milwaukee, University of Wisconsin (UWM) and Marquette University.

• Emergency Medicine has been working with Marquette to provide shadowing for medicine interested students. There may be opportunities for additional interactions with the Marquette pre-medicine students.

• Opportunities exist for a longitudinal annual program at UWM which could include the following.

o Meeting #1: Discuss career pathways at UWM o Meeting #2: SEMA panel of students travel to UWM, early evening meeting to discuss

what medical school is like. o Meeting #3: Pre-medical students travel to MCW to tour the Emergency Department

and discuss what residency is like. Pre-medical students may be split up into groups by interest. (i.e. physician, PA, nursing).

o Meeting #4: Pre-medical students meet with faculty regarding medicine careers/home work life balance.

o Meeting #5: Shadow experience after declared major at Froedtert Hospital. This would be a one-on-one opportunity as opposed to a group activity. (2016-2017)

These interactions are an opportunity to reach out to students considering medicine as a career and fit into the spectrum of learners on the continuum of education that we are working to reach. If faculty members are interested in participating in this activity, please send a message to: [email protected]

11 | P a g e

Medical Students

M1-M2 Overview MCW has a clinical experience for the first and second year medical students called the "Clinical Apprenticeship" during which the student spends 4 hours once per week in a clinical setting to shadow a faculty. This program runs on the calendar year and covers the second half of their M1 year (January-June) and the first half of their M2 year (September-December). The program handbook distributed by MCW to faculty participants clearly outlines each week’s objectives for learning.

The Emergency Medicine Department is a popular choice for students, and this year among first year students there are 25 first choice requests and 42 second choice requests to have this experience in the emergency department.

Every year, we open this opportunity up to any faculty, who are interested in participating, it is not mandatory. We currently have ~15 faculty participating.

Students are assigned to the following shifts with program faculty:

Monday, Tuesday and Fridays from 2:30-6:30pm (red or blue shift only)

Thursday from 8:00am – 12:00pm (red or blue shift only)

**Only 1 student will be scheduled per shift (ex. you would either have an M1/2, an M3 or an M4 at any one time)

This program is coordinated by the Education Coordinator (EC) and the Faculty lead for this course is listed on the contact page.

Currently, student participation/progress is evaluated by the Faculty lead after discussion with program faculty. There is not an evaluation form per shift.

The programs website is: http://www.mcw.edu/Medical-School/Faculty/CW-Faculty.htm

If faculty members are interested in participating in this activity, please send a message to: [email protected]

12 | P a g e

M3 Overview M3 Medical Student Elective M3 students interested in learning about clinical Emergency Medicine can choose the M3 elective. The goal is to give them exposure to EM and allow those interested in EM to determine if it is a good “fit” for them. This elective runs blocks 5-11 (approximately October through May) in the academic year. Four students are accepted per block. Students can expect:

• To gain exposure to Emergency Medicine principles and practice • To understand the signs and symptoms of the acutely ill or injured patient • To become familiar with the initial evaluation of a broad variety of medical and traumatic

emergencies • To develop a differential diagnosis based on life threatening causes of common chief complaints • To develop an approach to the initial resuscitation and management of the undifferentiated

patient • To begin to develop the knowledge, skills, and attitudes necessary for the practice of EM

The student experience includes:

• 12 clinical shifts • Self-study utilizing the textbook, other selected readings and videos provided to the students via

the D2L website • Attendance at EM Grand Rounds • Three simulation Education Modules taught at the STAR Center by EM faculty, scheduled in

advance by the EC. Topics include: Abdominal Pain, Shock, Difficulty Breathing & Airway and Chest Pain & ACLS

• Students complete two Trauma Alert Checklists • Students turn in two written Resuscitation Reflections • Students give one 10-minute oral presentation to an audience of residents and faculty on a pre-

approved topic not covered by the curriculum • One multiple-choice 45-question electronic final exam

Students are graded by:

• Daily shift evaluations completed by faculty • Education Module participation and preparation and selected quizzes

Evaluation of oral presentation by audience Final exam score Questions about the M3 elective can be directed to [email protected]

13 | P a g e

M4 Overview

M4 Medical Student Elective The M4 elective is designed to give students in their fourth year an opportunity to be involved with patient care in the ED. MCW M4 students interested in a career in Emergency Medicine are encouraged to take the M4 elective at MCW during blocks 1-3 (sometimes block 4), as well as an away EM elective to be competitive for the specialty. EM is not a required rotation at MCW, but a popular one. Many students take the elective who are not EM interested during blocks 5-10. Ten M4 students are accepted in blocks 1-4 to allow for EM interested students to get their necessary rotation grade and letters of recommendation, and six students are accepted in blocks 5-10 (the other 4 spots are for our M3 students during this time). Students can expect:

• To learn and understand the initial stabilization of critically ill and injured patients • To know the characteristics of certain life threatening injuries and illnesses and to understand

the methods for diagnosing and treating them • To learn the principles of diagnosis and management of a wide variety of disease processes • To understand the elements of effective, pre-hospital care and a total emergency medicine care

system The student experience includes:

• 13 shifts in the Emergency Department • Attendance at EM Grand Rounds • Didactic lectures on topics: History and Physical, Abdominal Pain, Dyspnea, Mega Code, ABG,

Metabolic Acidosis, The ST Segment, Bradycardia, SVT, Toxicology, Altered Mental Status, Wide Complex Tachycardia, Stroke and Shock

• Skills lab on orientation day working with suturing and splinting • Textbook reading assignments • Two 4-hour simulation sessions at the MCW STAR Center with a faculty member • One mock code oral examination • One electronic 80-question final exam

Students are graded by:

• Shift evaluations completed by faculty • Workshop participation • Workshop quiz • Simulation participation • Mock code exam • Final exam

Questions about the M4 elective can be directed to [email protected]

14 | P a g e

The following chart compares the three levels of learners involved in clinical activities listed in the above documents:

15 | P a g e

Residency

Overview and Objectives The residency has general objectives for all residents. As residents and as a program we intend to:

Master essential emergency medicine knowledge Acquire crucial administrative skills Learn to become educators and lifelong students Create the future leaders of Emergency Medicine

Attaining these objectives will promote a culture of excellence and an expectation of humble leadership among graduates of our program. In addition to these objectives, residents are required to meet the general competencies of the Accreditation Council for Graduate Medical Education (ACGME). Clinical Rotations EM1 Residents

• Orientation – 1 month • Emergency Medicine/Froedtert Hospital – 3 months (1 week vacation) • Cardiology – 1 month • Trauma Surgery – 1 month • Critical Care VA Medical Center (VAMC) – 1 month • Pediatric Emergency Medicine – 1 month • Pediatric Wards – 2 weeks • Pediatric ICU – 2 weeks • OB/GYN – 1 month (1 week vacation) • Anesthesiology VAMC and Ultrasound – 1 month (1 week vacation) • Neurosurgical ICU – 1 month

EM2 Residents

• Emergency Medicine Froedtert Hospital/Children’s Hospital – 8 months (2 weeks of vacation) • Medical ICU – 1 month • Surgical ICU – 6 weeks (1 week vacation) • Pediatric Anesthesiology – 2 weeks • Emergency Medicine St. Luke’s Hospital – 1 month

EM3 Residents

• Emergency Medicine Froedtert Hospital/Children’s Hospital – 9 months (2 weeks of vacation) • Toxicology – 1 month (1 week vacation) • Elective – 1 month • Ultrasound/Emergency Medical Services – 1 month

Questions about the M4 elective can be directed to [email protected]

16 | P a g e

Assessment Methods Shift Cards The Emergency Medicine Residency uses paper shift card evaluations. The purpose of the shift cards is to provide real time, quality feedback to the residents on a more consistent basis. There are 6 different color-coded shift cards each associated with medical competencies specific to Emergency Medicine. The residents are responsible for completing an evaluation on every shift with a goal of receiving evaluations on at least 80% of shifts. Faculty are responsible for completing an evaluation on 80% on shifts. Faculty are encouraged to make an attempt to observe at least one aspect of a patient encounter during a shift (i.e. present for the initial evaluation of the patient, re-evaluation, disposition update, giving bad news, having a difficult conversation, etc.). (See Appendix)

17 | P a g e

Clinical Competency Committee (EM and EMS combined) A Clinical Competency Committee (CCC) is a term used by the ACGME to describe a group of reviewers who evaluate a resident’s clinical competency based on identified criteria. The purpose of the CCC is to provide competency-based and milestone-specific evaluation of each residents progress related to graded responsibility (promotion), feedback with opportunity to improve (remediation), and verification of competence to practice without supervision (graduation). At all times the procedures and policies of the CCC comply with those of the Department of Emergency Medicine, Emergency Medicine Residency Training Program and the Medical College of Wisconsin Affiliated Hospitals Graduate Medical Education Office. CCC members are responsible for discussing each resident’s achievement of milestones and making a concrete recommendation based on data to the program director for resident progress, including promotion, remediation and dismissal. The CCC is responsible for advising the Program Director regarding each resident’s progress, including promotion, remediation and dismissal. Meetings occur semiannually and are scheduled based upon ACGME reporting dates. An ad hoc meeting to address pressing issues that cannot wait until a regularly scheduled meeting may also occur. If faculty members are interested in participating in this activity, please send a message to: [email protected]

18 | P a g e

Program Evaluation Committee (EM and EMS combined)

A Program Evaluation Committee (PEC) is a term used by the ACGME to describe a group of faculty members and resident(s) who should participate actively in an Annual Program Evaluation (APE). At all times the procedures and policies of the PEC will comply with those of the Department of Emergency Medicine, Emergency Medicine Residency Training Program and the Medical College of Wisconsin Affiliated Hospitals Graduate Medical Education Office. The PEC is appointed by the Program Director, Emergency Medicine and will consist of educational members who interact with residents in different settings and who are dedicated to resident education, willing to serve, reliable and professional. One Chief Resident will be appointed by the Program Director, Emergency Medicine to service on the committee. The Program Director, Emergency Medicine is designated as the facilitator of the APE. PEC members are responsible for:

• Planning, developing, implementing and evaluating the educational activities of the program • Reviewing and making recommendations for revision of competency-based curriculum goals

and objectives • Addressing areas of non-compliance with ACGME standards • Reviewing the program annually using evaluations of faculty, residents and other to monitor and

track: o Resident Performance o Faculty Development o Graduate Performance o Program Quality o Progress on the prior year’s action plan

Meetings will occur annually. An ad hoc meeting to address pressing issues that cannot wait until the next regularly scheduled meeting may also occur. If faculty members are interested in participating in this activity, please send a message to: [email protected]

19 | P a g e

Residency Orientation - July

Medical students who match into the Emergency Medicine Residency start their training by participating in a rigorous month of orientation. A full month of orientation helps to ease new residents to transition from medical school to residency and acclimate them to the hospital system. Training in ultrasound use, advanced airway management, splinting, and central line placement help incoming residents to feel comfortable performing procedures when working clinically in both the Adult and Pediatric Emergency Departments in the first 30 days.

The following topics are covered during residency orientation:

• Systems Based Training (12 hours) o EPIC (electronic medical record system)

EM Specific EPIC o Introduction to Froedtert Hospital o Slit lamp, tonopen, PACS o Introduction to Children’s Hospital of Wisconsin o Vocera

• Certification o Advanced Trauma Life Support (16 hours) o Advanced Cardiac Life Support (8 hours) o Basic Life Support (8 hours) o Basic Disaster Life Support (16 hours)

• Didactics (21 hours) o Professionalism (Part 1 and Part 2) o ED Social Services o AIDET o ED Nursing o SBAR (Situation Background Assessment Recommendation) o Toxicology o Introduction to Research o How to be a successful resident o Introduction to Flight for Life o Introduction to Wellness o Disaster Planning o Introduction to the ED Pharmacy o Introduction to New Innovations o Introduction to Emergency Medical Services (EMS) o Central Venous Line Didactics

• Simulation/Task Training (24 hours) o Airway Management o Chest Tube Workshop o Lumbar Puncture

20 | P a g e

o Splint Lab o Simulated Patient Encounters o Central Venous Line Simulation o Ultrasound

Additionally during this time various social activities, including a Milwaukee Brewers baseball game and welcome picnic, round out the month of activities.

21 | P a g e

Faculty Coverage of Residents (Clinical)

Three times throughout each academic year, Emergency Medicine residents collectively gather as a group for educational purposes, team building, and examination. During these planned absences, faculty provides coverage on all teams in the emergency department during resident absence.

Fall Resident Retreat • Residents are off from 1500 on Friday and return to the ED at 2230 on Saturday

Spring Resident Retreat

• Residents are off from 2300 Wednesday and return to the ED at 1500 on Thursday ABEM In-Training Exam

• Residents are off from 2200 Tuesday and return to the ED at 1500 Wednesday Annual Research Forum

• EM3 residents are off from 0700 Thursday and return to the ED at 1500 Thursday.

22 | P a g e

Resident Man Down Procedure

Resident absence

during a shift

Brief Absence(1-7 Days)

Medical College of WisconsinDepartment of Emergency Medicine

Resident Man Down Coverage - Process

Contact Chief Resident


FMLHCHW

Chief Resident informs Program

Director and Residency Office

Chief Resident informs Program

Director and Residency Office

Contact supervising faculty

Contact supervising faculty

Extended Absence

(> 1 week)

EM1Man Down

EM1Man Down

EM2/EM3Chief Resident attempts to find replacement for

entire shift

EM2/EM3Chief Resident attempts to find replacement for

entire shift

Replacement of resident


Flex to 12 hour shifts

Flex to 12 hour shifts

Pull EM3 on Red to work on Blue

Team

Pull EM3 on Red to work on Blue

Team

After January pull EM2 to work Red

Team

After January pull EM2 to work Red

Team

FMLHCHW

NotAvailable

EM3 Last

Resort

EM2Last

Resort



FMLH

Not available

ED staffed with one EM2 and one EM3 splitting the

ED

ED staffed with one EM2 and one EM3 splitting the

ED

FMLHCHW

FMLHCHW

Chief Resident and Program

Director to discuss schedule

modifications

Chief Resident and Program

Director to discuss schedule

modifications

FMLHCHW

EM1 not replacedEM1 not replaced

CHW

EM1Man Down

EM1Man Down

CHW



In most instances EM1 not replaced

In most instances EM1 not replaced

FMLHCHW

23 | P a g e

Non-Emergency Medicine Rotators The Emergency Medicine Residency hosts rotators from:

• Internal Medicine • Neurology • Anesthesiology • Psychiatry • Otolaryngology • Plastic Surgery • Orthopedic Surgery • Pediatric Emergency Medicine

Rotations are one month and occur in the Emergency Department at Froedtert Hospital. All non-emergency medicine rotators are members of the Red team and staff patients with the EM3 resident. Rotators have an opportunity to care for a large number of patients with a variety of medical conditions and presentations. In general, rotators will have first contact responsibility for patient care. This includes a focused history and physical, rational diagnostic testing, effective therapy and appropriate disposition.

Residents are supervised at all times by a senior Emergency Medicine resident and a faculty member of the Department of Emergency Medicine. Accredited faculty are teaching and supervising residents 24 hours a day. Rotators are expected to attend Emergency Medicine Grand Rounds unless it violated duty hours. EM3 residents complete evaluations at the end of the rotation for each rotator in New Innovations. Evaluations are based on the six ACGME outcome measures.

Questions about the non-EM rotators schedule can be directed to [email protected]

24 | P a g e

Specialty Rotations

Global Health Elective

In 2010, the Department of Emergency Medicine along with educators from the Wheaton system implemented a collaborative global health training program at Karl Heusner Memorial Hospital (KHMH), Belize City, known today as “Strengthening Emergency Care in Belize”. The vision for this program is “every citizen and visitor will have access too timely and quality emergency care in Belize”. Focused training of Belize learners occurs several times per year in both Milwaukee and Belize City with a long term goal of standardizing the care of patients with the development of expectations for both nurses and physicians, and integrating technology to improve patient care and management. The Karl Heusner Memorial Hospital (KHMH) Emergency Medicine rotation is available only to residents in the EM3 year of post-graduate training. This elective provides residents an experience in global health. Important elements of this experience are the development of leadership and consultation skills as well as practice of and reflection upon emergency medicine in a different culture, low resource setting, with fragmented EMS systems, and a distinctive environment of morbidity and mortality. If faculty members are interested in participating in this activity, please send a message to [email protected].

Toxicology Rotation An elective rotation in toxicology offers emergency medicine residents an opportunity to become versed in all aspects of adult and pediatric injuries and illnesses caused by intentional and/or accidental poisonings. Residents treat drug overdoses, suicide attempts, environmental and occupational hazards, plant and animal toxins, and potentially bioterrorism. The skills and knowledge acquired in this rotation are pertinent to the EM board examination. In addition, residents are exposed to consultations throughout the state while interacting with Wisconsin's only poison center.

Ultrasound Rotation Ultrasound training in the Emergency Medicine Residency focuses on residents developing the skills to apply technology in the rapid evaluation of critically ill and injured patients. Ultrasound (US) training is integrated into all three years of residency:

• EM1 o 4 hour simulation event during orientation

Completion of EMSONO Introduction to Ultrasound module o Ultrasound/Anesthesia combined rotation – one month

Completion of required EMSONO lectures and quizzes prior to the end of the rotation

• Practical Scanning • eFAST – Hemopericardium • eFAST – Hemoperitoneum • eFAST – Pneumothorax

25 | P a g e

• Vascular Access • Aorto Ultrasound • 1st Trimester Ultrasound

• EM3 o 4 hour simulation event o Completion of a minimum of 100 scans o Completion of required EMSONO lectures and quizzes prior to the end of the following

month Focused Gallbladder Ultrasound Soft Tissue Ultrasound Focused Renal Ultrasound Lower Extremity DVT Ultrasound Ocular US & Tendon Assessment Focused Echo Introductory Module – Part 1 Focused Echo Introductory Module – Part 2

Ultrasound Grand Rounds (didactic and hands on including the use of an Ultrasound simulator), the regular use of US in daily patient care and dedicated Ultrasound shifts throughout training occur. All residents become proficient in the use of ultrasound to evaluate trauma patients, patients in cardiac arrest, and patients with suspected AAA. The application of the skills sets needed for the aforementioned scans positions our residents to easily perform the RUSH exam (Rapid US for Undifferentiated Hypotension). Additionally, residents are exposed to and utilize ultrasound in performing procedures such as central line placement, paracentesis thoracentesis, and foreign body localization. While all of our faculty have received ongoing US training and are credentialed by the hospital to perform and interpret point of care US in the critical patient, a core group of faculty have been established to provide ongoing regular contact with residents specifically to focus on their US training. This group of faculty has both highly developed ultrasound skills, strong interest in promoting the ultrasound training for residents, performing ultrasound research and in the administrative aspects necessary to maintain and continually improve our academic emergency medicine ultrasound program. All residents leaving the program will achieve the currently recommended number of scans (150-200) and receive verification of their ultrasound experience. Flight for Life

Beginning in the EM2 year, residents may be selected to participate in a one year experience on the air medical transport system, Flight for Life (FFL), which is under the medical direction of an MCW physician. This experience may be extended for up to one additional year. Residents will learn the physiology of air medical transport and be an active member of the transport team. Residents will develop a project pertaining to helicopter EMS, which can be used as their scholarly project. Residents participate in quarterly combined crew meetings and an annual Human Patient Simulator (HPS) lab. Scholarly articles pertaining to air medical transport will be part of the required reading, along with a variety of PowerPoint presentations. Residents also participate in the QI/QA committee, Safety committee, and Standards and Practice committee.

26 | P a g e

Emergency Medical Services (EMS) Fellowship

Overview and Objectives The ACGME accredited Emergency Medical Services (EMS) fellowship program at the Medical College of Wisconsin (MCW) is dedicated to training physicians in the science of out-of-hospital medical care. For 15 years, MCW’s EMS fellowship has been preparing physicians to serve as medical directors of EMS systems. This fellowship consists of education and training meant to provide the fundamentals in the safe and efficient delivery of medical care in the out-of-hospital setting. The EMS fellowship program is designed to be a twelve month educational experience. The activities of the fellowship program occur in a variety of facilities and locations. Patient care observations occur in the Emergency Departments of Froedtert Hospital, as well as in the out-of-hospital setting with Milwaukee County Emergency Medical Services (EMS) providers. In addition, the fellow participates in the administrative and training activities related to the medical direction of the Milwaukee County EMS, State of Wisconsin EMS, City of Milwaukee Fire Department, and the Flight for Life (FFL) programs. Activities occur both on-campus and at various locations in Milwaukee, Milwaukee County, Fond du Lac, and Madison, Wisconsin. During fellowship training, fellows are provided with experiences in the practice and administrative components of EMS systems to gain a detailed understanding of the field of out-of-hospital medicine. These experiences will provide a basis to determine functioning, designs, and processes necessary to ensure quality of patient care in the pre-hospital setting. The EMS fellow will also observe in real-time various EMS managers and providers while they administer the EMS system and deliver medical care to patients. These experiences will allow the fellow to gain in-depth knowledge of the delivery of emergency medical services. Such experiences include incidental patient contact, where the fellow will be present with licensed providers when they conduct patient care. The fellow observes the delivery of care and may have the ability to conduct limited patient histories and exams under the direct supervision of a licensed provider. The fellow will also discuss assessment and treatment modalities with licensed providers. However, the fellow will not have the authority to determine clinical management, perform procedures, nor have contact with a patient independently or without the direct supervision of a licensed provider. Hands-on experience will include: 1. Participation with EMS field providers 2. Participation as an EMS educator 3. Participation in quality improvement activities 4. Emergency vehicle operations 5. Vehicle and technical rescue 6. Participation in disaster drill 7. EMS coverage for mass gatherings 8. EMS base station (radio) operations

27 | P a g e

9. Participation in local, state, and national EMS organizations 10. Air medical services 11. Participation in variance investigation 12. Ongoing interaction with the EMS Medical Director 13. Participation in tactical medicine activities Assessment Methods Fellows are evaluated based on written and verbal feedback from MCW faculty, as well as providers, staff, and officials from the area EMS systems. The fellow will be judged on the ability to work cooperatively in a real-life setting with EMS professionals, as well as the proficiency in learning and adapting principles of EMS care and system management. In addition, evaluations consider the fellow’s ability to effectively complete various EMS tasks and projects assigned. The fellow will also be rated on the design and implementation of an EMS-related research project, with an end goal of a publication-quality paper. Clinical ED Shifts and Moonlighting The ACGME requires EMS fellows to work clinically to maintain their current board skills, usually in emergency medicine. The fellowship provides for four hours per month wherein the EMS fellow will work on a Thursday during Emergency Medicine Grand Rounds. Fellows are asked to select which Thursday they would like to work and confirmation is send via Outlook.

EMS fellows are also instructors and are allowed to moonlight clinically.

Questions about the EMS Fellowship can be directed to [email protected]

28 | P a g e

Department Educational Activities

Emergency Medicine Grand Rounds The grand rounds series reviews topics that may or may not be covered on clinical rotations with recurring topics intended to teach residents all aspects of the ACGME general competencies. In addition, residents have the opportunity to learn interpersonal, communication, and teaching skills while presenting lectures and cases. The core CME series is approved for a maximum of 2 hours of CME credit per week. Grand rounds is held each Thursday beginning at 7:30am (CME 8:30am – 10:30am) with the Emergency Medicine/Trauma Interdisciplinary Conference held every 2nd Tuesday of the month beginning at 7:00am (CME 7:00am – 10:00am). Grand Rounds sessions are located in Conference Room H, The Pavilion. Components of grand rounds include:

• Core CME sessions • Journal Club review/Evidence based medicine • EMS curriculum • Emergency Medicine/Trauma Interdisciplinary Conference (case review) • Toxicology case conference • Ultrasound Curriculum • Simulations and procedure labs • Continuous quality improvement/patient safety • Risk management • Research Methodologies • Education • Palliative care • Mock Oral Board Review • Written Board Review • Pediatric Curriculum (2 hours during 1st Thursday of every month)

Faculty attendance requirements are set by the department chair and are currently 40 hours per academic year, unless otherwise negotiated with him. In addition, to maintain our Level 1 trauma certification, faculty are required to accumulate 48 hours of trauma CME averaged over a 3 year period. Presenting faculty receive feedback after all Grand Rounds presentations. Evaluations are completed by faculty, fellows, residents and students in attendance and reviewed by the Program Director. All grand rounds evaluations are stored electronically.

Emergency Medical Services (EMS) Grand Rounds The EMS grand rounds series reviews topics pertaining to pre-hospital medicine covered in the fellowship curriculum. EMS Grand Rounds is located in the Clinical Cancer Center and begins each Thursday at 12:00pm.

29 | P a g e

Simulation

The use of high fidelity simulation is an integral part of the learning activities for our students and residents. The activities that use simulation all occur at the STAR Center and make use of SimMan 3G. We have a core group of faculty that teach using simulation.

If faculty are interested in participating in simulated activates or learning how to use simulation as a teaching tool, please contact: [email protected].

Medical Student

M3 – There is a component of each of the three modules that uses simulation in blocks 5-10. These cases cover the core topics of chest pain, abdominal pain and difficulty breathing

M4 – There are two 3 hours sessions each block for our M4 students. These sessions correlate with the student’s didactic material and are cases that involve ACLS and acutely ill patients.

Residency

During residency, live simulations occur during Grand Rounds on a scheduled basis. In these sessions, residents are chosen to run cases independently or in pairs, and then they debrief with the group who reviewed it remotely. These cases are designed to be not only real cases, but as realistic as possible in the simulated setting.

Sick Sim – Occurs quarterly and focuses on the medically ill patient

Pediatric Sim – occurs 1-2 times per year and focuses on the medically ill pediatric patient

Trauma Sim – Each year we run a 4 hour long workshop designed to prepare the rising EM2’s to be captain and doc right in our trauma system and the rising EM1’s to be the airway doc.

Trauma Conference – At the beginning of each year, we have a combined residency simulation program between EM and Trauma Surgery. During this 2 hour session, we run cases that introduce the new EM and surgery residents to the idea of working as a trauma team.

Flight for Life – The Medical Director for Flight for Life runs simulations for the flight nurses on a regularly occurring basis.

Continuing Medical Education (CME) Physicians are expected to engage in continuous learning and periodic assessment throughout the length of their board certification. The guiding principles include ensuring that the highest standards of patient care are established and maintained, and assuring patients, physicians, and other stakeholders that certified physicians are being assessed by reliable and valid measures to continually improve patient

30 | P a g e

American Board of Emergency Medicine – Maintenance of Certification (MOC) Physicians must complete an average of 25 AMA PRA Category 1 CreditsTM per year or acceptable equivalent; eight of the credits each year must be self-assessment credits.

The State of Wisconsin, Department of Safety and Professional Services Physician

Continuing Education requires 30 hours of Category 1 AMA or AOA.

For Osteopathic board certified physicians, see the following link for more information:

http://www.osteopathic.org/INSIDE-AOA/DEVELOPMENT/CONTINUING-MEDICAL-EDUCATION/Pages/default.aspx

Journal Club The Emergency Medicine residency provides for approximately six journal club sessions per academic year. Journal Club enhances resident research education by offering an opportunity to critically evaluate current research that is relevant to the clinical practice of emergency medicine in a comfortable setting that also offers the opportunity to spend social time with peers and faculty. Learning objectives provide residents the opportunity to demonstrate the ability to critical evaluate current and relevant emergency medicine research and describe the findings of recent literature that may affect clinical practice in the emergency department. General Rules of Journal Club:

• EM faculty will voluntarily host journal club on the evening of their choosing. Journal club will not be held on Thursday evenings during resident interviewing. Hosting journal club will be considered an education activity that will be accounted for in the distribution of education RVU funds.

• All journal clubs will start at 6pm with the article review to be started at 7pm. • Two articles will be reviewed at each journal club. • There will be 5 journal clubs per year, one of which will have an EMS theme. • Each senior resident and the EMS fellow will be responsible for leading the discussion for one

journal club during the year. Residents will volunteer for the journal club they want lead. • EM faculty will be expected to attend journal club as often as possible and attending journal

club will be counted toward faculty’s required conference hours. • All residents are required to attend journal club unless they are working during journal club. • All residents will be expected to have reviewed the articles and completed an evaluation form

prior to attending journal club. All journal clubs will follow the same basic outline:

• A volunteer faculty host will be identified and will select the date of journal club – dates will be selected when the clinical schedule is released.

• The host will select two articles on a similar topic immediately after the date is selected. The Research Director will highlight one of the articles during a 30-minute research concepts lecture during grand rounds prior to the date of journal club.

o Selected articles should be current and relevant to patient care in the emergency department



31 | P a g e

• Two senior residents will be solicited to volunteer to discuss the articles approximately 3 weeks prior to journal club

o The host and senior resident should meet prior to journal club to discuss the articles and identify the critical issues to discuss during journal club

• The research coordinator will send the selected articles to all residents and faculty along with the evaluation guide two weeks prior to journal club

• The research coordinator will provide the host with a sign in sheet. All residents and faculty should sign in to be credited for attendance. The host will return the sign in sheet to the research coordinator after journal club.

Journal Club Schedule:

6pm Arrive and have dinner 7pm Begin article discussion 8pm Social hour

If faculty members are interested in hosting a journal club, please send a message to [email protected] Student Specific

Advising

At the end of the M3 year, students begin to seek Advisors for their M4 year. The advisor role is:

• To discuss goals/interests, help plan the M4 schedule including choice of electives, time off for interviewing, USMLE Step 2 preparation

• Reviewing and approving lottery selections in the Registrar’s system • Offering guidance if student is not certain of specialty • Inquire about red flags

A guide to advising medical students is located at: G:Education Document/ Faculty Advising Guide for EM bound M4's 2014-15 If faculty members are interested in learning more about advising medical students, please send a message to [email protected] Observing

Observing is the term we use for anyone who would like to “shadow”, but is not an MCW student. This would include students from other institutions, the general public or other interested parties.

In this case to cover the hospital for liability issues and ensure confidentiality, Observer Paperwork must be completed, returned to the Education Coordinator (EC) and approved by the EM Medical Director before the session can be scheduled.

The EC works with the student schedule to find a time they are available and then coordinates with the faculty member on their interest and availability.



32 | P a g e

Shadowing

MCW students often request to “shadow” a physician for one or several shifts. Some do this to see what a “day-in-the-life-of” an emergency physician looks like. Some do it to gain some EM experience. Some want to solidify their choices before submitting their final schedules to the medical school. These students contact our Education Coordinator (EC) to request the experience. The EC works with the student schedule to find a time they are available and then coordinates with the faculty member on their interest and availability. Shadowing is typically scheduled in a 4 hour block on a shift when the faculty does not have another Medical student learner scheduled (M4/M3 rotation or Clinical Apprenticeship). Standard Letter of Evaluation (SLOE) EM-interested medical students often ask for letters of recommendation. These letters are called Standard Letters of Evaluation (SLOE). These are the letters that faculty write for EM-interested students who ask for letters of recommendation. The exceptions to using this would be: 1) Non-EM applicants (ex. Neurology) and 2) A research letter of recommendation. These would be completed on department letter head. SLOE’s come in two forms – the Department SLOE and Individual SLOE. Departmental: This is a composite letter of evaluation written by committee and based on objective criteria about how the student did on the rotation. Students typically ask the EC for this letter, which is written by a group of letter writers made up of the residency and medical student team. Per recent CORD surveys, the Department SLOE holds the most weight and programs prefer this when available. Individual: The 2nd most important is the individual SLOE which holds more weight when the letter writer is familiar and frequently writes such letters (There is a specific question on the form that asks “How many letters did you write last year?”) Most students will ask EM faculty for this SLOE. Letters from EM physicians not in SLOE form (i.e. this often happens in non-academic Institutions) may be looked at but not closely; they give little objective information that program Directors are looking for. Similarly, letters from outside of EM (e.g. Internal Medicine) hold very little weight. (Trauma surgery, Pediatric EM may be exceptions) Traditional Student Letters of Recommendation Students going into a specialty other than EM may also ask faculty for a letter of recommendation. This may happen if you worked on a research project with a student, were their advisor or had some other special connection. Faculty are free to write these letters but should NOT utilize the SLOE form. These letters should be written like any other business correspondence and be printed on letterhead. The EC can assist with uploading these letters to the students file.

33 | P a g e

Residency Specific

Advising

The Program Director and Associate/Assistant Program Director(s) will be formal advisors to all residents and will conduct the bi-annual performance review. Faculty Advocates The Emergency Medicine Residency provides residents with a faculty advocate(s). Faculty advocates are assigned several residents who will meet as a group. The purpose of the advocate is to:

• Expand collaboration among faculty and residents as well as peer advising • Discuss “what’s going well and what’s not going so well” and bring any issues confidentially back

to the program director • Discuss career planning, life-work balance, etc. • Act as a personal advocate for the resident’s well-being during residency, fostering a supportive

environment and providing resources as necessary to insure a healthy balance between personal and professional life during training.

• Foster strong relationships between faculty, residents and peers • Build trust and respect confidentiality • Provide advice, coaching and/or feedback to residents

The Emergency Medicine Residency encourages all residents to select one or more faculty to serve as their mentor. The purpose of a mentor is to:

• Provide residents with assistance in career planning during residency • Be a personal role model

If you are interested in participating in this Departmental initiative contact [email protected]

Resident Letters of Recommendation

Faculty may be asked at times to write a letter of recommendation for a resident with respect to their after residency career plans. Copies of all letters are retained electronically by the Residency Office.

34 | P a g e

Scholarship

There are many opportunities for scholarship available to faculty. While scholarship can take on many forms, the recurring local conferences provide an opportunity for faculty to display their education scholarship.

• MCW pathways – The pathway program is designed to give medical students an individualized part of their curriculum. There is an annual Pathways Research Forum that allows students to display their work. If you worked with a student on a project for Pathways, this is an opportunity for you to work with them to display their work.

• MCW Innovation Research Forum – This is an annual event in the spring in which anyone at MCW can display their innovative work. This is open to any MCW student, resident or faculty.

• EM research forum – The Department of EM has an annual research forum held each spring. There is a mix of scholarship presented that includes faculty, fellows, residents, students and anyone else who submits a project that is accepted. There are oral and poster presentations. This is also where the residents present their final project. (See Appendix)

35 | P a g e

Appendix

Student Assessment Forms (Electronic)

M3 Shift Assessment: http://www.surveygizmo.com/s3/2357321/M3-Medical-Student-Clinical-Observation-Form

M4 Shift Assessment: http://www.surveygizmo.com/s3/2165100/M4-Medical-Student-Clinical-Observation-Form

http://www.surveygizmo.com/s3/2357321/M3-Medical-Student-Clinical-Observation-Form




36 | P a g e

Resident Assessment Forms

Shift Card Assessments

Medical Knowledge

During today's shift you did the following well:

During today's shift you could have improved:

Date: EM Level:

Resident Name: (Printed) Faculty Name: (Printed)

Resident Signature: Faculty Signature:

Observed Patient Encounter YES NO

All the time(EXCELLENT)

Communicates pertinent information to emergency physicians and other healthcare colleaguesDemonstrates appropriate medical knowledge in the care of emergency medicine patients

Manages and prioritizes critically i l l or injured patients

Correctly identifies "sick versus not sick" patientsSynthesizes essential data necessary for the correct management of patients

Constructs a l ist of potential diagnoses based on initial assessment

Department of Emergency Medicine Shift Card - Medical/Clinical Knowledge(Inform the attending at the start of your shift that they will be asked to complete this form)

1 2 3

Department of Emergency Medicine Shift Card - Medical/Clinical Knowledge

Performs a physical exam based on presenting complaint

Goals & Objectives: Identify sick versus not-sick. Identify the most l ikely diagnosis and generates a differential diagnosis. Implements an effective treatment plan.

(N/A)Rarely

(↓ AVERAGE)

Some of the time

(AVERAGE)

Most of the time

(↑ AVERAGE)

Uses all available medical information to develop a l ist of ranked differential diagnoses

Recognizes l imits of knowledge

37 | P a g e

Patient Care



Date: EM Level:





Effectively uses technology for patient care, medical communication and learning

Ensures transitions of care are accurately and efficiently communicatedDemonstrates abil ity to call on system resources to provide optimal health care

Employs task switching

Considers additional diagnoses for patient who is under observation and alters treatment plan accordinglyMakes correct decision regarding admission/discharge of patients

Uses available data to prioritize differential diagnoses to determine appropriate treatment planRecognizes in a timely fashion when further clinical intervention is necessary

Orders appropriate diagnostic studies

(N/A)Rarely

(↓ AVERAGE)

Some of the time

(AVERAGE)

Most of the time

(↑ AVERAGE)

Assists patients in navigating the healthcare system

Department of Emergency Medicine Shift Card - Patient Care/Management(Inform the attending at the start of your shift that they will be asked to complete this form)

1 2 3

Department of Emergency Medicine Shift Card - Patient Care/Management

Adheres to standards ensuring a safe working environment

Employs processes that optimize patient safety

Goals & Objectives: Prioritizes critical initial stabil ization. Performes a focused history and physical exam. Applies results of diagnostic testing. Determines a focused differential diagnosis and treatment plan. Implements an effective patient treatment plan. Provides patient education and appropriate discharge instructions.

38 | P a g e

Interpersonal Skills and Communication

During todays shift you did the following well:


Date: EM Level:




All the time(EXCELLENT)(N/A)

Rarely(↓ AVERAGE)

Some of the time

(AVERAGE)

Most of the time

(↑ AVERAGE)

Demonstrates respect for diversity, cultural, ethnic, spiritual, emotional and age-specific differences among patientsDemonstrates abil ity to communicate challenges such as drug seeking behavior, delivering bad news, unexpected outcomes, medical errors

Establishes rapport with and demonstrates empathy toward patients and their families

Elicits patient's reasons for seeking health care and l istens effectively to patients, families and all members of the healthcare team.

Communicates information to patients and families using verbal, nonverbal, written, and technological skil ls and confirms understanding

Participates as member of a health care team

Effectively communicates ED course and management plans to staff, physicians and other healthcare providers.

Negotiates, de-escalates and resolves conflicts

Goals & Objectives: Demonstrate interpersonal and communication skil ls. Communicate effectively with patients, families, and the public, across a broad range of socioeconomic and cultural backgrounds. Communicate effectively with physicians, other health professionals, and health related agencies. Work effectively as a member or leader of a health care team. Communicate sensitive issues or unexpected outcomes.

Department of Emergency Medicine Shift Card - Interpersonal Skills and Communication(Inform the attending at the start of your shift that they will be asked to complete this form)

1 2 3

Department of Emergency Medicine Shift Card - Interpersonal Skills and Communication

Evaluates the validity of a DNR order

Formulates sufficient admission or discharge plans and engages patient or surrogate to effectively implement plan

39 | P a g e

Practice Based Learning and Improvement



Date: EM Level:





Identifies and implements new knowledge, guidelines, standards, technologies or services

Recognizes l imits of knowledge

Correctly interprets results of diagnostic procedures

Participates in the education of patients, families, students, trainees, peers, and other health professionals

Interprets results of diagnostic studies, recognizing l imitations and seeking interpretive assistance when appropriate

Practices cost effetive ordering of diagnostic studies

Performs self-assessment

Department of Emergency Medicine Shift Card - Practice Based Learning & Improvement(Inform the attending at the start of your shift that they will be asked to complete this form)

1 2 3

Department of Emergency Medicine Shift Card - Practice Based Learning & Improvement

Leads team reflection

Goals & Objectives: Participates in performance improvement to optimize ED function, self-learning and patient care.

(N/A)Rarely

(↓ AVERAGE)

Some of the time

(AVERAGE)

Most of the time

(↑ AVERAGE)

Demonstrates evidence-based medicine

40 | P a g e

Professionalism



Date: EM Level:





Recommends strategies by which patient access to care can be improvedDemonstrates need for accurate patient care documentation

Listens effectively to patientsEnsures clear communication and respect among team members

Maintains patient confidentiality

Effectively communicates with patients and their families minimizing the potential for stress, conflict and misunderstanding

Demonstrates a will ingness to see patients throughout the entire shiftManages medical errors according to principles of responsibil ity and accountabil ity

Arrives on time and is prepared to workIs appropriately dressed

Goals & Objectives: Demonstrates a commitment to carrying out professional responsibil ities, adherence to ethical principles and sensitivity to a diverse patient population.

(N/A)Rarely

(↓ AVERAGE)

Some of the time

(AVERAGE)

Most of the time

(↑ AVERAGE)

Department of Emergency Medicine Shift Card - Professionalism

Department of Emergency Medicine Shift Card - Professionalism(Inform the attending at the start of your shift that they will be asked to complete this form)

1 2 3

41 | P a g e

Procedures

PROCEDURE PERFORMED:

Airway Management Wound Management

Anesthesia & Acute Pain Management Vascular Access

During the procedure selected above you did the following well:

During the procedure selected above you could have improved:

Date: EM Lev




Department of Emergency Medicine Shift Card - Procedures

Department of Emergency Medicine Shift Card - Procedures

1 2 3

Goals & Objectives: Performs indicated procedure on all appropriate patients, takes steps to avoid complications and recognizes the outcome and/or complications resulting from the procedure

(N/A)Rarely

(↓ AVERAGE)

Some of the time

(AVERAGE)

Most of the time

(↑ AVERAGE)

Obtains informed consent

Knows indications, contraindications, anatomic landmarks, equipment, anesthetic and procedural technique potential complications for common ED procedures

AIRWAY MGMT: Knows pharmacology agents for RSI including indications and contraindications

Identifies pertinent anatomy and/or physiology for the procedure

ANES/ACUTE PAIN: Performs pre sedation assessment, obtains informed consent, orders appropriate choice and dose of medications for procedural sedation

AIRWAY MGMT: Performs rapid sequence intubation in patients using airway adjuncts and implements post intubation management

WOUND MGMT: Performs simple wound repair using sterile technique, educates patients on appropriate outpatient wound care mgmt

VASC ACCESS: Demonstrates knowledge of indications, contraindications and complications for various vascular access modalities

WOUND MGMT: Performs complex wound repairs and/or manages a severe burn

VASC ACCESS: Accurately places a deep vein catheter

42 | P a g e

Annual Program Evaluation

[Subject Name]

[Subject Program]

[Evaluation Dates]

Evaluator

[Evaluator Name]

[Evaluator Program]

The mission of the residency is to train outstanding emergency physicians in an environment that is challenging, but fair and enjoyable. Please help us determine if we are achieving our goal.

1. Program Commitment and Support

Is the program succeeding in training outstanding Emergency Physicians?

Poor Below Average Satisfactory Above Average Excellent Outstanding N/A

Please comment on the strengths of the program

Comment

Remaining Characters: 5,000

What would make this a stronger training program?

Comment

43 | P a g e


2. Professional Standards

Are you treated fairly as a resident in this program?


Comments


3. Attitude & Motivation

Understanding that residency is difficult, are you enjoying the challenge?


3. Attitude & Motivation

What can we do to improve the joy of training while learning to excel as an ER doc?

Comment


44 | P a g e

Emergency Medicine Research Forum

2015 Presentations

Increasing the Completion Rate of an M4 Emergency Medicine Student Evaluation Form using a Mobile Electronic Platform Presenting Author: Maxwell Nanes, DO Co-Authors: Matthew Tews, DO; Robert Treat, PhD Assessment, Measurement, and Treatment of Pain by Emergency Medicine Services Presenting Author: Kari Haley, MD Co-Authors: E. Brooke Lerner, PhD; Ronald G. Pirrallo, MD, MHSA; Clare Guse, MS

A Comparison of the Accuracy of Mass Casualty Triage Schemes Presenting Author: Courtney McKee, BS Co-Authors: Brian Willenbring, BA, NREMT-B; E. Brooke Lerner, PhD; Ronald Pirrallo, MD, MHSA, FACEP; Richard Schwartz, MD, FACEP Positive Association between Ondansetron and Significant Cardiac Events in Adult and Elderly Hospitalized Patients Presenting Author: Mengda Zhang, JMS Co-Authors: Aniko Szabo, PhD; David D. Gummin, MD; Amy E. Zosel, MD, MSCS Positive Association between Ondansetron and Significant Cardiac Events in Adult and Elderly Hospitalized Patients Presenting Author: Mengda Zhang, JMS Co-Authors: Aniko Szabo, PhD; David D. Gummin, MD; Amy E. Zosel, MD, MSCS 2015 Posters

Case Control Study Identifying Factors Associated with Death within 48 Hours of Admission to the Emergency Department Presenting Author: Jamie Aranda, MD Co-Authors: Matt Borgo, MD; Ying Zhang, PhD; Caroline Pace, MD A Survey of the Language of Satisfaction in Children Presenting Author: Molly Pilarski, MD Co-Authors: Connie Truong, MD; Amy L. Drendel, DO, MS Emergency Medicine Ultrasonography: A Pilot Survey of Point-of-Care Ultrasound Use by Emergency Physicians in Milwaukee County Presenting Author: Stephanie Dreher, MD, MCWAH Co-Authors: Caroline Pace, MD Use of Fibrinolysis in Acute Pulmonary Embolism Presenting Author: Shanna Paul, MD Co-Authors: Alicia M. Pilarski, DO

45 | P a g e

Mass Gathering, Mass Casualty and Incident Command Presenting Author: Craig Bilbrey, MD Co-Authors: E. Brooke Lerner, PhD; Timothy Lenz, MD

new faculty orientation manual · education service line – primary contacts.....6 . faculty...

Documents