Bengiamin Deena Ibrahim, Fierro Lizveth, Estes Molly, Kiemeney Michael, Young Timothy Patrick
Laboratory for Innovations in Medical Education, Loma Linda University School of Medicine, Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, CA.
J Educ Teach Emerg Med. 2021 Jul 15;6(3):C1-C8. doi: 10.21980/J8BH17. eCollection 2021 Jul.
This medical education (MedEd) rotation is designed for post graduate year 3 (PGY-3) residents.
The rotation runs over one month for each PGY-3.
Resident physicians have teaching responsibilities during and after training. These responsibilities expand beyond teaching medical students and junior residents to include teaching advanced practice providers, nursing colleagues, and prehospital personnel.1 The need for formal teaching curricula in graduate medical education is recognized, but practical examples are lacking.2.
Our objectives were to provide our senior residents with exposure to various aspects of the field of MedEd, to further develop their teaching skills and to encourage them to consider a career in academic emergency medicine.
The educational strategies used in this curriculum include 1) clinical shifts supervising small groups of medical students with dedicated faculty supervision, 2) a structured simulation-based medical student teaching activity where the resident is able to provide feedback and teach medical students, 3) a MedEd project, 4) required readings that cover a variety of topics including education theory, curriculum design, and feedback, 5) case-based didactic presentation at our monthly case conference, and 6) one hour of postgraduate year 1 (PGY-1) small group facilitation focusing on fundamentals of emergency medicine.
PGY-3 residents completed an online survey prior to residency graduation. The timing of the survey was purposefully delayed to the end of the academic year to allow the residents time to practice techniques they learned during their MedEd rotation.
Thirteen residents (93%) completed a survey. Five residents (38%) reported that the rotation had "some" or more impact on their career decision. The other 8 residents reported "almost no impact" or "a little bit of impact." Ten residents (77%) reported that they would "sometimes," "often," or "almost always" use the teaching techniques they learned during the rotation. The highest rated activities were simulation-based teaching and dedicated clinical teaching shifts. Confidence with bedside teaching improved after the session, with a median confidence before the session of 3/5 (moderately confident; IQR 2-3) and a median confidence after the session of 4/5 (quite confident; IQR 3-4, p=0.006).
Our MedEd rotation improved teaching confidence but had low impact on career decision. Residents rated the interactive, faculty-supervised components of the rotation highest. We recommend that programs interested in instituting a MedEd rotation first trial the rotation as an elective and utilize established formal teaching activities.
Medical Education, resident physician, medical student teaching, simulation, academic medicine.
本次医学教育（MedEd）轮转专为三年级住院医师（PGY - 3）设计。
每位PGY - 3的轮转为期一个月。
住院医师在培训期间及之后都有教学职责。这些职责不仅包括教授医学生和低年级住院医师，还涵盖教授高级实践提供者、护理同事和院前急救人员。1人们认识到在毕业后医学教育中需要正式的教学课程，但缺乏实际范例。2
我们的目标是让高年级住院医师接触医学教育领域的各个方面，进一步提升他们的教学技能，并鼓励他们考虑从事学术急诊医学职业。
本课程采用的教育策略包括：1）在有专门教员监督的情况下，临床轮班指导一小批医学生；2）开展基于模拟的结构化医学生教学活动，住院医师能够提供反馈并教授医学生；3）一个医学教育项目；4）涵盖教育理论、课程设计和反馈等各种主题的必读材料；5）在我们每月的病例讨论会上进行基于病例的理论讲解；6）一小时针对一年级住院医师（PGY - 1）的小组辅导，重点是急诊医学基础。
PGY - 3住院医师在住院医师培训毕业前完成了一项在线调查。调查时间特意推迟到学年末，以便住院医师有时间实践他们在医学教育轮转期间学到的技巧。
13名住院医师（93%）完成了调查。5名住院医师（38%）报告称该轮转对他们的职业决策有“一定”或更大影响。其他8名住院医师报告“几乎没有影响”或“有一点影响”。10名住院医师（77%）报告他们会“有时”“经常”或“几乎总是”使用他们在轮转期间学到的教学技巧。评价最高的活动是基于模拟的教学和专门的临床教学轮班。培训后床边教学的信心有所提高，培训前信心中位数为3/5（中等信心；四分位间距2 - 3），培训后信心中位数为4/5（相当有信心；四分位间距3 - 4，p = 0.006）。
我们的医学教育轮转提高了教学信心，但对职业决策的影响较小。住院医师对轮转中互动性强、有教员监督的部分评价最高。我们建议，对开展医学教育轮转感兴趣的项目首先将该轮转作为选修课进行试点，并采用既定的正式教学活动。
医学教育、住院医师、医学生教学、模拟、学术医学。
