Implementation of a Medical Education Rotation for Senior Emergency Medicine Residents.

AUDIENCE AND TYPE OF CURRICULUM

This medical education (MedEd) rotation is designed for post graduate year 3 (PGY-3) residents.

LENGTH OF CURRICULUM

The rotation runs over one month for each PGY-3.

INTRODUCTION

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.

EDUCATIONAL GOALS

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.

EDUCATIONAL METHODS

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.

RESEARCH METHODS

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.

RESULTS

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).

DISCUSSION

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.

TOPICS

Medical Education, resident physician, medical student teaching, simulation, academic medicine.