Establishing an Elective Rotation Director and Its Effect on Elective Opportunities and Satisfaction

Elective rotations are valuable, allowing trainees to personalize their educational experience, focuson areas of weakness, and offer personal and professional development. Emergency medicine(EM) residency program elective rotations may be limited due to the absence of awareness ofopportunities and administrative support. We sought to increase the breadth of elective rotationopportunities, improve residents’ satisfaction with their elective rotations, and enhance theopportunities for clinical training. To increase the breadth of our elective rotation opportunities, weestablished an elective rotation director—a dedicated faculty member to aid in elective planningand provide administrative support. This faculty member met with all residents during their secondyear, coordinated new electives with the graduate medical education office, and assisted withadministrative tasks. Ten new rotations (two local, five domestic away, three international away)were established during the position’s first two years, increasing available rotations from nine to 19.A survey was sent to graduates of the program two years before and two years after the positionwas established to inquire about their elective experience. Of 64 graduates, 49 (76.6%) participatedin the survey. Graduates exposed to the dedicated faculty member reported increased exposure tonovel learning environments (p<0.001), improved wellness (p<0.001), and were more likely than predirectorgraduates to choose the same elective rotation (p=0.006). Programs with multiple electiverotations may benefit more from this position, but additional resources may be needed given theassociated increase in administrative time

Establishing an Elective Rotation Director and Its Effect on Elective Opportunities and Satisfaction

Elective rotations are valuable, allowing trainees to personalize their educational experience, focuson areas of weakness, and offer personal and professional development. Emergency medicine(EM) residency program elective rotations may be limited due to the absence of awareness ofopportunities and administrative support. We sought to increase the breadth of elective rotationopportunities, improve residents’ satisfaction with their elective rotations, and enhance theopportunities for clinical training. To increase the breadth of our elective rotation opportunities, weestablished an elective rotation director—a dedicated faculty member to aid in elective planningand provide administrative support. This faculty member met with all residents during their secondyear, coordinated new electives with the graduate medical education office, and assisted withadministrative tasks. Ten new rotations (two local, five domestic away, three international away)were established during the position’s first two years, increasing available rotations from nine to 19.A survey was sent to graduates of the program two years before and two years after the positionwas established to inquire about their elective experience. Of 64 graduates, 49 (76.6%) participatedin the survey. Graduates exposed to the dedicated faculty member reported increased exposure tonovel learning environments (p<0.001), improved wellness (p<0.001), and were more likely than predirectorgraduates to choose the same elective rotation (p=0.006). Programs with multiple electiverotations may benefit more from this position, but additional resources may be needed given theassociated increase in administrative time

The Council of Emergency Medicine Residency Directors Academy for Scholarship Coaching Program: Addressing the Needs of Academic Emergency Medicine Educators

Introduction: Didactic lectures remain fundamental in academic medicine; however, many faculty physicians do not receive formal training in instructional delivery. In order to design a program to instill and enhance lecture skills in academic emergency medicine (EM) physicians we must first understand the gap between the current and ideal states. Methods: In 2012 the Council of Emergency Medicine Residency Directors (CORD) Academy for Scholarship designed a novel coaching program to improve teaching skills and foster career development for medical educators based on literature review and known teaching observation programs. In order to inform the refinement of the program, we performed a needs assessment of participants. Participants’ needs and prior teaching experiences were gathered from self-reflection forms completed prior to engaging in the coaching program. Two independent reviewers qualitatively analyzed data using a thematic approach. Results: We analyzed data from 12 self-reflection forms. Thematic saturation was reached after nine forms. Overall inter-rater agreement was 91.5%. We categorized emerging themes into three domains: participant strengths and weaknesses; prior feedback with attempts to improve; and areas of desired mentorship. Several overlapping themes and subthemes emerged including factors pertaining to the lecturer, the audience/learner, and the content/delivery. Conclusion: This study identified several areas of need from EM educators regarding lecture skills. These results may inform faculty development efforts in this area. The authors employed a three-phase, novel, national coaching program to meet these needs

The Council of Emergency Medicine Residency Directors Academy for Scholarship Coaching Program: Addressing the Needs of Academic Emergency Medicine Educators

Introduction: Didactic lectures remain fundamental in academic medicine; however, many faculty physicians do not receive formal training in instructional delivery. In order to design a program to instill and enhance lecture skills in academic emergency medicine (EM) physicians we must first understand the gap between the current and ideal states.Methods: In 2012 the Council of Emergency Medicine Residency Directors (CORD) Academy for Scholarship designed a novel coaching program to improve teaching skills and foster career development for medical educators based on literature review and known teaching observation programs. In order to inform the refinement of the program, we performed a needs assessment of participants. Participants’ needs and prior teaching experiences were gathered from self-reflection forms completed prior to engaging in the coaching program. Two independent reviewers qualitatively analyzed data using a thematic approach.Results: We analyzed data from 12 self-reflection forms. Thematic saturation was reached after nine forms. Overall inter-rater agreement was 91.5%. We categorized emerging themes into three domains: participant strengths and weaknesses; prior feedback with attempts to improve; and areas of desired mentorship. Several overlapping themes and subthemes emerged including factors pertaining to the lecturer, the audience/learner, and the content/delivery.Conclusion: This study identified several areas of need from EM educators regarding lecture skills. These results may inform faculty development efforts in this area. The authors employed a three-phase, novel, national coaching program to meet these needs

Coaching educators: Impact of a novel national faculty development program for didactic presentation skills

BackgroundDidactic lectures remain common in medical education. Many faculty physicians do not receive formal training on public presentations or leading instructional sessions. Coaching has emerged in medical education with the potential to positively impact skills. We sought to evaluate a novel, national faculty peer-coaching program created to improve lecture presentation skills and foster career development.MethodsThis was a mixed-methods study of participant and faculty perceptions after completing the Council of Residency Directors in Emergency Medicine Academy Coaching Program. Participants completed an online evaluative survey consisting of multiple choice and Likert-type items. Program coaches participated in semistructured interviews. Descriptive statistics were reported for survey data. Thematic qualitative analysis by two independent reviewers was performed on interview data.ResultsDuring 2012 to 2017, a total of 30 participants and 11 coaches from 37 residency programs across the United States engaged in the program. Twenty-four (80%) participants completed the survey. Eight (73%) coaches participated in semistructured interviews. Data were collected between October and December 2018. The mean ± SD numbers of national presentations participants had given before and after the coaching program were 6.92 ± 7.68 and 16.42 ± 15.43, respectively. Since their coaching, most participants (87.5%) have been invited to give a lecture at another institution. Many participants felt that the program improved their lecture evaluations, public speaking, ability to engage an audience, and professional development. Almost all (92%) would recommend the program to a colleague. The coaches perceived multiple benefits including improved skills, self-reflection, networking, career advancement, and personal fulfillment. Suggestions for improvement included improved administrative processes, more clear expectations, increased marketing, and increased participant and coach engagement.ConclusionParticipants and coaches perceived multiple benefits from this novel, national faculty coaching program. With identification of the success, challenges, and suggestions for improvement, others may benefit as they develop coaching programs in medical education

The Council of Emergency Medicine Residency Directors’ (CORD) Academy for Scholarship in Education in Emergency Medicine: A Five-Year Update

The Council of Emergency Medicine Residency Directors’ (CORD) Academy for Scholarship in Education in Emergency Medicine was founded in 2010 to support emergency medicine educators, advance educational methods and scholarship in Emergency Medicine, and foster collaboration among members. As one of the first academies housed in a specialty organization, the CORD Academy concept has been successfully implemented, and has now grown to thirty members in the categories of Distinguished Educator, Academy Scholar, and Academy Member in four focus areas (Teaching and Evaluation; Enduring Educational Materials, Educational Leadership, and Education Research). In this update, the Academy leadership describes the revised academy structure, evolution of the application, and reports the activities of the three Academy pillars – membership/awards/recognition; faculty development and structured programs; and education research and scholarship – in the first five years of the Academy

Adaptive introgression of the beta-globin cluster in two Andean waterfowl

Introgression of beneficial alleles has emerged as an important avenue for genetic adaptation in both plant and animal populations. In vertebrates, adaptation to hypoxic high-altitude environments involves the coordination of multiple molecular and cellular mechanisms, including selection on the hypoxia-inducible factor (HIF) pathway and the blood-O transport protein hemoglobin (Hb). In two Andean duck species, a striking DNA sequence similarity reflecting identity by descent is present across the ~20 kb β-globin cluster including both embryonic (HBE) and adult (HBB) paralogs, though it was yet untested whether this is due to independent parallel evolution or adaptive introgression. In this study, we find that identical amino acid substitutions in the β-globin cluster that increase Hb-O affinity have likely resulted from historical interbreeding between high-altitude populations of two different distantly-related species. We examined the direction of introgression and discovered that the species with a deeper mtDNA divergence that colonized high altitude earlier in history (Anas flavirostris) transferred adaptive genetic variation to the species with a shallower divergence (A. georgica) that likely colonized high altitude more recently possibly following a range shift into a novel environment. As a consequence, the species that received these β-globin variants through hybridization might have adapted to hypoxic conditions in the high-altitude environment more quickly through acquiring beneficial alleles from the standing, hybrid-origin variation, leading to faster evolution