Clinical teaching: An evidence-based guide to best practices from the Council of Emergency Medicine Residency Directors

Clinical teaching is the primary educational tool use to train learners from day one of medical school all the way to the completion of fellowship. However, concerns over time constraints and patient census have led to a decline in bedside teaching. This paper provides a critical review of the literature on clinical teaching with a focus on instructor teaching strategies, clinical teaching models, and suggestions for incorporating technology. Recommendations for instructor-related teaching factors include adequate preparation, awareness of effective teacher attributes, using evidence-based-knowledge dissemination strategies, ensuring good communication, and consideration of environmental factors. Proposed recommendations for potential teaching strategies include the Socratic method, the One-Minute Preceptor model, SNAPPS, ED STAT, teaching scripts, and bedside presentation rounds. Additionally, this article will suggest approaches to incorporating technology into clinical teaching, including just-in-time training, simulation, and telemedical teaching. This paper provides readers with strategies and techniques for improving clinical teaching effectiveness

Development and Implementation of the Bring Your Own Water Treatment System in Dense, Rural, and Mountainous Rwandan Communities

Over a billion people in the world lack access to safe drinking water1. While numerous technological, medical, and educational solutions have been implemented for the benefit of disadvantaged communities, there is no \u27magic bullet\u27. Instead, development agencies must partner directly with these communities to address their public health needs through appropriate technology solutions, backed up by education and assessment. The Bring Your Own Water (BYOW) Treatment System developed by the Engineers Without Borders-USA chapters at the University of Colorado at Boulder Chapter (EWB-CU) and the Johnson Space Center (EWB-JSC) is uniquely designed to address the water treatment requirements of two poor and overpopulated Rwandan communities. The BYOW system consists of a gravity-fed roughing filter, rapid sand filter, and solar-powered ultraviolet irradiation system. The BYOW system treats water collected in containers by local residents from any contaminated or suspect source. A key component is a self-filling tank for backwashing of the filter. The system treats water at a rate of approximately 10 liters per minute, and can provide up to 5,000 liters of treated water per day. The BYOW system performed successfully in long term tests in Houston, Texas. Activated sludge collected from a municipal sewage plant (over 70 NTU turbidity, 3,000 CFU/ml E. Coli) was introduced as input. The BYOW-treated effluent water was significantly cleaner (less than one NTU, 0-2 CFU/ml E. Coli). A system installed in Muramba in 2006 was well accepted by users. A second iteration with significant improvements was installed in Mugonero in 2007. After two months of community testing, water quality results indicate that rainwater passed through the Mugonero BYOW system was reduced from up to 60 CFUs/ml coliform bacteria and up to 4.5 NTU turbidity to zero CFUs/ml and less than 2.25 NTU. The BYOW system has the potential to be replicated around the world where communities have similar water treatment requirements, and no available treatment infrastructure or surplus energy resources

Journal Club in Residency Education: An Evidence-based Guide to Best Practices from the Council of Emergency Medicine Residency Directors

Journal clubs are an important tool for critically appraising articles and keeping up-to-date with the current literature. This paper provides a critical review of the literature on the design and structure of journal clubs in residency education with a focus on preparation, topic selection, implementation, and integration of technology. Recommendations for preparation include developing clearly defined goals and objectives that are agreed upon by all journal club participants; mentorship from experienced faculty members to ensure appropriate article selection, maintenance of structure, and applicability to objectives; distribution of articles to participants 1–2 weeks prior to the scheduled session with reminders to read the articles at predetermined intervals; and the use of a structured critical appraisal tool for evaluating the articles. Recommendations for topic selection include selecting a primary objective of either critical appraisal or informing clinical practice and ensuring that the articles align with the objective; involving learners in the topic- and article-selection process; and having the article selection driven by a specific clinical question. Recommendations for implementation include hosting sessions in the evening and away from the hospital environment; providing food to participants; hosting meetings on a monthly basis at regularly scheduled intervals; mandating journal club attendance; and using theories of adult learning. Recommendations for integration of technology include using previously established, effective strategies and determining the feasibility of creating an online journal club versus joining an established journal club. It is the authors’ intention that after reading this paper readers will have new strategies and techniques for implementing and running a journal club at their home institutions

Journal Club in Residency Education: An Evidence-based Guide to Best Practices from the Council of Emergency Medicine Residency Directors

Journal clubs are an important tool for critically appraising articles and keeping up-to-date with the current literature. This paper provides a critical review of the literature on the design and structure of journal clubs in residency education with a focus on preparation, topic selection, implementation, and integration of technology. Recommendations for preparation include developing clearly defined goals and objectives that are agreed upon by all journal club participants; mentorship from experienced faculty members to ensure appropriate article selection, maintenance of structure, and applicability to objectives; distribution of articles to participants 1-2 weeks prior to the scheduled session with reminders to read the articles at predetermined intervals; and the use of a structured critical appraisal tool for evaluating the articles. Recommendations for topic selection include selecting a primary objective of either critical appraisal or informing clinical practice and ensuring that the articles align with the objective; involving learners in the topic- and article-selection process; and having the article selection driven by a specific clinical question. Recommendations for implementation include hosting sessions in the evening and away from the hospital environment; providing food to participants; hosting meetings on a monthly basis at regularly scheduled intervals; mandating journal club attendance; and using theories of adult learning. Recommendations for integration of technology include using previously established, effective strategies and determining the feasibility of creating an online journal club versus joining an established journal club. It is the authors’ intention that after reading this paper readers will have new strategies and techniques for implementing and running a journal club at their home institutions

A Novel Approach to Neonatal Resuscitation Education for Senior Emergency Medicine Residents

The majority of pediatric visits occur in general emergency departments. Caring for critically ill neonates is a low-frequency but high-stakes event for emergency physicians, which requires specialized knowledge and hands-on training. We describe a novel clinical rotation for emergency medicine (EM) residents that specifically augments skills in neonatal resuscitation through direct participation as a member of the neonatal resuscitation team. The neonatal resuscitation rotation evaluation median score of 4 (interquartile range [IQR] 3,4) was higher compared to all other off-service senior resident rotations combined (median 3, IQR 3,4) for the academic year 2018-2019. Ninety-two percent of residents evaluated the curriculum change as beneficial (median 4, IQR 4,4). The neonatal resuscitation rotation was rated more favorably than the pediatric intensive care rotation (median 4 IQR 3,4 vs median 3, IQR 2, 3) at a tertiary care children’s hospital during the third year. Residency programs may want to consider implementing a directed neonatal resuscitation experience as part of a comprehensive pediatric curriculum for EM residents

A Novel Approach to Neonatal Resuscitation Education for Senior Emergency Medicine Residents

The majority of pediatric visits occur in general emergency departments. Caring for critically ill neonates is a low-frequency but high-stakes event for emergency physicians, which requires specialized knowledge and hands-on training. We describe a novel clinical rotation for emergency medicine (EM) residents that specifically augments skills in neonatal resuscitation through direct participation as a member of the neonatal resuscitation team. The neonatal resuscitation rotation evaluation median score of 4 (interquartile range [IQR] 3,4) was higher compared to all other off-service senior resident rotations combined (median 3, IQR 3,4) for the academic year 2018-2019. Ninety-two percent of residents evaluated the curriculum change as beneficial (median 4, IQR 4,4). The neonatal resuscitation rotation was rated more favorably than the pediatric intensive care rotation (median 4 IQR 3,4 vs median 3, IQR 2, 3) at a tertiary care children’s hospital during the third year. Residency programs may want to consider implementing a directed neonatal resuscitation experience as part of a comprehensive pediatric curriculum for EM residents