To remedy the lack of objective data when assessing the pharmacotherapy sub-competency (PC5) we introduced a unique approach that actively involves departmental clinical pharmacists in determining the milestone level achieved by the resident.
Burnout, depression, and suicidality among residents across all specialties have become a critical focus of attention for the medical education community. Prevalence studies have revealed rates of burnout among residents to be as high as 76%, as measured by the Maslach Burnout Inventory (MBI).
Through a joint collaboration involving Academic Life in Emergency Medicine’s (ALiEM) Wellness Think Tank, Essentials of Emergency Medicine (EEM), and the Emergency Medicine Residents’ Association (EMRA), a one-day Resident Wellness Consensus Summit (RWCS) was organized.
We set out to determine the feasibility of using third-year medical students’ action learning projects (QI projects) to expedite implementation of evidence-based pathways for three common patient diagnoses in the ED setting as well as develop a model for promoting bidirectional alignment at an institutional level. We further evaluated clinician perspectives on using medical students at the forefront of QI pathway development.
Volume 17, Issue 3, May 2016
Ryan Miller, BS et al.
Introduction: Over the past decade, medical students have witnessed a decline in the
opportunities to perform technical skills during their clinical years. Ultrasound-guided central
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venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine,
anesthesia, and general surgery residents, often during their first month of residency. However, the
acquisition of skills required to safely perform this procedure is often deficient upon graduation from
medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have
been introduced into undergraduate medical education to train venous access skills. Criticisms of
simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical
variances when compared to living patients. The purpose of our investigation was to design and
evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver.
Methods: This was a cross-sectional study at an urban academic medical center. An 18-point
procedural knowledge tool and an 18-point procedural skill evaluation tool were administered
during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver
lab, procedure naïve third-year medical students were trained on how to perform ultrasoundguided
central venous access of the femoral and internal jugular vessels. Preparation of the fresh
cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the
femoral and internal jugular vein respectively.
Results: Fifty-six third-year medical students participated in this study during their surgical
clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite
numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12
(p<0.001) and procedural knowledge scores improved from an average score of 4 to 8 (p<0.001).
Conclusion: The use of this novel cadaver model prevented extravasation of fluid, maintained
ultrasound-imaging quality, and proved to be an effective educational model allowing third-year
medical students to improve and maintain their technical skills.
Emergency medicine (EM) is a young specialty and only recently has a recommended medical student curriculum been developed. Currently, many schools do not require students to complete a mandatory clerkship in EM, and if one is required, it is typically an overview of the specialty.