Volume 16, Issue 6, November 2015.
Mark Favot, MD, et al.
Introduction: The curriculum in most emergency medicine (EM) clerkships includes very little
formalized training in point-of-care ultrasound. Medical schools have begun to implement ultrasound
training in the pre-clinical curriculum, and the EM clerkship is an appropriate place to build upon this
training. The objectives are (1) to evaluate the effectiveness of implementing a focused ultrasound
curriculum within an established EM clerkship and (2) to obtain feedback from medical students
regarding the program.
Methods: We conducted a prospective cohort study of medical students during an EM clerkship
year from July 1, 2011, to June 30, 2012. Participants included fourth-year medical students
(n=45) enrolled in the EM clerkship at our institution. The students underwent a structured program
focused on the focused assessment with sonography for trauma exam and ultrasound-guided
vascular access. At the conclusion of the rotation, they took a 10-item multiple choice test assessing
knowledge and image interpretation skills. A cohort of EM residents (n=20) also took the multiple
choice test but did not participate in the training with the students. We used an independent samples
t-test to examine differences in test scores between the groups.
Results: The medical students in the ultrasound training program scored significantly higher on
the multiple-choice test than the EM residents, t(63)=2.3, p<0.05. The feedback from the students
indicated that 82.8% were using ultrasound on their current rotations and the majority (55.2%) felt
that the one-on-one scanning shift was the most valuable aspect of the curriculum.
Discussion: Our study demonstrates support for an ultrasound training program for medical
students in the EM clerkship. After completing the training, students were able to perform similarly to
EM residents on a knowledge-based exam.
Volume 16, Issue 6, November 2015.
Mira Mamtani, MD, et al.
Graduate medical education is increasingly focused on patient safety and quality improvement; training
programs must adapt their curriculum to address these changes. We propose a novel curriculum for
emergency medicine (EM) residency training programs specifically addressing patient safety, systemsbased
management, and practice-based performance improvement, called “EM Debates.” Following
implementation of this educational curriculum, we performed a cross-sectional study to evaluate the
curriculum through resident self-assessment. Additionally, a cross-sectional study to determine the
ED clinical competency committee’s (CCC) ability to assess residents on specific competencies was
performed. Residents were overall very positive towards the implementation of the debates. Of those
participating in a debate, 71% felt that it improved their individual performance within a specific topic,
and 100% of those that led a debate felt that they could propose an evidence-based approach to
a specific topic. The CCC found that it was easier to assess milestones in patient safety, systemsbased
management, and practice-based performance improvement (sub-competencies 16, 17,
and 19) compared to prior to the implementation of the debates. The debates have been a helpful
venue to teach EM residents about patient safety concepts, identifying medical errors, and process
improvement.
Volume 16, Issue 6, November 2015.
Joseph House, MD, et al.
Introduction: Faculty educational contributions are hard to quantify, but in an era of limited
resources it is essential to link funding with effort. The purpose of this study was to determine the
feasibility of an educational value unit (EVU) system in an academic emergency department and
to examine its effect on faculty behavior, particularly on conference attendance and completion of
trainee evaluations.
Methods: A taskforce representing education, research, and clinical missions was convened
to develop a method of incentivizing productivity for an academic emergency medicine faculty.
Domains of educational contributions were defined and assigned a value based on time expended.
A 30-hour EVU threshold for achievement was aligned with departmental goals. Targets included
educational presentations, completion of trainee evaluations and attendance at didactic conferences.
We analyzed comparisons of performance during the year preceding and after implementation.
Results: Faculty (N=50) attended significantly more didactic conferences (22.7 hours v. 34.5
hours, p<0.005) and completed more trainee evaluations (5.9 v. 8.8 months, p<0.005). During
the pre-implementation year, 84% (42/50) met the 30-hour threshold with 94% (47/50) meeting
post-implementation (p=0.11). Mean total EVUs increased significantly (94.4 hours v. 109.8 hours,
p=0.04) resulting from increased conference attendance and evaluation completion without a change
in other categories.
Conclusion: In a busy academic department there are many work allocation pressures. An EVU
system integrated with an incentive structure to recognize faculty contributions increases the
importance of educational responsibilities. We propose an EVU model that could be implemented
and adjusted for differing departmental priorities at other academic departments.
