Authors: Eric Shappell, MD – University of Chicago and James Ahn, MD – University of Chicago
Recent publication finds EM residents value training level-specific teaching, highlights topics of interest and desired teaching methods
No one would disagree that educational content appropriate for a PGY-1 resident has limited overlap with that of a PGY-3 or -4 resident, or vice versa. Why then are most didactics delivered to residents of all training levels? Sure, the occasional grand rounds or guest speaker may be high-impact enough to warrant the participation of all levels of training, but for the majority of topics presenters likely spend their time alternating between flying over the heads of some learners and dropping to a level too basic for others. Given how bizarre this combined approach would seem at any prior education level (e.g. MS2s and MS4s), it is strange that this practice is so common in the graduate medical education setting. This convention likely remains so prevalent more as a result of the administrative burden of developing and implementing two or more separate curricula than it does anyone’s belief that it is actually the best method of instruction. We aim to relieve this burden of level-specific education by developing a nationally-scalable intern curriculum, the first step of which was conducting the needs assessment described in our recently published manuscript.
The purpose of this needs assessment was threefold:
- Determine if residents perceived a dedicated intern curriculum as a valuable contribution to resident education
- Determine the preferred educational strategies for a dedicated intern curriculum for the current generation of learners
- Establish a list of topics residents believe should be included in a dedicated intern curriculum
To answer these questions, we surveyed all emergency medicine residents in the Chicagoland area (n = 300, 51% response rate) which includes representation from academic, county, and community programs. The overwhelming majority of residents believed an intern curriculum would add value to education, and comments in the open-ended portion of the survey included sentiments such as “I wish this was in place when I started residency.” Residents were also keen on hands-on experiences such as simulation and preferred dedicated asynchronous resources (e.g. FOAM and custom reference materials) to textbook readings. These findings are in line with recent interpretations of preferred learning strategies for millennials.
Image source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5226759/
These results advocating for intern curricula are all well and good in theory, but the aforementioned administrative burden of turning this theory into practice must be addressed. There are now multiple robust resources that can significantly lower the burden of entry for programs interested in deploying an intern curriculum at their site. In fact, two rapidly developing resources are explicitly designed for this purpose: EM Fundamentals and Emergency Medicine Foundations. Both of these resources host online content for learners to review prior to small group sessions in addition to offering ready-to-go materials for small group activities including facilitator guides for program leadership. These resources may be used together to implement a dynamic flipped-classroom curriculum for interns with minimal administrative effort.
This study confirms that residents value training level-specific education for interns that is rooted in hands-on experiences, non-textbook educational materials, and high-yield topics. The administrative burden of developing such a curriculum is significant, however adoption of an existing open-access curricular resource such as EM Fundamentals or Emergency Medicine Foundations can considerably reduce the effort required for local implementation.
Shappell E, Ahn J. A Needs Assessment for a Longitudinal Emergency Medicine Intern Curriculum. West J Emerg Med. 2017;18(1):31-34.
Eric Shappell, MD (@ericshappell) is Clinical Associate and Medical Education Fellow in the Section of Emergency Medicine at the University of Chicago Pritzker School of Medicine (@UChicagoEM). Eric is the Editor-in-Chief of EMFundamentals.com (@EMFundamentals) and Associate Editor of Multimedia Content at EmergencyMedicineFoundations.com.
James Ahn, MD (@ahnjam) is Assistant Professor, Associate Residency Director, and Medical Education Fellowship Director in the Section of Emergency Medicine at the University of Chicago Pritzker School of Medicine (@UChicagoEM). James is the Senior Advisor for EMFundamentals.com (@EMFundamentals).