Emergency medicine residency programs around the country develop didactic conferences to prepare residents for board exams and independent practice. To our knowledge, there is not currently an evidence-based set of guidelines for programs to follow to ensure maximal benefit of didactics for learners. This paper offers expert guidelines for didactic instruction from members of the Council of Emergency Medicine Residency Directors Best Practices Subcommittee, based on best available evidence. Programs can use these recommendations to further optimize their resident conference structure and content. Recommendations in this manuscript include best practices in formatting didactics, selection of facilitators and instructors, and duration of individual sessions. Authors also recommend following the Model of Clinical Practice of Emergency Medicine when developing content, while incorporating sessions dedicated to morbidity and mortality, research methodology, journal article review, administration, wellness, and professionalism.
Lectures are a common instructional method in medical education. Understanding the cognitive processes and theories involved in learning is essential for lecturers to be effective. Cognitive load theory is one theory that is becoming increasingly recognized in medical education and addresses the appropriate use of one's working memory. Memory is essential to knowledge acquisition. Two types of memory can be considered, working memory (processing of information) and long-term memory (storage of information). Working memory has a limited capacity. Cognitive load refers to the amount of information processing activity imposed on working memory and can be divided into three domains: intrinsic, extraneous, and germane. By attending to cognitive load, educators can promote learning. This paper highlights various ways of improving cognitive load for learners during lecture-based instruction by minimizing extraneous load, optimizing intrinsic load, and promoting germane load.
Postresidency career choices are complex decisions that involve personal, professional, and financial preferences and may be influenced by training programs. It is unknown how residents navigate these decisions during emergency medicine (EM) residency. We explored EM residents' perspectives on career decision making and how residency programs can support career planning.
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.
COVID necessitated the shift to virtual resident instruction. The challenge of learning via virtual modalities has the potential to increase cognitive load. It is important for educators to reduce cognitive load to optimize learning, yet there are few available tools to measure cognitive load. The objective of this study is to identify and provide validity evidence following Messicks' framework for an instrument to evaluate cognitive load in virtual emergency medicine didactic sessions.
Abstract Background Scholarly tracks typically consist of longitudinal subspecialty‐specific curricula and mentorship for residents. Roughly one in five emergency medicine (EM) residency programs offer scholarly tracks, allowing residents to explore a niche and develop skills to prepare them for their future careers. There is limited information on the faculty workforce that leads scholarly tracks. Our objective was to understand the workforce characteristics of EM track leaders, specifically their effort and compensation. Methods We performed a cross‐sectional survey study of EM scholarly track leaders who were identified by reviewing program websites and directly contacting program coordinators. Participants completed an electronic survey consisting of multiple‐choice and completion items. We calculated descriptive statistics. Results There were 112 of 276 (40%) track leaders who completed the survey, including 63 (57.3%) males and 47 (42.7%) females. The mean (±SD) age was 42.6 (±7.5) years. A majority (62.5%) had completed fellowship. Participants supervise a mean of 2.6 residents per year and spend a median (range) of 7.6 (4–10.7) hours per month on track activities. A total of 57.1% of participants received no compensation for their role. Nonmonetary benefits included career satisfaction (87.6%), intellectual stimulation (76.4%), departmental recognition (41.6%), and increased scholarly productivity (33.7%). Overall, 71.7% of faculty track leaders would recommend the role to a colleague. Conclusions This study characterizes the current EM scholarly track leader workforce in terms of demographics, activities, time and effort, and compensation. It sheds light on this key educational role and on the opportunity to provide better support to faculty track leaders. These results may inform decision making of current and would‐be scholarly track leaders as well as institutional leadership.
On the basis of the tripartite mission of patient care, research, and education, a need has arisen to better support faculty in non-revenue-generating activities, such as education. As a result, some programs have developed education value unit (EVU) systems to incentivize these activities. The purpose of this scoping review is to analyze the existing literature on EVUs to identify current structures and future directions for research.The authors conducted a literature search of 5 databases without restrictions, searching for any articles on EVU systems published from database inception to January 12, 2022. Two authors independently screened articles for inclusion. Two authors independently extracted data and all authors performed quantitative and qualitative synthesis, consistent with best practice recommendations for scoping reviews.Fifty-eight articles were included. The most common rationale was to incentivize activities prioritized by the department or institution. Of those reporting funding, departmental revenue was most common. The majority of EVU systems were created using a dedicated committee, although composition of the committees varied. Stakeholder engagement was a key component for EVU system development. Most EVU systems also included noneducational activities, such as clinical activities, scholarship activities, administrative or leadership activities, and citizenship. Incentive models varied widely but typically involved numeric- or time-based quantification. EVUs were generally seen as positive, having increased equity and transparency as well as a positive impact on departmental metrics.This scoping review summarizes the existing literature on EVU systems, providing valuable insights for application to practice and areas for future research.
Abstract Objectives Medical education fellowships in emergency medicine (EM) provide training in teaching, assessment, educational program administration, and scholarship. The longitudinal impact of this training is unknown. Our objective was to characterize the career outcomes of medical education fellowship graduates. Methods We solicited curriculum vitae (CV) from graduates of U.S. EM education fellowships by email. We abstracted data from CVs with a standard instrument that included program characteristics, employment history, leadership positions, awards, and scholarly productivity. We calculated and reported descriptive statistics. Results A total of 71 of 91 (78%) graduates participated. Thirty‐three completed a 1‐year fellowship and 38 completed a 2‐year fellowship. Nineteen (27%) completed an advanced degree during fellowship. Median (range) graduation year was 2016 (1997–2020). The majority, 63 of 71 (89%), work in an academic setting. Graduates held leadership positions in continuing medical education, graduate medical education, and undergraduate medical education. Forty‐eight (68%) served on national medical education committees. The mean ± SD number of national medical education awards was 1.27 ± 2.03. The mean ± SD number of national medical education presentations was 7.63 ± 10.83. Graduates authored a mean ± SD of 3.63 ± 5.81 book chapters and a mean ± SD of 4.99 ± 6.17 peer‐reviewed medical education research publications. Ten (14%) served on journal editorial boards, 34 (48%) were journal reviewers, and 31 (44%) had received a medical education grant. Conclusion EM medical education fellowship graduates are academically productive and hold education leadership positions.
