This is a lecture paired with facilitated small group sessions and is targeted towards emergency medicine residents and physicians.

The enneagram is a well-established and popular personality theory that asserts that there are nine basic personality types, and that each enneagram type, 1-9, operates from a basic fear and a basic desire that produces predictable behavioral patterns and preferences.1-2 The enneagram has long been used as a tool to enhance self-awareness and to better understand internal defenses and reactions,3-5and as such, it has been increasingly utilized to enhance self-growth and development in the fields of education, parenting, and business.6-7 While some studies have used the enneagram as a tool to predict natural empathy or stress levels of those in the medical field, particularly in nursing and medical school students,8-9 little has been published on the use of the enneagram as a tool to enhance self-awareness, leadership, and teamwork in the medical field.  Emergency medicine is a specialty in which residents and physicians must not only be self-aware but must also be attuned to the dynamics of their healthcare team in order to succeed. We believe that the enneagram is the ideal tool to enhance these crucial skills.

The primary aim of this session was to enhance participants’ self-awareness by identifying their enneagram type and therefore their predictable behavioral patterns.  The secondary aim was to discuss strategies to improve teamwork and physician team leadership by directly addressing the type’s strengths and weaknesses in these interactions.

By the end of this session, the learner will be able to: 1) Self-identify with a primary enneagram personality type.  2) List the fears, desires, and motivations of the enneagram type.  3) Describe struggles in interacting with other disparate enneagram types. 4) Discuss strategies for success in facing conflict and interacting with other team members.

This lecture was designed to educate emergency department physicians and residents on the enneagram tool.  The introductory lecture takes about 20 minutes, and following this foundational presentation, learners split into small groups.  Small group sessions take an additional 20 minutes during which facilitators guide learners through a discussion on their enneagram type and the potential strengths and challenges that each type might face in professional situations.  This session was hosted during an Emergency Medicine Resident Education Conference.  Due to COVID-19 restrictions, the session was presented virtually on a synchronous video platform with small group breakout rooms.

Following the session, the educational content was evaluated by our residents and faculty by a Likert reaction survey.  The survey assessed both the form and effectiveness of the delivery method and the impact of the content in the session.

A total of 17 responses with a mix of faculty and PGY years were collected after the session. In the post-session survey, 23% (6) of participants reported that the session was “moderately important in better understanding myself,” and 38.5% (4) of participants reported that the session was “quite important in better understanding myself.”  62% (11) of participants agreed or strongly agreed that the session helped them to understand their peers’ personalities and communication preferences.

Overall, this educational content and delivery in this format was well received and effective in enhancing residents’ understanding of themselves and their team’s personalities. Our residents and faculty engaged in insightful conversations around their own enneagram type and shared their successes and struggles in interacting with other enneagram types. At the end of the session, our participants left with not only greater self-awareness but also with an appreciation for the preferences and personalities of others on the medical team.

Enneagram, leadership, teamwork, self-awareness, emotional intelligence.

Introduction: The evaluation of an unstable peripartum patient in the emergency department includes a differential diagnosis spanning multiple organ systems. Splenic artery aneurysm (SAA) is one of those rare diagnoses with potentially high morbidity and mortality.

Case Series: This case series explores two unusual cases of postpartum SAAs. Despite differences in presentation, both patients had a ruptured SAA.

Conclusion: Often, SAAs are misdiagnosed. Early diagnosis is key, especially for the fetus. If the patient presents in shock, the expedited diagnosis and treatment can be lifesaving for both the mother and the fetus.

Introduction: Medical students transition to intern year with significant variability in prior clinical experience depending on their medical school education. This leads to notable differences in the interns’ ability to perform focused histories and physical exams, develop reasoned differentials, and maximize care plans. Providing a foundational experience for these essential skills will help to establish standardized expectations despite variable medical school experiences.

Methods: During an orientation block, interns participated in a standardized patient experience.  Interns were presented with three common chief complaints: abdominal pain; chest pain; and headache. Faculty observed the three patient encounters and provided immediate verbal and written feedback to the interns based on a standardized grading rubric.

Results: All residents that participated “agreed” or “strongly agreed” that the experience was a meaningful educational experience. 90% of the interns reported the experience would change their clinical practice. Additionally, 75% of residents survyed one year after the experience felt the experience changed their clinical practice. Faculty felt the learning experience allowed them to address knowledge gaps early and provide early guidance where needed.

Conclusion: This article describes an emergency medicine residency program’s effort to provide a foundational experience for interns in evaluating emergency department patients. The intent was to “level the playing field” and establish “good habits” early in intern year with the realization that prior experiences vary significantly in July of intern year.