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Amazing & Awesome: Incorporating Positive Case-Based Discussion in Emergency Medicine Residency Curriculum to Improve Learning and Team Morale

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Learning Objectives: 1. Discuss and analyze cases with exemplary team performance using root cause analysis and case reflection. 2. Demonstrate the importance of clinical learning opportunities from successful cases in medical education (Safety-II Thinking). 3. Value positive clinical cases to boost team morale

Introduction: While M&M has long been part of residency training, few programs dedicate time to highlight above-and-beyond patient care. With this learning gap identified, the Amazing and Awesome (A&A) didactic series was created and implemented. While Saves-of-the-Month awards recognize exemplary care, A&A provides a deeper inspection of the cases. Literature review of other programs with A&A focused on reframing the culture of medicine from Safety-I thinking (reacting to errors) to Safety-II thinking (learning from resilient systems and successful interventions). Currently, there is no data available to assess its perceived value by residents in their education or its impact on morale.

Objectives: as above

Curricular Design: At the Stanford EM residency program, we incorporated a monthly 30-minute session into our didactic curriculum. Two residents present the A&A case chosen as a “Save of the Month,” focusing on the contributions of the entire healthcare team-physicians, nurses, techs, pharmacist, consultants, etc. Each resident describes the case, highlighting key concepts, critical actions by the care team, and other contributing systems processes that led to the “Save” or exemplary performance. The resident shares the framework as clinical pearls for colleagues to apply in similar challenging clinical scenarios. After 6 total sessions, a survey was administered to residents to evaluate their perceived value of the didactics in their education. Ultimately 26/60 residents completed the survey. Unanimously, 100% of respondents reported A&A was a valuable addition to their curriculum, and 96% of respondents voted to keep A&A in the curriculum. Many comments focused on A&A’s positive impact on residency morale.

Impact/Effectiveness: Our resident response to the Amazing and Awesome didactics in GME helps identify a gap in potential learning opportunity and potential morale improvement, and this series could easily be implemented by other programs.

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