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Open Access Publications from the University of California

About

JETem is an online, open access, journal-repository for EM educators in all major topic areas. We focus on active learning and technology. Submissions include team-based learning (modified and classic), small group learning, simulation, podcasts, workshops, lectures, curricula, innovations and submissions to our image and video bank. For our fully searchable site, and details regarding submissions please go to www.JETem.org

Table of Contents

Team-Based Learning

Emergencies in Hemodialysis Patients

Audience: This classic team-based learning (cTBL) session is appropriate for medical students or emergency medicine residents.

Introduction: Over 380,000 patients have renal failure in the United States and 90% of these patients are managed on hemodialysis. Hemodialysis patients have high rates of morbidity and mortality. Understanding the management of emergencies unique to these patients is essential for any emergency physician..

Objectives: By the end of this session, the learner will: 1) describe primary dialysis complications; 2) construct a full differential for a dialysis patient presenting with complications; 3) formulate an appropriate treatment and resuscitation in an acutely ill dialysis patient; 4) plan appropriate disposition and utilization of consultants for dialysis complications.

Methods: The format of this educational session is cTBL.

Topics: Hemodialysis emergencies, TBL, team-based learning, dialysis, ESRD, renal disease.

Small Groups

Approach to Acute Headache: A Flipped Classroom Module for Emergency Medicine Trainees

Audience: This module is designed for emergency medicine trainees. Though it focuses on those early in their career (medical students and junior residents), it is applicable to all emergency medicine learners.

Introduction: In the United States, headache is the fifth most-common primary complaint of patients presenting to the emergency department and can be the primary symptomatic manifestation of many life-threatening illnesses. The emergency physician plays a unique role in diagnosing and managing these patients. The emergency physician’s two major responsibilities are to relieve headache pain and to ensure that life-threatening causes are diagnosed and treated.

Objectives: At the end of this module, the learner will be able to: 1) list the diagnoses critical to the emergency physician that may present with headache; 2) identify key historical and examination findings that help differentiate primary (benign) from secondary (serious) causes of headache; 3) discuss the indications for diagnostic imaging, lumbar puncture and laboratory testing in patients with headache; 4) recognize life-threatening diagnoses on CT imaging and CSF examination; 5) describe treatment strategies to relieve headache symptoms.

 

Methods: This module includes a complete flipped classroom module. Learners are responsible for viewing a 20-minute video prior to the 30-minute small-group, case-based didactic discussion portion. The learners are assessed with multiple-choice question assessments, for low stakes retrieval practice or spaced practice. This could alternatively be run as a team-based learning session, with the pre- and post-tests used as an individual or group readiness assessment test, and the small group exercises converted to a group application exercise.

 

Topics: Headache, subarachnoid hemorrhage, migraine, occult trauma, meningitis, temporal arteritis, carbon monoxide toxicity, acute glaucoma, cervical artery dissection, space occupying lesion, idiopathic intracranial hypertension.

Lectures/Podcasts

A Faculty Development Session or Resident as Teacher Session for Didactic and Clinical Teaching Techniques; Part 1 of 2: Engaging Learners with Effective Didactic Teaching

Audience: This workshop is intended for faculty members in an emergency medicine (or other) residency program, but is also appropriate for chief residents and medical student educators, including basic science faculty.

Introduction: Faculty development sessions are required by the Accreditation Council for Graduate Medical Education and enhance the learning environment within residency programs. Resident as teacher sessions are important in helping residents transition from junior learners to supervisors of medical students and junior residents. Part I of this two-part workshop introduces learners to effective techniques to engaging learners during didactic sessions.

Objectives: By the end of this workshop, the learner will: 1) describe eight teaching techniques that encourage active learning during didactic sessions; 2) plan a didactic session using at least one of eight new teaching techniques for didactic instruction

Methods: This educational session is uses several blended instructional methods, including team-based learning (classic and modified), the flipped classroom, audience response systems, pause procedures in order to demonstrate effective didactic teaching techniques.

Topics: Faculty development, didactics, residency conference, pause procedures, commitment activities, team based learning, small group learning, jigsaw, problem based learning, think pair share, one minute paper, the muddiest point, audience response systems.

A Faculty Development Session or Resident as Teacher Session for Clinical and Clinical Teaching Techniques; Part 2 of 2: Engaging Learners with Effective Clinical Teaching

Audience: This workshop is intended for faculty members in an emergency medicine (or other) residency program, but is also appropriate for chief residents and medical student clerkship educators.

Introduction: Faculty development sessions are required by the Accreditation Council for Graduate Medical Education and enhance the learning environment within residency programs. Resident as teacher sessions are important in helping residents transition from junior learners to supervisors of medical students and junior residents. Part I of this two-part workshop introduces learners to effective techniques to engaging learners with clinical and bedside teaching.

Objectives: By the end of this workshop, the learner will: 1) describe and implement nine new clinical teaching techniques; 2) implement clinical teaching techniques specific to junior and senior resident learners.

Methods: This educational session is uses several blended instructional methods, including team-based learning (modified), the flipped classroom, audience response systems, pause procedures.

Topics: Faculty development, clinical teaching, bedside teaching, one-minute preceptor, two-minute observership, teaching scripts, Aunt Minnie, SPIT, activated demonstration, teaching scripts.

 

Oral Boards

Carbon Monoxide Poisoning

Audience: This oral boards case is appropriate for all emergency medicine learners (residents, interns, and medical students).

Introduction: Carbon monoxide (CO) is a colorless and odorless gas that typically results from combustion. It binds hemoglobin, dissociating oxygen, causing headache, weakness, confusion and possible seizure or coma. Pulse oxygen levels may be falsely elevated. Practitioners should maintain a high index of suspicion for carbon monoxide poisoning. If caught early CO poisoning is reversible with oxygen or hyperbaric oxygen therapy.

Objectives: The learner will assess a patient with altered mental status and weakness, ultimately identifying that the patient has carbon monoxide poisoning. The learner will treat the patient with oxygen and admit/transfer the patient for hyperbaric oxygenation.

Method: Oral boards case

Topics: Carbon monoxide poisoning, toxicology, carboxyhemoglobin, altered mental status, oral boards, hypoxia, pulse oximetry.

Simulation

Mesenteric Ischemia

Audience: This simulation session is appropriate for emergency medicine residents at any level or medical students.

Introduction: Mesenteric ischemia is a rare, but serious cause of abdominal pain. Practitioners must recognize the diagnosis quickly. The clinical course rapidly advances from bowel ischemia to infarction, sepsis, and frequently death. Mesenteric ischemia accounts for approximately 1% of all ED cases of abdominal pain in the elderly, but the mortality is as high as 93%.

Objectives: At the end of this simulation session, the learner will: 1) Recognize signs and symptoms of mesenteric ischemia; 2) order appropriate imaging and labs in the workup of an elderly patient with abdominal pain; 3) manage a patient with mesenteric ischemia, a rare, but serious cause of abdominal pain in the elderly; 4) discuss anchoring bias, specifically related to patients referred to the ED with an established diagnosis by outside specialists.

Methods: This educational session is a high-fidelity simulation.

Topics: Mesenteric ischemia, simulation, abdominal pain in the elderly, SIRS, lactic acidosis, anchoring bias.