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The goal of the emergency medicine conference series is to cover the core content of the American Board of Emergency Medicine as outlined in its Model of Clinical Practice while teaching how to integrate practical applications of knowledge, discussing cutting-edge literature and focusing on career development. The core content is covered over a 24-month cycle, enabling it to be covered twice in the four-year residency format. Formal didactics occur every Friday morning. Residents have this time protected from clinical activity during almost all of their rotations, excluding the intensive care unit. We utilize a variety of formats to cover the content, including faculty and resident lectures, small group discussions, case conferences, procedure labs (cadaveric and animal based), and evidence-based reviews.
A brief description of each is listed below.
Prior to July 1, the EM1s have a two-week introduction to the department, clinical and administrative leaders. During this time, they will also integrate into the Johns Hopkins family and the city of Baltimore via social gatherings. After July 1, the EM1s have a four-week-long orientation prior to the start of their full-time clinical obligations. The orientation is structured to help residents become familiar with the basic concepts of emergency medicine practice. In addition to supervised shifts in the Emergency Department during the second half of orientation, EM1s have a focused conference series that addresses basic medical topics, such as chest pain; approach to toxidromes; airway management; sepsis; basic procedural skills assessed via checklist observation, such as splinting, suturing, LPs and central lines; a four-hour cadaver lab for advanced procedures; introduction to ultrasound; and miscellaneous topics, such as charting, billing and coding, and professionalism and communication skills.
Highly Interactive Teaching
These three-hour sessions focus on the core content. There are approximately 20 sessions per year. They are designed to encompass all aspects of the topic, typically a chief complaint, being taught during the session. Included are sessions primarily dedicated to pediatric complaints, toxicological presentations and the general emergency medicine core content.
Hour 1: This faculty-led didactic session covers the differential diagnosis associated with the topic, use of ancillary tests and how to create a management plan for patients. Evidence-based guidelines can be discussed here or during the following small-group hours.
Hours 2 and 3 for EM1-3: The second and third hours are small group sessions. The EM1- 3 residents rotate through three 40-minute sessions with their respective PGY year and receive teaching specific to their training level. The sessions cover the more detailed aspects of the topic for the day, including treatment options, the evidence supporting treatment and ancillary tests, literature review, discussion of podcasts and case-based teaching. These sessions encourage group interaction and discussion.
Hours 2 and 3 for EM4: The EM4 residents attend a two-hour session that focuses on advanced learning. The first hour may include practice-based guidelines and their supporting evidence, case discussion, oral board review or review of literature. The second hour covers topics that every new attending will encounter in their practice. These include billing, building your CV, malpractice issues, comparison of different practice settings and opportunities for career paths, financial issues, and other topics that residents suggest for inclusion in these sessions.
Mortality and Morbidity Conference
A monthly one-hour mortality and morbidity conference is held to discuss cases submitted by faculty, residents or nurses, or that are obtained via our hospital reporting system. An EM3 resident leads the session in conjunction with a faculty mentor. These multidisciplinary discussions allow for all members of our patient care teams to follow the case presentation and discussion of the case by an analysis of a standard set of factors known to contribute to error in the emergency department. This involves a systems-based approach, which analyzes not only errors in judgment or decision-making, but also contributing factors, such as failures in teamwork and communication, availability of departmental and institutional resources, and societal factors. These sessions are used to help make recommendations to our clinical leadership to remedy deficits that are identified.
Core Content Lecture Series
EM2 and EM3 residents are required to prepare lectures covering core content topics in emergency medicine. EM2 residents present a 30-minute talk, and EM3 residents present a 60-minute talk. All residents are provided with one-on-one assistance from the program director for content and slide preparation. EM4 residents are required to participate in the same fashion as a faculty member and run small group discussions on our highly interactive teaching days.
Case Conference Series
EM4 residents are required to prepare a case conference, which occur on a monthly basis. These 60-minute sessions allow EM4s to choose a topic of their choosing and moderate a case-based discussion with practical teaching pearls for the audience.
Trauma Conference Series
This is a series of interactive presentations and are a joint-led conference between the Department of Emergency Medicine and the Division of Acute Care and Adult Trauma Surgery. These conferences take place quarterly and have one resident from emergency medicine and one from surgery present a case for discussion by the audience. Each case has take-home pearls for diagnosis or management.
This series, which occurs monthly, is focused on teaching residents the basics of reading the medical literature and determining the applicability to their own practice. EM2 residents develop a PICO question under the mentorship of our two EBM faculty members and work with the assistance of a medical librarian to find answers to their questions. They present an objective review of the literature and lead a discussion of the article with the group.
This series, which occurs quarterly, is focused on teaching residents the basics of basic research skills. Core research faculty members lead sessions on research, ethical conduct, IRB and basic stats. In addition, short Web-based didactics are available, which have been prepared by our faculty members to help educate residents about key areas of their research, such as study design, identifying study populations, and writing abstracts and posters.
The ultrasound curriculum is composed of both small-group teaching sessions incorporated into our highly interactive teaching days and dedicated skill sessions in conference. A total of 10 hours of dedicated content occurs per year, as well as clinical correlation sessions in our small-group teaching. This curriculum is designed to supplement the ultrasound experience residents obtain during their ultrasound rotations in their first and second years, and while they are working in the Emergency Department.
Reviews are held annually for both oral and written examination. All residents are able to participate in simulated oral boards cases with faculty members during conference time twice a year. Additionally, graduating residents are invited to a supplemental session to enhance their experience. Additionally, a full-day interactive session of high-yield content is held shortly prior the annual in-service exam. Residents obtain electronic review materials via the education committee and the program director.
Grand Rounds lectures occur between six to eight times per year. Experts in the field of emergency medicine are invited to discuss their areas of interest for a one-hour time slot.
This conference, held 10 to 12 times a year, is devoted to the discussion of patients with interesting and/or difficult management problems that may involve deceptive presentations. Cases are presented by EM3 residents in a co-run session with our chairman, Dr. Kelen. These sessions heavily rely on audience participation and on faculty and senior resident panel involvement.
In addition to the sessions listed above, residents receive instruction in EKG interpretation, radiology reading and splinting and participate in a departmental CPC competition. Residents also participate in sessions on residents as teachers in the emergency department. A dedicated hour is also held quarterly in which residents can meet with their QI groups during conference time.
The Johns Hopkins Department of Emergency Medicine Residency Program