Emergency Medicine

Overview:

The Emergency Medicine curriculum of the Memorial Hospital Family Medicine Residency consists of structured skills training, didactics and clinical experiences (consisting of at least 2 blocks with a minimum of 200 hours of clinical training) in the care of patients of all ages with acute illnesses and injuries in the emergency care setting. The clinical training occurs in Memorial Hospital 's Emergency Department.

Goals :

•  At the completion of the Emergency Medicine Curriculum, the resident will have an understanding of Emergency Care Services in a community hospital setting which will facilitate appropriate interactions with Emergency Medicine Physicians in their future practice.

•  At the completion of the curriculum, the resident will have the knowledge and skills in the areas of acute illnesses and injuries in the setting of the emergency care setting pertinent to the practice of Family Medicine.

 

Objectives:

 While caring for patients in the Emergency Department, the resident:

Rotation 1

• is able to perform an appropriate history and physical examination. (PC)
• presents clinical findings to the supervising physician with an appropriate broad differential diagnosis. (MK)
• interprets data related to the Emergency Department patient and initiates management decisions under close supervision of an Emergency Room attending physician. (PC)
• accurately shares medical information with patients and families and assesses the patient's comprehension of the information. (ICS)
• demonstrates sensitivity and responsiveness to a diverse patient population, including patients with diversity of gender, age, culture, race, religion, disabilities and sexual orientation. (P)

Rotation 2

• is able to perform primary and secondary surveys in the assessment of trauma patients and assist in the stabilization of trauma patients. (PC)
• interprets data related to the emergency department patient and carries out management decisions with supervision of an Emergency Room attending physician as needed. (PC)
• incorporates diverse sources of information into effective communication and relationship building with patients. (ICS)
• analyzes current medical literature related to patient care and is able to convey this information to peers and attending physicians. (PBLI)
• demonstrates a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information and informed consent. (P)

 

The resident must continue to meet usual residency obligations to his/her Family Medicine Center population including attending scheduled clinics, caring for continuity patients admitted to Memorial Hospital, and rounding in the nursing home. The resident is expected to attend noon conferences and abide by duty hour restrictions in keeping with usual program policies. Upon completion of the rotation, the resident must complete and return the evaluation form provided by the program.

There are no specific procedural requirements for this rotation. However, there is a separate Procedures Curriculum and residents may gain experiences meeting these requirements during this rotation. Procedures typically performed by residents on this rotation include: 

Skin laceration repair/suturing

Anoscopy

Joint aspiration/injection

Cast/Splint application

Endotracheal intubation

Lumbar puncture

 

Implementation:

 

Educational Methods:

  

BLS Course:   Offered during orientation and all PGY-1 residents are required to pass. Residents must subsequently recertify as needed.

 

ACLS:   Offered during orientation and all PGY-1 residents are required to pass. Residents must subsequently recertify as needed.

 

PALS: Offered during orientation and all PGY-1 residents are required to pass. Residents must subsequently recertify as needed.

 

ALSO: Offered during the first academic year and all PGY-1 residents are required to pass.

 

Didactic Sessions: The noon conference curriculum consists of at least six lectures per academic year or eighteen conferences over the three years of residency training.

 

Patient Care-Emergency Medicine Rotation: Prior to the commencement of the rotation, the resident will plan their rotation schedule with the Senior Associate Director. A copy of the schedule will be provided to the resident, the Emergency Department, and a copy will be placed in the resident's evaluation notebook in order to track hours completed. The resident is required to complete 2 blocks with a minimum of 200 hours. The Emergency Department is staffed at all times by Emergency Medicine Department Physicians. Residents work under these staff physicians' supervision. Residents will staff patient visits before patients are discharged or admitted and procedures are supervised unless the resident has previously demonstrated competency.

 

Self directed learning-longitudinal: Utilizing resources listed in this document, Family Medicine faculty, Emergency Medicine Medical Staff, and patient care experiences.

 

Resources:

BLS, ACLS, PALS and ALSO Course Manuals

Pfenninger and Fowler's Procedures for Primary Care Textbook

Up to Date as available through the Memorial Hospital Library website

Memorial Library

Methods of Evaluation:

Performance-based evaluation methods include:

•  Rotation evaluations will be filled out by Emergency Medicine staff physicians following each rotational block (Attachment A)

•  Procedure log and evaluations

Attachments:

A-Rotation Evaluation form adapted for rotation 1 and rotation 2 objectives

Evaluation for Emergency Medicine Rotation 1

 

1) Is the resident able to perform an appropriate history and physical examination? 

YES     NO

 

2) Is the resident able to present clinical findings to the supervising physician with an appropriately broad differential diagnosis?

YES     NO

 

3) Is the resident able to interpret data related to emergency department patients and initiate management decisions under close supervision of an Emergency Room attending physician?

YES     NO

 

4) Is the resident able to accurately shares medical information with patients and families and assesses the patient's comprehension of the information?

YES     NO

 

5) Does the resident demonstrate sensitivity and responsiveness to a diverse patient population, including patients with diversity of gender, age, culture, race, religion, disabilities and sexual orientation?

YES     NO

 

Evaluation for Emergency Medicine Rotation 2

 

1) Is the resident able to perform primary and secondary surveys in the assessment of trauma patients and assist in their stabilization?

 YES     NO

 

2) Is the resident able to interpret data related to emergency department patients and carry out management decisions with supervision of an Emergency Room attending physician as needed?

 YES     NO

 

3) Does the resident incorporate diverse sources of information into effective communication and relationship building with patients? 

YES     NO

 

4) Is the resident able to analyze current medical literature related to patient care and convey this information to peers and attending physicians?

 YES     NO

 

5) Does the resident demonstrate a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information and informed consent?

 YES     NO