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A collection of tried and true, evidence-based strategies to incorporate teaching into the clinical environment. Includes tips for diagnosing clinical decision making, helping learners recognize clinical teaching and feedback, teaching procedures, and making the most of learning opportunities... 

Caring

Compassion fatigue is the mental and physical exhaustion affecting healthcare providers as a result of the work we do. In the ED, we're especially vulnerable; factors that contribute to compassion fatigue include high volume, high acuity, crowding, performance metrics, boarding, interruptions, and patients who are rude, aggressive, and present frequently (anecdotally, pandemics do not seem to help)...

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As faculty, we want residents to graduate as clinical experts who are prepared to handle any emergency thrown their way. Getting there requires that they spend every shift engaged in deliberate practice. Just showing up and seeing patients isn’t enough – that’s a recipe for arrested development...  

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When we’re presented with a problem, our brains shunt the cognitive work to either of two pathways, called system 1 and system 2. When we use system 1 processing, we’re making use of patterns, experience, intuition, and heuristics to guide our problem solving and decision making. System 1 is efficient, easy, and accurate – about 90 percent of the time. That 10 percent is a real bummer, though...

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How do you integrate scientific evidence into clinical practice and how are you teaching residents to do the same? While your anecdotal experiences are important sources of learning for trainees, it is also critically important to incorporate scientific evidence into your clinical teaching. Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence to guide decision making for individual patients...

Frozen Popsicles

New roles and new sites can be disorienting for learners, whether they are interns new to the ED or experienced residents taking on additional responsibilities. Providing an effective orientation for learners at the beginning of the shift decreases learner anxiety and allows them to work towards realistic goals in a more effective way—which makes your job easier...

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In general, female emergency medicine residents are more likely than their male colleagues to have lower reported milestone attainment in a pattern reflective of bias, receive negative personality-related feedback, and receive conflicting feedback (especially as it relates to confidence, leadership/independence, and receptiveness to feedback)...

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Learners will be more likely to remember things that they experience through multiple senses, so after they see a patient and listen to your teaching point, take a moment to jot down the concept on a shared piece of paper, white board, or Post-it note...

Doctor Talking To Patient

Often, how well we communicate with our teams, our patients and their families, and our consultants (and how well they reciprocate) can determine whether we go home feeling good about our day - not to mention the important relationship between communication and patient outcomes. The same is true of our learners; helping them develop great communication skills and habits now will pay dividends over their...

Surgeons

It’s a common refrain in academic EDs: sometimes, it feels like there are learners everywhere! A senior resident here, a junior resident there, a few medical students of varying levels—and some off-service rotators to keep things interesting. How do you make sure patients are receiving optimal care while addressing the educational needs of all these people?...

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As our senior residents become ever more confident in their clinical practices, they will also be honing their teaching and supervisory skills. As faculty, that can make your job even more complicated. How does one effectively supervise learners at multiple levels of training? How do we teach learners to be teachers themselves? The answer is to start with the basics and set clear expectations. 

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When you ask residents to self-identify their goals at the start of the shift, how often do you hear that they “want to work on efficiency?” It seems like every day, right? No matter their level of training, “efficiency” seems to be what they think we want to hear. But what does that even mean? The next time you hear this, push back on efficiency as a training goal.