AMHIMResidency.com

Overview

The Emergency Room rotation exposes the resident to a wide variety of medical problems that present emergently. Residents will spend time in both the acute and non acute/ambulatory sections of the ER. Residents will be responsible for the primary assessment of patients and, after discussion with attending staff, initiation of primary treatment. Residents will develop and refine competencies in interpretation of EKGs and CXR (and log these activities). Residents will also gain experience in suturing of minor wounds.

Principle Teaching/Learning Activities

Morning Report

This conference occurs from 8:30 to 9:30AM (M,T,TH,F) in the resident resource room. Residents present cases to either a subspecialty attending or to a core faculty. Generalist. Residents are expected to prepare educational bullets to share with the group.

Grand Rounds

This conference is a lecture driven format and occurs on Wednesday mornings in the Beardwood classroom.

ER Confernces

This conference series is part of the ongoing lecture series prepared by the ER attendings for other members in their department and any residents or students on rotation.

Attending Rounds

Attending rounds occur at least three times a week for 1 ½ hours (total 4 ½ hours per week). Residents present cases to the primary teaching attending and receive both didactic and bedside teaching.

Noon Conference

This conference occurs daily from 12 to1PM. A variety of presentations occur during this sessions including but not limited to: journal club, autopsy rounds, clinical didactics, communication video tape review, ethics topics etc.

Principle Educational Goals by Competency

In the tables below the principle educational goals for the General Medical Floors are outlined by competency. The second column of the table indicates the teaching activity that is most relevant to that competency.

MR= Morning Report AR=Attending Rounds NC=Noon Conference

DPC =Direct Patient Care GR= Grand Rounds ER Conference

Patient Care- Principle Educational Goals	Learning Activities
Refine skills in history taking	DPC, MR
Refine skills in physical examination	DPC, AR
Recognize common emergency medicine problems and generate relevant differential diagnosis	ER CONFERENCE
Refine skills in ordering and interpreting diagnostic tests (EKG, ABG, CXR)	MR, DPC, AR, ER CONFERENCE
Gain exposure in casting, splinting and suturing	ERC

Medical Knowledge -Principle Educational Goals	Learning Activities
Increase clinical medical knowledge of general medical problems that present emergently	MR, ERC
Increase basic science knowledge of general medical problems that present emergently	GR, ERC
Demonstrate ability to find relevant medical literature	ERC, MR, AR

Practice Based Learning and Improvement -Principle Educational Goals	Learning Activities
Identify areas that need improvement in medical knowledge, decision making, and communication in regards to the care of patients presenting with emergent medical problems	MR, ERC
Develop mechanisms to improve on identified areas of weakness	MR, AR

Interpersonal Skills and Communication-Principle Educational Goals	Learning Activities
Communicate plan of care with patients	DPC
Communicate effectively with nursing	DPC
Communicate effectively with other physicians involved in the care of patients in the emergency setting	DPC
Present cases to other members of the care team and in educational conferences	MR, AR, ERC

Professionalism -Principle Educational Goals	Learning Activities
Behave professionally towards patients and other members of the care team	DPC

Systems Based Practice –Principle Educational Goals	Learning Activities
Gain an understanding on how best to utilize and access hospital resources for the care of patients in the emergency setting	ERC, DPC
Gain an understanding on how best to establish and maintain services for patients leaving the ED	ERC, DPC
Use evidence based and cost conscious strategies to care for patients in the emergency setting	ERC, DPC

Specific Curricular Content Areas:

Cardiovascular

Acute or chronic congestive heart failure

Arrhythmias

Cardiopulmonary arrest

Chest pain, stable and unstable angina, myocardial infarction

Hypertension, hypertensive emergencies

Shock

Syncope

Unstable thoracic or abdominal aortic aneurysms

Dermatology

Cutaneous ulcers

Rash

Domestic Violence

Endocrine

Acute complications of hyperthyroidism, hypothyroidism

Addisonian crisis

Diabetes mellitus, hypoglycemia, hyperglycemia, diabetic ketoacidosis

Gastroenterologic

Acute abdomen

Acute diarrhea

Acute liver failure

Acute pancreatitis

Ascites

Bleeding

Bowel obstruction

Gallstones, cholecystitis

Nausea and vomiting

Hematologic

Acute complications of sickle cell disease

Anemia, leukopenia, thrombocytopenia

Easy bruising, purpura, ecchymosis

Polycythemia, leukocytosis, thrombocytosis

Hyperthermia, hypothermia

Infectious

Active tuberculosis

Encephalitis

Herpes simplex infection

Herpes zoster infection

HIV infection (including infectious complications)

Meningitis

Otitis externa media

Pharyngitis

Pneumonia, bronchitis

Prostatitis, urethritis, epididymitis

Sepsis

Sexually transmitted diseases

Sinusitis

Upper respiratory infection

Urinary tract infection, pyelonephritis

Viral hepatitis

Neurologic

Coma

Head trauma

Headache

Seizure

Transient ischemic attack, stroke, subarachnoid hemorrhage

Ophthalmologic

Acute loss of vision

Red eye

Otolaryngologic

Epistaxis

Vertigo

Overdose, poisoning

Pulmonary

Acute respiratory failure

Asthma

Chronic obstructive pulmonary disease

Pneumothorax

Pulmonary embolism, deep venous thrombosis, phlebitis

Severe airway obstruction

Renal

Acute renal failure, chronic renal insufficiency

Electrolyte, acid-base disorders

Renal colic, kidney stones

Rheumatologic

Acute arthritis (including gout)

Back pain

Sexual abuse