Didactics and Conferences
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Emergency Medicine Journal Club typically occurs on the last Thursday of each month, when residents and attendings gather to discuss journal articles over dinner. These sessions begin with a review of a basic research or statistical topic, followed by the presentation of three articles selected to address a particular clinical question. Journal Club is attended by faculty with a wide variety of research and clinical interests, allowing residents to draw on multiple experiences and viewpoints as they learn to navigate the medical literature.
Internal Medicine Journal Clubs take several formats. One format focuses on an in-depth analysis of a single article using the McMaster’s EBM format. The intent of this journal club is to teach skills of critical appraisal. The second format is a current literature potpourri. In this format, residents break into small groups, read several timely articles and summarize them for their colleagues. The intent of this format is to help residents remain abreast of the current literature. Lastly, we have a “rapid” fire journal club in our outpatient clinic that reviews a select group of recent journals and how they will impact on our practice of medicine.
Emergency Medicine/Internal Medicine journal clubs occur semiannually. Residents from both specialties are encouraged to attend to discuss articles on topics both applicable and high-yield between the specialties. Faculty from both divisions as well as pulmonary and critical care medicine are invited to facilitate discussions.
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We are lucky at Ohio State to have access to the state-of-the-art Clinical Skills Center, and take advantage of this resource monthly during our skills labs. Coordinated and led by senior resident/faculty pair, skills lab sessions make use of both high- and low-fidelity simulators, animal and cadaveric models, volunteer patients and occasionally, even each other to review and practice emergency medicine-relevant skills. We are also fortunate to have non-emergency medicine colleagues who are often willing to lend their expertise to these activities.
Recent skills labs have included the following:
- Obstetrics: Residents reviewed and practiced first trimester ultrasound on a phantom model, as well as third trimester ultrasound on a pregnant volunteer. A station covering both normal and complicated deliveries was led by an OB/GYN faculty member with an interest in education.
- ENT: Epistaxis treatment was discussed and then practiced using a low-fidelity model. Drainage and treatment of auricular hematomas was reviewed with the use of a cadaveric model. Finally, residents were given the opportunity to perform nasopharyngoscopy on a volunteer under the direction of a speech therapist and ENT resident.
- Airway: Residents gained familiarity with a variety of adjunct/rescue airway devices and technique using both mannequins and cadavers, all under the direction of experienced emergency medicine faculty.
- Obstetrics: Residents reviewed and practiced first trimester ultrasound on a phantom model, as well as third trimester ultrasound on a pregnant volunteer. A station covering both normal and complicated deliveries was led by an OB/GYN faculty member with an interest in education.
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Residents are required to participate in at least one scholarly activity during the course of their training. This may be a basic science project, a clinical or epidemiological study, a case report or a collective clinical review of publishable quality. The purpose of the requirement is to introduce the resident to the critical evaluation of the biomedical literature and research methodology. Emergency medicine faculty are active in all facets of research and scholarly activity and serve to guide residents through this requirement.
For basic science research projects, the faculty are actively involved in interdisciplinary research within the university. In addition, ongoing pre-hospital and emergency department clinical research projects provide an opportunity for residents to participate in robust nationally recognized clinical studies. Residents are encouraged to publish and present at regional or national meetings during their training. Emergency medicine residents gain an understanding of evidence-based medicine principles and learn to critically review literature under the guidance of our research faculty.
Emergency Medicine Didactics and Conferences
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All residents present one prepared lecture during their final year of training. These lectures are drawn from a variety of appropriate topics chosen by each resident. While these lectures are modeled after traditional PowerPoint presentations, an emphasis is placed on discussion and audience participation. Accordingly, residents are encouraged to be creative in their approach to presenting their topic. Recent examples include expert panels of both emergency medicine and non-emergency medicine faculty, and the use of social media to solicit real-time audience input.
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Pre-hospital care is emphasized throughout the residency program. The curriculum is both longitudinal and concentrated in a dedicated two-week block in the PGY-2 year under the direction of EMS faculty and fellows. In addition to accompanying paramedic teams on emergency calls, residents will be directly involved in the planning and operation of the EMS systems.
Since 2004, the Center for EMS at The Ohio State University Wexner Medical Center has been dedicated to improving outcomes for cardiac arrest, trauma and other patients in our community. A cooperative effort between the Department of Emergency Medicine, Ohio State's Wexner Medical Center and the Center for EMS (CEMS) seeks to provide an educational and research resource to the central Ohio EMS community. By uniting the efforts of the pre-hospital provider with the hospital-based team, the CEMS is dedicated to providing everyone in the community the best opportunity for survival and improved quality of life.
MedFlight of Ohio is the critical care transport service serving central Ohio and operated by The Ohio State University Wexner Medical Center, Grant Medical Center and Akron General Hospital. Howard Werman, MD, serves as Medflight’s medical director and also is an active member of our Ohio State Wexner Medical Center’s Emergency Medicine faculty. Online medical control for the helicopter and mobile ICU is provided by the emergency department at Ohio State. Residents may also elect to participate in patient transports with the crew of MedFlight and will participate in physician medical direction of the program.
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The Emergency Medicine Lecture Series takes place on Wednesday mornings. The traditional lecture sessions covering the core content of emergency medicine is augmented by several repeating conferences. We host a monthly multi-disciplinary trauma morbidity and mortality session that is regularly attended by colleagues, which make up the multi-disciplinary trauma care team as well as staff from the medical examiner's office. Emergency medicine M&M also occurs monthly, providing an opportunity to discuss difficult cases in a collegial and collaborative setting. During pediatric and adult emergency department follow-up, residents present interesting cases in an oral board format, allowing the opportunity to not only discuss the salient medical aspects of the cases, but also to review and practice strategies for successful completion of the ABEM oral board exam.
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EM residents are divided into four small group discussions with two emergency medicine attendings as facilitators. The small groups are made up of residents from all levels and meet monthly for a two-hour session. Topics are usually selected based on resident requests and have included oral board review, end of life care in the emergency department, ventilator management (including several residents being "treated" with non-invasive positive pressure ventilation), and mock EMS base station calls.
We highly value our small group sessions for multiple reasons. The small group format emphasizes a personal approach to education that we regard highly at Ohio State. We firmly believe that, as adult learners, residents should have a certain amount of control over what they learn, and the small group format affords us this curricular latitude. There is no set small group curriculum, and groups are encouraged to be creative in their exploration of the nuances of emergency medicine. Additionally, residents are able to draw not only on the experiences of faculty members, but also work collaboratively to teach one another, enhancing our "residency family" environment.
Internal Medicine Didactics and Conferences
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Internal Medicine Tuesday Conference Block is three hours of educational activity held in a block on Tuesday afternoons following a housestaff lunch. Residents on elective and CPB months are free of clinical duties on Tuesday afternoons to attend this conference. Tuesday inpatient rounding schedules are adjusted so that residents can finish most of their clinical work by noon (similar to a weekend day). The content of the conference varies from session to session. Incorporated lectures include core topics in general and subspecialty medicine.
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Housestaff gather between outpatient clinics or continuity clinics daily at noon (except Tuesdays). They are introduced to a variety of outpatient patient care topics, such as hypertension management, outpatient diabetic care, the approach to evaluation of headache in an outpatient setting, etc.
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The Internal Medicine Grand Rounds weekly conference highlights recent advances in internal medicine and draws accomplished speakers and investigators from within the university as well as around the world. Topics range from comprehensive updates on common clinical problems to
emergency medicine presentations.
All residents present one prepared lecture per year. These lectures are drawn from a variety of appropriate topics chosen at the beginning of each year. While these lectures are modeled after traditional one-hour PowerPoint presentations, an emphasis is placed on discussion and audience participation. Accordingly, residents are encouraged to be creative in their approach to presenting their topic. Recent examples include expert panels of both emergency medicine and non-emergency medicine faculty, and the use of social media to solicit real-time audience input. -
The current interns present a case and, with one of the program directors, facilitate an in-depth discussion geared towards the needs of the interns. This is a popular conference among the interns and allows each of them the opportunity to expand their differential diagnosis and management plans, as well as become comfortable with presenting to a group of their peers.
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The OSUWMC Internal Medicine Residency has developed a nationally recognized innovation in morbidity and mortality conferences. The traditional conference has been replaced with a resident peer review conference, where residents use the tools of medical error root cause analysis and quality improvement to identify and correct problems that led to suboptimal outcomes for our patients. An emphasis is placed on systematic problem solving and prevention rather than blame.
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One case from an inpatient service is presented at each of these popular conferences. A program director or other attending physician and the chief resident facilitate an in-depth discussion about the presentation, physical exam, differential diagnosis, diagnosis and patient management of a particular disease process. This highly educational conference remains a favorite among housestaff.