Emergency Medicine

Residency: Curriculum


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Our clinical and didactic curriculum is one of our biggest strengths as a program! We are very proud that both our clinical and didactic curriculum is heavily shaped by our residents. Our curriculum ideally balances our ‘tried-and-true’ methods with a dynamic and evolving approach to training quality EM physicians. We believe in the adult-learning theory of education and as such our didactics include a large amount of small group learning, an emphasis on shorter lectures (15-30 min sessions are a regular thing!), case-based learning, simulation, and frequent oral board examination practice- read more in the sections that follow! .

Shaped by regular feedback from our current and former residents, we are proud to highlight our block schedule and some key curricular features.

PGY-1 PGY-2 PGY-3
Orientation/EM – 1 block EM – 9.0 blocks (each month includes 1-2 CMH shifts & EMS) EM – 10.5 blocks (each month includes 1-2 CMH shifts & EMS)
EM – 4 blocks (including EMS) Elective – 0.5 block Community EM at TMC LW- 0.5 block
Internal Medicine – 0.5 block Critical Care Medicine at TMC (as Supervisor) – 1 block Elective – 1 block
Ultrasound – 0.5 block Community EM at SLH – 0.5 block Pediatric EM at CMH – 1 block
Critical Care Medicine at TMC– 1 block Pediatric ICU at CMH – 1 block
Pulmonary Critical Care at SLH -1 block Pediatric EM at CMH – 1 block
Neurosurgical ICU at SLH – 0.5 block
Cardiology at SLH – 0.5 block
OB at TMC- 0.5 block
NICU at TMC– 0.5 block
Trauma Surgery at TMC– 1 block
Anesthesiology at SLH – 0.5 block
ED/MSK at TMC – 0.5 block
Pediatric EM at CMH – 1 block

1 Block = 4 weeks

Clinical Curriculum Highlights:
Dr. Carney, KFCD Medical Director (3rd from Left), and UMKC EM residents (starting 4th from left: Phi Dinh, Matt Twillman, and Jarret Gardner) enjoying a break at the KC Air Show while providing medical direction.
Dr. Carney, KFCD Medical Director (3rd from Left), and UMKC EM residents (starting 4th from left: Phi Dinh, Matt Twillman, and Jarret Gardner) enjoying a break at the KC Air Show while providing medical direction.

EMS: Our EMS rotation is a longitudinal experience over the course of the three-year training program with varying responsibilities per PG year. Our faculty members are the medical directors for both the Kansas City, Missouri Fire Department and Johnson County, Kansas EMS systems, giving our residents unique opportunities to see EMS in action on both sides of the state line. Experiences include: Ambulance and supervisor ride-alongs, QI/protocol reviews, administrative meetings, and paramedic teaching/mentoring. All our residents become certified as base-station physicians and provide pre-hospital direction for a large urban paramedic system. Our residents also have unique opportunities to participate as healthcare providers at mass gatherings and citywide disaster events. Aeromedical experience is not available.

(most recently the KC Chiefs Superbowl Parade!) and citywide disaster events. Our department also leads a paramedicine training program and additional teaching opportunities within that program are available for those interested. Aeromedical experience is not available. 

Emergency Medicine's Chiefs group tweet

 

Pictured: Our EM residents, pediatric EM fellows, and EM faculty were so excited about the opportuntity to provide medical care during the Chiefs Superbowl Parade we had to announce it on Instagram!! Pictured Left to right: Drs. Whitton, Dubey, Opferman, Sycip, Lampe,  Halleron, Brown, Bogle, Abernathy, and Mark

 

Pediatrics: Our primary site for pediatric training is at Children’s Mercy Hospital, which is continually recognized as one of the top Children’s hospitals in the country. Our pediatric experience is both focused and longitudinal. The curriculum includes dedicated rotations in the PICU, NICU, and CMH Main ED (1 full block/year). Our PGY2 and PGY3 residents continue to work 1-2 CMH ED shifts/block while rotating in the TMC ED. This provides continual pediatrics exposure. CMH has one of the busiest EDs in Kansas City and was one of the first established Pediatric Emergency Medicine fellowships in the country. Our residents consistently say they feel comfortable caring for ill children by the end of their training.

Ultrasound: Please see our dedicated Ultrasound section for more details.

Wellness and Community Engagement: We have a robust wellness program that includes didactics and special conferences, social events, and book clubs. Didactic topics include career planning, financial wellness, and resilience. Our annual Wellness day incorporates both fun and learning (always with food!). We also participate in community service events benefitting programs and partners that serve our patients. A biannual wellness survey for faculty and residents is done. Please see our dedicated Wellness page for more details.

Resident Dr. Brad Beran (red hat) participating in an injured patient rescue during his wilderness medicine elective.

Elective program features: Residents are encouraged to individualize their elective time based on educational experience needs/interests. The program works with residents to optimize elective time for research or other educational experiences. Recent electives include: ICU, sedation/procedures, oral surgery, radiology (pediatric and adult), ultrasound, research, education/simulation, and administration. In early 2020 resident Dr. Brad Beran did a wilderness medicine elective in the Jefferson National Forrest (led by Virginia Tech Carilion School of Medicine). He learned the how to plan the evacuation of injured patients in the wildnerness, manage common EM injuries in the wilderness medicine context, and perform key survival skills.

Pictured from L to R (Dr. Jim O’Brien, Deven Bhatia, MS6, Dr. Jesal Amin, and Dr. Inboriboon). A few of our EM residents and EM bound medical student in Thailand on elective. They were able to learn about emergency medicine education abroad while Dr. Inboriboon was in Thailand on a Fulbright.

Over the past few years numerous EM residents have done global health or international medicine electives with a focus on emergency medical care. In 2019 a few of our EM residents Drs. Jim O’Brien and Jesal Amin were able to learn about EM education in Thialand while our then-Associate Program Director Dr. Charlie Inboriboon was in Thailand on a Fulbright scholarship.

Dr. Sean Mark teaching Chinese physicians about clinical skills during his international elective in China. He also did sessions regarding effective teaching strategies.

Dr. Sean Mark traveled to China in October 2019 during his PGY-3 elective time for an international medicine elective. During his time in the northeast of China, he had the opportunity to tour the emergency medicine landscape in the region, teach chinese physicians from every chinese province about International Medicine and public health a  s well as effective teaching, and experience the rich chinese culture. Dr. Mark traveled with Dr. Nicholas Comninellis from the Institute for International Medicine (INMED) who coordinated local contacts in the area.

 

Faculty and Residents at shift change. Pictured from L to R Abigail Halleron, Amanda Wavrin, Emily Hillman, Stefanie Ellison, Srikala Subramanian, and Phi Dinh

Mentorship and feedback: We provide robust mentorship, advising, and opportunities for bidirectional and multisource feedback. Each resident is assigned a PGY2 and faculty advisor at the start of the residency program to assist and guide the resident throughout training. The residents meet with their advisor biannually. The residency leadership team also meets with each resident biannually to discuss wellness, evaluations, and the resident’s progress towards graduation. Residents receive regular performance feedback including face-face shift evaluations, procedure evaluations, monthly faculty consensus evaluations, biannual Milestones assessments, and yearly peer-peer evaluations. Residents are also given the opportunity to confidentially evaluate the program and faculty on an annual basis.

Wellness and Community Engagement

We have a robust wellness program that includes didactics and special conferences, social events, and book clubs. In 2019-2020, we expanded our wellness initiative with a bold move: We had 20 hours of conference time dedicated to our wellness program, led by our wellness committee. It went so well we now dedicate the 5th Thursday of every month to resident wellness. These conference days include a mix of wellness-related learning and experiences chosen by the wellness committee to be fun and relaxing and a way to destress and connect with peers.

Didactic topics include career planning, financial wellness, and resilience. Other experiences mixed with those didactics have included: yoga, a muay-tai session (at a local gym owned by one of our ED security guards!), and puppy therapy.  The wellness committee also found ways to enhance other conference days- for example our faculty and wellness committee members cooked breakfast for residents at the annual holiday conference at the Unviersity’s Diastole Also- they didn’t let the COVID-19 pandemic stop them! The committee held the wellness conference virtually, including a virtual cooking class led by then-PGY2 Karl Hesson!

We also participate in community service events benefitting programs and partners that serve our patients. This past year we did a service day at the and another day at . A biannual wellness survey for faculty and residents is done. Please see our dedicated for more details.

 

Residents Quality Management Meeting: This bi-monthly meeting facilitates communication about residency program activities. Residents are provided an updated dashboard that includes performance review information, status on procedure logging, and meeting residency requirements. We discuss opportunities for improvement within the residency and between EM residents, faculty, nursing, off-service rotations and support staff. Resident feedback to improve processes and their educational experiences in the ED and on other clinical rotations is solicited and discussed.

“The program has a strong and established presence at the hospital. The attendings are supportive, the residents are friendly, and it’s a great learning environment.”

Eric Canaday, DO
Class of 2014

Emergency Medicine Conferences
Resisents managing a critically-ill (simulated) pediatric patient at our UMKC simulation center
Resisents managing a critically-ill (simulated) pediatric patient at our UMKC simulation center.

We strive to make our didactic conferences interactive, interesting, and clinically relevant. To that end, we continue to incorporate adult learning techniques such as simulation, small group learning, case-based discussions, and the “flipped classroom” approach in addition to traditional didactics. Each month has a dedicated systems-based theme. The simulation and “hands on days”, journal clubs, and theme of the month sessions follow the monthly theme (for example: CV, Neuro, ID, etc). Each year we start with Resuscitation/Procedural basics in July but the from there the themes vary but are designed to return every 2 years. Residents have a suggested reading schedule using Tintinalli’s Emergency Medicine as their core text.  For board style practice questions, we use the ROSH Review question bank. Each month residents compete a ROSH test that is related to the monthly theme.  We are especially proud of how we seamlessly continued didactics virtually in 2020 due to the COVID-19 pandemic- it really showed how adaptable our faculty and residents can be!  We were able to use breakout rooms to maintain small group learning. We are excited to be back in person for our simulation days beginning this summer!

We have developed a comprehensive Google Education website for our residency, which houses our curriculum and suggested reading schedule, resident dashboards, calendars, forms, and multiple other learning resources. We can go on and on! Below is a brief description of our regularly held educational sessions.

Case Conference: Weekly conference that pairs one EM attending and EM resident who present an interesting clinical case aimed at highlighting key issues pertinent to emergency medicine. Real-life cases from the ED are presented in an interactive manner with the audience, with a focus on problem solving. We implement man oral boards format/style of questioning where a randomly selected resident audience member is chosen to work through the case, with additional audience participation. It is followed by a brief 30 minute didactic from the presenting resident.

Theme of the month reviews:  These reviews were revamped in 2019 with resident input and have been a hit!  During the 1 hour session, 3 residents will present for 15-20 minutes on 3 different focused, EM relevant topics, that fall under the monthly systems-based theme. A secondary objective of this session is for rewsidents to hone their presentation skills- with only 20 minutes they must work on delivering a concise but memorable talk.  The topics are chosen to cover the core EM content of the Model of Clinical Practice of Emergency Medicine over a 2-year period (available on ABEM website). Topics are presented by the residents with faculty input and oversight.

Faculty Lecture Series: Given by our emergency medicine faculty. Faculty discuss Core Content of EM, including areas of their expertise. Interactive discussion, Board-style review questions, current literature review, case-based discussions, and simulation experiences are some of the adult learning strategies used. The faculty may use an audience-response system to get “real-time” feedback to ensure that residents understand key concepts.

Resident Education Cases: 30 minute clinically based sessions given by faculty. The focus is on practical topics such as procedures, imaging, ultrasound, or ECG interpretation that tie into our “theme of the month”. We often use the EM Foundations Courses (‘click here to learn more’) for these sessions.

EM Foundations Sessions:   1 hour case-based learning sessions where 4 faculty lead simultaneous small groups through 2, 30 minute cases. The cases are relevant to the monthly theme, PG year specific (tailored to your needs!), and are related to some of our asynchronous learning opporutnities (see more below). We use the EM Foundations Courses and online curriculum (‘click here to learn more’) for these sessions. 

EM Journal Club: Monthly conference that discusses recent journal articles from the EM literature, with a focus on critically interpreting the literature and developing an understanding of evidence-based medicine. A team approach is used with a PGY-1, 2 and 3 resident presenting different aspects of the article and key concepts with the guidance and input of our departmental Research Director and a faculty mentor.

 Annual Cadaver Lab: Over the course of several weeks each Fall, residents practice infrequently done but life-saving, procedures with direct EM faculty supervision. Direct feedback on procedural skills is given. This experience includes an annual introduction to the procedures, a procedural knowledge test, and skills evaluation. Procedures done include but are not limited to:  chest tubes, pericardiocentesis, thoracotomy, retrograde intubation, DPL, and lateral canthotomy. Each session is also paired with procedural simulations in our simulation center and mock oral board practice. This allows us to keep group sizes small, all while covering a lot of ground!

Faculty member Stefanie Ellison, MD leading an adult COVID-19 simulation to prepare our residents for the assessment and resuscitation of a critical COVID-19 patient.
Faculty member Stefanie Ellison, MD leading an adult COVID-19 simulation to prepare our residents for the assessment and resuscitation of a critical COVID-19 patient.

Simulation and “Hands on” experiences: We have implemented adult, active learning through our “hands on” days. These simulation-heavy experiences are held monthly and include a combination of case-based learning, oral board cases, critical care simulations, and procedural training. We often incorporate inter-professional education with the assistance of our ED pharmacy team. These sessions in our state-of-the-art simulation center occur monthly and are based on the “theme of the month”. Recent sessions have included: management of difficult airways, vascular access, US workshops, Transvenous pacing/defibrillation, and adult and pediatric resuscitations. Our residents regularly teach using simulation and serve as instructors for ACLS (we teach all graduating medical students at the school o f medicine!), medical student clerkship education (airway simulation), and the GME Central line course.

Emergency Medicine Foundations:  We are avid users of the online EM Foundations curriculum. This flipped-classroom model is designed to provide small group case-based learning on essential topics in emergency medicine. We provide EM foundations sessions at least bimonthly. We also host special EM Foundations “Lunch and Learns” for PGY-1 residents. We cater lunch and select cases that are “must know” for PGY-1 EM residents.

Wellness Series: We dedicate the 5th Thursday conferences to resident wellness-read more above!

Emergency Medicine Morbidity and Mortality conference: Monthly case-based conferences that focus on on improving patient safety and quality improvement and system changes. A Chief Resident moderates and leads the case-based presentation and collaborates with a PGY-2 who presents relevant teaching points. In 2020 we are partnering with our hospital quality improvement and patient safety team (QIPS) for a few mock root-case-analyses as part of the conference.

Emergency Medicine/Internal Medicine Morbidity and Mortality conference: Interdisciplinary quarterly conference that emphasizes a team approach to patient care, including quality improvement practices and patient safety. 

Multidisciplinary Trauma conference: Monthly conference with the Department of Surgery that emphasizes the institutional teamwork necessary to care for a trauma patient from the pre-hospital setting to the Emergency Department to Surgery to Intensive Care to Rehab to discharge. Includes didactics from local, regional, and national content experts in trauma care.

Emergency Medicine/Trauma Services Morbidity and Mortality conference: Monthly conference that emphasizes a team approach to patient care, including quality improvement practices and patient safety. 

Pediatric conferences: Pediatric emergency medicine faculty from Children’s Mercy Hospital gives regular monthly didactic conferences over core content. Pediatric simulation and sedation workshops are also provided annually. In addition, we incorporate pediatric activities into most of our simulation activities. Once annually we are invited to a dedicated pediatric simuation center to do an intensive peds-only simulation day.

Additional experiences: We also try to “break up the routine” on occasion. Recent examples of more innovative opportunities include: a Wilderness event with sessions on mass casualty management and field procedures and a procedural “boot camp” for our PGY1 class focusing on frequently performed procedures such as lumbar punctures, ultrasound-guided IV access, and slit-lamp usage.  We also have regular pre-conference PGY-1 “rookie camps” which focus on core clinical skills.

Asynchronous learning: Asynchronous learning is an important part of providing flexibility for our residents.  We are excited to provide many opportunities for learning to count towards your conference attendance!   Each month we provide an opportunity for asynchronous learning before our EM Foundations sessions- we send out the suggested reading and related ROSH test and attestion forms to make it easy to participate and get an extra hour of conference credit. We also utilize Academic Life in Emergency Medicine (ALiEM U) site; an on-line open-access, peer-reviewed site with a large number of learning modules for which you can receive asynchronous credit. Residents also have opportunity for asynchronous credit through Journal Club assignments, on-line teaching modules, and we created some in-house modules during the COVID-19 pandemic.