Why is it that EM appears to be the only specialty where there are a bunch of people in every department that are doing education "research", where there is at least one meeting every week to talk about how to make resident evals more "meaningful", where you can be the smartest clinician, but all your evals are talking about are "did not sit down with the patient". Sure, I get it, we need to be trained for Press-Ganey, but it seems like no other specialty cares about all of this. Granted, I do think that a little bit of it may be helpful in let's say other residencies, where it sometimes appears that someone has no communication skills at all. But it seems like all of this is a legit career pathway in academic EM, even more in pseudo-academic community settings. Everybody else must be laughing at us? And all these useless meetings, new evaluation methods, OSCEs and so on - they seem to feed into the cycle of always more, always something new (and conveniently allow for another admin job to open up, another "360 evaluation").... I guess everyone who trained 10+ years ago must really suck, because they didn't have "milestones" and their superiors cared more about clinical performance than "empathy" and customer service skills.
Focus on Education
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Do you dare imply that some people hide in academics to isolate themselves from to tougher realities of private practice and create work just to justify their own jobs?
If so, then you are correct.
Every lecture, meeting, trip to teach some board review course, or OSCE given is one less shift ground out in the pit under the pressure of the volume, acuity, Press-Ganey and profit drooling hospital CEOs. So you're somewhat correct in that some (not all) in academics do it to escape the pressures of private practice. Many of these academic types that work 4 shifts per month, will preach how amazing EM is, not letting you in on the reality that 4/5 of you will not be able to find such a cushy job, but instead will be shelled on the front lines, suffering shift-work circadian rhythm disorder.
You're wrong to think its EM specifics though. You're seeing it more in EM because you're closest to it. Trust me, there's no shortage of academic sandbaggers in other specialties.
The OSCEs are ACGME required in other specialties, too. As far as Press Ganey, trust me, your attending hate it too and realize how stupid it is. They're just preparing you for how stupid it's going to be in the real world (even more stupid) and preparing you for the fact you'll have to unlearn half of what you were taught become some patient demand bad care, and complained. Just wait for the pointless yearly LLSAs (homework for attending that you have pay to do) and 10 year board recerts that cost thousand of dollars more.
So you're right, that some in academics are there because they can reduce the tough clinical load while replacing it with cushy paper pushing type activities that seem useless. But you're way off if you think it's EM specific. So I agree, it's BS. But I can tell the only level of BS that rivals it is the BS you're dealt from private practice administrators, outrageously stupid government and insurance rules and regulations, Obamacare, HCAHPS, etc. Consider the irrational stuff you're seeing now, mere child's play.
Add this one to your stickies, and mark with, "Birdstrike told me":
*The profession of medicine is becoming one where if you are a rational and critical-thinking person, you're going to spend a tremendous amount of time scratching your head in disbelief of the endless stupidity you see required and enacted by those in charge.*
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Birdstrike, I agree with all of this, but it appears that this focus on evals and education research is quite unique to EM. Agree that the rest of the PG BS and so on is also effecting other specialties (or will soon)
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We're a young specialty and haven't had the optimum method of teaching engraved in stone and passed down from attending to attending in an unbroken chain since Hippocrates. We port educational methods from other specialties - grand rounds, M&M, morning report, bedside teaching, controlled simulations. All of these have some usefulness, but none of them are perfect for training purposes. Grand rounds is typically a block of lecture that has all of the inefficiencies lecturing to an audience has in imparting information. M&M is fantastic for driving home the most not miss points but tends to focus on the dramatic at the expense of the common. Bedside teaching is great but difficult to do effectively given time pressure and you have to be on shift and seeing the patient (or doing the procedure on the patient) to benefit. Sim labs solve some of the major issues with acquiring cognitive or procedural skills in patients with rare presentations but artificial environments and lack of simulator fidelity means it's not a magic bullet yet. Considering the challenges in trying to cram a working knowledge of acute care in every field of medicine into 3 years of training, I think the focus on how to educate is pretty reasonable.
In terms of evaluation, I think that's simply a reflection of how controlled our specialty is by our customers. While it's painful and most of the data generated is meaningless from a practice improvement standpoint, there probably is some value in learning to take feedback from all sources. The ability to deal with criticism and respond appropriately is a core competency in EM.
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I'm proud of the commitment to education in our specialty.
My program has a dedicated SIM center for EM residents and I think this is an educational highlight.
Teaching EM residents is a challenge. No time for rounding style patient focused teaching.
While I generally hate rounding, bedside teaching can be very effective if done well.
I'm not a fan of the useless evals either, but I'd treat this as a separate issue.
The attendings who are commited to real teaching, usually give better feedback.
Sure there are plenty of evals that aren't really helpful.
I just ignore those (unless there is a hidden teaching point).
My program has a dedicated SIM center for EM residents and I think this is an educational highlight.
Teaching EM residents is a challenge. No time for rounding style patient focused teaching.
While I generally hate rounding, bedside teaching can be very effective if done well.
I'm not a fan of the useless evals either, but I'd treat this as a separate issue.
The attendings who are commited to real teaching, usually give better feedback.
Sure there are plenty of evals that aren't really helpful.
I just ignore those (unless there is a hidden teaching point).
