Asynchronous Didactics

[EMPD]

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So I am seriously wanting to revamp our conference days to make them much more useful. I'm really starting to believe that conference needs to be modernized to reflect a new way of learning. I feel that simulation, mock oral boards, and the utilization of PEER VIII should be the foundation of conference hours. On top of that, I think there are roughly 30 essential EM topics that need to be covered every 18 months. I also think that the RRC's allowance of 20% of conference to be asynchronous means we should be taking advantage of all the incredible Podcasts out there. I'm a loyal fan of Scott Weingart's EMCRIT, Mel Herbert's EMRAP, Cliff Reid's RESUS, Rob Orman, Dave Newman, and many more. I'd like to hear if any of you have a favorite Podcast, or any ideas from your own programs where your PD has improved conference hours.

 

[justin8818]

I would recommend ultrasoundpodcast.com with Matt Dawson and Mike Mallin. Pretty great.

 

[dotcb]

I work in a program that has tried to innovate more interactive sessions into our conference time. It is so-so. One thing I would not recommend is avoiding a classic M & M conference. Getting everyone in a room to review some of the best cases from the past week is incredibly useful. M & M was probably the best learning activity from my residency outside of on-the-job learning. A different resident lead it each week, picked the cases from a logbook where we logged cases that were interesting, rare, or could have gone better. Residents presented their own cases. It was well attended by faculty, who chimed in, because the cases were so good. It was not blame oriented, and you learned from each other. Educational innovation is great, but forgoing this tradition would be a mistake.

I love podcasts, listen to them often, and did in residency. But I don't think you need to block out conference time for them. Discussion of them? Maybe.

 

[Hamhock]

I work in a program that has tried to innovate more interactive sessions into our conference time. It is so-so. One thing I would not recommend is avoiding a classic M & M conference. Getting everyone in a room to review some of the best cases from the past week is incredibly useful. M & M was probably the best learning activity from my residency outside of on-the-job learning. A different resident lead it each week, picked the cases from a logbook where we logged cases that were interesting, rare, or could have gone better. Residents presented their own cases. It was well attended by faculty, who chimed in, because the cases were so good. It was not blame oriented, and you learned from each other. Educational innovation is great, but forgoing this tradition would be a mistake.

I love podcasts, listen to them often, and did in residency. But I don't think you need to block out conference time for them. Discussion of them? Maybe.

👍 I couldn't agree more regarding the importance of a "no-blame" M&M...

I modernization technique that I think could be utilized more? --> The incorporation of resident conferences from other sites. As much as I learned from and appreciated many of the great educators in my residency program, it was hard to compete with the best of the lectures on the now dead corecontent.com....that is, I felt bad for our faculty trying to reproduce lectures that were already mastered by some of the best lecturers from LAC/USC. I actually put more effort into watching USC/LAC's conference via corecontent.com each week than I did into attending my home resident conference.

Perhaps modern conference could include video of the best lectures from other resident conferences. Perhaps more sharing between programs would be useful.

Another thing I have seen that is very useful and could be incorporated more frequently in cities with multiple residency programs: All-LA Conference, All-NYC conference, and All-Bay Area Conference.

The first two also record the lectures and put them online.

HH

Oh -- also: the more asynchronous credit for residents, the better, IMO...we are adult learners and must by now know how best we learn...and learning should be up to us, for the most part...it would have been great to get "conference" credit for all of the hours I spent outside of conference...in fact, often I was in conference just for the "credit" and felt that there was a lot of effort on the residency's part just to come up with "OK" material for the five weekly hours.

HH

 

[Apollyon]

👍 I couldn't agree more regarding the importance of a "no-blame" M&M...

I modernization technique that I think could be utilized more? --> The incorporation of resident conferences from other sites. As much as I learned from and appreciated many of the great educators in my residency program, it was hard to compete with the best of the lectures on the now dead corecontent.com....that is, I felt bad for our faculty trying to reproduce lectures that were already mastered by some of the best lecturers from LAC/USC. I actually put more effort into watching USC/LAC's conference via corecontent.com each week than I did into attending my home resident conference.

Perhaps modern conference could include video of the best lectures from other resident conferences. Perhaps more sharing between programs would be useful.

Another thing I have seen that is very useful and could be incorporated more frequently in cities with multiple residency programs: All-LA Conference, All-NYC conference, and All-Bay Area Conference.

The first two also record the lectures and put them online.

HH

Oh -- also: the more asynchronous credit for residents, the better, IMO...we are adult learners and must by now know how best we learn...and learning should be up to us, for the most part...it would have been great to get "conference" credit for all of the hours I spent outside of conference...in fact, often I was in conference just for the "credit" and felt that there was a lot of effort on the residency's part just to come up with "OK" material for the five weekly hours.

HH

(Warning - name-dropping bashing to follow; no anonymous "my program" stuff)

Almost 10 years ago, when I was a resident, we would have joint conference once a quarter with UNC. We at Duke and the UNC residents mixed like oil and water - that is, we didn't. We weren't so much united, but they were. They were cliqueish, snobby, and condescending. One guy there, who is now regularly published in throwaways, had an ego that would be outsized for an attending - and he was an EM-2! I mean, to be honest, there was more than one female resident that, by sight, I would like to have met and possibly gotten to know, but that was NOT happening. Quite candidly, they even thought that their facilities and presentations were better than ours, simply because it was theirs. That was quelled just a bit after Dave Marcozzi (now of the Dept of Health and Human Services) gave an ass-kicking presentation on his time in Iraq.

So, if it is an in-person, live joint conference, forcibly, if needed, mix them together.

 

[NERDY]

As a med student, I've enjoyed the sim center experiences. Do those count towards conference time?

 

[EMPD]

The RRC does not really stipulate the content of the didactics. Most programs use a monthly "system" based curriculum. But the actual individual hours are not governed. So yes, SIM, M&M, oral boards, are all relevant and part of conference hours.

 

[Groove]

So I am seriously wanting to revamp our conference days to make them much more useful. I'm really starting to believe that conference needs to be modernized to reflect a new way of learning. I feel that simulation, mock oral boards, and the utilization of PEER VIII should be the foundation of conference hours. On top of that, I think there are roughly 30 essential EM topics that need to be covered every 18 months. I also think that the RRC's allowance of 20% of conference to be asynchronous means we should be taking advantage of all the incredible Podcasts out there. I'm a loyal fan of Scott Weingart's EMCRIT, Mel Herbert's EMRAP, Cliff Reid's RESUS, Rob Orman, Dave Newman, and many more. I'd like to hear if any of you have a favorite Podcast, or any ideas from your own programs where your PD has improved conference hours.

We started this a couple years ago... I have mixed feelings about it. It looks good on paper, but in reality... we've had a few problems with it. The weak residents will love it because conferences are shorter and they can write down or enter that they listened to a podcast, took a quiz, fulfilled some nebulous asynchronous credit requirement and it's easy credit. We also have a requirement for 70% conference attendance. Conference attendance for us is also a metric that can be used to penalize residents... especially in granting them moonlighting privileges. So... is the 70% calculated from the traditional conference attendance or the combined traditional conference attendance with asynchronous credit? If you pick the former, then residents can't miss as many conference days without getting penalized. If you tabulate it in tandem with asynchronous credit, the calculation algorithm gets complicated and the residents complain is it's not transparent and kept up to date because it's more difficult to see where they stand with conference "attendance". It's been a mess a few times because the numbers were off and the calculations were erroneous and residents were getting penalized when they shouldn't have. It's been largely fixed now, but again... the asynchronous portion is what the resident makes of it. Weak residents will make it a weak experience. Strong residents will make it a strong experience. Asynchronous makes sense in that you should get credit for outside learning experiences as part of your formal didactics, at least in theory.. but there is little supervision which begs the question... what is the value in traditional conference didactics? The value is that residents are forced to attend and to listen and I personally find more value and learning in group discussion, but call me old school. Personally, I think the asynchronous component should be a learning component that residents should be doing on their own anyway.

Regardless, I seem to be in a minority as most of our program enjoys the asynchronous aspect, though I suspect it's because it's largely an easy requirement to fulfill.

 

[deleted109597]

I would like to start something similar to journal club but with set asynchronous podcasts. That way, the podcasts themselves can be vetted (although Rob, Scott, and Mel have great ones already). Then, we can have an intelligent group discussion about the merits of the podcast. I would argue in a way that it's even better than journal club, because for that, we spend an hour talking about the nebulous statistics of some article that took 10 minutes to read, if they aren't reading it during the actual conference itself.

 

[Groove]

I would like to start something similar to journal club but with set asynchronous podcasts. That way, the podcasts themselves can be vetted (although Rob, Scott, and Mel have great ones already). Then, we can have an intelligent group discussion about the merits of the podcast. I would argue in a way that it's even better than journal club, because for that, we spend an hour talking about the nebulous statistics of some article that took 10 minutes to read, if they aren't reading it during the actual conference itself.

I think that's an excellent idea... Use the asynchronous component in the formal didactics as group discussion or what have you... That way, the residents are forced to listen or read the assignment and have a clear incentive.

To give you an example of how this can be abused... We use CORD exams and Challenger quizzes as asynchronous. CORD is required, regardless, so it's free asynchronous credit for something that we would do anyway. Challenger quizzes can be taken as many times as you want and the resident is given 1 hour asynchronous for completion of quiz and print out of score. Well.. people will pick random topics with only say... 5 or 8 questions and just take it multiple times quickly, or even legitimately for an easy 1 hour asynchronous credit. They might list an EMCrit podcast that they listened to on their own, or skip through it and write down a brief summary, simply to get the 1-2 hour asynchronous credit. In my opinion...things like that aren't adequately supervised "learning" experiences. Residents should be doing test banks, reading, listening to EMRap, EMCrit, etc.. anyway, so it seems a bit redundant to me to have that fulfill an asynchronous metric while formal didactic conferences shorten.

Then again... we have a 100% first time board pass rate for the past 5 years I believe, so maybe it's a legitimate learning experience. Either way, I think your idea works best by incorporating it into your formal didactics.