Practical Teaching in Emergency Medicine Practical Teaching in Emergency Medicine Second Edition Edited by Chief Editor Robert L. Rogers Associate Editors Amal Mattu Michael E. Winters Joseph P. Martinez Terrence M. Mulligan A John Wiley & Sons, Ltd., Publication This edition first published 2013 2013 by John Wiley & Sons, Ltd. Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technical and Medical business with Blackwell Publishing. Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell. 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It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Practical teaching in emergency medicine / chief editor, Robert L. Rogers ; associate editors, Amal Mattu ...[et al.].–2nd ed. p.;cm. Includes bibliographical references and index. ISBN 978-0-470-67111-5 (pbk.) I. Rogers, Robert L. II. Mattu, Amal. [DNLM: 1. Emergency Medicine–education. 2. Emergency Service, Hospital. 3. Teaching–methods. WX 18] 616.025–dc23 2012023221 A catalogue record for this book is available from the British Library. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Typeset in 9/11 pt Meridien by Laserwords Private Limited, Chennai, India 1 2013 First and foremost, this book is dedicated to my beautiful wife, Tricia, and my two wonderful children, Harrison and Gabriella. Without their love, guidance, and constant support, this book would not have been possible. Family comes first. I dedicate this book to all of the educators of emergency medicine in USA and around the world: may this book inspire you to educate how to teach our craft and deliver the best patient care possible. To the emergency medicine residents and students at the University of Maryland: you are the reason I drive to work with energy and enthusiasm for teaching. I would like to thank my mom and dad for their encouragement and love throughout life. I am where I am today because of them. To Linda Kesselring, who edited the book and transformed its contents into an amazing work. The success of this book is due in large part to her tireless efforts. Rob L. Rogers My thanks to my family for their constant support; my colleagues, residents, and students for their inspiration to teach and to learn; and to all those who spend their time teaching emergency medicine around the world ... may your efforts continue to help our specialty flourish. Amal Mattu To the medical students and emergency medicine residents at the University of Maryland for making me look forward to my shifts and to Lisa, Nicholas, Dylan, and Luke for making me happy to go home. Joseph P. Martinez To Erika, Hayden, Emma, Taylor, and Olivia, for your endless love and support; you are my world and my inspiration for everything. To the emergency medicine residents and faculty at the University of Maryland, it is a privilege to be your colleague. Michael E. Winters I am very excited to be involved as coeditor for the second edition of Practical Teaching in Emergency Medicine. My involvement stems from the enormous interest and growth of emergency medicine education, practice and development in the international setting, and from the demand to share the contents of this book with the international emergency medicine community. I would like to offer my deepest thanks to my coeditors, especially Rob Rogers, without whom this material would most likely still reside in the collective minds of our teachers instead of in a book form. I would also like to thank my beautiful wife Kristina without whom I would not be able to do most anything. Terrence M. Mulligan Contents Editors and Contributors, xi Preface, xxi Section 1 Background/Introduction Chapter 1 Adult learners in the emergency department, 3 Ellen J. O’Connell and Kurt C. Kleinschmidt Chapter 2 Obstacles to teaching in the emergency department, 15 David K. Duong, Esther K. Choo, and Jeffrey A. Tabas Chapter 3 Teaching and patient care in emergency medicine, 25 Michael A. Bohrn and David A. Kramer Chapter 4 Mentoring in emergency medicine, 35 Gus M. Garmel Section 2 Teaching in the Emergency Department and Beyond Chapter 5 Bedside teaching in the emergency department, 59 Kevin G. Rodgers Chapter 6 Teaching invasive medical procedures, 72 Siamak Moayedi and Mercedes Torres Chapter 7 Providing feedback in the emergency department, 85 David A. Wald Chapter 8 The computer as a teaching tool, 98 Joshua S. Broder Chapter 9 Educational technology: Web 2.0, 118 Michael C. Bond and Robert Cooney vii viii Contents Chapter 10 Teaching the intangibles: professionalism and interpersonal skills/communication, 137 David K. Zich and James G. Adams Chapter 11 Teaching lifelong learning skills: journal club and beyond, 151 Christopher R. Carpenter Chapter 12 Medical podcasting 101, 163 Robert Orman and Scott D. Weingart Chapter 13 Use of simulation in emergency department education, 177 Traci L. Thoureen and Sara B. Scott Section 3 Teaching Specific Groups Chapter 14 Teaching medical students, 189 David E. Manthey Chapter 15 Teaching residents from other services in the emergency department, 203 Michelle Lin and Amer Z. Aldeen Chapter 16 The education of resident physicians in emergency medicine, 216 Jonathan G. Wagner, William K. Mallon, and Stuart P. Swadron Chapter 17 Teaching residents how to teach, 237 Carey D. Chisholm Chapter 18 Teaching to an international audience, 248 Terrence M. Mulligan Chapter 19 The emergency department consultation: teaching physician–physician communication to improve patient outcomes, 268 Chad S. Kessler, Yalda Afshar, and Albert C. Vien Section 4 Improving as an Educator in Emergency Medicine Chapter 20 Characteristics of great teachers, 285 Jennifer Avegno and Peter M. C. DeBlieux Contents ix Chapter 21 Effective presentation skills, 295 Joseph R. Lex Jr. and Zachary Repanshek Chapter 22 Small-group discussion skills, 307 Matthew D. Deibel and Mary Jo. Wagner Chapter 23 Faculty development as a guide to becoming a better teacher, 319 Gloria J. Kuhn Section 5 Teaching Techniques and Strategies Chapter 24 Strategies for effective clinical emergency department teaching, 339 Glen W. Bandiera and Shirley Lee Chapter 25 Pearls and pitfalls in teaching: what works, what does not?, 352 Brian Clyne and David G. Lindquist Index, 361 Editors and Contributors Chief Editor Robert L. Rogers FACEP, FAAEM, FACP Associate Professor of Emergency Medicine and Medicine Director, Undergraduate Medical Education Director, Teaching Fellowship Department of Emergency Medicine University of Maryland School of Medicine Baltimore, MD, USA Associate Editors Amal Mattu, MD, FAAEM, FACEP Professor and Vice Chair Director, Faculty Development Fellowship Department of Emergency Medicine University of Maryland School of Medicine Baltimore, MD, USA Michael E. Winters, MD, FACEP, FAAEM Associate Professor of Emergency Medicine and Medicine Director, Combined EM/IM Program Co-Director, Combined EM/IM/Critical Care Program Department of Emergency Medicine University of Maryland School of Medicine Baltimore, MD, USA Joseph P. Martinez, MD Assistant Professor of Emergency Medicine Assistant Dean for Student Affairs Department of Emergency Medicine University of Maryland School of Medicine Baltimore, MD, USA xi xii Editors and Contributors Terrence M. Mulligan, DO, MPH, FACOEP, FNVSHA, FACEP, FAAEM, FIFEM Assistant Professor in Emergency Medicine Department of Emergency Medicine University of Maryland School of Medicine Baltimore, MD, USA Extraordinary Senior Lecturer/Visiting Assistant Professor Division of Emergency Medicine Stellenbosch University Cape Town, South Africa Contributors James G. Adams, MD Professor and Chair Department of Emergency Medicine Northwestern University, Feinberg School of Medicine Northwestern Memorial Hospital Chicago, IL, USA Yalda Afshar, PhD MD/PhD candidate c/o 2012 Medical Scientist Training Program University of Illinois at Chicago College of Medicine Chicago, IL, USA Amer Z.