Curriculum

About Residency Curriculum

The Wright State University Integrated Residency in Emergency Medicine follows the R1-R3 format to board certification. We prepare excellent generalist emergency physicians who are prepared to care for any condition, in any emergency department, with compassion and skill.

The evaluation and management of critically ill patients is highly stressed. From a philosophical perspective, we believe that critical care medicine is an extension of emergency medicine. Emergency physicians are intensivists, who also do acute care; rather than primary care physicians, who also do critical care. A solid training in critical care medicine allows the emergency medicine resident better understanding of the natural history and treatment of critically ill patients seen in the emergency department, as well as process issues which might affect optimal care of patients.

Over the three years of training, emergency medicine residents participate in five months of dedicated, interdisciplinary experiences in adult medical and surgical, pediatric medical and surgical, and adult trauma ICUs. These experiences allow the resident opportunities to encounter a wide spectrum of pathological conditions in adult and pediatric intensive care patients. The critical care training is coordinated and supervised by a departmental academic faculty member trained and triple-boarded in emergency medicine, internal medicine, and critical care medicine. This enables residents to learn and experience critical care medicine from an emergency medicine perspective.

By the completion of residency, our emergency physicians have gained an increased level of self-confidence, maturity and clinical judgment in evaluating and treating critically ill patients, as well as increased proficiency in procedures necessary for initial and sustained care.

Summary Block Rotations

R1 Year

The first year of training is designed to provide a broad base for residents to acquire the knowledge, skills and abilities requisite to emergency medicine throughout the remainder of their training and future careers. R1s are expected to see as wide a variety of patient ages, social situations, presenting complaints, management approaches and disposition decisions as possible. R1s must also acquire the technical skills in the handling of medical and surgical disorders in all age groups.

July of the R1 year begins with an intense month-long orientation including seminars, simulation, and procedural training to prepare the new resident with a foundation to approach some of the most common and potentially most serious undifferentiated patient complaints. A session on the rational use of ancillary studies is also presented. Managing personal & professional stress is another session targeted at resident wellness. Additionally, a series on workplace violence, physical safety in the ED, and personal defensive tactics is presented during the orientation month. This prepares R1s for three hands-on defensive-tactics classes that will follow. ED directors discuss documentation, risk management, cultural barriers to care, and patient satisfaction. Additionally, an introduction to disaster medicine is provided. R1s are fully introduced to their integral roles in disaster-response plans for the eight-county Ohio Emergency Management Agency Region II. R1s subsequently complete the short course in basic disaster life support (BDLS). This is complemented by a day of hands-on instruction in personal protective equipment (PPE) and decontamination techniques for healthcare providers managing patients exposed to chemical, biological, or radiological (CBR) materials.

The R1 resident will work a reduced number of shifts in the emergency department during the orientation month.

R2 Year

The second year of training is designed for more in-depth exposure to emergency medicine. R2s are expected to focus on critical care, while refining their skills and efficiency managing less-emergent patients.

R3 Year

Senior residents are expected to apply and disseminate the knowledge they have gained from their previous training. As part of their graded responsibilities, R3s assume more supervisory and educational roles. During their teaching block, R3s also assist in the education of medical students in small-group discussions, high-fidelity simulations and clinical observation and feedback.

*Residents all experience a longitudinal experience in a pediatric emergency department in their second and third year.

Resident Conferences

All conference time is protected from clinical responsibilities to ensure maximum resident participation. Throughout all conferences, there is a focus on evidence-based medicine.

EM Didactic Conference

This weekly four-hour didactic conference is attended by all faculty, residents, and medical students in theDepartment of Emergency Medicine. The conference is divided into two hour blocks. The first two-hour block is spent in interactive small groups of 12 residents with faculty facilitation. The second two-hour block is spent in a traditional lecture format with all medical students, residents, and faculty together. Residents are expected to spend at least one hour each week in asynchronous preparation for this conference. Breakfast is provided to residents and students for each weekly conference.

• Small Group Curriculum includes:
  • Case-based Concentrated Topics in Emergency Medicine
  • Visual Diagnosis Longitudinal Curriculum: EKG/Radiology/Clinical images
  • Oral and Written Board Review

• Lecture Curriculum includes:
  • Core Content from the ABEM Model of the Clinical Practice of Emergency Medicine
  • Case Conference and Discussion

• Asynchronous Learning
  • Weekly reading assignments
  • Multimedia presentations
  • Commercial board review question bank

Morbidity and Mortality Conference

The morbidity and mortality conference presents cases with unexpected or suboptimal outcomes or near missesfor critical evaluation. Cases are selected for their educational value as an important part of the quality improvement process. Emphasis of discussion is placed on system improvement and controllable factors contributing to the case. Cases are presented by residents with a faculty mentor. This conference occurs on alternating academic blocks opposite the trauma conference.

Trauma Conference

Trauma conference is a joint conference between the Department of Emergency Medicine and Trauma Surgery. These conferences are presented by faculty and focus on a select topic in the multidisciplinary management of trauma patients. This conference occurs on alternating academic blocks opposite the morbidity and mortality conference. It is
attended by residents, faculty, and ancillary staff from both
departments.

Year-Directed Conference

The R1 year-directed conference (YDC) concentrates on the approach to the undifferentiated patient complaint. The ability to conduct simultaneous resuscitation and treatment while evaluating life-threatening and other serious problems is an essential skill for all emergency physicians. Small-group sessions enable case-based discussions where R1s can ask questions and draw on the real-world experiences.

The focus areas of the R2 year-directed conference (YDC) are critical care and procedural skills. The small-group discussions, experiential activities, and short courses specific to the R2 year increase the residents’ confidence in these critical skills.

Success in personal and professional lives is one key characteristic for a fulfilling long-term career in emergency medicine. The R3 year-directed conference (YDC) focuses on the related knowledge, skills, and abilities necessary to achieve this. The small-group discussions are led by local experts in the respective topics.

Journal Club

Journal Club helps residents develop the skills necessary for life-long learning throughout their career. Under the direction of a faculty mentor, residents develop the skills necessary to formulate an appropriate clinical question, find and critically appraise relevant literature,  and implement practice-changing advancements.

Research and statistical training relevant to the articles to be discussed is provided by a faculty member actively involved in research design in the Department of Emergency Medicine prior to the Journal Club discussion.