An expert discusses strategies for implementing a good academic emergency medicine training program. Key aspects include: - Strong selection process and induction training to prepare students. - Focused clinical rotations, electives, life support courses, procedures, and skills training to build proficiency. - Daily teaching, case discussions, bedside learning and faculty coverage to mentor students. - Evaluations, research, workshops and conferences to assess progress and support continued learning. - Exit exams to ensure students have achieved expected competencies before completing the program.

1. Good academics in Emergency
Medicine training program
Dr.Venugopalan P P
DA,DNB,MNAMS,MEM[GWU]
Director ,Aster DM Health care Ltd.
Deputy Director ,MIMS Academy,
Founder & Executive Director ANGELS –Active Network Group of Emergency
Life Savers
India, Kerala

2. Focus
• DNB Emergency medicine
• Strategies to make good teaching schedule
• Implementation of program
• A good start , strong progression and
excellent exit
• Contents and beyond …..
• Students expectations Faculty expectation

3. Emergency Medicine
Initial evaluation, treatment and disposition of
any person at any time for any symptom,
event or disorder deemed by the person or
someone acting on his or her behalf to require
expeditious medical, surgical or psychiatric
attention.
ACEM

4. Emergency Physician
• A specialist who has been trained to
engage in the immediate initial recognition,
evaluation and disposition of patient with
acute illness and injury..
Specialists who doesn’t passionate and
spend time in ER will not understand
the “issue and challenges” of
emergency medicine

5. MCI
• July 21st 2009
• Primary specialty
• Rapid growth
• Need of the Nation
• Need of health care system
National Board of examination officially declared DNB program in
November 2013

6. Triage
Cueing
Affective state
Fatigue &
Shift work
Long waiting time
For Bed
Medication errors
Assessment-Diagnosis-Triage Treatment-Management-Disposition
Admit
Discharge
EMS
ED Design
Patient
Presentation
Information Gap
Over crowding
Report
Delay
Lab errors
Orphaned Pt
Resource
Constrain
Team work problem
Authority Gradient
Transition of Care
Sense
Making
Radiology
Error
Cognitive properties of
the mind
Violation producing
factors
Procedural
factors
Inadequate
Discharge
Plan
Follow up
failures
Sources of Failures and Errors in ED

7. Acad Emerg Med. 2000 Nov;7(11):1204-22.
Promoting patient safety and preventing medical error in emergency departments.
Schenkel S.
Author information
Abstract
An estimated 108,000 people die each year from potentially preventable iatrogenic injury. One in 50 hospitalized patients experiences a preventable adverse event. Up to 3% of these injuries and
events take place in emergency departments. With long and detailed training, morbidity and mortality conferences, and an emphasis on practitioner responsibility, medicine has traditionally faced the
challenges of medical error and patient safety through an approach focused almost exclusively on individual practitioners. Yet no matter how well trained and how careful health care providers are,
individuals will make mistakes because they are human. In general medicine, the study of adverse drug events has led the way to new methods of error detection and error prevention. A combination
of chart reviews, incident logs, observation, and peer solicitation has provided a quantitative tool to demonstrate the effectiveness of interventions such as computer order entry and pharmacist order
review. In emergency medicine (EM), error detection has focused on subjects of high liability: missed myocardial infarctions, missed appendicitis, and misreading of radiographs. Some system-level
efforts in error prevention have focused on teamwork, on strengthening communication between pharmacists and emergency physicians, on automating drug dosing and distribution, and on
rationalizing shifts. This article reviews the definitions, detection, and presentation of error in medicine and EM. Based on review of the current literature, recommendations are offered to enhance the
likelihood of reduction of error in EM practice.
PMID:
11073469
[PubMed - indexed for MEDLINE]
•108000 preventable deaths from iatrogenic injuries per year
•1 in 50 hospitalized patients experiences preventable adverse events
•3% from ER

8. Emergency Medicine
Make practice more
stressful • Decision making
• Dynamic nature
• Errors in judgments
• Communication
• Unknown cases
• Unexpected issues
• Unlimited numbers
• Exposed environment

9. How can we implement
a good academic program in EM?

10. Selection
Induction
Rotation
Electives
Examination and Exit
CET
Ice break
EM allied
specialties
Reputed
institutions
Multiple and
focused
E
M
E
R
G
N
C
Y
M
E
D
I
C
N
E

11. Induct with warm intro
• Introduction of EM and
ER
• Knowing entire hospital
• Process and protocol
• Team building and
getting along
• E Based learning

12. Induction
• Communication
• Presentation skills
• Basic sciences
• Research methodology
• Life support courses

13. Life support courses
• BLS[Basic life support]
• ACLS[Advanced life
support]
• PALS[Pediatric advanced
life support]
• NALS[Neonatal Advanced
Life support ]
• ITLS [International
Trauma life support]
• ATLS[Advanced Trauma
life Support]

14. Focused training Programs
• BDLS[Basic Disaster Life
support ]
• ADLS[Advanced Disaster
Life Support]
• ATULS[Advanced Trauma
Ultrasound Life
Support]
• HAZMAT
• ECHO and Ultrasound
• Wound care management

15. Daily case discussion
• Daily rounds
• Weekly grand rounds
• Weekly academic clubs
Early morning 2-4 am is highly potential for
errors and wrong judgments

16. Morning reports
• Focus on minor and major issues
• Review codes
• Follow up cases

17. Bedside teaching
• Success of program
• Discuss cases
• Communication skills
• Teaching skills
• Equipment orientation
• Team work
• Paramedic education

18. Faculty coverage
• 24 hours faculty
coverage
• Every case is a chapter
• Modulate students
• Inculcate extra attitude
• Free time – Simulations

19. Faculty
as
Learners
Academic
growth
Inculcating
Creativity
Professional
excellence
Community
engagements
Strategic
Planning

20. Procedures
• Essential procedure to
be accomplished
• Expected numbers
• Supervised
• Self
• Simulation based

21. Log book
• Academic
• Clinical
• Procedure
• Seminars
• Conferences
• Workshop
• Special works
Must be submitted and
signed monthly basis

22. Thesis and research
• Search topics
• Department thrust
areas
• Institutional Research
committee
• Institutional ethics
committee
• Time bound execution
• Presentable and
publishable projects
Beneficial for the student ,institution and Community

23. Evaluation
• Clinical skill
• Decision making
• Communication skill
• Knowledge base
• Presentation skill
• Attitude and aptitude
• Teaching skill
• Strength and weakness
Empower
students

24. Monthly Modular system
• Plan to cover entire curriculum in 36 module
• Pre planed teaching schedule
• Students presentations
• Faculty presentations

25. Rotation
• Define the objective
• Interactive
• 360 degree feedback
• Confidential report

26. Electives
• Reputed centers
• Trauma centers
• Burns centers
• Pediatric and Obstetric institutions
• Palliative care

27. Faculty and students exchange
program
• Regional
• National
• International

28. Public education
• Basic life support
• Trauma life support
• Disaster managements
• Public health
• Stroke
• First response training

29. Skill lab and simulations

30. Workshops
• Mechanical Ventilation
• ABG
• Wound care
• Ultrasound
• Vascular access
• Procedural sedation
• Nerve blocks

31. Conferences and seminars
• Regional
• National
• International
Motivate students to
prepare and submit
abstracts

32. Mortality , Journals
• Monthly Basis
• Journal reviews
• Medical News board in the department
• E based groups to share recent advances

33. Medical Records
• Prompt
• Regular entry
• Electronic records
• Police intimation
• Wound certificate
• Reference letters
• Photographs and Videos

34. Books & Resources

35. Journals

36. E Learning

38. Scope of social media in
emergency medicine

39. Exit exams
• Written
• Clinical
Objective
Eliminate personal bias
Relevant Basic science
OSCE
Oral board style
Monthly Yearly Final

41. OSCE

43. Thank you so much …..
www.drvenu.net , www.emergencymedicinemims.com

44. www.drvenu.net