Emergency Medicine

Rotation Goals and Objectives

  1. General Description
    1. Family Physicians actual practices vary considerably in the extent to which they provide emergency services to their patients. The goal of teaching in this area is to provide residents with the skills and expertise expected of family physicians with active practices involving this area. These rotations will be the resident's intensive experience in the field of emergency medicine, and the resident will learn the management of emergent patients who have just arrived at care facilities. The resident will achieve competency in the management of emergency disorders commonly cared for by family physicians.
    2. Residents activities while on this service will include observing and working alongside physicians specializing in Emergency Medicine. The resident is on a one on one basis with the attending emergency medicine physician so didactic material is delivered to the resident on an informal basis throughout the course of each day. A firm understanding of what consultative services are useful to patient presenting with emergency problems will be developed. Assigned readings by the attending physician will be part of the learning process.
    3. Residents are expected to continue to follow their patients in the Family Medicine Center during this rotation.
    4. Level: PGY 2, 3, and 4 year
    5. Location: Renown Regional Medical Center and St. Mary's Regional Medical Center
    6. Duration: 2 rotations - 4 weeks each
    7. The Emergency Medicine experience is a full time rotation.
    8. Four half days per week are spent in the Family Medicine Center.
    9. Work hour form submission is required at the completion of this rotation
      1. The evaluation of the resident on this rotation will be done by the completion of a Family Medicine evaluation form by the Emergency Room attending at the end of the rotation.
      2. The resident will fill out a rotation evaluation form at the end of the rotation.
      3. The knowledge and skills acquired during this rotation will be evaluated by a Family Medicine faculty as the resident provides care to patients in the Family Medicine Center.
      4. The resident's performance on the American Board of Family Medicine In-Training Examinations will also be used to assess knowledge in this area.
  2. Patient Care Skills To Be Mastered
    1. Performance of Emergency Medical history taking
    2. Performance of Emergency Medical physical examination
    3. Develop the ability to recognize and provide initial treatment to life threatening, acute emergency problems
    4. Skills in the initial management of psychiatric emergencies
    5. Develop the abilities in the principles of tissue handling, repair of trauma and asepsis
    6. Under supervision, the resident will perform common procedures to include lumbar puncture, laceration repair, closed reduction of simple fractures, insertion of chest tube, arterial puncture, catheterization, stabilization of fractures, intubation, CPR, bacterial and viral cultures, and physical assessment of the injured patient.
  3. Medical Knowledge skills to be mastered
    1. Development of an appropriate cognitive base necessary for the diagnosis and initial treatment of acute life threatening emergencies such as myocardial infarction, shock, pulmonary edema, trauma and coma
    2. The resident will become familiar with the medical legal implications of Emergency Room care.
    3. Develop an appropriate knowledge base regarding common urgent patient problems
    4. Develop an appropriate knowledge of therapeutics used in the care of patients experiencing medical and traumatic emergencies
  4. Practice Based Learning and Improvement
    1. This competency is addressed longitudinally throughout the rotation.
      1. Scientific evidence will be reviewed by the resident and attending emergency physician in the context of their patients in the Emergency Department.
      2. The practical implementation of evidence-based medicine will be discussed as the medical decision making is reviewed.
      3. Information technology will be utilized by the resident as he or she is required to research topics as directed by the attending physician.
      4. Information technology will be used as the electronic health record is implemented in the hospital.
      5. The resident will also be evaluated on the steps they took during the rotation to improve their shortcomings.
  5. Interpersonal and Communication Skills
    1. This competency is addressed longitudinally throughout the rotation.
      1. The resident will observe and be observed, taught and evaluated in the performance of obtaining patient histories, documenting histories, writing prescriptions, educating patients about treatment plans and prognosis, and interactions with patients, families, office staff and physicians.
  6. Professionalism
    1. This competency is addressed longitudinally throughout the rotation.
      1. The attending physician will observe and assess the resident's sense of personal responsibility including attendance, promptness, motivation, completion of duties, and appropriate dress.
      2. Ethical and legal practice skills will be taught
      3. Respect for cultural, age, and gender differences will be taught, observed and evaluated.
      4. The resident is expected to treat patients, families, support staff and colleagues with respect, understanding, sympathy and honesty
  7. Systems Based Practice
    1. This competency is addressed longitudinally throughout the rotation.
      1. The resident will learn to become aware of available resources and the cost effectiveness of testing and therapeutic options
      2. The resident will gain an increasing understanding of the role of the patient, physician, support staff, Emergency Department and insurer in the health care environment.

Revision: May 5, 2018 by Richard D. Williams, MD