Long BeachEmergency Medicine Rotation Goals and Objectives

Department of Emergency Medicine Residency Training Program

Harbor – UCLA Medical Center

Goals:

Develop the fundamental skills of the practice of emergency medicine, under direct supervision,in a high acuity, high volume, non-academic, level I trauma center including but not limited to:

  1. Perform an appropriateand complaint-focused history and physical exam
  2. Demonstrate an appropriate differential diagnosis for each complaint
  3. Recognize critically ill medical or trauma patients
  4. Develop and carry out basic treatment plans and perform necessary procedures through admission or discharge
  5. Develop proficiency in multi-tasking, documentation, time efficiency and cost efficiency
  6. Develop and institute more advanced treatment plans and procedures
  7. Develop and hone resuscitation and stabilization skills

Objectives:

  1. Demonstrate skill in “Data Gathering” that includes but are not limited to:
  2. Perform an appropriate focused history and physical exam (* PC, MK, ICS, PR)
  3. Appropriate ordering and interpretation of ancillary tests (* PC, MK, SBP)
  4. Gather essential and accurate information from all available sources (* PC, SBP)
  1. Demonstrate skill in “Problem Solving” that includes but are not limited to:
  2. Generate an appropriate and complete differential diagnosis for an undifferentiated patient(* PC, MK)
  3. Appropriate organization of data collection in relation to patient management decisions (* PC, MK, PBL)
  4. Generate an expanded differential diagnosis including possible atypical presentations (* PC, MK, PBL)
  1. Demonstrate skill in “Patient Management” that includes but are not limited to:
  2. Development of a basic treatment plan (* PC, MK, SBP)
  3. Prompt recognition and appropriate emergency stabilization of the unstable patient (*PC, MK, SBP)
  4. Institutes appropriate advanced treatment plans (* PC, MK, ICS, PR, SBP)
  1. Demonstrate a “Medical Knowledge” that includes but are not limited to:
  2. Demonstrates an advanced fund of medical knowledge (*MK)
  3. Understands the scientific basis for their decisions (*MK, PBL)
  1. Demonstrate technical proficiency in “Procedural Skills” that includes but are not limited to:
  2. Suturing, lumbar puncture, splinting, I/D abscess(*PC)
  3. Endotracheal intubation, central venous access, direction of a medical resuscitation(*PC)
  4. Conscious sedation, ultrasound, and direction of a trauma resuscitation(*PC)
  1. Demonstrate skill in “Efficiency” of care that includes but are not limited to:
  2. Effectively manages 3-10 patients simultaneously (*PC, MK, SBP)
  3. Effectively multi-tasks and adjusts to increased patient care demands as needed (*PC, MK, SBP)
  1. Demonstrate appropriate “Interpersonal and Communication Skills” that includes but are not limited to:
  2. Demonstrates effective information exchange with patients, their families, and professional associates (*ICS, PR)
  3. Demonstrates appropriate conflict resolution skills (*ICS, PR)
  4. Works effectively with others as a leader (*ICS, PR)
  1. Demonstrate appropriate “Professionalism” skills that includes but are not limited to:
  2. Introduces self to patient and/or family (*PR)
  3. Respectful of patient’s privacy and confidentiality(*PR)
  4. Demonstrates respect, compassion, and integrity (*PR)
  1. Demonstrate skill in proper “Documentation” that includes but are not limited to:
  2. Medical record is accurate, complete, timely, and appropriate (*PC)
  3. Appropriately documents medical decision making(*PC)
  4. Documents ED course including re-evaluation of patient if applicable(*PC)
  5. Become comfortable creating and utilizing a verbally dictated ED medical record
  1. Demonstrate an understanding of a “Systems-Based Practice” that includes but are not limited to:
  2. Understands basic resources available for care of the emergency department patient (*SBP)
  3. Utilizes the consultation process appropriately (*SBP, PC)
  4. Provides appropriate leadership to peers and staff(*SBP, PC)
  1. Demonstrate an awareness of the importance of “Practice Based Learning and Improvement” that includes but are not limited to:
  2. Uses appropriate information resources (ie, texts, online web sites, etc.) for care of patient (* PBL, PC)
  3. Applies knowledge of scientific studies to care (* PBL, PC)

(* denotes core competency area: PC-Patient Care, MK-Medical Knowledge, ICS-Interpersonal and Communication skills, PR-Professionalism, SBP-Systems Based Practice, PBL-Practice Based Learning and Improvement).

Methods:

Clinical Activities:

The rotation will be spent in the Emergency Department at Long Beach Memorial Medical Center during the 3rd and 4th years. Residents are expected to evaluate and manage patients presenting to the emergency department under the direct supervision of the emergency medicine faculty. The senior year resident will have much more responsibility and autonomy in the ED after successful completion of their first two years of EM training.The residents will be expected to initiate management and treatment decisions after their initial discussions with their supervising physicians. The resident is expected to manage multiple patients of varying different acuity levels thus learning appropriate organizational and patient flow skills. They are expected to recognize and stabilize unstable ED patients including medical and trauma patients with appropriate supervision. The resident should involve the supervising physician as early as possible in the patient care decision making process.

Note: As a minimum, residents shall be allowed 1 full day in 7 days away from the institution and free of any clinical or academic responsibilities. While on duty in the emergency department, residents may not work longer than 12 continuous hours. There must be at least an equivalent period of continuous time off between scheduled work periods. The residents should not work more than 60 scheduled hours per week seeing patients in the emergency department and no more than 72 duty hours per week inclusive of conference attendance.

The resident is expected to keep an up to date procedure log during the month and to log 10 follow-up patient encounters per month.

Didactics:

Attend all regularly scheduled EM conferences, interdepartmental conferences, simulation and procedure or cadaver labs and complete all asynchronous learning assignments.A calendar may be found on the Department’s website (

Recommended Reading:

Specific directed reading recommendations and learning experiences will be provided by the residency director throughout the training program.

Evaluation:

  1. Daily feedback by supervising emergency medicine faculty and/or housestaff.
  2. Direct observation of patient care and procedures by faculty.
  3. Formal written evaluation at end of rotation by emergency medicine faculty, peers, nursing, clerks and patients.
  4. Training level specific attainment of “Emergency Medicine Milestones” as defined by the ACGME and ABEM.
  5. Written evaluation of rotation by EM resident.
  6. Formal testing on annual ABEM in-service exam and departmental quizzes on topics addressed on rotation and didactics.
  7. Annual curriculum review by program director, faculty and residents.

Contact Information:

Assignments will be scheduled as directed by Elayne Turner. You may contact her with requests, questions and prior to the start of the rotation at