Teresa M Chan1,2, Kenneth Van Dewark3, Jonathan Sherbino1,2, Matthew Lineberry4. 1. Division of Emergency Medicine Department of Medicine McMaster University Hamilton ON. 2. McMaster program for Education Research, Innovation, and Theory (MERIT) Hamilton ON. 3. Department of Emergency Medicine University of British Columbia Vancounver BC. 4. Simulation Research, Assessment, and Outcomes, Zamierowski Institute for Experiential Learning, and Department of Health Policy and Management University of Kansas Medical Center Kansas City KS.
Abstract
BACKGROUND: Busy environments, like the emergency department (ED), require teachers to develop instructional strategies for coaching trainees to function within these same environments. Few studies have documented the strategies used by emergency physician (EP)-teachers within these busy, chaotic environments, instead emphasizing teaching in more predictable environments such as the outpatient clinic, hospital wards, or operating room. The authors sought to discover what strategies EP-teachers were using and what trainees recalled experiencing when learning to handle these unpredictable, overcrowded, complex, multipatient environments. METHOD: An interpretive description study was conducted at multiple teaching hospitals affiliated with McMaster University from July 2014 to May 2015. Participants (10 EP-teachers and 10 junior residents) were asked to recall teaching strategies related to handling ED patient flow. Participants were asked to describe techniques that they used, observed, or experienced as trainees. Two independent coders read through interview transcripts, analyzing these documents inductively and iteratively. RESULTS: Two main types of strategies to teach ED management were discovered: 1) workplace-based methods, including both observation and in situ instruction; and 2) principle-based advice. The most often described techniques were workplace-based methods, which included a variety of in situ techniques ranging from conversations to managerial coaching (e.g., collaborative problem-solving of real-life administrative dilemmas). CONCLUSIONS: A mix of strategies are used to teach and coach trainees to handle multipatient environments. Further research is required to determine how to optimize the use of these techniques and innovate new strategies to support the learning of these crucial skills.
BACKGROUND: Busy environments, like the emergency department (ED), require teachers to develop instructional strategies for coaching trainees to function within these same environments. Few studies have documented the strategies used by emergency physician (EP)-teachers within these busy, chaotic environments, instead emphasizing teaching in more predictable environments such as the outpatient clinic, hospital wards, or operating room. The authors sought to discover what strategies EP-teachers were using and what trainees recalled experiencing when learning to handle these unpredictable, overcrowded, complex, multipatient environments. METHOD: An interpretive description study was conducted at multiple teaching hospitals affiliated with McMaster University from July 2014 to May 2015. Participants (10 EP-teachers and 10 junior residents) were asked to recall teaching strategies related to handling ED patient flow. Participants were asked to describe techniques that they used, observed, or experienced as trainees. Two independent coders read through interview transcripts, analyzing these documents inductively and iteratively. RESULTS: Two main types of strategies to teach ED management were discovered: 1) workplace-based methods, including both observation and in situ instruction; and 2) principle-based advice. The most often described techniques were workplace-based methods, which included a variety of in situ techniques ranging from conversations to managerial coaching (e.g., collaborative problem-solving of real-life administrative dilemmas). CONCLUSIONS: A mix of strategies are used to teach and coach trainees to handle multipatient environments. Further research is required to determine how to optimize the use of these techniques and innovate new strategies to support the learning of these crucial skills.
Authors: Renée E Stalmeijer; Diana H J M Dolmans; Ineke H A P Wolfhagen; Albert J J A Scherpbier Journal: Adv Health Sci Educ Theory Pract Date: 2008-09-17 Impact factor: 3.853