R1 Objectives
Emergency Medicine
R1s are assigned to the SMH ED daily for 4 weeks. They will work an average of four 10-hour shifts over 7 days.
Medical Knowledge
- Develop a core knowledge in nonobstetrical/nongynecological emergencies
- Efficiently assess and develop a differential diagnosis for the common medical conditions/symptoms that present emergently such as:
- Headache
- Syncope/dizziness/seizures
- Cardiac arrest
- Hyper/hypoglycemia
- Nausea/vomiting/diarrhea
- GI bleeding
- Fever
- Shock
- Arrhythmias
- Chest pain
- Allergic reactions
- Muscle weakness/paralysis
- Shortness of breath
- Asthma
- Urinary tract disorders
- Thrombotic/hemorrhagic events
- Initiate first line therapy in common medical and surgical emergencies
- Recognize surgical and gynecological emergencies
- Differentiate between patients who need outpatient versus inpatient services
Patient Care
- Perform a history and physical examination on a patient with a medical or surgical emergency
- Order and interpret diagnostic tests on patients with a medical or surgical emergency
- Correctly interpret electrocardiograms and cardiac monitoring data
- Perform:
- ECG
- Arterial blood gas
- Suturing and stapling of lacerations
- Intravenous access on difficult patients
- Intubation
- Participate in code situations
Interpersonal and Communication Skills
- Consult appropriately with additional hospital services for provision of patient evaluation/care
- Communicate effectively with other members of the team
- Provide adequate sign-out to team members to insure good continuity of care
Professionalism
- Increase sensitivity to drug and alcohol abuse and the effect it has on patients, their health and families
- Accept value systems that differ from your own
- Gain an understanding of reasons patients utilize the emergency department for their medical care
Practice Based Learning
- Gain a working knowledge of the admissions process
- Use information technology to support your own education on common medical and surgical emergencies
System Based Practice
- Gain an appreciation of uninsured patients that must use the emergency room as their primary care clinic
- Begin to understand the cost of tests that are ordered and how it will impact patient management
Learning Resources
- Residents will attend ob/gyn conferences on Thursday mornings
- UpToDate is available online hospital-wide. EM faculty will recommend additional educational resources.
- The interns’ best resources are each other and their upper-level residents; they are encouraged and expected to ask questions.
Evaluations
- Faculty and resident colleagues are encouraged to provide direct verbal feedback so that resident performance can be commended or improved during the rotation
- Residents are evaluated in writing at the end of each rotation using a standardized evaluation form given to supervising ED attendings and upper-level residents. These evaluations are compiled for the resident's semi-annual review.
- Problems, which appear to be of a more urgent nature, will be brought immediately to the attention of the resident and residency program director for discussion.
- Residents will receive a form at the end of each rotation soliciting feedback regarding the rotation and faculty. This information is shared anonymously and used for course/faculty improvement activities.