CDEM Voice Spring 2013

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A M E D I C A L

V O I C E F O R S T U D E N T E D U C A T O R S

The Voice of CDEM was formed in 2008 and is comprised of medical student educators who are committed to enhancing medical student education within our specialty. A Quarterly Newsletter

Issue 1 - Spring 2013

President’s Message Atlanta Here We Come! Sorabh Khandelwal, our fearless leader, talks about where we are and where we are going. Page 1 Check out all of the amazing events we have planned at the Annual Meeting! Page 2

Journal Club From the amazing blog “Academic Life in EM” created by Michelle Lin, Javier Benítez reviews the concept of “Information Management”. Page 3

An Update on our National Exams Corey Heitz summarizes the status of: A. The CDEM Exam B. The NBME Exam C. All of the above! Page 4

There’s An App For That! Rahul Patwari discusses a Read by QxMD, a flipboard for Medical Journals Page 5

Want to Get Involved? Contact us to submit to the newsletter, join a committee, or any other way you’d like to get involved. Page 6

President’s Message: Not Bad… So Far national and international experts with EM medical student education. The International Federation For Emergency Medicine (IFEM) uses CDEM content for its globally available EM clerkship.

Sorabh Khandelwal, MD At first glance, this title may suggest a half glass full mentality. To the contrary, it is simply meant to imply that CDEM is only in its infancy with respect to what it can and will achieve. It’s amazing to see all that CDEM has accomplished since the organization’s inception in 2008. Even prior to joining SAEM as its first Academy, CDEM was active in developing content that changed the way that EM medical student educators interfaced with students. The list of accomplishments is truly spectacular – EM Clerkship Primer, Spring 2013

educational sessions and a track at CORD, educational sessions at SAEM, acceptance into the Alliance for Clinical Education (ACE), standardized curricula, SAEM Tests, CDEM self study modules, DIEM cases, and most recently working together with the NBME to create the EM Advanced Clinical Examination. We have been recognized as the

None of these accomplishments could have happened without the vision of CDEM leadership and the dedication and commitment of our membership. CDEM is still young. Find out what is in store for our future on page 5...

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SAEM in Atlanta

The Program Committee is excited to present an outstanding lineup for the SAEM Annual Meeting in 2013. Nicholas Kman, MD - Academic Assembly Program Committee Co-Chair Thursday, May 16 Annual Business Meeting

• 8:00 - 9:00 am CDEM Business Meeting

Friday, May 17 CDEM Sponsored Sessions

Friday, May 17 Program Evaluation, Assessment and Improvement Workshop

•8:00 - 8:50 am Educational Portfolio: Your Secret Weapon for Promotion International E-F combined (6th floor)

We are excited to present the Program Evaluation, Assessment and Improvement Workshop. This session • 9:00 - 11:00 am will be led by Hugh Stoddard, M.Ed., 2013 CORD Annual Meeting Ph.D. and Assistant Dean for Medical “Can’t Miss” Topics. • 9:00 - 9:50 am Education at Emory University This session will focus on the SLOR Good to Great: Effective Feedback to School of Medicine. This session will update, the NBME exam, and Learners with Difficulties give participants (both program Milestones for Medical Students. Dr. International E-F combined (6th floor) directors and clerkship directors) the Michael Beeson will update the group tools and knowledge necessary to on Milestones at 10:30am. assess their program. Participants will be taught what the LCME and • 11:00 - 12:00 pm ACGME is looking for when CDEM Initiatives Fair. evaluating programs. Learners will This will be a networking session be able to work with our guest with participants discussing CDEM speaker on program evaluation, self-study modules, social media, the assessment, and improvement. newsletter, and the National M4 Examination. David Manthey, Michelle Lin & Lorraine Thibodeau having fun at CORD Academic Assembly 2013 in Denver. 2

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Journal Club From the amazing blog “Academic Life in EM” created by Michelle Lin, Javier Benítez reviews the concept of “Information Management”. Reproduced with permission. Information overload by verbeeldingskr8 on Flickr

“Keeping up with the literature these days is quite a daunting task. Medical information has increased exponentially over the past few decades and continues to do so. We spend a great deal of time and energy memorizing information which soon may become obsolete (see this excerpt from the book The Half-Life of Facts by Arbesman). Expecting physicians to keep a busy practice AND keep up with all the most current literature is impractical. By the time textbooks are published, the information is already a few years old and this puts us at risk of not practicing the most up to date and best evidence practice. We also know that with the increasing volume of information there has been new development on statistics on how to Spring 2013

evaluate this vast amount of data. Most physicians are not properly equipped with the necessary statistical skills or time to analyze this vast amount of information.

oriented, and often too impractical to be applied at the point of care. Furthermore, it is unrealistic to expect that all physicians expertly conduct critical appraisals of all the literature.

So how DOES a practicing physician keep up with the most current, evidenceIn contrast, information based medicine (EBM)?” management "focuses on using currently available In his post on Academic Life information tools to remain in EM on April 22, 2013, up to date with new valid Javier Benitez reviews a information that is relevant 2005 Academic Medicine to the care of patients and is article by Drs. Slawson and accessible while taking care Shaughnessy: Teaching of patients." evidence-based medicine: should we be teaching Check out the rest of the information management post at http:// instead? They “propose that academiclifeinem.blogspot. physicians should learn com/2013/04/learninghow to manage information information-managementinstead of becoming experts instead-ebm.html in EBM. The authors point Slawson DC, et al. Teaching out that having physicians evidence-based medicine: should read the literature using the we be teaching information traditional EBM approach is management instead?Acad Med. 2005 Jul;80(7):685-9. PMID time consuming, not patient 15980087

Check out a recent publication by CDEM members Paul Y. Ko, Aaron W. Bernard, Stacey L. Poznanski, Robert Cooney, Sorabh Khandelwal & Michelle Lin. This review, sponsored by the Alliance for Clinical Education, highlights selected medical education articles published in emergency medicine journals typically not read by clinician educators in other specialties. Journal Watch From ACE (Alliance for Clinical Education): Annual Review of Medical Education Articles in Emergency Medicine, 2010-2011 http://www.tandfonline.com/ doi/abs/ 10.1080/10401334.2013.772 003.

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Clerkship Assessments: An Update Corey Heitz, MD Good instructional design includes objectives, a curriculum, and an assessment tool. In 2006, CDEM developed the EM Curriculum Guide (revised in 2010) complete with goals and objectives. Subsequently, our curriculum went live on www.cdemcurriculum.org. Now, we have an assessment tool to match! In 2011, we released a 50 question, multiple choice examination covering the topics of the EM M4 curriculum. Last year, this examination was revised and a second version was released. Together, these exams constitute freely accessible, nationally available, 50question multiple choice exams that assess the EM M4 curriculum topics, found on www.cdemcurriculum.org. The table below compares the two versions of the exams in terms of difficulty level (percent correct) and point biserial correlation (a measure of discriminatory value; USMLE and other licensing exams use 0.15 as a target number. Easy questions tend to be less discriminatory.) Data is shown from exams administered since July 2012.

National EM Average score average rpb M4 Exam (SD) Version Version 1 80.9 (3.85) 0.217 Version 2

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72.1 (3.95)

0.196

FAQs Do students taking it earlier in the year score higher? Question performance did not change on version 1 between the first 1,000 students taking it in academic year 2012-2013 and the second 1,000 students. Where should passing scores be set? While the NBME exams are scored differently, many institutions use a “2 standard deviations below the mean” rule to determine pass/fail cutoff. This rule is being used by many clerkships for the National EM M4 Exam. What upcoming changes are expected? • Question revisions on Version 2 to improve performance of some low-rpb question (and one negative rpb) •Addition of “sample items” for performance before inclusion into the scored exam •Demographic data gathering for more fine-grained data reporting (EM-bound vs non-EM bound, etc.) Tell me about the NBME exam? The NBME released a 100-question, 2-form, multiple choice Advanced Clinical Examination in April 2013. This will be free for the first year to any who use it. The NBME does not recommend the test be used for high stakes assessment until performance data can be analyzed. The exam covers the suggested curriculum topics as well as other important EM topics.

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There’s an App for That! Rahul Patwari, MD A Flipboard for Medical Journals! Read by QxMD is a free application available on iPhone and iPad which interfaces with your library’s proxy system providing you with access to journals via a sleek interface. After downloading, it asks you to create an account which includes entering your institution and specialty. It then presents you with the relevant journals within that speciality for you to follow. You have full access to the abstracts. If your institution’s library subscribes to those journals then you can also download the PDFs, share them via email or even start a collaborative discussion.

More information can be found at their web site:

The app can be downloaded from the iTunes app store:

http://www.qxmd.com/apps/readby-qxmd-app

https://itunes.apple.com/us/app/ read-personalized-medical/ id574041839?mt=8

relationships and building new ones. This past year, we formed a new relationship with EMRA while continuing to enhance our Sorabh Khandelwal, MD relationships with SAEM and CORD. continued from page 1... These relationships will bring wonderful opportunities for our While there are many future directions for growth, I would like to members. A perfect example of the highlight two key areas. Over the next fruits of these relationships is the new SAEM Education Research Grant several years, we would like to offered to SAEM members to fund a develop new content that is medical education research project. interactive and available anytime, anywhere. The CDEM self-study The success of our organization modules will be revised and could be depends on the continued made available in different formats engagement of our members. Stay such as iBooks and iTunesU. CDEM involved. Join committees. Help one has become global and could another. Send us your ideas. The continue its international impact. The intended consequence…you will second area for growth involves contribute to the ever-changing strengthening our current education of those that deliver

President’s Message: Not Bad… So Far

Spring 2013

Feel free to find me online at @rahulpatwari on Twitter.

emergency care. The unintended consequence of all this effort…you will make friendships that will last a lifetime. I hope these newsletters will serve to inform our membership as to the wonderful happenings in CDEM, provide some educational content, and highlight some of our talented members. Many thanks to all the initial contributors and a special thank you to Dr. Stacey Poznanksi (Chair, CDEM Communications Committee), Melissa McMillian (Administrator, CDEM) and Kara Welch (EM Clerkship Coordinator at SUNY Upstate) for their effort in getting this newsletter completed.

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In Appreciation The following committees work hard every day to make CDEM a truly phenomenal academy. Consider joining a committee today! Academic Assembly CDEM Program Committee Nicholas Kman (Co-Chair) Nicholas.kman@osumc.edu Michael Smith (Co Chair) msmith2@metrohealth.org Doug Franzen Marianne Haughey Kathy Hiller Julianna Jung Torrey Laack David Manthey Sundip Patel Laurie Thibodeau Laura Thompson Michael Van Meter David Wald Grant Wei Kathleeen Wittels

Alliance for Clinical Education (ACE) ACE Executive Committee Dave Wald ACE General Council Douglas S. Ander Jonathan Fisher Sorabh Khandelwal David Wald Communications Committee David Cheng Leslie Zun Publications Committee Paul Ko Research Committee Jonathan Fisher Ted Gaeta

Communications Committee

Awards Committee Latha Ganti Stead (Chair) latha.stead@gmail.com Kathy Hiller David Cheng William Goldenberg Michael Takacs Maria Ramos

SAEM EMIG - Grant Review Nicole DeIorio (Chair) deiorion@ohsu.edu David A. Wald Matthew Tews Corey Heitz Doug Ander Melissa Marinelli

NBME Task Force Dave Wald (Chair) david.wald@tuhs.temple.edu Doug Franzen Corey Heitz Jonathan Fisher Kathy Hiller Emily Senecal Luan Lawson-Johnson Shahram Lotfipour Kim Askew

Stacey Poznanski (Chair) stacey.poznanski@gmail.com Melissa McMillian Kara Welch

Our Mission • To advance the education of medical students as it pertains to the specialty of emergency and acute care medicine. • To serve as a unified voice for EM clerkship directors and medical student educators on a national level.

SAEM Program Committee Sarah Ronan-Bentle Med Student Symposium Josh Wallenstein Todd Guth Innovations Laurie Thibodeau

SLOR Task Force CDEM Representatives

Testing Workgroup Emily Senecal (Co-Chair) Corey Heitz (Co-Chair) esenecal@partners.org Douglas S. Ander Kim Askew Linda Druelinger Matt Emery Jonathan Fisher Katherine Hiller Laura R. Hopson Luan Lawson Leslie C. Oyama Mark Saks John Sarko Michael D. Smith Gregory J. Tudor Charles Worrilow Collette M Wyte Leslie Zun

Nicole Deiorio Sarah Ronan-Bentle

Board Jonathan Fisher - Past President Sorabh Khandelwal - President Lorraine Thibodeau - President-Elect Emily Senecal - Secretary Josh Wallenstein - Treasurer

• To provide a forum for EM clerkship directors and medical student educators to communicate, share ideas, and generate solutions to common problems.

Jennifer Avegno - Member at Large Rakesh Engineer - Member at Large Nicholas Kman - Member at Large Corey Heitz - Member at large

• To foster undergraduate medical education research and provide a platform for collaboration.

For more details contact:

• To foster the professional development and career satisfaction of EM clerkship directors and medical student educators. • To foster relationships with other organizations to promote medical education.

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cdem@saem.org SAEM 2340 S. River Road #208 Des Plaines, IL 60018, USA Phone: 847-813-9823 Fax: 847-813-5450 community.saem.org

Spring 2013


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