Crystal is a 3rd year EM resident who is meeting with her program director at her mid-year feedback session to discuss her progress. After she finishes the meeting and is reassured that she is achieving all of her clinical milestones thus far, she grabs dinner with the other 3rd year EM residents in her program. As they all discuss their progress, she realizes that all of the male residents were told in their …
CAEP GeMES | Residents’ Perception of Direct Observation in a Clinical Setting
Audrey is a 2nd year EM resident who is on her 3rd shift with Dr. Stewart, an EM staff physician. In the middle of the shift, Dr. Stewart tells Audrey that he would like to observe her as she assesses her next patient. Audrey is concerned that his decision to observe her is due to mistakes made in her previous assessment where she did not consider PE as an alternative diagnosis. As a …
CAEP GeMES | Selection of an Appropriate Tool for Direct Observation of Trainees by Supervisors
Catherine is a 3rd year medical student who is finishing the last shift of her core emergency medicine rotation. She is interested in matching to neurology. During the shift, she asks her staff, Dr. Stewart, if he would be willing to observe her while she performs a neurological exam and provide feedback on her performance. Dr. Stewart agrees, but is unsure of what aspects of the assessment he should focus on during the …
CAEP GeMES | Impact of Rudeness on Overall Medical Team Performance
Eric is a first year Emergency Medicine resident who just started his shift. The emergency department gets notified of an incoming patient with a history of liver cirrhosis who started to vomit frank blood. As the team is preparing the resuscitation room, the respiratory therapist asks Eric what intubation equipment he would like to use. Before he has a chance to answer, one of the nurses tells the respiratory therapist, “He’s just a …
CAEP GeMES | Effects of Leadership Styles and Power Dynamics on Patient Safety
Alyssa is a first year Emergency Medicine resident working on a late night shift with Dr. Howard, whom she has never worked with before. After diagnosing a patient with Sepsis NYD, Dr. Howard starts the patient on piperacillin-tazobactam at 4.5 g IV q6h, but forgets to take into account that the patient has a history of chronic kidney disease and needs renal dosing. Alyssa notices this, but is unsure of whether or not …
CAEP GeMES | Workplace-Based Assessment Design Optimization
It’s the end of another long Emergency Department shift, and Dr. Wu’s resident approaches him to complete her shift evaluation form. She had a solid shift. Dr. Wu self-admittedly finds every post-shift debrief awkward and gives his usual bland assessment (“You are right on track”) and cursory feedback (“Continue reading around cases”). Later that evening, Dr. Wu thinks about the interaction and feels a bit guilty. He wonders how he might be able …