Online Asynchronous Learning

PEMBlog

One of the first Pediatric Emergency Medicine educational blogs with greater than 1.28 million lifetime views since August 2012. The blog is focused on key topics in Pediatric Emergency Medicine and has afforded me the opportunity to mentor numerous trainees and colleagues in the creation of asynchronous online materials. It has also highlighted the work of colleagues in PEM and at Cincinnati Children’s, as well as the work of organizations such as PECARN and the AAP Section on Emergency Medicine. The social media index from Academic Life in Emergency Medicine lists PEMBlog as the 38th ranked Emergency Medicine site in the world, and the #2 Pediatric focused site. It has also been recognized as one of the Top 70 medical blogs on Feedspot (#34). My Symplur healthcare social graph score is 51.71. This is an index of my involvement in online healthcare conversations and places me in the 4thto 5th highest decile of all users on the platform. I have mentored dozens of trainees and taught them how to develop and publish online asynchronous content.

Readers are drawn to the site via (data as of February 14, 2023):

Microsoft Excel File with list of all PEMBlog posts (up to date as of 2/14/2023)

PEM Currents

PEM Currents: The Pediatric Emergency Medicine Podcast

PEMCincinnati.com/podcasts

2013 – Present

PEM Currents: The Pediatric Emergency Medicine Podcast is one of the leading podcasts in Pediatric Emergency Medicine, featuring brief (15-20 minute) episodes focused on key topics in Pediatric Emergency Medicine. I produce each episode and edit and publish all the content. It is available on multiple platforms include Apple Podcasts, Google Play, Spotify, Stitcher and more including direct streaming of episodes on the podcast website and PEMBlog.com. It has been widely cited on educational websites and was named best Pediatric Emergency Medicine podcast in Academic Emergency Medicine. To date I have had almost 690,000 cumulate listens of my episodes. It has a 4.6 out of 5-star cumulative rating on Apple Podcasts. I have also mentored numerous trainees and colleagues in the creation of podcasts and have offered CME through Cincinnati Children’s for multiple episodes. I have mentored dozens of trainees and taught them how to develop and publish online asynchronous content.

Microsoft Excel File with list of all PEM Currents: The Pediatric Emergency Medicine Podcast episodes and listener statistics (up to date as of 2/14/2023)

Emergency Department Rotation Director

Every rotation offered to pediatric residents must have a rotation director. This individual is a faculty physician who has various administrative and educational responsibilities. As the Emergency Department Rotation Director I am responsible for the residents’  overall education in the ED, as well as our ongoing curriculum and evaluations. I am the administrative faculty contact for over 180 pediatric residents, 50 emergency medicine residents, and 3 dozen outside rotating trainees. I am also part of the Curriculum Competency Committee, a group composed of the individual rotation directors as well as the Pediatric Residency Program leadership.

Every rotation offered to pediatric residents must have a rotation director. This individual is a faculty physician who has various administrative and educational responsibilities. As the Emergency Department Rotation Director I am responsible for the residents’  overall education in the ED, as well as our ongoing curriculum and evaluations. I am the administrative faculty contact for over 180 pediatric residents, 50 emergency medicine residents, and 3 dozen outside rotating trainees. I am also part of the Curriculum Competency Committee, a group composed of the individual rotation directors as well as the Pediatric Residency Program leadership.

Rotations

In addition to the ED core rotation our faculty contribute to the education of our trainees in the following elective/selective rotations:

  • Liberty Emergency Department
  • Urgent Care
  • Child Abuse
  • Injury Prevention & Advocacy
  • Emergency Department Procedure Elective
  • Transport Medicine
  • Toxicology
  • Simulation Elective

The ED Rotation Curriculum

Residents consistently rate the quality of the educational content, and the rotation experience in the ED at CCHMC highly. We have won numerous Division Teaching Awards. Our residents receive extensive clinical teaching, often in a one-on-one fashion with attendings and fellows. We are also responsible for a series of Noon Conferences (4-5 per year) that focus on high impact topics (sepsis, traumatic brain injury and respiratory failure for example) presented by national leaders in Pediatric Emergency Medicine.

The highlight of the ED Rotation Curriculum is the bimonthly Friday morning education sessions. One half of these sessions consist of ED faculty and fellows giving traditional didactic lectures (3 per lecture day). Faculty contribute materials for the residents to review prior to the conference, and focus on practical, case-based learning. In this flipped classroom model we are embedding knowledge beforehand, and the residents’ comprehension of background material will enrich discussions with the faculty. The subject matter is determined by reviewing resident feedback, the American Board of Pediatrics content specifications, faculty areas of expertise and seasonal trends (hypothermia in the winter months, orthopedic injuries during the summer).

Once per month we also hold “Sim days” where we divide the residents into small groups and have them rotate through stations in the ED. While one group of residents is participating in an in-situ simulation (sample topics: status asthmaticus, anaphylaxis, hypovolemic shock), the others are afforded the opportunity for deliberate practice in critical skills such as bag mask ventilation, endotracheal intubation, IO placement and use of the defibrillator – all precepted by myself, volunteer faculty and other health care professionals. The simulation scenarios rotate through an 18-month calendar.

We continue to strive for improvement, and thus each session we acquire written feedback from the residents. Check out a sample evaluation sheet for a lecture based day, and one for a sim day.

During these session we average 13-20 residents in attendance. Over the past 18 months we have had nearly four dozen different presenters and collected over 300 individual feedback forms. Sample topics presented include;

  • Airway and respiratory emergencies
  • Orthopedic and sports injuries
  • Infectious Disease emergencies
  • Child abuse
  • Abdominal pain
  • Toxicology
  • Traumatic brain injuries
  • Seizures
  • Psychiatric emergencies
  • DKA
  • Acute testicular/scrotal pain
  • Ophtho emergencies
  • Jaw injuries
  • Newborn emergencies
  • Pain and sedation
  • Abscess management

Orientation

Given the number of trainees rotating through the ED each month it was imperative that we develop an orientation that met the needs of our trainees and was accessible to them on their own time since it would be highly unlikely that we could get them all together in the same room given the staggered nature of their first shift of the rotation. We employed the full process of curriculum design, including a targeted needs assessment and ultimately developed an online, multimedia rotation orientation that we have adapted to changes in the rotation over time. Residents attested that they viewed the orientation via email. I built the site using WordPress and it is hosted on a secure domain. The site was taken offline in late 2021 following the move to the new Critical Care Tower and Emergency Department at Cincinnati Children’s.

Evaluations

We developed an online evaluation for the more than 250 trainees that rotate through the Emergency Department in order to capture shift based pediatric milestones focused evaluations by their attendings and fellows. It features a customized customized Qualtrics survey optimized for mobile devices and after initial deployment in 2013 has been maintained with an eye towards ongoing improvement initiatives designed to increase and maintain faculty evaluation complete rates. The data we have amassed has helped us identify areas for improvement in dozens of residents in a manner that our previous processes couldn’t achieve.