WikEM elective and asynchronous learning

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Background

Proudly Supports the WikEM Elective

This page outlines the use of WikEM as a reading elective and/or asynchronous learning platform for medical residency programs. The project is organized by OpenEM Foundation and the "WikEM Elective" is officially endorsed by the American Academy of Emergency Medicine Resident Student Association. Residency programs across the globe are encouraged to participate.

Rationale

Many emergency medicine and other medical specialty residency programs offer "reading electives" for several weeks of their curriculum and/or have asynchronous learning activities (aka “individualized interactive instruction”).[1] The U.S. Emergency Medicine Residency Review Committee (RRC) allows residents to use asynchronous learning for up to 20% of educational time.[2]

However, these activities can be difficult to monitor, leading to numerous problems in documentation and performance. The WikEM Elective and its asynchronous learning platform allows residency programs to better supervise residents as they study topics of their own choosing.

Additionally, all contributions are then in the open domain as part of the open access movement, thus benefiting medical practitioners around the globe, as well as being immediately available to the contributor, their fellow residents, and their residency program via the WikEM website and its native mobile applications.

Benefits

  • WikEM serves as a point of care source of medical information for practitioners around the world and resident contributions are read by tens of thousands of people!
  • By editing and writing content, residents engage in active learning and synthesize the medical literature into "need to know" bedside pearls and treatment information.
  • By referencing work, residents will stay current with evidence based medicine.
  • Residents can become a WikEM editor through our open and transparent promotion process.

Getting Started

Thanks for wanting to help out on WikEM! People are the core of the wiki. Your knowledge translates into bedside practice.

To get started

If you are looking for ways to contribute

Also

Books

Requirements

Tracking the Contribution Score

  • For asynchronous learning documentation, each 0.5 contributions points = 1 hour
  • Residents are responsible for achieving a contribution score of 20 for every one week of WikEM Elective
  • Progress is easily tracked at on the Contribution Score page

Documentation

  • WiKEM software tracks all edits residents make and can serve as proof of activity during the WikEM elective.
  • For a history off all edits, go to to: http://www.wikem.org/wiki/Special:Contributions/YOUR-USER-NAME
  • Contact info@wikem.org if you need an official certificate for a residency elective.

Goals and Objectives

WikEM elective goals and objectives

  • A wide variety of suggested objectives are listed with corresponding milestones to help fit the needs of individual learning plans and asynchronous learning needs. Those seeking to create individualized goals and objectives for elective documentation purposes can select relevant sections to build a personalized elective proposal for their residency leadership and/or Graduate Medical Education office to review.
  • At the completion of the elective, the resident should be able to:
Sample Objectives Associated milestones
Organize and construct clinical features for selected disease processes, syndromes, or chief complaints.

Integrate classification criteria into new or existing clinical feature sections.

Performance of Focused History and Physical Exam (PC2) Abstracts current findings in a patient with multiple chronic medical problems and, when appropriate, compares with a prior medical record and identifies significant differences between the current presentation and past presentations
  • Level 4- Synthesizes essential data necessary for the correct management of patients using all potential sources of data
  • Level 5- Identifies obscure, occult or rare patient conditions based solely on historical and physical exam findings
Critique existing literature regarding diagnostic testing for applications and limitations. Construct or modify sections to assist users with result interpretation. Diagnostic Studies (PC3) Applies the results of diagnostic testing based on the probability of disease and the likelihood of test results altering management.
  • Level 2- Orders appropriate diagnostic studies
  • Level 3- Interprets results of a diagnostic study, recognizing limitations and risks, seeking interpretive assistance when appropriate. Reviews risks, benefits, contraindications, and alternatives to a diagnostic study or procedure
  • Level 5- Discriminates between subtle and/or conflicting diagnostic results in the context of the patient presentation
Build, design, or update differential diagnoses sections for specific chief complaints, syndromes, or disease processes.

Categorize differentials via severity, organ systems, or other classifications to assist users with prioritization and management.

Diagnosis (PC4) Based on all of the available data, narrows and prioritizes the list of weighted differential diagnoses to determine appropriate management
  • Level 1- Constructs a list of potential diagnoses based on chief complaint and initial assessment
  • Level 3- Uses all available medical information to develop a list of ranked differential diagnoses including those with the greatest potential for morbidity or mortality
  • Level 4- Synthesizes all of the available data and narrows and prioritizes the list of weighted differential diagnoses to determine appropriate management
Formulate treatment recommendations from existing literature in a concise format organized via severity, target organ systems, or disposition. Pharmacotherapy (PC5) Selects and prescribes, appropriate pharmaceutical agents based upon relevant considerations such as mechanism of action, intended effect, financial considerations, possible adverse effects, patient preferences, allergies, potential drug-food and drug-drug interactions, institutional policies, and clinical guidelines; and effectively combines agents and monitors and intervenes in the advent of adverse effects in the ED.
  • Level 1- Knows the different classifications of pharmacologic agents and their mechanism of action.
  • Level 2- Applies medical knowledge for selection of appropriate agent for therapeutic intervention Considers potential adverse effects of pharmacotherapy
  • Level 3- Considers array of drug therapy for treatment. Selects appropriate agent based on mechanism of action, intended effect, and anticipates potential adverse side effects.
Judge current recommended management and disposition plans then update articles to reflect new evidence. Justify updates by synthesizing relevant medical literature into concise recommendations. Disposition (PC7) Establishes and implements a comprehensive disposition plan that uses appropriate consultation resources; patient education regarding diagnosis; treatment plan; medications; and time and location specific disposition instructions
Construct or edit procedural guides to assist point of care users via clear illustrations and instructions. Link relevant work up, complications, and external articles. General Approach to Procedures (PC9) Performs the indicated procedure on all appropriate patients (including those who are uncooperative, at the extremes of age, hemodynamically unstable and those who have multiple co-morbidities, poorly defined anatomy, high risk for pain or procedural complications, sedation requirement), takes steps to avoid potential complications, and recognizes the outcome and/or complications resulting from the procedure.
  • Level 2- Knows indications, contraindications, anatomic landmarks, equipment, anesthetic and procedural technique, and potential complications for common ED procedures
  • Level 3- Correctly interprets the results of a diagnostic procedure
  • Level 5- Teaches procedural competency and corrects mistakes
Critique new bedside ultrasound applications in the literature and create articles to assist in acquisition and interpretation of images. Other Diagnostic and Therapeutic Procedures: Goal-directed Focused Ultrasound (Diagnostic/Procedural) (PC12) Uses goal-directed focused Ultrasound for the bedside diagnostic evaluation of emergency medical conditions and diagnoses, resuscitation of the acutely ill or injured patient, and procedural guidance.
Implement an independent reading plan that reviews existing literature to build a portfolio of evidence based articles. Medical Knowledge (MK) Demonstrates appropriate medical knowledge in the care of emergency medicine patients.
Use an open access contribution system to assist providers via a point of care resource. Technology (SBP3) Uses technology to accomplish and document safe healthcare delivery.

Contact Info

See Also

References

  1. Alternatives to the conference status quo: summary recommendations from the 2008 CORD Academic Assembly Conference Alternatives workgroup. Sadosty AT, Goyal DG, Gene Hern H Jr, Kilian BJ, Beeson MS Acad Emerg Med. 2009 Dec; 16 Suppl 2():S25-31
  2. Frequently Asked Questions: Emergency Medicine. Accreditation Council for Graduate Medical Education Review Committee for Emergency Medicine; 2012. Available at: http://www.acgme.org/acgmeweb/Portals/0/PDFs/FAQ/110_Emergeny_Medicine_FAQs.pdf