Video Interview – Rob Rogers – Part 1

Great messages for medical students, interns and new EM residents!

Are you ready to meet the genuine people behind the professional?

iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts will share their habits, give advice on life, wellness and the profession.

Our guest is Dr. Rob Rogers.

Trained in Emergency Medicine and Internal Medicine, Rob Rogers currently practices Emergency Medicine at the University of Kentucky’s Chandler Hospital in the Department of Emergency Medicine. An innovative medical educator on the cutting edge of creativity, he shares his knowledge on the monthly medical education Medutopia Podcast. Rob co-founded The Teaching Institute and in 2014 created The Teaching Course at The University of Maryland. As a passionate medical education enthusiast, podcast evangelist, learning choreographer, and entrepreneur, Rob works tirelessly to change the world of medical education by reinventing it.

The full interview is 24 minutes long and includes many advice on life, wellness, and our profession. We will be sharing short videos from this interview. However, the full interview will be published as an audio file in our Soundcloud account. 

This interview was recorded during the EACEM2018 in Turkey. We thank EMAT.

The interview was recorded and produced by

Arif Alper Cevik

Elif Dilek Cakal

Murat Cetin

iEM Weekly Feed 14

Welcome to iEM Weekly Feed!

Sharing is caring!

With this feed, you do not miss anything. You will find all published blog posts and chapters during this week. Click the “title” or “read more” to open each page you interested in.

Stabbing LLQ Pain

A 19-year-old female presents to the emergency department (ED) complaining of 48 hours of worsening, stabbing left lower quadrant abdominal pain. The patient notes an

Read More »

Video Interview: Tracy Sanson – Part 3

Are you ready to meet the genuine people behind the professional? iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts

Read More »

Video Interview: Tracy Sanson – Part 2

Are you ready to meet the genuine people behind the professional? iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts

Read More »

A Week Before!

iEM Weekly Feed 13

Welcome to iEM Weekly Feed! Sharing is caring! With this feed, you do not miss anything. You will find all published blog posts and chapters

Read More »

44% Female Contributors in iEM

62 out of 142 contributors are female professionals. iEM Education Project We have 62 female contributors (emergency medicine doctor, resident, intern, medical student) out of

Read More »

Video Interview: Tracy Sanson – Part 1

Are you ready to meet the genuine people behind the professional? iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts

Read More »

My Road to Emergency Medicine

Helene Morakis Vice-President of the International Student Association of Emergency Medicine MS4 at Queen’s School of Medicine Incoming EM resident at the University of British

Read More »

Five Tips About Well-being During and After Medical School

Even the best of us suffer from burnout from time to time. It is utterly human as training in medicine is very demanding itself and

Read More »

What Was Hot In February?

Communication is the key!

Reflections by Vijay Nagpal and Bret A. Nicks While many believe the environment of care is the greatest limiting factor as opposed to quality communication,

Read More »

Medical students’ ultrasound training – SURVEY

There are many studies showing benefits of ultrasound training about understanding anatomy, pathologies and improving clinical decision making. Countries show different approaches to implementing ultrasound

Read More »

Kunafa Knife and Play Dough for Ultrasound Training

Around two years ago, Prof. Abu-Zidan came with a plastic triangular shape spatula to one of our morning meetings. He said that Alper, I found

Read More »

Welcome!

International Emergency Medicine (iEM) Education Project is an international, non-profit project, endorsed by International Federation for Emergency Medicine (IFEM) and supported by emergency medicine professionals

Read More »

Shock

by Maryam AlBadwawi Introduction Shock, in simple terms, is a reduced circulatory blood flow state within the body. The inadequate circulation deprives the tissues of its

Read More »

Chest Pain

by Asaad S Shujaa Introduction Chest pain is one of the most common symptoms presented in the emergency department (ED), and it is worrisome because

Read More »

Poisonings

by Harajeshwar Kohli and Ziad Kazzi Case An 18-year-old, previously healthy female, presents to the Emergency Department with nausea, vomiting, and tremors. She states 45

Read More »

Abdominal Pain

by Shaza Karrar Case Presentation A 39-year-old female presented to the emergency department (ED) complaining of right-lower-quadrant (RLQ) pain; pain duration was for 1-day, associated

Read More »

List of Sections and Chapters

International Emergency Medicine Education Project’s book is “iEM for Medical Students/Interns” and consist of 130 chapters written by 127 international contributors. Emergency physicians, residents, interns and

Read More »

Stabbing LLQ Pain

A 19-year-old female presents to the emergency department (ED) complaining of 48 hours of worsening, stabbing left lower quadrant abdominal pain. The patient notes an intermittent, foul-smelling vaginal discharge for the past week. She also endorses fever, nausea, vomiting, dyspareunia, dysuria, and generalized fatigue. The patient is sexually active with one male partner and uses combination OCPs in conjunction with inconsistent utilization of condoms. She denies vaginal bleeding, fevers, jaundice, vomiting, constipation, or diarrhea. Her last menstrual period (LMP) ended 16 days ago and was typical of her usual menses. The patient has a history of menarche at 14 and coitarche at 17. She denies any use of tobacco but admits intermittent alcohol and marijuana use. She has no past medical or relevant family history. There are no known drug allergies.

Physical exam reveals a well-developed female in mild discomfort but no acute distress. Her vitals are unremarkable except for a temperature of 38.5 and a heart rate of 102. Her abdominal exam reveals moderate tenderness to palpation, worse in the left lower quadrant, with no rebound tenderness. There is no costovertebral angle tenderness, Rovsing sign or McBurney point tenderness. External genitalia is unremarkable. A pelvic exam demonstrates foul purulent discharge in the vaginal vault emanating from the cervical os with no visible blood products. Cervical motion tenderness and pain on palpation of bilateral adnexa are present. Left adnexa is more tender and has a palpable mass on it.

Want to learn more?

Video Interview: Tracy Sanson – Part 3

Are you ready to meet the genuine people behind the professional?

iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts will share their habits, give advice on life, wellness and the profession.

Our guest is Dr. Tracy Sanson.

Dr. Sanson is a practicing Emergency Physician. She is a consultant and educator on Leadership development and Medical education and Co-Chief Editor of the Journal of Emergencies, Trauma and Shock; an Emergency Medicine international journal.

Part 3

The full interview is 10 minutes long and includes many advice on life, wellness, and our profession. We will be sharing short videos from this interview. However, the full interview was published as an audio file in our Soundcloud account. 

This interview was recorded during the EACEM2018 in Turkey. We thank EMAT.

The interview was recorded and produced by

Arif Alper Cevik

Elif Dilek Cakal

Murat Cetin

Video Interview: Tracy Sanson – Part 2

Are you ready to meet the genuine people behind the professional?

iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts will share their habits, give advice on life, wellness and the profession.

Our guest is Dr. Tracy Sanson.

Dr. Sanson is a practicing Emergency Physician. She is a consultant and educator on Leadership development and Medical education and Co-Chief Editor of the Journal of Emergencies, Trauma and Shock; an Emergency Medicine international journal.

Part 2

The full interview is 10 minutes long and includes many advice on life, wellness, and our profession. We will be sharing short videos from this interview. However, the full interview was published as an audio file in our Soundcloud account. 

This interview was recorded during the EACEM2018 in Turkey. We thank EMAT.

The interview was recorded and produced by

Arif Alper Cevik

Elif Dilek Cakal

Murat Cetin

iEM Weekly Feed 13

Welcome to iEM Weekly Feed!

Sharing is caring!

With this feed, you do not miss anything. You will find all published blog posts and chapters during this week. Click the “title” or “read more” to open each page you interested in.

44% Female Contributors in iEM

62 out of 142 contributors are female professionals. iEM Education Project We have 62 female contributors (emergency medicine doctor, resident, intern, medical student) out of

Read More »

Video Interview: Tracy Sanson – Part 1

Are you ready to meet the genuine people behind the professional? iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts

Read More »

My Road to Emergency Medicine

Helene Morakis Vice-President of the International Student Association of Emergency Medicine MS4 at Queen’s School of Medicine Incoming EM resident at the University of British

Read More »

Five Tips About Well-being During and After Medical School

Even the best of us suffer from burnout from time to time. It is utterly human as training in medicine is very demanding itself and

Read More »

A Week Before!

iEM Weekly Feed 12

Welcome to iEM Weekly Feed! Sharing is caring! With this feed, you do not miss anything. You will find all published blog posts and chapters

Read More »

iEM Newsletter – February 2019

Welcome to the iEM Education Project Monthly Newsletter. We will share the achievements, information about top posts, chapters, activities and future plans of the project

Read More »

Against Medical Advice and Elopement

In certain circumstances, patients may request to leave prior to completion of their medical evaluation and treatment. In this situation, it is essential for the

Read More »

ICON360: Tracy Sanson – Full Interview – Audio

iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts will share their habits, give advice on life, wellness and the

Read More »

Professionalism and social media

Some reflections by Dr. Amila Punyadasa It seems like nearly everyone, certainly from the Generations Y and Z, is using Facebook or Twitter these days

Read More »

What Was Hot In February?

Communication is the key!

Reflections by Vijay Nagpal and Bret A. Nicks While many believe the environment of care is the greatest limiting factor as opposed to quality communication,

Read More »

Medical students’ ultrasound training – SURVEY

There are many studies showing benefits of ultrasound training about understanding anatomy, pathologies and improving clinical decision making. Countries show different approaches to implementing ultrasound

Read More »

Kunafa Knife and Play Dough for Ultrasound Training

Around two years ago, Prof. Abu-Zidan came with a plastic triangular shape spatula to one of our morning meetings. He said that Alper, I found

Read More »

Welcome!

International Emergency Medicine (iEM) Education Project is an international, non-profit project, endorsed by International Federation for Emergency Medicine (IFEM) and supported by emergency medicine professionals

Read More »

Shock

by Maryam AlBadwawi Introduction Shock, in simple terms, is a reduced circulatory blood flow state within the body. The inadequate circulation deprives the tissues of its

Read More »

Chest Pain

by Asaad S Shujaa Introduction Chest pain is one of the most common symptoms presented in the emergency department (ED), and it is worrisome because

Read More »

Poisonings

by Harajeshwar Kohli and Ziad Kazzi Case An 18-year-old, previously healthy female, presents to the Emergency Department with nausea, vomiting, and tremors. She states 45

Read More »

Abdominal Pain

by Shaza Karrar Case Presentation A 39-year-old female presented to the emergency department (ED) complaining of right-lower-quadrant (RLQ) pain; pain duration was for 1-day, associated

Read More »

List of Sections and Chapters

International Emergency Medicine Education Project’s book is “iEM for Medical Students/Interns” and consist of 130 chapters written by 127 international contributors. Emergency physicians, residents, interns and

Read More »

44% Female Contributors in iEM

62 out of 142 contributors are female professionals.

iEM Education Project

We have 62 female contributors (emergency medicine doctor, resident, intern, medical student) out of 142. This is 44%, and we need more. Please share with your colleagues, students. We need you!

How to be a contributor!

Video Interview: Tracy Sanson – Part 1

Are you ready to meet the genuine people behind the professional?

iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts will share their habits, give advice on life, wellness and the profession.

Our guest is Dr. Tracy Sanson.

Dr. Sanson is a practicing Emergency Physician. She is a consultant and educator on Leadership development and Medical education and Co-Chief Editor of the Journal of Emergencies, Trauma and Shock; an Emergency Medicine international journal.

Part 1

The full interview is 10 minutes long and includes many advice on life, wellness, and our profession. We will be sharing short videos from this interview. However, the full interview was published as an audio file in our Soundcloud account. 

This interview was recorded during the EACEM2018 in Turkey. We thank EMAT.

The interview was recorded and produced by

Arif Alper Cevik

Elif Dilek Cakal

Murat Cetin

My Road to Emergency Medicine

Helene Morakis

MS4 at Queen’s School of Medicine

Incoming EM resident at the University of British Columbia

My first shadowing exposure to clinical medicine was in Pediatric Emergency Medicine (EM). Before starting medical school, I lifeguarded during my studies. Over six years, I had sent a handful of children to the Pediatric Emergency Department (ED) and always wondered what happened to them. I expected the shadowing experience to be chaotic and stressful.

The supervising physician shattered all my preconceived stereotypes about emergency medicine: she listened empathetically to patients and their parents, she took the time to teach her timid mob of medical learners and she managed to stay calm while juggling multiple cases of varying acuity. I left that shift – and all of my subsequent adult and peds EM shadowing shifts – in awe. I wanted to be part of this group of skilled physicians that made meaningful short connections with patients and was eager to tackle any case that came through the door.

I wanted to be part of this group of skilled physicians that made meaningful short connections with patients.

While in medical school I found I also loved the collaborative setting, the fast pace and the challenging contrast between cases in EM. My first two EM clerkship shifts entailed performing CPR, providing patient education in English, French and Spanish (and kicking myself for not learning at least three more languages!), ruling out a stroke in a non-verbal patient, and suturing a laceration after an assault. I was hooked. The opportunity to care for patients during their most difficult moments solidified my passion for Emergency Medicine. I love the “anyone, anything, anytime” mantra shared across ED’s that I visited on electives.

The opportunity to care for patients during their most difficult moments solidified my passion.

ANY

One
Thing
Time

EM is a broad and flexible field

Being fascinated by healthcare delivery in diverse settings and motivated by social justice I was interested particularly in Global Health and Wilderness Medicine in my pre-clinical years before dedicating myself to EM. Luckily, EM is a broad and flexible field and allows me to combine all of these interests.

I have been particularly interested in the online community that is working to advance EM and recruit medical students to the growing specialty on an international scale. Learning from and contributing to projects such as iEM is motivating and I am energized by like-minded medical learners around the world. My passion outside of school in the past two years has been working with the International Student Association of Emergency Medicine.

EM community is the best!

I may be biased, but I think the EM community is the best! There is an incredibly dynamic and well-established online presence that I have found very welcoming. Along with learning tips and tricks from FOAMed gurus, I had the opportunity to reflect on the EM mindset and social issues with the FemInEM community. Going to the FemInEM Idea Exchange 2018 (FIX18) conference last year in NYC as a student ambassador was an incredible experience and made me motivated to continue connecting with like-minded EM colleagues online.

Shana Zucker medical student, LGBTQIA+ advocate, at the FIX18 conference presenting her Queericulum

When I’m not in the hospital, I like to play outside. Participating in Wilderness Medicine allows me to do so even more and I like to think about how to deliver healthcare in non-hospital environments. I love that I can continue pursuing this passion through EM. The Wilderness Medical Society (WMS) has conferences, courses and research opportunities for medical students. I am working on my Fellowship of the Academy of Wilderness Medicine (FAWM) and hoping to gain more on the ground experience and contribute to research in this field as I move through my career!

When I’m not in the hospital, I like to play outside.

Hiking King’s Throne in Kluane National Park, YT, Canada, between EM shifts in Whitehorse, YT

The excitement and variety continue after shifts in EM. Between the online medical education community, on-shift teaching, research opportunities, the world of simulation and the interdisciplinary applications of EM, it is a specialty that academically has a lot of opportunities. Shift work is challenging, but offers flexibility to pursue my hobbies outside of work. There is a general culture of work-life integration and promotion of wellness shared among emergency physicians. At my home school program, Queen’s Department of Emergency Medicine, I saw this reflected in the resident and faculty mindsets and it contributed to my own prioritization of my wellness.

EM is a specialty that academically has a lot of opportunities.

The best advice I have received about choosing a specialty has been to follow my passions. The road to EM has been a fun adventure and has given me plenty of opportunities to do so. I am excited to start residency at the University of British Columbia. With teaching opportunities, unique pathology and a high volume of trauma, the residency at Vancouver General Hospital will be a busy but incredible ride.

Vancouver, BC, Canada

I look forward to pursuing my outdoor interests and enjoying urban amenities in Vancouver between shifts. With faculty and resident involvement in Wilderness Medicine and Global EM, I see many fun opportunities lying ahead!

If you liked this story, you may like these too!

Five Tips About Well-being During and After Medical School

Even the best of us suffer from burnout from time to time. It is utterly human as training in medicine is very demanding itself and combined with the life issues it can be weary. Well, we can control the chaos. Here are five tips for creating a system to support long term-term success and a happy life.

1

Adopt a healthy lifestyle and be persistent: Back to basics: Embrace a sustainable, healthy diet; drink approximately eight glass of water; sleep at least eight hours a day and exercise regularly. You need to take care of your body: A healthy diet and adequate water enhance stamina; regular and enough sleep promotes learning, memory, stress relief and performance; exercising helps you to relieve stress and increases endurance. Sacrificing any of these for studying more does not miraculously help you reach success. Building a career is a long path: You have to stay strong.

For more on this topic: National Health Service, Why We Sleep by Matthew Walker 

2

Regulate your time wisely: Have you ever met an astonishingly successful professional who seems to be participating in every social activity? Do not fret! Learning how to manage your time will get you there. Let me share a few tricks with you: Decide your priorities and learn to say “no” to the rest. Spending ten minutes to planning your day will sometimes save you a few hours – hours that you may spend on your hobbies or with your family or friends. Conquer procrastination and do it now! Create a study area and be minimalist about it. Get rid of your phone (and your social media accounts!) while studying. If you feel you lose your focus, it is probably time for a break. A bullet journal is an excellent way to plan your day, month and future.

For more on this topic: Eat that Frog by Brian Tracy, Bullet Journal, Work Life Balance

3

Regulate your Energy Wisely: Managing your time is essential but not enough. If you have ever struggled not to sleep in the second half of a 2-hour lecture, then you are not alone. Energy management, a newer concept than time management, is about to change our beliefs related to performance and happiness. Here are a few basics: According to Jim Loehr and Tony Schwartz, you must be physically energized, emotionally connected, mentally focused and spiritually aligned for long-term performance, health and happiness. Overuse and underuse will hinder your energy, you need to balance your energy expenditure by intentional challenges and resting in between. Studying continuously will damage your performance in the long term.

For more on this topic: The Power of Full Engagement by Jim Loehr & Tony Schwartz

4

Recognize and change your values: Identify your priorities. If you are prioritizing medicine over your health and happiness, you are in the wrong. You and your well-being are your top priorities. Your job or your academic performance does not define you, you are more than that. Determine your personal and professional long-term goals, then create a road map. Check and update your goals regularly. Do not let the first bump on the road demotivate you; if you stay persistent, you will reach your goals sooner or later.

For more on this topic: How To Make Work-Life Balance Work by Nigel Marsh

5

Spend quality time with your family and friends: If you think that you can accomplish all by yourself, think again. Spending quality time with your friend and family has numerous personal and professional benefits: It helps you to relieve stress, create an early network and a supportive net, diversify your area of interests, rest your mind by distracting it away from medicine. Always remember: “If you want to go fast, go alone. If you want to go far, go together.”

For more on this topic: Why It’s Important to Spend More Time with Friends and Family, 4 Reasons Friends And Family Are Good For Your Health

iEM Weekly Feed 12

Welcome to iEM Weekly Feed!

Sharing is caring!

With this feed, you do not miss anything. You will find all published blog posts and chapters during this week. Click the “title” or “read more” to open each page you interested in.

Video Interview – Rob Rogers – Part 1

Great messages for medical students, interns and new EM residents! Are you ready to meet the genuine people behind the professional? iEM team proudly presents

Read More »

iEM Weekly Feed 14

Welcome to iEM Weekly Feed! Sharing is caring! With this feed, you do not miss anything. You will find all published blog posts and chapters

Read More »

Stabbing LLQ Pain

A 19-year-old female presents to the emergency department (ED) complaining of 48 hours of worsening, stabbing left lower quadrant abdominal pain. The patient notes an

Read More »

A Week Before!

Video Interview: Tracy Sanson – Part 3

Are you ready to meet the genuine people behind the professional? iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts

Read More »

Video Interview: Tracy Sanson – Part 2

Are you ready to meet the genuine people behind the professional? iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts

Read More »

iEM Weekly Feed 13

Welcome to iEM Weekly Feed! Sharing is caring! With this feed, you do not miss anything. You will find all published blog posts and chapters

Read More »

What Was Hot In January?

List of Sections and Chapters

International Emergency Medicine Education Project’s book is “iEM for Medical Students/Interns” and consist of 130 chapters written by 127 international contributors. Emergency physicians, residents, interns and

Read More »

Abdominal Pain

by Shaza Karrar Case Presentation A 39-year-old female presented to the emergency department (ED) complaining of right-lower-quadrant (RLQ) pain; pain duration was for 1-day, associated

Read More »

Respiratory Distress

by Ebru Unal Akoglu Case Presentation A 40-year-old female with a history of diabetes mellitus presents with a complaint of 6 days cough and muscle

Read More »

Chest Pain

by Asaad S Shujaa Introduction Chest pain is one of the most common symptoms presented in the emergency department (ED), and it is worrisome because

Read More »

Shock

by Maryam AlBadwawi Introduction Shock, in simple terms, is a reduced circulatory blood flow state within the body. The inadequate circulation deprives the tissues of its

Read More »

Emergency Medicine: A Unique Specialty

by Will Sanderson, Danny Cuevas, Rob Rogers Imagine walking into the hospital to start your day – ambulances are blaring, the waiting room is clamoring, babies

Read More »

Choosing the Emergency Medicine As A Career

by C. James Holliman The specialty of Emergency Medicine (EM) is a great career choice for medical students and interns.  In August 2013, I celebrated

Read More »

PoCUS – RUSH Protocol

by Rasha Buhumaid Why use POCUS in undifferentiated hypotension? Hypotension is a high-risk sign which is associated with increased morbidity and mortality rate. The differential

Read More »

How to read head CT

by Reza Akhavan and Bita Abbasi For a standard approach to read head/brain computed tomography (CT) scan, one should adhere to systematic algorithms. The predefined

Read More »

iEM Newsletter – February 2019

Welcome to the iEM Education Project Monthly Newsletter. We will share the achievements, information about top posts, chapters, activities and future plans of the project that you kindly contributed, supported or showed your interest.

Content

Project Contributors

0
Countries
0
Contributors

We reached 141 contributors from 19 different countries in February. Our recent contributor is Vicky Noble from USA. Dr. Noble is the vice-chair for academic affairs and the residency program director at University Hospitals in Cleveland Ohio where she is starting the hospital-wide point of care ultrasound program for the system. She is a Professor at Case Western Reserve School of Medicine. She is a former chair of the ACEP Ultrasound Section, has been on the boards of the World Interactive Network Focused on Critical Ultrasound (WINFOCUS), Point of care Ultrasound in Resource-limited Environments (PURE) and the American Institute of Ultrasound in Medicine (AIUM). 

She is the president-elect for the Society for Ultrasound in Medical Education (SUSME). She is the co-author of the Manual of Emergency and Critical Care Ultrasound textbook, now in its second edition. Her research interests include lung ultrasound, ultrasound volume assessment and technology solutions to guide ultrasound interpretation as a means to broaden access to diagnostic ultrasound. With over a decade of experience in teaching ultrasound and starting ultrasound programs now at two facilities she can give advice on research, starting a program and ultrasound program administration as well as international training efforts. She is a true evangelist for the technology.

ICON360 interview series continues with Dr. Noble. Stay tuned!

Posts Published In February

iEM Weekly Feed 14

Welcome to iEM Weekly Feed! Sharing is caring! With this feed, you do not miss anything. You will find all published blog posts and chapters

Stabbing LLQ Pain

A 19-year-old female presents to the emergency department (ED) complaining of 48 hours of worsening, stabbing left lower quadrant abdominal pain. The patient notes an

Video Interview: Tracy Sanson – Part 3

Are you ready to meet the genuine people behind the professional? iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts

Video Interview: Tracy Sanson – Part 2

Are you ready to meet the genuine people behind the professional? iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts

iEM Weekly Feed 13

Welcome to iEM Weekly Feed! Sharing is caring! With this feed, you do not miss anything. You will find all published blog posts and chapters

44% Female Contributors in iEM

62 out of 142 contributors are female professionals. iEM Education Project We have 62 female contributors (emergency medicine doctor, resident, intern, medical student) out of

Video Interview: Tracy Sanson – Part 1

Are you ready to meet the genuine people behind the professional? iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts

My Road to Emergency Medicine

Helene Morakis Vice-President of the International Student Association of Emergency Medicine MS4 at Queen’s School of Medicine Incoming EM resident at the University of British

Five Tips About Well-being During and After Medical School

Even the best of us suffer from burnout from time to time. It is utterly human as training in medicine is very demanding itself and

iEM Weekly Feed 12

Welcome to iEM Weekly Feed! Sharing is caring! With this feed, you do not miss anything. You will find all published blog posts and chapters

iEM Newsletter – February 2019

Welcome to the iEM Education Project Monthly Newsletter. We will share the achievements, information about top posts, chapters, activities and future plans of the project

Against Medical Advice and Elopement

In certain circumstances, patients may request to leave prior to completion of their medical evaluation and treatment. In this situation, it is essential for the

ICON360: Tracy Sanson – Full Interview – Audio

iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts will share their habits, give advice on life, wellness and the

Top Reads In February

Free iBook

A free book (ibook and pdf) for EMERGENCY MEDICINE CLERKSHIP Students (iEmergency Medicine for Medical Students and Interns – 2018, Version 1) will be shared through iem-student.org in March. STAY TUNED! or better REGISTER on the sidebar to get email alert or follow us on social media. 

February Website Usage

Visiting Countries
104
Visitors
2,268
Views
5,351

Overall Website Usage

0
Countries
0
Visitors

Against Medical Advice and Elopement

In certain circumstances, patients may request to leave prior to completion of their medical evaluation and treatment. In this situation, it is essential for the last health care professional caring for the patient to document clearly why the patient left and attested that the patient had the mental capacity to make such a decision at that time (Henry, 2013). While some electronic documentation systems have templates in place to assist with this documentation, Table 2 provides basic information for against medical advice (AMA) discharge documentation that can be used to create a uniform template (Henry, 2013; Siff, 2011; Levy, 2012; Devitt, 2000).

What to do?

Interventions in the ED Discharge Process

DomainIntervention
ContentStandardize approach
DeliveryVerbal instructions (language and culture appropriate)
Written instructions (literary levels)
Basic Instructions (including return precautions)
Media, visual cues or adjuncts
ComprehensionConfirm comprehension (teach-back method)
ImplementationResource connections (Rx, appointment, durable medical supplies, follow-up)
Medication review

An attempt should be made to provide the patient with appropriate discharge instructions, even if a complete diagnosis may not yet be determined. Include advice for the patient to follow up with his physician, strict return precautions, and concerning symptoms that should prompt the patient to seek further care. It should also be made clear that leaving against medical advice does not prevent the patient from returning to the emergency department for further evaluation if his symptoms worsen, or if he changes his mind. Despite a common notion to the contrary, simply leaving against medical advice does not automatically imply that physicians are immune to potential medical liability (Levy, 2012; Devitt, 2000). If a patient lacks decision-making capacity to be able to adequately understand the rationale and consequences of leaving AMA and his condition places him at risk for imminent harm, involuntary hospitalization is warranted. In unclear circumstances and if available, psychiatry can assist in determining capacity, especially in the case of patients with mental health conditions.

Elopement is a similar process where patients disappear during the care process. While it is difficult to provide discharge paperwork for these patients, documenting the actions taken to find the patient is essential (e.g., searching the ED, having security check the surrounding areas). In addition, attempt to reach the patient by phone to discuss his elopement and any additional care issues or concerns. Documentation of these attempts or any additional conversation is very important (Henry, 2013; Siff, 2011).

To Know More About It?

References

  • Brooten J, Nicks B. Discharge Communications. In: Cevik AA, Quek LS, Noureldin A, Cakal ED (eds) iEmergency Medicine for Medical Students and Interns – 2018. Retrieved February 27, 2019, from https://iem-student.org/discharge-communications/
  • Henry GL, Gupta G. (2013). Medical-Legal Issues in Emergency Medicine. In Adams (Ed.), Emergency Medicine Clinical Essentials, 2nd Ed; 1759-65. Philadelphia, PA: Elsevier.
  • Siff JE. (2011). Legal Issues in Emergency Medicine. In Tintinalli’s (Ed.), Emergency Medicine, 7th Ed; 2021-31. McGraw-Hill.
  • Levy F, Mareiniss DP, Lacovelli C. The Importance of a Proper Against-Medical-Advice (AMA) Discharge. How Signing Out AMA May Create Significant Liability Protection for Providers. J Emerg Med. 2012;43(3):516-520.
  • Devitt PJ, Devitt AC, Dewan M. An examination of whether discharging patients against medical advice protects physicians from malpractice charges. Psychiatr Serv. 2000;51:899-902.

ICON360: Tracy Sanson – Full Interview – Audio

iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts will share their habits, give advice on life, wellness and the profession.

In this episode, we shared the full interview of Dr. Tracy Sanson. 

Who is Dr. Sanson?

Dr. Sanson is a practicing Emergency Physician. She is a consultant and educator on Leadership development and Medical education and Co-Chief Editor of the Journal of Emergencies, Trauma and Shock; an Emergency Medicine international journal. A frequent speaker for Emergency Medicine programs, Dr. Sanson also serves as a core faculty member for the American College of Emergency Physicians. Dr. Sanson has consulted and lectured nationally and internationally on administrative and management issues, leadership, professionalism, communication, patient safety, brand development, personal development, womenäó»s issues and emergency medical clinical topics for a wide range of health care organizations. Dr. Sanson’s experience spans 20 + years in Emergency Medicine Education and ED management and leadership development. She has held director positions in the US Air Force, University of South Florida and TeamHealth for the past 15 + years. Dr. Sanson trained at the University of Illinois at Chicago for medical school and her emergency medicine residency. She is well versed in leadership, patient safety and medical management issues having served on TeamHealth’s Medical Advisory Board, Patient Safety Office Division Director and faculty in their Leadership Courses. (resource: https://feminem.org/author/tracy-sanson-md/)

iEM team proudly presents the ICON360 project. In this pleasantly educational series, world-renowned experts will share their habits, give advice on life, wellness and the profession.

The interview was recorded and produced by

Arif Alper Cevik

Elif Dilek Cakal

Murat Cetin

Professionalism and social media

Some reflections by Dr. Amila Punyadasa

It seems like nearly everyone, certainly from the Generations Y and Z, is using Facebook or Twitter these days for one reason or another. Although not a fan myself, I do concede that when used with prudence, social media and the Internet is an invaluable resource for teaching and learning. It can support physicians’ personal expression, improve camaraderie and improve the dissemination of public health messages. Equally, it risks broadcasting unprofessional content online that reflects poorly on individuals, their affiliated institutions, and the medical profession alike.

Just saw an 18-year-old unmarried G5P0, with Chlamydia, herpes, and gonorrhea. Disgusting!

Hypothetical tweet

Physicians' SOCIAL MEDIA USE

 physicians must be cognizant of patient confidentiality and privacy and monitor their Internet presence

For example, let us consider a hypothetical tweet from a female doctor to her colleague describing a recent patient: ‘Just saw an 18-year-old unmarried G5P0, with Chlamydia, herpes, and gonorrhea. Disgusting!’ This tweet would have contravened a few of Wilkinsons (2009) so-called ‘behaviors inherent to good medical professionalism.’ This doctor should have had “respect for her patients’ diversity” and shouldn’t have been so judgmental (in this case, about the patients alleged sexual promiscuity and lifestyle). She also should have upheld patient confidentiality (as although the patient’s name wasn’t tweeted, the descriptors used about her obstetric and sexual histories would surely have made her easily identifiable amongst her friends and family who might have come across this tweet). The doctor should have, in my opinion, had better regard for professional boundaries and exercised greater judgment and discretion.

Defining unprofessionalism online and policing it has been challenging. However, with the increase in awareness of such occurrences, regulatory bodies have published various documents in an attempt to regulate physician’s activities on social media sites. The General Medical Council (GMC) has attempted to do exactly this with its paper. It warns against the blurring of boundaries between ones public and private lives and advices that privacy on these sites cannot be guaranteed. Furthermore, it stresses that physicians must be careful with regards to patient confidentiality, elaborating that although one piece of information may not breach confidentiality by itself, together, a few may certainly do so.

In summary, physicians must be cognizant of patient confidentiality and privacy and monitor their Internet presence to ensure that information posted is both accurate and appropriate. With regards to interaction with patients through social media, again, this interaction should fall within the boundaries of established professional norms. If a physician feels that such an interaction transgresses such norms, he/she should report the matter to the relevant authorities. Finally, it is imperative that physicians realize that inappropriate online interactions may have a negative impact on their reputations and that of their institutions, career advancements, and, perhaps most damning, may serve to undermine public trust in the medical profession as a whole.

To learn more about it

References