Enhancing resident confidence, knowledge, and skills in obstetrics and neonatal resuscitation through simulation

Learning Objectives/Educational Objectives: Objectives included providing hands-on training to improve confidence in high-risk deliveries and neonatal resuscitation, and assuring ACGME delivery requirement compliance. : Introduction/Background: COVID19 has affected offservice rotations for emergency medicine residents by limiting provider numbers in patient care areas. To mitigate the educational impact of decreased exposure to deliveries, we developed an obstetrics (OB) simulation (sim) curriculum. Curricular Design: The curriculum consists of 4 sim sessions: 1) normal vaginal delivery & shoulder dystocia;2) breech, cord prolapse, cord presentation;3) postpartum hemorrhage & perimortem c-section;and 4) breech delivery, neonatal resuscitation, post-partum hemorrhage care. Sessions include a facilitated discussion, practice of techniques and procedures, and a comprehensive, high-fidelity sim. By the end of the 4 sessions, residents complete 13 deliveries, 1 c-section, 2 post-partum hemorrhage resuscitations, and 1 pediatric resuscitation. Throughout the year they will receive monthly e-mailed pearls for spaced repetition of knowledge. Additionally, at the end of the academic year, residents will repeat the final session, perform another c-section, and practice 5 additional deliveries. Impact/Effectiveness: After overwhelmingly positive session feedback from the class of 2020, the curriculum was added as a required adjunct to the OB rotation. The class of 2021 has completed the 4 sessions prior to rotating on OB. Residents completed a 15-item confidence and knowledge assessment prior to the 1st and 4th sessions which demonstrated a significant improvement in both median reported confidence on a 3-point likert scale (1.5 [interquartile range(IQR) 1.2-1.5]) vs 2.1 [IQR 1.9-2.3], p=0.02) and median percentage of correct responses for knowledge-based questions (18 [IQR 12-65] vs 82 [IQR 71-88], p=0.03). Residents will take the quiz at the end of the academic year to assess confidence and knowledge retention, and further refine the OB sim curriculum.

Using collective memory work in development education

This article captures aspects of community responses to COVID-19 through a participatory and interdisciplinary approach, namely collective memory-work (CMW). Using an autoethnographic CMW, we share experiences on the theme of solidarity in the backdrop of a global health pandemic and ‘black lives matter’ across continents. As a methodology CMW has been adapted and adjusted by scholars informed by the purpose of its application, institutional frameworks, and organisational necessities. In the summer of 2020, a CMW symposium was scheduled in an Irish university but postponed due to COVID-19 restrictions. The scholars, however, decided to go online and work on the symposium. This article provides insights into the impact of the two events on the lives of four women scholars aged between 51 and 79 years who formed one of the discussant groups. The unfolding of the two global pandemics, namely racism and COVID-19, leads to reflections upon the conflicts experienced around solidarity, especially between participating in demonstrations in solidarity with #blacklivesmatter, and distancing ourselves in solidarity with all risk groups for COVID-19. One group’s right to breathe stood in opposition to another group’s right to breathe. The process of writing this piece on CMW also taught us to collectively own our final thoughts and words in this article. © 2021, Centre for Global Education. All rights reserved.

Underrepresented in medicine scholars develop a diversity, equity, and inclusion curriculum via virtual externship

Intro/Background: The Denver Health Underrepresented in Medicine (URiM) Clerkship in Emergency Medicine awards up to ten scholarships per year to 4th year medical students from underrepresented groups to participate in a hybrid clinical and community service-based rotation. Due to COVID-19, visiting student rotations were cancelled in 2020. The clerkship was converted from a 4 week in-person externship to a virtual format during which the scholars helped develop a diversity, equity, and inclusion (DEI) residency curriculum. Purpose/Objective: The overarching goal of this work is to improve cultural responsiveness through instruction in the DEI pillars of awareness, attitude, knowledge, and skills within the residency and department of emergency medicine by: 1) advancing our recruitment efforts by engaging URiM scholars in a virtual clerkship, 2) providing the scholars with training and mentorship from experts in DEI, curriculum design, and research, and 3) developing a comprehensive, evidence-based, 2-year DEI curriculum. Methods: The virtual clerkship ran for 13 weeks from July to October. Scholars participated in 7 hours of didactic training from faculty mentors (4 hours on DEI and 3 hours on education theory, curriculum design, and scholarship) and discussions on assigned readings to establish baseline knowledge. A needs assessment of the residency, a focus group, and the personal URiM experiences of the scholars and faculty guided the overall curriculum design, topic selection, and session format. Outcomes (if available): Six of the ten awardees chose to participate in the virtual clerkship and helped create 10 hours of curriculum content focused on the 4 DEI pillars of awareness, attitude, knowledge and skills to be delivered in lecture, simulation, flipped classroom, and small group formats. Scholars created slide-decks and facilitator guides for each session and delivered example presentations at the end of the rotation. Scholars received mentorship on the emergency medicine residency application and interview process. Summary: The COVID-19 pandemic and racial upheaval in the United States in 2020 demanded innovation in medical student education and mentorship, URiM recruitment, and DEI curriculum development. We successfully engaged six URiM 4th year medical students in a virtual clerkship, provided training in DEI and curriculum design, conducted a needs assessment and focus group within our residency to inform curriculum design, and created a robust, evidence-based, recurring 2-year DEI curriculum for our emergency medicine residency and could be easily adapted for other settings.