Every Wednesday morning, residents have 5 hours of protected didactic time to engage with faculty and across classes – building our community and learning the core concepts of Emergency Medicine together.
A New Curriculum
In response to resident and faculty feedback, DHREM recently underwent a comprehensive redesign of our conference curriculum in 2018. This redesign focused on best practices in educational theory and curriculum design, and reinforced the focus of the curriculum on core content topics.
The new curriculum is a two-year repeating curriculum, meaning that each resident will be exposed to the content twice throughout their four-year residency. The curriculum actively engages residents with frequent small group sessions, faculty-facilitated discussions, and hands-on skill labs. While the majority of sessions are presented by our renowned Emergency Medicine faculty, our residents advance their presenting skills during conference through resident lectures including a 15-minute core content lecture as a PGY-2, case conference as a PGY-3 and a 30-minute grand rounds style lecture as a PGY-4.
DHREM Didactic Curriculum Goal
To provide the foundational knowledge, skills, and attitudes for emergency medicine trainees to successfully practice the full scope of emergency medicine in a high-quality, evidence-based, compassionate and confident manner.
Core content makes up the majority of the remaining conference curriculum with the goal to develop expert understanding of the pathophysiology, pharmacology, diagnosis and management of the array of medical conditions within the scope of Emergency Medicine. While the curriculum is mainly divided by organ systems, based on the American Board of Emergency Medicine (ABEM) Model of Clinical Practice, content is interleaved rather than presented in blocks. For example, toxicology content will be distributed throughout the year rather than condensed into a several week block.
Morbidity and Mortality (M&M) Conference
Each week, a 90-minute M&M conference is held, alternating between Denver Health and the University of Colorado. Cases are largely self-referred and these conferences offer an excellent learning opportunities and discussion around quality improvement and patient safety. M&M conferences are presented by PGY3 residents at the University of Colorado and Chief Residents at Denver Health.
"We do not learn much by asking why the way a practitioner framed a problem turned out to be wrong. We learn when we discover why that framing seemed so reasonable at that time."
Wears RL, Nemeth CP. Replacing Hindsight with Insight: Toward Better Understanding of Diagnostic Failures. Ann Emerg Med 2007;49:206-209.
The Professional Development curriculum focuses on arming our residents with the interpersonal and professional skills necessary to provide excellent patient care and serve as leaders in Emergency Medicine. This includes oral-board preparation, expert guest lectures such as Rob Orman and Scott Weingart, and a robust evidence based medicine (EBEM) curriculum. Each month residents are paired with an attending to either review essential articles that underpin current clinical practice or evaluate emerging data for practice-changing insights. Residents are guided through this process to develop expertise not only in the data but also in critical appraisal of research design, methods, statistical analysis and translation to clinical practice.
This curriculum is meant to expose our residents to the breadth of career opportunities available within Emergency Medicine and to empower them with the skills and connections to choose the job of their choice upon graduation. This is developed in a variety of ways including resident driven career tracks, networking and Q/A sessions with community providers and resources such as financial planning and medicolegal sessions.
In addition to the clinically focused categories above, we have various threads that span the two-year curriculum designed to create holistic providers – including a new comprehensive Diversity, Equity & Inclusion (DEI) curriculum focusing on cultural responsiveness and sensitivity and their implications on health equity and patient outcomes.
Throughout the year, faculty-run simulations are offered to emphasize high-yield procedures including airway management, chest tube placement, pericardiocentesis, cricothyrotomy, etc. Additional simulations during EM2 and EM3 to practice medically complex and trauma cases emphasizing team roles and communication are held at the University of Colorado Center for Advancing Professional Excellence (CAPE). Additionally, during EM4, there are multiple obstetrics and neonatal resuscitation simulations to practice obstetric and neonatal emergencies- such as resuscitative hysterotomies, breech deliveries, and pre-term neonate resuscitations. There are also opportunities to participate in Virtual Reality Simulations.