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May 24, 2011

Skip lecture.

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We've been talking lately about resident conference attendance at my shop. It has always seemed to me that sitting a bunch of adults down and reading slides to them is an incredibly poor way to have them learn anything.

As a thought experiment: try to remember even a conference TOPIC from your lecture series last month. Bet you can't.

For what it's worth, I spent most of my second year of medical school snoozing the back of the lecture hall or doing crossword puzzles with Harold Bach. I studied, but lecture bored me nearly to death.

Since we're all a bunch of nerds (especially Seth) we looked up some data. Hern et al. showed that attendance at conference is poorly correlated with scores on the EM inservice exam. Michelle Lin has a much better discussion of this than I could ever manage over at ALIEM.

Mostly in conference I fiddle with my Blackberry and fantasize about switching to the Droid X. It is so silly to walk off a busy shift with critical patients to go listen to someone read PPT slides about pediatric abdominal pain; I wish the RRC would realize this and half conference time.

The last conference I gave was Weingart inspired: I talked about my practice (a little bit presumptuous for a PGY3) with vascular access and said some controversial things such as:
  • femoral lines suck (actually this is just true)
  • peripheral dopamine sucks
  • you can do subclavians in patients with mild to moderate coagulopathy without worrying too much
  • arterial lines can be quite dirty
Not everyone agreed with me, but we spent most of the time arguing back and forth. I didn't see anyone snoozing. I also used Prezi, which you should check out, instead of powerpoint.

When I am king* I will ban the following:

  • epidemiology slides
  • progressive maps showing how fat/diabetic/hypertensive/old the US population is getting
  • pathophysiology slides that take up more than 0.04% of the total talk
  • attempts to make boring lectures clinically relevant by having mini-cases
  • lectures about basic life skills, e.g. how to talk with people on the phone


*Seth will be court jester, housing czar, Defense Minister, and ambassador to Laos.

from seth:
To combat conference atrophy, we're implemented an Asynchronous Learning curriculum, where residents will review book chapters, podcast episodes, or other resources, summarize them online, and create a quiz. Residents can get credit by either posting their own content or taking others' quizzes. Not a huge step but the goal is to encourage and reward the use of some of the great educational resources out there, while cutting down on didactic time, theoretically leaving the remaining traditional conference higher-yield (Grand Rounds, resident M&Ms, our new-and-improved journal clubs, and trauma/critical care talks).

Also, G. McMurtrie Godley's shoes will be tough to fill.

Finally, last month: hand emergencies & burns.

Hern HG, et al. Conference attendance does not correlate with emergency medicine residency in-training examination scores. Acad Emerg Med. 209; 16:S63-S66.

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