EM MINDSET

Cognitive Load and the Emergency Physician

You may not know what cognitive load is, but if you work in an Emergency Department (ED) you are probably carrying a ton of it. Cognitive load refers to the total amount of mental effort burdening your working memory at any given time. Working in an ED can involve extremely high cognitive load, and learning to understand and manage it can make you more efficient and less stressed on shift. In the field of ED management, the ED bed is often described as the ‘Million Dollar resource’. If that is true, then the cognitive machinery of the Emergency Physician has to be the ‘Billion Dollar resource’.

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Teaching the Modern EM Resident

Current EM residents, as part of the Millennial Generation (born between 1981 and the present), now see this new technology as a way of life, and feel the need to be connected online at all times.5,6 As a result, many EM residents have abandoned the traditional lecture hall and textbooks, and have taken to their electronic devices and the World Wide Web for obtaining information.

In order to continue providing quality education that meets the needs of the modern EM resident, the type and quality of educational resources that we deliver must also change.

So the question becomes: How do we use these new resources to guide the education of our current EM residents both on and off shift?

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One Physician's Advice to the New Grad

To the Class of 2015 – Congratulations!! You’ve made it. After at least 11 years of post-high school education, you have finally reached that proverbial finish line and are ready to transition from resident to attending. What I would like to share with you is some advice about what life is like on the other side. Now that you have finished residency, it’s safe to say that you know the medicine really well. But, I have come to find that your learning about life as a professional is just beginning.

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The Art of Decision Making: Emergency Medicine Style

It’s 3pm on a Monday after a holiday. The department is bustling, and you feel like there are patients crammed into every conceivable space. Alarms are going off on patient monitors. You’re in the midst of discussing a case with a resident when a nurse puts an ECG in front of you to review and sign. Just as you finish reviewing the ECG, you turn back to your resident, only to get a phone call from the radiologist notifying you of an abnormal finding on another patient’s CT scan. After looking through the scan, you help guide your resident through an appropriate plan and disposition of the patient they saw, and decide it’s time to round on a few patients you need to see. As you rise from your chair, your EMS phone goes off, and you get word of a cardiac arrest that will arrive in 5 minutes. It’s just then that you realize you have to pee so bad it hurts. Sounds like a typical emergency department shift for many of us, doesn’t it?

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