Emergency Medicine: PD Post - May 2017

Safety

If you haven’t seen it already, here is our residency program’s “Resident Safety Policy”.

Safety has been on my mind. About a week ago, a resident and I saw a male patient who is struggling with addiction. I asked the patient to consider the possibility that his symptoms may be result of his addiction. The patient got angry, steeped in denial, and yanked out his IV. I assessed the situation, made a split second decision, and instead of withdrawing I established eye contact with the patient.

The situation de-escalated.

After leaving the room, the resident who had stood by and watched the interaction expressed his concern that I had put myself in harm’s way. I left that day, and thought about the feedback. I still am.

Medicine is hard. It’s unsafe at times. As much as it can be rewarding.

I often think about where patient-centered care, physician wellness, personal safety and personal fulfillment intersect. Incidentally, I came across Dr. Shelly Dev’s account featured on the DOM website.  Dr. Shelly Dev’s account featured on the DoM website. Very honest and poignant. What is it about the way we teach and practice medicine that takes “us” on a path that makes “it”, the balance, hard to figure out?

I see the tide of Competence by Design as a new promise, an opportunity of sorts…the possibility of medical education that strikes a balance, or at least an opportunity to look for the balance in earnest.

As promised, here are the accounts of another three of our CBD subcommittee members. Danielle Porplycia (research coordinator), Dr. Alex Stefan, and Allana Wong, PGY-1.

	“I look very forward to seeing the impact of a competence based medical education on the growth and development of all departments. To me, the journey to CBD means creating the tools to provide improved education, and in turn improved patient care. A wide-ranging confidence, through competence.” - Danielle Porplycia
	"I see CBD as a paradigm shift in the way we give and receive feedback in medicine. I hope that the increased focus on individual abilities and actual performance in the clinical setting will give teachers the opportunity to offer more open and honest feedback, from which our learners will benefit. In the long run, I think CBD will encourage physicians to be more mindful and reflective in their practice, constantly reassessing our own performance and filling in the gaps as necessary.”- Alex Stefan
	“Competence by Design will help residents discover their strengths, target their weaknesses, and ultimately build the confidence they need to practice in a fast-paced and ever-changing environment. CBD will be a way for us to ensure that training and evaluation are accountable - to learners, to teachers, and most importantly, to our patients.” - Allana Wong