#66 – How to be a Good Student on Emergency Medicine Rotation


Guest for the Episode

John B. Hurt, MPAS, PA-C

Assistant Professor and Director of Academics and Curriculum – Samford University – Department of Physician Assistant Studies

My 10 Rules

  1. Be on time
    • On-time = early
  2. Introduce yourself to the team
    • Preceptor and/or supervising physician
    • Charge nurse
    • Secretary or unit clerk
  3. Be Goal Oriented
    • Shift
      • Have 1-2 objectives for every shift you work
    • Rotation
      • Talk with your preceptor about what you want to see/do/experience
        • Actively seek out these experience
  4. Always Be Doing Something
    • Checking labs/images
    • Ask to draw blood for techs
    • Ask if you can get anything for your preceptor/staff
    • Review cases
      • There is something to be learned about every case we see in the ED
      • Look them up, write them down
      • Ask your preceptor what their decision making looks like
  5. Develop an algorithmic approach to common ED presentations
    • Chest pain, abdominal pain, AMS, fever, dyspnea, back pain, nausea/vomiting, trauma
      • Fast the providers what they do
      • Write these out to reference in the future
      • Get familiar with clinical decision instruments
        • Ottawa Rules, NEXUS, PERC, Canadian C-Spine
  6. 1-minute Presentations are an absolutely must
    • Have your diagnosis and plan ready
    • Differential diagnosis
      • Life threats, most likely, plausible, Zebras
  7. Disposition is the end decision in EM
    • Every patient either gets admitted or discharged
    • Before your preceptor makes the decision, make your own and see if your right
  8. See every type of patient that walks through the door
    • Don’t cherry pick (unless it is on your bucket list)
    • This will help you immensely throughout your career
  9. Go up and see the patients you admit before you leave the hospital after a shift
    • It will benefit your decision in the long run if you see what the inpatient team is doing
    • Your patients will also appreciate you checking on them
  10. Get feedback after every shift (if possible)
    • Plus-Delta approach
      • Things you do well (plus)
      • Things you can change (delta)

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