Foundations III

Foundations III

Foundations III is an advanced curriculum targeting PGY3/4 learners with a focus on the “Art of Emergency Medicine”. F3 provides a mix of critical care sessions and topics that are crucial to daily EM practice, but have traditionally been neglected within resident education (e.g. billing and coding, medicolegal pitfalls, decision-making capacity, care of vulnerable populations, wellness, etc).  This course includes 30 classroom meetings (50 min) led by a single instructor, including topic discussion and breakout activities.  Suggested paired asynchronous content is available for reference.  Content may also be used for independent study if F3 is not officially implemented by your program leadership.

Please make sure your session leaders review the Foundations III Instructor Guide prior to facilitating the meetings below.

Selected topics within F3 are appropriate for any level learner.

Paired assessments for selected F3 units are now available to programs who have Rosh Review or PEER subscriptions.

Virtual Conference– For adapted use of this course in the virtual setting, please review our Virtual FoEM page.

 

Foundations III Meetings

Mouse over non-linked Asynchronous Resources for full title

Meeting	Unit & Session	Meeting Resources	Asynchronous Resources
1	Personal Development: Physician Wellness I 1) Burnout and Resilience 2) Mindfulness 3) Develop Mindfulness Practices for the ED 4) Self-reflection 5) Practice Self-reflection	Teaching Guide Guided Meditation	Suggested Preparation Annals Burnout Mayo Burnout Paired Resources Meditation Apps JAMA Narrative Med UCLA Guided Meditations Stanford Wellness
2	Ethics: AMA and Capacity 1) Decision Making Capacity 2) Against Medical Advice	Teaching Guide	Suggested Preparation NEJM Article Paired Resources Annals: Refusal Refusal of Care Risk Management
3	Special Populations: Care of the Psychiatric Patient in the ED 1) Initial Management of the Severly Agitated Patient 2) Medical Evaluation of the Potential Psychiatric Patient 3) Management of the Boarding Psychiatric Patient	Teaching Guide	Suggested Preparation ACEP Psych Care Paired Resources LITFL: De-escalation LITFL: Physical Restraints LITFL Chemical Restraints Psychopharm of Agitation
4	Clinical Skills: Workplace Violence and Disaster Management 1) Mass Casualty Incidents (MCI) and Disasters 2) Active Shooter Situations 3) Workplace Violence	Teaching Guide	Suggested Preparation Annals Hospital Shootings ACEP: ED Gunfire Paired Resources Disaster Planning EMS for MCI JEM: Disaster Medicine ACEP: ED Violence DHS: Active Shooter
5	Clinical Skills: Rural EM and EMTALA 1) STEMI Management in Resource Limited Settings 2) EMTALA and Inter-hospital Transfers 3) Thrombolytics in STEMI 4) EMS Personnel 5) Limited Resource Medicine	Teaching Guide	Suggested Preparation EMTALA Q&A EMTALA FAQ Paired Resources ACEP: STEMI Critical Access Hospitals EMTALA Mt. Sinai: EMTALA Basics Avoiding EMTALA Penalties
6	Personal Development: The Job Hunt I 1) Practice Environments 2) The Application Timeline 3) Cover Letter and CV Development	Teaching Guide	Suggested Preparation MD Job Tips Paired Resources CORD: Job Search Professional Life Fellowship Training Article Cover Letter
7	Personal Development: Physician Mental Health Emergencies 1) Depression and Suicidality 2) Suicidality and Physician Impairment	Teaching Guide	Suggested Preparation The Darkside of EM EMRAP: MD Suicide Paired Resources EMRAP: Resident Suicide Preventing MD Distress Med License and Mental Health Med Board: Physician Impairment AMA: MD Wellness
8	Ethics and Clinical Skills: End of Life Care and Surrogacy 1) Understanding Advanced Care Planning Documents and Surrogacy 2) Goals of Care Discussions 3) End-of-Life Care	Teaching Guide Learner Activity	Suggested Preparation AD Myths Opioid Infusions Paired Resources NEJM: Decision Makers Living Wills and DNR
9	Personal Development: Personal Finance I 1) Savings and Budgeting 2) Investing Basics 3) Renting or Buying your Residence	Teaching Guide Learner Activity	Suggested Preparation WCI: MD Budgets WCI: Debt Renting vs Buying Paired Resources WCI: Investing Bogleheads: Finances
10	Special Populations: Analgesia Stewardship 1) The USA Opioid Epidemic and Pain Control in the ED 2) Communicating with Patients with Opioid Use Disorders 3) Opioid Withdrawal	Teaching Guide	Suggested Preparation ACEP: Opioids HHS: Combating the Opioid Epidemic Paired Resources Renal Colic Pain JAMA: Opioid vs Nonopioid ACEP: Ketamine Opioid Substitution Tx ED Bridge: Buprenorphine
11	Critical Care: Acute RV Failure 1) Right heart failure basics 2) Managing right heart failure	Teaching Guide	Suggested Preparation Review of Right Heart Failure in the ED Paired Resources Critical Care Right Heart Failure Review Crashing Pulmonary Hyperension Patient NUEM Blog: Right Heart Failure Deeper Dive
12	Non-Clinical Skills: Team Leadership and Conflict Resolution 1) Team Leadership basics 2) Working with advanced practice providers 3) Basics of conflict management	Teaching Guide	Suggested Preparation Grace Under Pressure
13	Personal Development: Personal Finance II 1) Disability Insurance 2) Life Insurance 3) Student Loan Management	Teaching Guide	Suggested Preparation Disability Insurance Life Insurance Student Loans/Investing Paired Resources WCI: Student Loans Life Insurance Disability Insurance
14	Critical Care: Physiologically Unstable Intubations 1) Hypoxic Intubations 2) Hypotensive Intubations 3) Acidotic Intubations	Teaching Guide	Suggested Preparation Intubating the Critically Ill Patient Study of intubating in ramp vs sniffing position in the ICU Paired Resources Intubating the hypotensive patient Intubating the Hypoxic Patient Intubating the Acidotic Patient
15	Personal Development: Physician Wellness II (Errors and Second Victim) 1) Medical Errors 2) Second Victim Syndrome	Teaching Guide	Suggested Preparation Error Disclosure Second Victim Syndrome Effect of Errors on Residents Paired Resources ACEP Statement on Error Dislosure Disclosure of Medical Error Caring for the clinician after an adverse event Debriefing Best Practices (CORD Wellness group) Second Victim Rapid Response Team
16	Personal Development: The Job Hunt II 1) The Job Interview 2) Contract Basics	Teaching Guide	Suggested Preparation Job Searches Paired Resources 5 Steps for Physician Interviews The 10 Biggest Legal Mistakes Physicians Make The Physician's First Contract HBR Job Offer Negotiation
17	Critical Care: The Critically Ill Vented Patient 1) Pre-intubation management 2) The Slowly Worsening Ventilated Patient 3) The Crashing Ventilated Patient	Teaching Guide	Suggested Preparation NUEM Blog: Crashing Patient on a Vent EMCrit Crashing Vented Patient Paired Resources Summary of ARDS and COPD Cardiac Arrest and Intubation EMCrit Respiratory Drive EMCrit Bipap and HFNC PulmCCM COPD Review
18	Special Populations: Geriatric Care 1) Introduction to geriatric care 2) Dementia in the ED 3) Diposition of the geriatric patient 4) High Risk Medications and Falls	Teaching Guide	Suggested Preparation Falls Evaluation in the Elderly Podcast Management of Behavioral Issues in Older Adults Paired Resources ACEP Geriatric Guidelines Beers Criteria
19	Special Populations: Sex Based Crimes 1) Sexual Assault 2) Sex Trafficking	Teaching Guide	Suggested Preparation Human Trafficking: A Guide Identification and Approach for the Emergency Physician Sold For A Chrysler 300 A Safe Place to Come Paired Resources HEAL (Sex Trafficking Resource) CDC Guidelines for SA Care
20	Critical Care: Cardiogenic Shock (LV) 1) Cardiogenic Shock 2) Left Ventricular Assist Devices	Teaching Guide	Suggested Preparation Cardiology Corner: Cardiogenic Shock How to Manage LVADs Paired Resources VADs in the ED Experts Recs for Mgmt of Cardiogenic Shock
21	Non-Clinical Skills: Residents as Teachers	Teaching Guide Learner Reference
22	Non-Clinical Skills: Billing and Coding 1) Overview of Documentation and Billing 2) Review of 2023 E/M Coding Guidelines 3) Practice Documentation and Coding	Teaching Guide	Paired Resources ACEP 2023 Documentation Guide ACEP 2023 Documentation FAQs AAEM Business of EM AMA CPT E/M Revisions
23	Critical Care: Advanced ACLS 1) Refractory Ventricular Fibrillation 2) Pseudo-PEA	Teaching Guide	Suggested Preparation Pseudo-PEA Refractory Ventricular Fibrillation Paired Resources Esmolol and Ventricular Fibrillation Double Seq Defibrillation POCUS and CPR Pauses
24	Non-Clinical Skills: Bias in Medicine 1) Basics of bias in medicine 2) Gender bias	Teaching Guide	Suggested Preparation Implicit Bias Test (Harvard) Implicit Bias Summary Paired Resources Impact of Cognitive Stressors and Bias in the ED Gender Bias and medical care
25	Personal Development: Medical Malpractice 1) Epidemiology of medical malpractice and basic legal terminology 2) Risk Mitigation 3) Anatomy of a lawsuit	Teaching Guide	Suggested Preparation Factors Influencing Risk of Medical Malpractice Paired Resources Unnecessary Imaging Culture of Medicine and Malpractice
26	Clinical Skills: Patient Centered Communication and Breaking Bad News	Teaching Guide
27	Clinical Skills: Child Abuse and Neglect 1) Non-Accidental Trauma - History and Exam 2) NAT - Medical Decision Making and Resource Utilization	Teaching Guide	Suggested Preparation Identification of Child Abuse and Neglect NUEM Blog: NAT Paired Resources CAPTA CDC Child Abuse and Neglect Prevention
28	Special Populations: Special Needs Children 1) Care of the Autistic Child 2) Care of the Child with Chronic Medical Conditions	Teaching Guide	Paired Resources PEMP: Special Needs
29	Special Populations: Transgender Patients and Domestic Violence 1) Overview of terminology and introduction to transgender medicine 2) Silicone Embolism Syndrome 3) Chest Binding	Teaching Guide	Suggested Preparation Beyond Bathrooms — Meeting the Health Needs of Transgender People Reported Emergency Department Avoidance, Use, and Experiences of Transgender Persons in Ontario, Canada Paired Resources The Report of the 2015 U.S. Transgender Survey Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People Creating equal access to quality health care for transgender patients
30	Special Populations: Working with Immigrant Patients 1) Appropriate use of language assistance 2) "Medical Spanish"	Teaching Guide	Suggested Preparation NEJM on use of translators Best Practices for Improving Communication with limited english proficiency patients Paired Resources Laws regarding use of interpreters White paper on use of interpreters to decrease health disparities Informed consent for limited english proficiency patients Unplanned ED return visits in limited english proficiency patients
31	Non-Clinical Skills: Patient Handoffs 1) Introduction & Best Practice Analysis 2) Review Standardized Handoff Tools 3) Handoff Practice Cases	Teaching Guide	Paired Resources SAEM - Transfer of Care 10 Tips to Minimize Error at ED Sign-Out Rounds Implementation of ED I-PASS as a Standardized Handoff Tool in the Pediatric Emergency Department
32	Non-Clinical Skills: Microaggressions & Allyship 1) Types of Microaggressions 2) Addressing microaggressions 3) Being an ally at workplace 4) Explore privilege	Teaching Guide Learner References	Suggested Preparation Confronting Implicit Bias and Microaggressions BMJ Talk Medicine: How to treat someone who's racist or sexist Paired Resources Unlocking the Power of Allyship: Giving Health Care Workers the Tools to Take Action Against Inequities and Racism
33	Clinical Skills: Trauma-Informed Care (TIC) 1) TIC procedures 2) TIC learning environment 3) TIC care systems	Teaching Guide Learner References	Suggested Preparation Acad Med: Trauma-Informed Medical Education TIC Equity Toolkit TIC in the ED (Review) Paired Resources TIC in the ED: Recommendations TIC Best Practices