While emergency medicine (EM) faculty are generally the most appropriate teachers for EM residents, there are components of the EM curriculum that benefit from specialist input. However, many times non-EM specialists have little appreciation for the challenges inherent in EM practice. In addition, presentations by specialists may address topics that are relevant to their practice, but outside the scope of EM. Residency leaders can feel challenged in giving constructive feedback to faculty speakers from other departments. In our setting, as in most, outside specialists are contributing their time without contractual requirements or personal benefit.

We developed the Consultant Chat, a novel didactic format for specialists who are frequently consulted by the emergency department (ED). Expert consultants are selected by the senior EM residents and invited to come have a “chat” with our residents for 1 hour during the weekly EM conference time. These specialists do not prepare a presentation; they simply answer questions from the audience and share their experience. Residents are instructed to come prepared with questions that are specific, case based, and pragmatic. Common questions include: How would you expect us to approach “X” presentation? Under what circumstances would you want to be called in the middle of the night? What is your biggest “gripe” about cases that you have seen from the ED? Take-home points are recorded by an assigned resident and distributed to all EM residents and faculty as a summary document of “clinical pearls.”

The Consultant Chat has greatly fostered collaboration with our specialists from other departments. In the last 18 months, we have held over a dozen Consultant Chat sessions with specialists from orthopedic surgery, plastic surgery, otolaryngology, neurology, gastroenterology, urology, and oral/maxillofacial surgery. The consultants feel honored to be selected by the residents, there is minimal time commitment on their part, and the informal atmosphere is engaging for all parties. They are motivated to share their knowledge with residents that will have a positive impact on patient care and may prevent unnecessary phone calls from the ED. The residents drive the discussion to ensure their education needs are met, and this self-directed learning style allows them to derive maximal value from the sessions. In addition, our faculty enjoy attending these sessions, as they can contribute their experience and management viewpoints, and engage their specialist colleagues in a friendly, educational atmosphere.

Our EM residents have expressed greater comfort and confidence in knowing when to consult specialists from the ED, and anecdotal evidence suggests that communication with outside departments has improved. Our specialists have gained a greater understanding of the limited resources and challenges of the ED, as these are openly discussed during the sessions. Our curriculum committee, composed of residency leadership and selected faculty and residents, has evaluated the positive feedback from these sessions and worked to make them a regular component of the EM curriculum. Our novel didactic format has proven successful in our EM program; it could also be successfully adapted to any “generalist” training program, such as family medicine, internal medicine, pediatrics, or general surgery. The Consultant Chat represents a didactic model that develops not only the medical knowledge of our trainees, but also essential skills in communication, professionalism, and collaboration.

Author notes

Editor's Note: We are pleased to present the 2017 New Ideas articles showcasing novel, implemented initiatives in graduate medical education. This year, 100 submissions were reviewed and 13 innovative approaches were selected. We encourage feedback via e-mail ([email protected]) regarding your experience with these New Ideas at your institution, as well as reactions to this section in general.