Lund, Sweden

Pedagogic Principles

Clarity in Emergency Medicine

Regional Training: Why?

Clinical practice is essential but not sufficient to acquire and maintain the skills required of a specialist in Emergency Medicine (EM). Regular training sessions are also essential. The aims of these sessions are to complement clinical practice by:

  • focussing on the recognition and management of serious, time-critical conditions that rarely present to the Emergency Department

  • practising procedures that are seldom performed in the emergency room

  • highlighting the results of new studies and the latest guidelines

  • discussing the links between symptoms, pathophysiology, pharmacology, diagnostic principles, ethics and logistics in order to develop the ability to solve new situations based on analogy

The term ”regional” refers to the fact that these training sessions are held locally and run by physicians belonging to local emergency programs. Local training is advantageous in several regards:

  • it minimizes transportation times and expenses and makes short, regular training sessions feasible

  • it provides a forum for reflection on and development of local practice, and facilitates the integration of education with clinical practice

  • it hones the teaching skills of local residents and specialists

  • it provides a forum where physicians in the program regularly meet

In regards to Swedish EM residents, this training program is designed to:

  • satisfy the Swedish EM curriculum requirements regarding Delmål C1, C2, C3, C5, C9 and Delar av delmål A1, A5, A6, C11, C13

  • prepare for the Swedish Specialist Examination in Emergency Medicine

  • prepare for the European Board Examination in Emergency Medicine Part A and Part B

Constructive Alignment

Constructive Alignment is the main pedagogical model underlying the design of our regional training program. Constructive Alignment emphasizes:

  • engagement in learning activities (instead of listening to lectures)

  • aligning learning activities with the objective (the ability to deliver quality clinical care within the realm of EM) and assessment (the Swedish Specialist Examination in Emergency Medicine and the European Board Examination in Emergency Medicine)

In accordance with Constructive Alignment, each training session includes four items:

  • a pretest

  • a brief lecture introducing the training session and refreshing key algorithms and/or differential diagnoses

  • simulation training focusing on resuscitation, diagnosis, decision-making, procedures, organization and communication . . .

  • a group discussion

An article published in the Swedish Medical Journal, Läkartidningen, (Dryver E, Andersson N, Friberg H. Education of specialists in emergency medicine according to a current pedagogical model. The basis is scenario training and clinical practice under supervision. Läkartidningen 2011;108:1183-6) presents in more detail the pedagogical principles underlying our training program.


SWESEMs (Swedish Society for Emergency Medicine) Education Committee has developed checklists for processes in Emergency Medicine to achieve alignment between the Swedish Specialist Examination in Emergency Medicine and clinical practice. These checklists are also meant as educational tools in order to align education with clinical practice and the specialist examination, and they are used to give feedback during the training sessions.

An article published in the European Journal of Emergency Medicine describes the form and function of the Swedish examination and the role of the checklists (Dryver E, Eriksson A, Söderberg P, Kurland L. The Swedish specialist examination in emergency medicine: form and function. Eur J Emerg Med 2015;Aug 26).


Knowledge is a prerequisite for competence. The main purpose of the pretest is to provide participants in the regional training with the opportunity to freshen up or learn some of the knowledge related to the scenarios and procedural skill stations. The pretests reduce the heterogeneity in knowledge among participants and make it possible to focus on training and skills development. Other purposes include:

  • covering the knowledge expected of a specialist in Emergency Medicine, in alignment with SWESEMs Core Curriculum in Emergency Medicine and the European Curriculum for Emergency Medicine

  • preparing residents for certification in Emergency Medicine, namely the Swedish Specialist Examination in Emergency Medicine and The European Board Examination in Emergency Medicine (especially Part A)

The pretests consist of questions and references to articles, videos, blogs etc. where the answers can be found. For each training session there is a corresponding pretest. Over half of the pretests (written in Swedish) are currently posted on this site. The goal is to post the remaining pretests and up-date them periodically. Anyone involved in EM education is welcome to use and adapt the pretest material. Comments and suggestions for further development (better selection of topics, questions, references, etc.) are welcome.

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