A Story About Mesenteric Ischemia
This interactive module is designed for implementation within an emergency medicine residency program. The target audience is first through fourth year (PGY 1 to PGY 4) residents, medical students, physician assistant fellows, physician assistant students, physician assistants and attending physicians.
Although mesenteric ischemia accounts for only 1% of emergency department visits, it carries a high mortality rate.1-3. The overall mortality associated with mesenteric ischemia is between 60% to 90% and climbs exponentially once bowel wall infarction occurs.2,3 Acute arterial occlusion is the most familiar form of mesenteric ischemia. However, there are other forms of mesenteric ischemia that are not as well recognized or well known that still carry significant mortality rates. Early recognition, diagnosis and treatment are the mainstays in reducing the mortality of this condition.1Knowing all forms of mesenteric ischemia is essential for an emergency medicine clinician.
This module utilizes a combination of a traditional flipped classroom model with a novel approach of narrative medicine. Learners will read assigned articles and complete a question sheet in preparation. In didactics, the group will divide into small groups to create a narrative about a patient who presents with one of the four forms of mesenteric ischemia. This modality utilizes active learning, discussion and synthesis.
After participation in this module, learners will be able to: 1) List the types of mesenteric ischemia, 2) identify risk factors and historical components that differentiate each type of mesenteric ischemia, 3) provide the diagnostic modality of choice, and 4) describe the appropriate treatment in each type of mesenteric ischemia.
This module utilizes the flipped classroom model of education for independent learning along with small group discussion. Learners will independently complete pre-assigned readings and questions based on the readings. In didactics sessions, learners will then create a narrative of a patient presenting with one of the types of mesenteric ischemia. Each of the narratives will be shared with the entire group in the final 30 minutes of the didactic session. If programs choose, the type of mesenteric ischemia may be revealed at the end, allowing for participants to select the form they suspect is being presented.
Mesenteric ischemia, abdominal pain, flipped classroom, small group.