Emergency Physicians Think in Spirals

As adult learners, junior clerks on core rotations in emergency medicine (EM) are expected to "own" their patients and follow them from presentation to disposition in the Emergency Department (ED). Traditionally, we teach clerks to present an exhaustive linear list of symptoms and signs to their preceptors. This does not apply well to the fast-paced ED setting. Mnemonics have been developed to teach clerks how to present succinctly and cohesively. To address the need for continual patient reassessment throughout the patient's journey in the ED, we propose a complimentary approach called SPIRAL.