|Jeffrey Druck, MD||University of Colorado Health Sciences Center, Denver, Colorado|
|David Pearson, MD, MS||Carolinas Medical Center, Charlotte, North Carolina|
|Jonathan Claud, MD, MBA||Legacy Salmon Creek Hospital, Vancouver, Washington|
The immense body of knowledge that emergency medicine (EM) encompasses is constantly growing and ever changing. Textbooks build a strong foundation for the EM resident, but journal articles critical for modifying and improving EM practices are equally important for a well-rounded education. Determining which journal articles are vital to an EM residency education is a challenge. Lacking a formalized list of key articles available to EM residents and realizing that a list of articles without a guide may be difficult and confusing for novice readers, we created the “Colorado Compendium”: a recommended reading list, limited to 100 articles with accompanying summaries, tailored to emergency medicine residents.
Internalizing the canon of knowledge in emergency medicine (EM) is a daunting task. As we all know, this knowledge base is not completed during residency. Instead, residency serves as the launching point for a lifetime of medical education. How do residents become familiar with the library of knowledge that will aid them at the bedside? Textbooks are a start. Clinical hours are the mainstay. But journal articles provide the basis for a change in practice. The Colorado Compendium is an attempt to identify sentinel articles that are often referred to during clinical rotations. By providing a summary of each article, residents are exposed to the information that lies in these references, while the complete articles remain for further investigation.
Attending physicians at the Denver Health Residency in Emergency Medicine were queried via email as to which articles they deemed important for inclusion in the list of “top articles in emergency medicine,” with no other caveat listed. In response, we received recommendations for several hundred articles. From this group, we culled for duplication and outdated articles. There were no absolute requirements regarding the characteristics of each article. The litmus test for inclusion was to ask whether an article would fundamentally enhance the clinical expertise of residents practicing EM. The list was narrowed by the authors to 100 articles. Subsequently, the three authors compiled a one-page summary of each article. The summaries were then reviewed and edited by attending physicians at Denver Health Medical Center and the University of Colorado Health Sciences Center with an interest or specialization in the subject area, after which the authors revised each summary.
Nationally available lists of articles pose a challenge from a resident education perspective. Using a national poll of “most important” leaves two critical issues that would need to be addressed: first, the issue of influence, and second, the issue of distance. For example, the Lifelong Learning and Self-Assessment (LLSA) articles, chosen by submission from a national audience, may include submissions from specific authors themselves.1,2 Also, this same pool of articles is subject to a bias towards new, untested modalities, as the inclusion of the nesiritide article in the 2005 LLSA list demonstrates.3Lastly, outside influences (drug companies, etc.) can be more apparent in a list that is based on suggestions, with secondary gain of increased knowledge of specific drugs influencing submissions. Through a literature review on PubMed using the search terms “emergency medicine article list,”4 no other lists are commonly available. Some commercial sites, such as eMedicine, have lists of articles relating to EM, but these articles are not based on published articles themselves, instead acting as a general topic summary.5 Finally, some web sites organize content based on subject, such as the New England Journal collection of EM articles. However, this is a collection of all EM-related articles listed in their publication, with no filter (and currently numbering at more than 250).6
That is not to say that some articles or guidelines included in our list are without any taint of influence or possible contradiction. However, we attempted to choose articles that have withstood the test of time in our program and guidelines that did not undergo immediate revision.
The article summaries themselves can be critiqued. As a conglomeration of opinion of three authors and one additional attending physician, there may be inherent bias in comments made. There may also be nuances in each article that are not discussed (or even mentioned) in the summaries that appear in the articles themselves. These summaries are not simply copies of the article abstracts, nor do they serve as adequate substitutes for reading the article itself. They are meant to serve as a brief guide to the associated full-text reference. Hopefully, residents reading the summaries will expand their knowledge base and will be encouraged to go to the original articles for further investigation.
How does one use the Colorado Compendium? Does distribution itself equal knowledge acquisition? This remains to be seen. Eighty-three different residency programs recently requested copies of the Colorado Compendium to incorporate in their curriculum. As with any educational endeavor, possession of a curriculum does not translate into an effect. At our program, weekly distribution of a single summary was thought to be a method that was best suited to resident interest. Other institutions have distributed the entireColorado Compendium at the beginning of residency. Assessing the Colorado Compendiumfrom an educational success standpoint is an ongoing process.
As a final note, our list and summaries are not meant to be a final document for all time. We intended for this Colorado Compendium to be a living document, with additions and deletions occurring in an ongoing fashion. To maintain an article-based source for resident education, we encourage others to assist us with updating and editing this list. The article summaries are available online at www.westjem.org as a related file, “Colorado Compendium,” via this link:http://repositories.cdlib.org/uciem/westjem/vol10/iss1/art7/
The Colorado Compendium is a starting point for article-based resident education. While textbooks form the basis for a broad knowledge base, the articles with summaries attempt to refine our knowledge of and potentially change our practice in EM.
Special thanks to faculty members who contributed a significant amount of their time to make this project a reality: Jason Haukoos, MD, MS, Kennon Heard, MD, Ben Honigman, MD, Raveendra S. Morchi, MD, Genie Roosevelt, MD, MPH, Fred Severyn, MD, and Kurt Whitaker, MD.
Supervising Section Editor: Michael Epter, DO
Submission history: Submitted June 11, 2008; Revision Received August 25, 2008; Accepted October 10, 2008
Full text available through open access at http://escholarship.org/uc/uciem_westjem
Address for Correspondence: Jeffrey Druck, MD. University of Colorado Denver School of Medicine, Division of Emergency Medicine, 12401 E. 17th Avenue, B-215, Aurora, CO 80045
Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources, and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.
1. American Board of Emergency Medicine. LLSA reading lists. 2008. [Accessed July 30, 2008]. Available at: http://www.abem.org/PUBLIC/portal/alias__Rainbow/lang__en-US/tabID__3426/DesktopDefault.aspx.
2. American Board of Emergency Medicine. LLSA Article Submission Process. 2008. [Accessed July 30, 2008]. Available at:http://www.abem.org/PUBLIC/portal/alias__Rainbow/lang__en-US/tabID__3435/DesktopDefault.aspx.
3. American Board of Emergency Medicine. LLSA reading List 2005. 2005. [Accessed November 15, 2006]. Available at: www.abem.org.
5. Web MD. Emergency medicine articles. eMedicine. Available at:http://www.emedicine.com/EMERG/. Access July 30, 2008.
6. Massachusetts Medical Society. Collections by disease or topic: emergency medicine.New England Journal of Medicine. [Accessed July 30, 2008]. Available at:http://content.nejm.org/cgi/collection/emergency_medicine.