To successfully provide effective patient care within a healthcare system and broader society facing health inequities and social injustice, emergency medicine (EM) residents must demonstrate a nuanced understanding of social determinants of health (SDOH). Classroom or bedside instruction may be insufficient to generate meaningful engagement with patients’ social contexts; experiential collaborative learning with community engagement has been suggested as an ideal modality for education about SDOH. We describe a low-cost, easily replicable activity involving observation and discussion of community murals within built environments. The tour was planned by EM faculty with expertise in graduate medical education, social EM, and the use of art in medical education. Prior to the activity, faculty selected murals situated in a variety of neighborhoods that would spark discussion on SDOH. Over the two-hour tour, residents stopped at city murals on a pre-planned route and engaged in observation and discussion. Faculty facilitators used established arts pedagogy, including visual thinking strategies and the concept of the “third thing,” to facilitate a collaborative exploration of murals, surrounding communities, and larger implications for patients. The activity was successful in providing residents with a nuanced, context-specific approach to SDOH, sparking greater curiosity about the communities they serve, and engaging residents in reflection and conversation about personal preconceptions and how to better engage with surrounding communities. Since murals and street art are present and accessible in many different settings, residency programs could consider implementing a similar activity as part of their didactic curriculum.
The discharge conversation is a critical component of the emergency department encounter. Studies suggest that emergency medicine (EM) residency education is deficient in formally training residents on the patient discharge conversation. Our goal was to assess the proficiency of EM residents in addressing essential elements of a comprehensive discharge conversation; identify which components of the discharge conversation are omitted; introduce “DC HOME,” a standardized discharge mnemonic; and determine whether its implementation improved resident performance and patient satisfaction.
In 1979 Drs. Lewis Goldfrank and Neal Lewin astutely perceived that the Bellevue Hospital emergency ward, the safety net of New York City, provided an exceptional learning environment for patient care. Every patient, in some capacity, was deemed an invaluable educational opportunity, and through this ideology the tradition of “Morning Report” was born. It would become a staple of the residency, and the department community as a whole, for the next 40 years.
We, the authors of the paper: “Implementation of a Physician Assistant Emergency Medicine Residency Within a Physician Residency” (West J Emerg Med. 2020 Dec 14;22(1):45–8) would like to address concerns raised by members of the emergency medicine (EM) community. Our article describes the successful implementation of a physician assistant (PA) training program within the existing framework of an EM residency. This article was submitted as a “brief educational advance.” It is a description of the logistics of our program and was not powered to draw any statistical conclusions on the limited data of an evaluation tool lacking validation, as was pointed out in the limitations. It does not support or suggest the equivalence of physician graduates of a 3- or 4-year residency in emergency medicine with PA training program graduates. As such, it does not seek to equate the two programs or the skills of their respective graduates, but instead to describe a successful interprofessional educational collaboration.
Physician assistants (PA) are an important part of emergency department healthcare delivery and are increasingly seeking specialty-specific postgraduate training. Our goal was to pilot the implementation of a PA postgraduate program within an existing physician residency program and produce emergency medicine-PA (EM-PA) graduates of comparable skill to their physician counterparts who have received the equivalent length of EM residency training to date (evaluated at the end of first year of EM training).
Racism impacts patient care and clinical training in emergency medicine (EM), but dedicated racism training is not required in graduate medical education. We designed an innovative health equity retreat to teach EM residents about forms of racism and skills for responding to racial inequities in clinical environments. The three-hour retreat occurred during the residency didactic conference to maximize resident participation. We prioritized facilitated reflection on residents’ own experiences of race and racism in medicine in order to emphasize these concepts’ relevance to all participants. We used workshop, small group, and panel formats to optimize interactivity and discussion. Post-retreat survey respondents indicated that the curriculum successfully promoted awareness of racism in the workplace. Participants also expressed interest in continued discussions about racism in medicine as well as desire for greater faculty and nursing participation in the curriculum. Residency programs should consider incorporating similar educational sessions in core didactic curricula.
Medical students transition to intern year with significant variability in prior clinical experience depending on their medical school education. This leads to notable differences in the interns’ ability to perform focused histories and physical exams, develop reasoned differentials, and maximize care plans. Providing a foundational experience for these essential skills will help to establish standardized expectations despite variable medical school experiences.
The focus of residency training is to ensure that graduates attain a minimum level of skills and knowledge in order to be able to practice independently. While there are multiple formal methods to evaluate a resident, there is a paucity of literature that describes whether programs have residents perform individual self-assessment (ISA) with the development of individualized learning plans (ILP) to better themselves. We sought to investigate the current state of emergency medicine (EM) residency programs using ISA and determine whether these assessments are used to develop an ILP for each resident.
Educational podcasts are used by emergency medicine (EM) trainees to supplement clinical learning and to foster a sense of connection to broader physician communities. Yet residents report difficulties remembering what they learned from listening, and the features of podcasts that residents find most effective for learning remain poorly understood. Therefore, we sought to explore residents’ perceptions of the design features of educational podcasts that they felt most effectively promoted learning.
Medical students pursuing an emergency medicine (EM) residency are advised to obtain at least two Standardized Letters of Evaluation (SLOE). Students often complete one rotation at their home institution and at least one “away” rotation at a program separate from their home institution. The SLOE was introduced as an objective evaluation tool. The aim of this study was to determine whether there was a difference in scores between home rotation and away rotation SLOEs.
Clinical rotations in emergency medicine (EM) can be challenging for medical students because of the lack of continuity with attending physicians. To overcome this challenge, institutions have started to match a student’s schedule with that of a resident, referred to as “paired shifts.” We sought to pilot and compare two schedule formats for fourth-year medical students (MS4) – a resident-paired shifts (RPS) and a traditional resident-unpaired shifts (RUS) schedule.
The development of clinical reasoning abilities is a core competency of emergency medicine (EM) resident education and has historically been accomplished through case conferences and clinical learning. The advent of the SARS-CoV-2 pandemic has fundamentally changed these traditional learning opportunities by causing a nationwide reliance on virtual education environments and reducing the clinical diversity of cases encountered by EM trainees.
The COVID-19 pandemic led to a large disruption in the clinical education of medical students, particularly in-person clinical activities. To address the resulting challenges faced by students interested in emergency medicine (EM), we proposed and held a peer-led, online learning course for rising fourth-year medical students.
Point-of-care ultrasound (POCUS) has an emerging presence in medical student education; however, there is limited evidence that this translates into appropriate clinical care. We aimed to evaluate the ability of medical students to integrate newly obtained POCUS knowledge into simulated clinical cases.
Lack of accreditation requirements affords global emergency medicine (GEM) fellowships the flexibility to customize curricula and content. A paucity of literature exists describing the state of GEM fellowship programs. We describe the current state of GEM fellowship curricula including which components are commonly included, and highlighting areas of higher variability.
The coronavirus disease 2019 pandemic forced a rapid transition of in-class residency conferences to online residency conferences; little is known about learners’ perceptions of this new didactic environment. Understanding learners’ perceptions of virtual classrooms can help inform current and future best practices for online, synchronous, graduate medical education.
Professional development is an important component of graduate medical education, but it is unclear how to best deliver this instruction. Book clubs have been used outside of medicine as a professional development tool. We sought to create and evaluate a virtual professional development book club for emergency medicine interns.
Medical and physician assistant (PA) students are often required to have Basic Life Support (BLS) education prior to engaging in patient care. Given the potential role of students in resuscitations, it is imperative to ensure that current BLS training prepares students to provide effective cardiopulmonary resuscitation (CPR). The objective of this study was to assess whether current BLS training produces student providers who can deliver BLS in an American Heart Association (AHA) guideline-adherent manner.
Clinical rotations in emergency medicine (EM) can be challenging for medical students because of the lack of continuity with attending physicians. To overcome this challenge, institutions have started to match a student’s schedule with that of a resident, referred to as “paired shifts.” We sought to pilot and compare two schedule formats for fourth-year medical students (MS4) – a resident-paired shifts (RPS) and a traditional resident-unpaired shifts (RUS) schedule.
Traumatic injuries disproportionately affect populations in low and middle-income countries (LMIC) where head injuries predominate. The Rwandan Ministry of Health (MOH) has dramatically improved access to emergency services by rebuilding its health infrastructure. The MOH has strengthened the nation’s acute emergency response by renovating emergency departments (ED), developing the field of emergency medicine as a specialty, and establishing a prehospital care service: Service d’Aide Medicale Urgente (SAMU). Despite the prevalence of traumatic injury in LMIC and the evolving emergency service in Rwanda, data regarding head trauma epidemiology is lacking.
Physician finances are linked to wellness and burnout. However, few physicians receive financial management education. We sought to determine the financial literacy and educational need of attending and resident physician at an academic emergency medicine (EM) residency.
Social emergency medicine (EM) is an emerging field that examines the intersection of emergency care and social factors that influence health outcomes. We conducted a scoping review to explore the breadth and content of existing research pertaining to social EM to identify potential areas where future social EM research efforts should be directed.
Leadership positions occupied by women within academic emergency medicine have remained stagnant despite increasing numbers of women with faculty appointments. We distributed a multi-institutional survey to women faculty and residents to evaluate categorical characteristics contributing to success and differences between the two groups.
Emergency departments (ED) use many medications with a range of therapeutic efficacy and potential significant side effects, and many medications have dosage adjustment recommendations based on the patient’s specific genotype. How frequently medications with such pharmaco-genetic recommendations are used in United States (US) EDs has not been studied.
While burnout is occupation-specific, depression affects individuals comprehensively. Research on interventions for depression in emergency medicine (EM) residents is limited.
