Can't stay up-to-date on the latest and greatest in emergency medicine education? The Academic Emergency Medicine Education and Training (AEMET) editorial board members present their must-read, practice-changing medical education articles published in the journal in 2023.
The authors report no financial conflict of interest.
Small-group discussion is an instructional strategy that is increasingly incorporated in emergency medicine (EM) educational settings. Compared to individualistic learning, small-group education enables learners to compare and synthesize perspectives in collaboration with peers and educators. This fosters communication, team-building, and critical thinking skills that are essential in EM professional environments. To ensure these benefits are delivered to EM small-group learners, educators should utilize instructional strategies grounded in learning theory.
A workgroup from the Society for Academic Emergency Medicine (SAEM) Simulation Academy and Education Research Interest Group sought to develop theory-informed recommendations for EM educators to optimize small-group instruction. Workgroup members were faculty with undergraduate medical education and EM residency leadership roles, including the development and deployment of small-group education.
Through primary literature review and iterative discussion, the workgroup identified a suitable theoretical framework, collaborativism, that postulates that small-group learning occurs as learners advance from divergent to convergent thinking through discussion. Through this lens, discussion is the centerpiece of small-group learning, and educational interventions that improve the quality of discussion also improve the quality of learning.
Collaborativism-informed strategies to strengthen small-group learning were proposed, organized by instructional design, learner–learner interactions, and educator–learner interactions. These educational interventions focused on enhancing engagement, cooperativity, and critical thinking behaviors in small-group learners as they engage in discussion. Recommended strategies were synthesized into a 50-min workshop presented at the 2024 SAEM Annual Meeting.
Professional identity formation (PIF) is an ongoing journey where individuals internalize the characteristics, values, and behaviors of the medical profession. This concept, deeply rooted in medical tradition, has gained attention in recent decades, shifting from a passive to a more intentional process. Theories of PIF draw from theories of personal identity formation and moral reasoning.
The purpose of this paper is to describe the development of a didactic on PIF presented at the 2024 Society for Academic Emergency Medicine annual conference.
The didactic was developed through literature review, expert consultation, and iterative discussions within a team of educators and was attended by approximately 20 participants.
Through interactive exercises, reflective tools, and literature-based insights, participants were prompted to explore their own PIF journeys.
This session emphasized the importance of fostering a holistic understanding of medical training and integrated personal development with broader societal and moral expectations as well as supported the ongoing evolution of professional identity.
Emergency departments serve as critical-access points for people experiencing homelessness (PEH). These patients face significant health disparities and are subject to stigmatization and misconceptions, often contributing to suboptimal care and moral distress among providers. Structural competency, a framework that addresses the social, political, and economic determinants of health, is crucial in rethinking the care of PEH in emergency medicine (EM).
This paper is based on the proceedings of the SAEM24 didactic session, which utilized a structural competency framework to address common misconceptions about unhoused patients. The session was developed through comprehensive literature reviews conducted by a multidisciplinary team and focused on integrating structural competency into EM practice.
To confront the bias and stigma surrounding PEH, the didactic session provided evidence throughout four key areas: the diversity and changing demographics of homelessness, understanding the structural and infrastructural drivers of homelessness, identifying the impact of homelessness on health and health care access, and implementing practical interventions aimed at improving health outcomes for unhoused individuals. These areas are critical in educating EM providers on the complexities of caring for unhoused patients and the systemic issues that exacerbate their health crises.
Addressing homelessness within EM through a structural competency framework is imperative for researching and delivering effective health care. Continuous education and policy advocacy are vital to confront the underlying structural determinants of health and enhance emergency care for unhoused populations.
The objective was to scope the literature and describe the extent and type of evidence about entrustable professional activities (EPAs) in postgraduate emergency medicine (EM) education.
Joanna Briggs Institute's methodology was used to find and extract relevant data from documents found in Ovid MEDLINE, EMBASE, and CINAHL, supplemented by a gray literature search using Google Advanced for EPA frameworks. Eligible documents discussed EPAs for doctors in structured EM training programs. Data extracted included research methods, research approach, participants, scope, EPA element addressed, and dominant logic used by EPA creators.
Data were extracted from 58 documents. Thirty-four of the documents (58.6%) were peer-reviewed journal articles, 18 (31.1%) were conference abstracts, and six (10.4%) were curriculum documents from EM organizations. Thirty documents were from Canada (51.7%). Twenty-five documents (43.1%) took an explorative approach. Twenty-one documents (36.2%) were translational in approach. Thirteen EPA frameworks, containing a total of 158 EPAs, were found.
EM is an expanding area of EPA development, but frameworks remain highly variable and unstandardized. Most studies are explorative or translational, leaving gaps in experimental research to justify EPA adoption and observational research to assess real-world outcomes.
There is limited understanding of factors influencing recruitment of emergency medicine (EM) residents identifying as races and ethnicities underrepresented in medicine (URM): Black/African American, Hispanic, American Indian/Alaskan Native, or Native Hawaiian/Pacific Islander. This study explored whether diversity of EM residents at the program level is associated with community diversity at the county level.
The proportion of URM residents in each EM residency program was determined using Association of American Medical Colleges academic year 2023–2024 data. We excluded newer programs without a full complement of residents and those not reporting race/ethnicity data. We used U.S. Census data to categorize each program's surrounding county as having lower diversity (<30% URM population), moderate diversity (≥30% to <49% URM population), or higher diversity (≥49% URM population). We used Kruskal–Wallis test with Dunn's procedure to determine whether the proportion of URM residents in a program was associated with the level of diversity in the surrounding county.
Among 247 included EM programs, 5% of residents were Black (range 0%–46% per program), 8% Hispanic (range 0%–43%), and 4% another URM race/ethnicity. The proportion of URM EM residents was significantly lower among programs in lower-diversity counties (median [IQR] 10% [6%–16%]) than among programs in moderate-diversity (median [IQR] 14% [8%–20%], p < 0.001) or higher-diversity (median [IQR] 15% [9%–22%], p < 0.001) counties. Similarly, programs in counties with higher Black populations had more Black EM residents, and programs in counties with higher Hispanic populations had more Hispanic EM residents.
EM residents at programs in lower-diversity counties are less likely to be URM than those in moderate- or higher-diversity counties. EM programs located in less diverse communities may require unique strategies to increase resident diversity.
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