Amber Cibrario, Rahul Bhat, Bruce M. Lo, Laura Oh, Deborah Diercks, Sarah Greenberger, Joshua Davis, David Carlberg, Christopher Sampson, Elaine Josephson
Implicit bias refers to unconscious attitudes and associations an individual holds about others, which can impact behavior and decisions. In the emergency department (ED)—a setting characterized by unpredictable patient volumes, overcrowding, high acuity, and significant stress—physicians often face increased cognitive demands, which may heighten susceptibility to implicit bias. This can adversely impact emergency medicine (EM) patient care and outcomes, as well as the well-being of frontline healthcare providers. In this paper, we outline how specific biases can affect both patient care and physician practice. Recognizing that the ED presents unique challenges, we propose targeted solutions to address bias at the individual, institutional, and specialty levels with the ultimate aim of improving the patient care experience and promoting equity in the EM workforce.
{"title":"The Unique Impacts of Implicit Bias on Emergency Medicine","authors":"Amber Cibrario, Rahul Bhat, Bruce M. Lo, Laura Oh, Deborah Diercks, Sarah Greenberger, Joshua Davis, David Carlberg, Christopher Sampson, Elaine Josephson","doi":"10.1002/aet2.70118","DOIUrl":"https://doi.org/10.1002/aet2.70118","url":null,"abstract":"<div>\u0000 \u0000 <p>Implicit bias refers to unconscious attitudes and associations an individual holds about others, which can impact behavior and decisions. In the emergency department (ED)—a setting characterized by unpredictable patient volumes, overcrowding, high acuity, and significant stress—physicians often face increased cognitive demands, which may heighten susceptibility to implicit bias. This can adversely impact emergency medicine (EM) patient care and outcomes, as well as the well-being of frontline healthcare providers. In this paper, we outline how specific biases can affect both patient care and physician practice. Recognizing that the ED presents unique challenges, we propose targeted solutions to address bias at the individual, institutional, and specialty levels with the ultimate aim of improving the patient care experience and promoting equity in the EM workforce.</p>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145825319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tiffany Murano, Douglas McGee, Felicia Davis, David Caro, Linda Regan
Background
The current ACGME EM program requirements (PR) use an annual minimum patient volume of 30,000 at the primary clinical site as a proxy to ensure sufficient clinical exposure for residents. As a part of the major revisions, the PR writing group proposes a modification of this requirement to define a minimum number of patient visits/resident during training using aggregate volumes from all EM rotation sites. Establishing this threshold intends to ensure that individual resident minimum encounter goals can be achieved by the end of residency through verification of adequate resources in the form of patient visits.
Methods
Using minimum values, it was determined that the current patient visits/resident is 3000. We used ACGME program information to calculate the aggregate ED patients/resident for each program by multiplying the weekly ED volume at each site by the number of weeks spent in EM rotations then dividing by the approved complement.
Results
Of the 282 programs (223 3-year and 59 4-year programs), 72.7% (205/282) had less than 5000, 51% (144/282) had under 4000, and 24.1% (68/282) had less than 3000 patient visits/resident (mean 4507.8, median 4219.5). Almost 25% of 4-year programs (14/59) were below 3000. With adjusted calculations to 3-year programs to account for an additional 31 weeks of EM as they transition to the proposed 4-year format, 28.2% (63/223) of programs fell below 5000, 9.4% (21/223) below 4000, and 0.9% (2/223) below 3000 patient visits/resident.
Conclusions
The PRWG determined that 3000 patient visits/resident aggregated across all sites during training should be the minimum resource as this is what most programs are currently providing, and it's consistent with the current PR. Although the ACGME isn't currently tracking patient encounters, the proposed PR will likely support the foundation of patient experiences geared towards an ideal target of 5000 patient encounters/resident.
{"title":"Establishing Minimum Patient Volume Requirements for Emergency Medicine Residencies","authors":"Tiffany Murano, Douglas McGee, Felicia Davis, David Caro, Linda Regan","doi":"10.1002/aet2.70122","DOIUrl":"10.1002/aet2.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The current ACGME EM program requirements (PR) use an annual minimum patient volume of 30,000 at the primary clinical site as a proxy to ensure sufficient clinical exposure for residents. As a part of the major revisions, the PR writing group proposes a modification of this requirement to define a minimum number of patient visits/resident during training using aggregate volumes from all EM rotation sites. Establishing this threshold intends to ensure that individual resident minimum encounter goals can be achieved by the end of residency through verification of adequate resources in the form of patient visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using minimum values, it was determined that the current patient visits/resident is 3000. We used ACGME program information to calculate the aggregate ED patients/resident for each program by multiplying the weekly ED volume at each site by the number of weeks spent in EM rotations then dividing by the approved complement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 282 programs (223 3-year and 59 4-year programs), 72.7% (205/282) had less than 5000, 51% (144/282) had under 4000, and 24.1% (68/282) had less than 3000 patient visits/resident (mean 4507.8, median 4219.5). Almost 25% of 4-year programs (14/59) were below 3000. With adjusted calculations to 3-year programs to account for an additional 31 weeks of EM as they transition to the proposed 4-year format, 28.2% (63/223) of programs fell below 5000, 9.4% (21/223) below 4000, and 0.9% (2/223) below 3000 patient visits/resident.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The PRWG determined that 3000 patient visits/resident aggregated across all sites during training should be the minimum resource as this is what most programs are currently providing, and it's consistent with the current PR. Although the ACGME isn't currently tracking patient encounters, the proposed PR will likely support the foundation of patient experiences geared towards an ideal target of 5000 patient encounters/resident.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arianna R. Moreno, R. Madelaine Paredes, Allyson Araña Mireles, Jae-Hyek Choi, Heang Sundermann, Kaysie Sachs, Dylan Rodriguez, Joseph K. Maddry
Background
The objective of our study was to evaluate the ability of Emergency Medicine (EM) physicians who have completed an accelerated extracorporeal membrane oxygenation (ECMO) course and mannequin training to initiate extracorporeal cardiopulmonary resuscitation (ECPR) in a swine model.
Methods
Twenty teams of two EM residents each were provided with 2 h of training on how to initiate ECPR using prerecorded instructional videos and hands-on training using an ECMO circuit, ECMO cannulas, and a task trainer model of a human pelvis. Following training, EM residents attempted to cannulate and initiate ECMO on anesthetized swine receiving cardiopulmonary resuscitation (CPR) after an electrically induced sudden cardiac arrest (SCA). The ability of and duration of time required for the two-resident teams to initiate veno-arterial ECMO on the swine was recorded. A knowledge assessment and survey were performed before and after course completion.
Results
Forty EM residents participated in this study, for a total of 20 teams. Seventy-five percent (15/20) of the teams successfully initiated ECMO. The average time to successful initiation of ECMO was 22 min and 10 s (95% CI 17:25–26:54). Participants' knowledge assessment scores improved by 21.1%, from a mean of 46.8%–67.9% correct after study completion (95% CI 13.3%–28.8%). Confidence in competency improved across all survey categories. The most frequent reason for unsuccessful ECPR was the inability to obtain appropriate vascular access.
Conclusions
An abbreviated two-hour ECPR training course for EM residents resulted in a 75% success rate of ECPR initiation on a swine SCA model. Training of EM physicians in ECPR may expand the number of hospitals capable of providing this therapy. Advanced engineering solutions or increased experience with ultrasound-guided vascular access during CPR may improve ECMO cannulation success rates.
背景：我们研究的目的是评估急诊医学（EM）医生在完成加速体外膜氧合（ECMO）课程和假人训练后在猪模型中启动体外心肺复苏（ECPR）的能力。方法：20个小组（每组2名急诊住院医师）接受了2小时的培训，学习如何使用预先录制的教学视频启动ECPR，并使用ECMO电路、ECMO套管和人类骨盆任务训练器模型进行实践培训。在培训之后，急诊住院医师尝试对电致心脏骤停（SCA）后接受心肺复苏（CPR）的麻醉猪进行插管和ECMO。记录了两个驻地小组对猪进行静脉-动脉ECMO的能力和所需的时间。课程完成前后分别进行知识评估和调查。结果：共有40名EM住院医师参与了本研究，共20个小组。75%（15/20）的团队成功启动ECMO。成功启动ECMO的平均时间为22分钟10秒（95% CI 17:25-26:54）。研究完成后，参与者的知识评估得分从平均46.8%-67.9%的正确率提高了21.1% （95% CI 13.3%-28.8%）。在所有调查类别中，对能力的信心都有所提高。ECPR失败最常见的原因是无法获得适当的血管通路。结论：在猪SCA模型上，对EM居民进行简短的两小时ECPR培训课程导致75%的ECPR启动成功率。对急诊医生进行ECPR培训可能会增加有能力提供这种治疗的医院的数量。先进的工程解决方案或在心肺复苏术中超声引导血管通路的经验增加可能会提高ECMO插管的成功率。
{"title":"Training of Emergency Medicine Residents to Initiate Extracorporeal Membrane Oxygenation Cardiopulmonary Resuscitation (ECPR)","authors":"Arianna R. Moreno, R. Madelaine Paredes, Allyson Araña Mireles, Jae-Hyek Choi, Heang Sundermann, Kaysie Sachs, Dylan Rodriguez, Joseph K. Maddry","doi":"10.1002/aet2.70116","DOIUrl":"10.1002/aet2.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The objective of our study was to evaluate the ability of Emergency Medicine (EM) physicians who have completed an accelerated extracorporeal membrane oxygenation (ECMO) course and mannequin training to initiate extracorporeal cardiopulmonary resuscitation (ECPR) in a swine model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty teams of two EM residents each were provided with 2 h of training on how to initiate ECPR using prerecorded instructional videos and hands-on training using an ECMO circuit, ECMO cannulas, and a task trainer model of a human pelvis. Following training, EM residents attempted to cannulate and initiate ECMO on anesthetized swine receiving cardiopulmonary resuscitation (CPR) after an electrically induced sudden cardiac arrest (SCA). The ability of and duration of time required for the two-resident teams to initiate veno-arterial ECMO on the swine was recorded. A knowledge assessment and survey were performed before and after course completion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty EM residents participated in this study, for a total of 20 teams. Seventy-five percent (15/20) of the teams successfully initiated ECMO. The average time to successful initiation of ECMO was 22 min and 10 s (95% CI 17:25–26:54). Participants' knowledge assessment scores improved by 21.1%, from a mean of 46.8%–67.9% correct after study completion (95% CI 13.3%–28.8%). Confidence in competency improved across all survey categories. The most frequent reason for unsuccessful ECPR was the inability to obtain appropriate vascular access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An abbreviated two-hour ECPR training course for EM residents resulted in a 75% success rate of ECPR initiation on a swine SCA model. Training of EM physicians in ECPR may expand the number of hospitals capable of providing this therapy. Advanced engineering solutions or increased experience with ultrasound-guided vascular access during CPR may improve ECMO cannulation success rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Difficult-to-Say ER Patient","authors":"Zhaohui Su","doi":"10.1002/aet2.70119","DOIUrl":"10.1002/aet2.70119","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steven McGaughey, Jordan Wackett, Elizabeth Silbermann
{"title":"AI Is Not a Four-Letter Word: Moving From Resistance to Responsible Integration in Emergency Medicine Education","authors":"Steven McGaughey, Jordan Wackett, Elizabeth Silbermann","doi":"10.1002/aet2.70114","DOIUrl":"https://doi.org/10.1002/aet2.70114","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kenji Numata, Masaya Higuchi, Yasuhiko Hirose, Anita Chary, Tadayuki Hashimoto, Daisuke Kato, Shan W. Liu, Tammie E. Quest, Joshua Hauser, Kirsten G. Engel, Kei Ouchi
Background
In Japan, the aging population has led to an increase in seriously ill patients requiring emergency care. Although palliative care training opportunities are limited in Japan, established programs exist in the United States (U.S.). To inform future adaptation of such programs for use in Japan, this study aims to identify barriers that emergency physicians (EPs) in Japan encounter when providing palliative care.
Methods
This qualitative study explored the end-of-life care decision-making processes of EPs in Japan. Semi-structured interviews were conducted with board-certified EPs using snowball sampling. Data were analyzed using a modified grounded theory approach, which was chosen for its ability to capture culturally nuanced decision-making, emphasizing reflection, theoretical clarity, and practical applicability. Iterative coding was conducted to inductively generate concepts and develop a conceptual framework describing EPs' decision-making processes. Data collection continued until theoretical saturation was achieved. Data were collected through online interviews conducted between January and August 2024.
Results
Thirteen board-certified EPs in Japan completed interviews. Most participants were male (76.9%) and most were 11–15 years after medical school graduation (n = 7). Analysis identified 16 concepts illustrating a three-phase decision-making process: (1) deciding to accept the transfer of end-of-life patients, (2) building trust with patients and families and conducting an assessment, and (3) determining the treatment plan. Common challenges included struggles with stalled interactions amid family distress and the dilemma of making decisions in the setting of clinical uncertainty, reflecting the emotional and ethical complexity of providing end-of-life care in time-pressured emergency settings.
Conclusions
This study highlights the challenges EPs in Japan face when making urgent decisions with limited time and information while building trust with patients and families. These findings clarify the current barriers to integrating palliative and end-of-life care in emergency settings and provide a foundation for developing culturally adapted educational programs.
{"title":"Adapting Palliative and End-of-Life Care Training for Emergency Physicians in Japan: A Modified Grounded Theory Study","authors":"Kenji Numata, Masaya Higuchi, Yasuhiko Hirose, Anita Chary, Tadayuki Hashimoto, Daisuke Kato, Shan W. Liu, Tammie E. Quest, Joshua Hauser, Kirsten G. Engel, Kei Ouchi","doi":"10.1002/aet2.70113","DOIUrl":"https://doi.org/10.1002/aet2.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In Japan, the aging population has led to an increase in seriously ill patients requiring emergency care. Although palliative care training opportunities are limited in Japan, established programs exist in the United States (U.S.). To inform future adaptation of such programs for use in Japan, this study aims to identify barriers that emergency physicians (EPs) in Japan encounter when providing palliative care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This qualitative study explored the end-of-life care decision-making processes of EPs in Japan. Semi-structured interviews were conducted with board-certified EPs using snowball sampling. Data were analyzed using a modified grounded theory approach, which was chosen for its ability to capture culturally nuanced decision-making, emphasizing reflection, theoretical clarity, and practical applicability. Iterative coding was conducted to inductively generate concepts and develop a conceptual framework describing EPs' decision-making processes. Data collection continued until theoretical saturation was achieved. Data were collected through online interviews conducted between January and August 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen board-certified EPs in Japan completed interviews. Most participants were male (76.9%) and most were 11–15 years after medical school graduation (<i>n</i> = 7). Analysis identified 16 concepts illustrating a three-phase decision-making process: (1) deciding to accept the transfer of end-of-life patients, (2) building trust with patients and families and conducting an assessment, and (3) determining the treatment plan. Common challenges included <i>struggles with stalled interactions amid family distress</i> and <i>the dilemma of making decisions in the setting of clinical uncertainty</i>, reflecting the emotional and ethical complexity of providing end-of-life care in time-pressured emergency settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the challenges EPs in Japan face when making urgent decisions with limited time and information while building trust with patients and families. These findings clarify the current barriers to integrating palliative and end-of-life care in emergency settings and provide a foundation for developing culturally adapted educational programs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carrie Maupin, Ambika Anand, Danielle Nesbit, Casey Morrone, Danielle Sultan
<p>The recent development of entrustable professional activities (EPAs) for emergency medicine (EM) medical education (MedEd) fellowships by Villa et al. [<span>1</span>] represents a significant milestone in the movement toward competency-based education in academic medicine training. These 16 EPAs, developed through a modified Delphi consensus process, provide a much-needed framework for establishing uniform expectations for MedEd fellowships across institutions and offer a common language for assessing fellows' readiness for independent educational practice. Previous literature has focused on implementing EPAs within undergraduate medical education and residency training structures, with limited focus on fellowships [<span>2-4</span>]. Additionally, many EPAs have been focused on improving clinical training rather than solely focusing on educational standards. However, implementation in the real-world setting of diverse fellowships with unique structures, resources, and cultures raises an important question: how can a national framework be meaningfully adopted across locally distinct programs?</p><p>To explore this question, we conducted a cross-institutional mapping exercise among three EM MedEd fellowship programs—Virginia Commonwealth University (VCU), Thomas Jefferson University, and UMass Chan Medical School. These fellowships vary in structure, scope, and available resources, but share a commitment to developing future clinician-educators. Our goal was to examine how each program's current activities align with these EPAs, identify areas of overlap or divergence, and assess the feasibility of adopting this new outcomes-based framework.</p><p>We reviewed the 16 EPAs outlined in the original article and mapped current fellowship competencies to each one. The mapping process was conducted in three deliberate stages to promote both local accuracy and cross-institutional consistency. First, each fellowship independently identified all formal and informal learning activities within its curriculum, drawing from program handbooks, rotation objectives, and course syllabi. These activities were then mapped to the 16 published EM MedEd EPAs by at least two program leaders at each site. Next, each site conducted an internal reconciliation step, classifying activities as “fully aligned,” “partially aligned,” or “not aligned” with specific EPAs. Finally, representatives from all three institutions shared results, reviewing each EPA and discussing discrepancies until full consensus was achieved. This collaborative adjudication ensured shared interpretation and reproducibility across programs. Our findings, summarized in the accompanying table, demonstrate a high degree of natural alignment with the proposed EPAs, underscoring the relevance and utility of the framework. For instance, all three programs address key EPAs such as “Creating an academic CV,” “Serving as a mentor to learners,” and “Applying evidence-based teaching methods to didactic instruct
{"title":"Applying Entrustable Professional Activities Across Emergency Medicine Medical Education Fellowships: A Cross-Institutional Commentary","authors":"Carrie Maupin, Ambika Anand, Danielle Nesbit, Casey Morrone, Danielle Sultan","doi":"10.1002/aet2.70110","DOIUrl":"https://doi.org/10.1002/aet2.70110","url":null,"abstract":"<p>The recent development of entrustable professional activities (EPAs) for emergency medicine (EM) medical education (MedEd) fellowships by Villa et al. [<span>1</span>] represents a significant milestone in the movement toward competency-based education in academic medicine training. These 16 EPAs, developed through a modified Delphi consensus process, provide a much-needed framework for establishing uniform expectations for MedEd fellowships across institutions and offer a common language for assessing fellows' readiness for independent educational practice. Previous literature has focused on implementing EPAs within undergraduate medical education and residency training structures, with limited focus on fellowships [<span>2-4</span>]. Additionally, many EPAs have been focused on improving clinical training rather than solely focusing on educational standards. However, implementation in the real-world setting of diverse fellowships with unique structures, resources, and cultures raises an important question: how can a national framework be meaningfully adopted across locally distinct programs?</p><p>To explore this question, we conducted a cross-institutional mapping exercise among three EM MedEd fellowship programs—Virginia Commonwealth University (VCU), Thomas Jefferson University, and UMass Chan Medical School. These fellowships vary in structure, scope, and available resources, but share a commitment to developing future clinician-educators. Our goal was to examine how each program's current activities align with these EPAs, identify areas of overlap or divergence, and assess the feasibility of adopting this new outcomes-based framework.</p><p>We reviewed the 16 EPAs outlined in the original article and mapped current fellowship competencies to each one. The mapping process was conducted in three deliberate stages to promote both local accuracy and cross-institutional consistency. First, each fellowship independently identified all formal and informal learning activities within its curriculum, drawing from program handbooks, rotation objectives, and course syllabi. These activities were then mapped to the 16 published EM MedEd EPAs by at least two program leaders at each site. Next, each site conducted an internal reconciliation step, classifying activities as “fully aligned,” “partially aligned,” or “not aligned” with specific EPAs. Finally, representatives from all three institutions shared results, reviewing each EPA and discussing discrepancies until full consensus was achieved. This collaborative adjudication ensured shared interpretation and reproducibility across programs. Our findings, summarized in the accompanying table, demonstrate a high degree of natural alignment with the proposed EPAs, underscoring the relevance and utility of the framework. For instance, all three programs address key EPAs such as “Creating an academic CV,” “Serving as a mentor to learners,” and “Applying evidence-based teaching methods to didactic instruct","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simanjit K. Mand, Corlin M. Jewell, Dana E. Loke, Meinkeng S. Acha-Morfaw, Collin T. Michels, Benjamin H. Schnapp
Background
Coaching holds great potential for learners in graduate medical education (GME) as the specialty transitions towards competency-based medical education (CBME). Coaching has already demonstrated holding great benefits in a variety of learner performance and well-being metrics. However, there is limited data on learner perceptions of longitudinal GME coaching initiatives.
Objective
To provide insight into learner perceptions of a longitudinal coaching program by conducting focus groups consisting of residents from a single emergency medicine residency.
Methods
Four semi-structured focus groups were conducted with residents from each post-graduate year. Audio recordings of focus group discussions were transcribed and a thematic analysis utilizing a constructivist approach was conducted.
Results
We identified five overarching themes: (1) resident understanding of the coach's role, (2) logistical elements that can affect the effectiveness of the coaching relationship, (3) relational factors that contribute to a successful coaching relationship, (4) resident perceptions of discussion topics and goal creation, and (5) future group opportunities for fostering more personal relationships and professional development.
Conclusion
Overall, residents noted several strengths in the longitudinal coaching approach, particularly around feedback reflection and utility, accountability, and goal-setting. There remain areas for improvement when introducing coaching program goals and the faculty coach role, in addition to future considerations around group coaching opportunities.
{"title":"Resident Perspectives on the Coaching Approach: A Qualitative Analysis of a Longitudinal Coaching Program in an Emergency Medicine Residency","authors":"Simanjit K. Mand, Corlin M. Jewell, Dana E. Loke, Meinkeng S. Acha-Morfaw, Collin T. Michels, Benjamin H. Schnapp","doi":"10.1002/aet2.70111","DOIUrl":"10.1002/aet2.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Coaching holds great potential for learners in graduate medical education (GME) as the specialty transitions towards competency-based medical education (CBME). Coaching has already demonstrated holding great benefits in a variety of learner performance and well-being metrics. However, there is limited data on learner perceptions of longitudinal GME coaching initiatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To provide insight into learner perceptions of a longitudinal coaching program by conducting focus groups consisting of residents from a single emergency medicine residency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four semi-structured focus groups were conducted with residents from each post-graduate year. Audio recordings of focus group discussions were transcribed and a thematic analysis utilizing a constructivist approach was conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified five overarching themes: (1) resident understanding of the coach's role, (2) logistical elements that can affect the effectiveness of the coaching relationship, (3) relational factors that contribute to a successful coaching relationship, (4) resident perceptions of discussion topics and goal creation, and (5) future group opportunities for fostering more personal relationships and professional development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, residents noted several strengths in the longitudinal coaching approach, particularly around feedback reflection and utility, accountability, and goal-setting. There remain areas for improvement when introducing coaching program goals and the faculty coach role, in addition to future considerations around group coaching opportunities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12672208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Pandemic and the Calm","authors":"Zhaohui Su","doi":"10.1002/aet2.70104","DOIUrl":"10.1002/aet2.70104","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cameron Pawlik, Andrew Zahn, Joel Moll, Sally A. Santen
<p>Board certification seeks to provide a rigorous and evolving mechanism to ensure physicians maintain high levels of clinical expertise throughout their careers. The American Board of Emergency Medicine (ABEM) board of directors has determined that ABEM certification will change. “ABEM is transitioning to a new Certifying Exam in 2026 to enhance the assessment of emergency physicians' competencies and relevance to practice. This move addresses feedback from stakeholders, including practicing physicians and healthcare leaders, indicating a desire for an exam that assesses a broader range of skills and provides a more meaningful assessment experience” [<span>1</span>].</p><p>With the impending change in EM board certification in summative assessment, it is helpful to understand how similar specialties to EM are determining initial certification. Understanding the variety of certification assessments and outcomes helps to evaluate the patterns in current EM pass rates in the greater community of medicine. This will help to evaluate the significance of recent changes in outcomes and to add credibility to our own certification process. This Educational Download provides information on current initial certification of the 10 most common specialties (Tables 1 and 2).</p><p>Certification ensures objective, arms-length validation of competencies, distinguishing it from passive, self-directed education. While initial certification verifies knowledge and skills at a single point in time, the structure of certification has transformed into a dynamic, longitudinal process that incorporates cognitive assessments, professional conduct verification, and quality improvement activities. This evolution is motivated by the accelerated pace of medical innovation and evidence that physician knowledge and skills decline over time without structured reinforcement [<span>2</span>]. Patients express a preference for certified physicians and expect ongoing verification of clinical currency. In this way, board certification can function as a public trust mechanism that reinforces professional standards and accountability [<span>3</span>]. Over time, the process for initial board certification across specialties, other than just EM, has constantly evolved. Examples of these changes include the move of standardized patient exams in Psychiatry to within residency, the addition of a communication observed standardized examination for Urology, and the continued effort at standardization of oral exams for procedural specialties [<span>4, 5</span>].</p><p>Data was compiled from the American Council for Graduate Medical Education (ACGME) [<span>6</span>] and respective medical specialty board certification websites as publicly published unless otherwise noted (see references for exact URL) [<span>7-26</span>].</p><p>C.P.: Study concept and design, acquisition of the data, analysis and interpretation of the data, drafting of the manuscript, critical revision of the manuscript. A.Z
{"title":"Across the Landscape: Initial Board Specialty Certification—Educational Download","authors":"Cameron Pawlik, Andrew Zahn, Joel Moll, Sally A. Santen","doi":"10.1002/aet2.70106","DOIUrl":"10.1002/aet2.70106","url":null,"abstract":"<p>Board certification seeks to provide a rigorous and evolving mechanism to ensure physicians maintain high levels of clinical expertise throughout their careers. The American Board of Emergency Medicine (ABEM) board of directors has determined that ABEM certification will change. “ABEM is transitioning to a new Certifying Exam in 2026 to enhance the assessment of emergency physicians' competencies and relevance to practice. This move addresses feedback from stakeholders, including practicing physicians and healthcare leaders, indicating a desire for an exam that assesses a broader range of skills and provides a more meaningful assessment experience” [<span>1</span>].</p><p>With the impending change in EM board certification in summative assessment, it is helpful to understand how similar specialties to EM are determining initial certification. Understanding the variety of certification assessments and outcomes helps to evaluate the patterns in current EM pass rates in the greater community of medicine. This will help to evaluate the significance of recent changes in outcomes and to add credibility to our own certification process. This Educational Download provides information on current initial certification of the 10 most common specialties (Tables 1 and 2).</p><p>Certification ensures objective, arms-length validation of competencies, distinguishing it from passive, self-directed education. While initial certification verifies knowledge and skills at a single point in time, the structure of certification has transformed into a dynamic, longitudinal process that incorporates cognitive assessments, professional conduct verification, and quality improvement activities. This evolution is motivated by the accelerated pace of medical innovation and evidence that physician knowledge and skills decline over time without structured reinforcement [<span>2</span>]. Patients express a preference for certified physicians and expect ongoing verification of clinical currency. In this way, board certification can function as a public trust mechanism that reinforces professional standards and accountability [<span>3</span>]. Over time, the process for initial board certification across specialties, other than just EM, has constantly evolved. Examples of these changes include the move of standardized patient exams in Psychiatry to within residency, the addition of a communication observed standardized examination for Urology, and the continued effort at standardization of oral exams for procedural specialties [<span>4, 5</span>].</p><p>Data was compiled from the American Council for Graduate Medical Education (ACGME) [<span>6</span>] and respective medical specialty board certification websites as publicly published unless otherwise noted (see references for exact URL) [<span>7-26</span>].</p><p>C.P.: Study concept and design, acquisition of the data, analysis and interpretation of the data, drafting of the manuscript, critical revision of the manuscript. A.Z","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12672183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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