AEM Education and Training最新文献_第3页

From Assistance to Autonomy: Evaluating Procedural Competency in Pediatric Emergency Medicine 从协助到自主：评估儿科急诊医学的程序能力。

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-09-28 DOI: 10.1002/aet2.70095

Richard Barber, Marideth Rus, Elizabeth Moran, Esther M. Sampayo, Deborah Hsu, Corrie E. Chumpitazi, Elizabeth A. Camp, Nidhi V. Singh

Objective

Pediatric emergency medicine (PEM) physicians require expertise in numerous procedural skills to manage emergencies in children. Fellows require hands-on experience, expert supervision, and standardized feedback to build procedural competency. Our objective was to develop and gather validity evidence for an evaluation tool to assess PEM fellows' ability to perform procedures.

Methods

We conducted a retrospective study of PEM fellows' procedural performance within a children's hospital system. Faculty evaluated fellows using a one-item, five-point entrustment/level of supervision scale. We focused on three frequently performed procedures: laceration repair, intubation, and procedural sedation. To assess changes in supervision scores by training year, we used a mixed-effects binary logistic regression model with scores ≥ 4 as the threshold. Adjusted odds ratios (aOR), 95% confidence intervals (CIs) and p values were reported. We also assessed inter- and intra-rater reliability overall, by procedure, and by semester.

Results

Data from 38 fellows and 137 supervising faculty evaluations were included. Compared to first-year fellows, second-year fellows were significantly more likely to receive higher scores (aOR = 4.95; 95% CI 3.78–6.47) and third-year fellows even more so (aOR = 10.15; 95% CI 6.71–15.35). Intra-rater reliability showed moderate to very strong correlation (ρ = 0.84), and by procedure: intubation (ρ = 0.78), lac repair (ρ = 0.92), and sedation (ρ = 0.85). Inter-rater reliability was poor across all measures. First-year fellows showed significant differences in intubation scores between specialties. No significant differences were found among third-year fellows.

Conclusion

A supervision-based evaluation tool demonstrated strong intra-rater reliability and captured increasing procedural competency among PEM fellows, as evidenced by progressively higher entrustment scores with increasing years in training. This tool may support standardized assessment and meaningful feedback throughout fellowship training.

目的：儿科急诊医学（PEM）医生需要在许多程序技能的专业知识来管理儿童的紧急情况。研究员需要实践经验、专家监督和标准化反馈来建立程序能力。我们的目标是开发和收集有效性证据的评估工具，以评估PEM研究员执行程序的能力。方法：我们进行了一个回顾性研究PEM研究员的程序性能在儿童医院系统。教师使用单项、5分委托/监督等级量表对研究员进行评估。我们重点介绍了三种常用的手术方法：撕裂伤修复、插管和手术镇静。为了评估不同培训年份监督评分的变化，我们采用混合效应二元logistic回归模型，得分≥4为阈值。报告了校正优势比（aOR）、95%置信区间（CIs）和p值。我们还按程序和学期评估了总体上评分者之间和评分者内部的可靠性。结果：纳入了38名研究员和137名指导教师的评估数据。与一年级的研究员相比，二年级的研究员明显更有可能获得更高的分数（aOR = 4.95; 95% CI 3.78-6.47），三年级的研究员更是如此（aOR = 10.15; 95% CI 6.71-15.35）。组内可靠性显示出中等至非常强的相关性（ρ = 0.84），通过手术：插管（ρ = 0.78），裂孔修复（ρ = 0.92）和镇静（ρ = 0.85）。评估者之间的信度在所有测量中都很差。第一年实习医生在不同专业的插管评分上有显著差异。在三年级的研究人员中没有发现显著差异。结论：基于监督的评估工具显示出较强的内部可靠性，并捕获了PEM研究员日益增长的程序能力，随着培训年限的增加，委托分数逐渐提高。这个工具可以在整个奖学金培训过程中支持标准化评估和有意义的反馈。

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引用次数: 0

Implementation of a Longitudinal Ultrasound Training Program for Senior Emergency Medicine Residents: Impact on Scan Volume and Accuracy 急诊住院医师纵向超声培训计划的实施：对扫描量和准确性的影响。

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-09-28 DOI: 10.1002/aet2.70100

Jessica Baez, Olivia Urbanowicz, Heidi Sucharew, Laura Syori, Olivia Gobble, Arthur Broadstock, Patrick Minges, Lori Stolz

Background

Point-of-care ultrasound (POCUS) is a critical skill in emergency medicine, yet training methods and assessment vary widely across residency programs. Skill degradation following initial training remains a persistent challenge.

Objective

To evaluate the impact of a longitudinal ultrasound curriculum implemented during the third year of residency (R3) on scan volume and competency.

Methods

A retrospective cohort study was conducted at a single academic emergency medicine residency program. Residents from six graduating classes were analyzed, comparing ultrasound examination volume and quality between those exposed to the longitudinal curriculum (intervention group) and those trained under the prior model (control group). The intervention included 2–8 faculty-supervised scanning shifts during the R3 year.

Results

A total of 84 residents performed 33,278 scans during the 6-year study period. Intervention group residents completed significantly more POCUS exams during their R3 year (mean 156.6 vs. 95.8; p < 0.01). Examination quality and diagnostic accuracy remained high, with no significant difference in advanced scan use.

Conclusion

A structured longitudinal ultrasound curriculum during senior residency meaningfully increases scan volume without compromising examination accuracy, supporting its adoption as a feasible strategy to reinforce POCUS competence.

背景：即时超声（POCUS）是急诊医学的一项关键技能，但培训方法和评估在住院医师项目中差异很大。初始训练后的技能退化仍然是一个持续的挑战。目的：评价住院医师第三年（R3）实施的纵向超声课程对扫描量和能力的影响。方法：回顾性队列研究在一个单一的学术急诊医学住院医师项目中进行。对6个毕业班住院医师进行分析，比较纵向课程组（干预组）和先验模式组（对照组）超声检查量和质量。干预措施包括在3年中2-8次教师监督的扫描班次。结果：在6年的研究期间，共有84名居民进行了33,278次扫描。干预组住院医师在第三年完成了更多的POCUS检查（平均156.6比95.8）。结论：在老年住院医师期间，结构化的纵向超声课程在不影响检查准确性的情况下显著增加了扫描体积，支持将其作为加强POCUS能力的可行策略。

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引用次数: 0

Development, Integration, and Evaluation of Street Medicine Into Emergency Medicine Resident Education 街头医学融入急诊医学住院医师教育的发展、整合与评价。

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-09-28 DOI: 10.1002/aet2.70099

John Spartz, Sarah Axelrath, April Krall, Barbara Blok, W. Gannon Sungar, Bonnie Kaplan, Lara Rappaport, Jason Haukoos, Evangelia Murray, Kathleen Joseph

Background

People experiencing homelessness (PEH) utilize the emergency department (ED) at higher rates than the general population. Emergency medicine (EM) physicians would benefit from increased exposure to homeless healthcare, including street medicine, which provides mobile care to PEH. Thus, leveraging a relationship with a local healthcare organization for the homeless, this project aimed to implement a street medicine experience for first-year EM residents and evaluate resident perceptions of the experience.

Methods

By partnering with an existing street medicine program, we piloted an elective one-day experience for first-year EM residents. Residents were invited to complete pre- and post-experience surveys using the Health Professionals' Attitude Toward the Homeless Inventory (HPATHI), augmented with additional Likert scale and qualitative questions. We calculated descriptive statistics and performed analysis of free-text answers using inductive and in vivo codes.

Results

We successfully piloted and integrated a street medicine experience into the curriculum of an EM residency program. 17/17 (100%) residents of the first-year class participated in the elective. 13/17 (76%) of residents completed the pre-survey and 9/17 (53%) of residents completed the post-survey. Although there were no statistical differences between pre- and post-surveys, major themes from free text responses included (1) practice-changing insights into systems- and community-based challenges within the lived experiences of PEH, and (2) interest in additional education dedicated to street medicine. On average, residents found the experience to be useful (mean 4.0, standard deviation [SD] 1.40) and valuable (mean 4.4, SD 1.01), felt more comfortable caring for PEH (mean 4.6, SD 0.73), and had a better understanding of community resources (mean 4.6, SD 0.73) after the experience.

Conclusion

We demonstrated the feasibility of incorporating a street medicine pilot experience into EM resident education, and, on average, residents perceived this experience as a valuable and useful addition to their education.

背景：无家可归者（PEH）使用急诊科（ED）的比率高于一般人群。急诊医生将受益于更多地接触无家可归者的医疗服务，包括为PEH提供流动护理的街头医疗。因此，利用与当地无家可归者医疗保健组织的关系，该项目旨在为第一年的EM居民实施街头医疗体验，并评估居民对体验的看法。方法：通过与现有的街头医疗项目合作，我们为第一年急诊住院医师试行了为期一天的选修课。邀请居民使用卫生专业人员对无家可归者的态度量表（HPATHI）完成体验前和体验后的调查，并辅以额外的李克特量表和定性问题。我们计算了描述性统计数据，并使用归纳和体内编码对自由文本答案进行了分析。结果：我们成功地试点并将街头医疗经验整合到EM住院医师项目的课程中。17/17（100%）的一年级学生参加了选修课。13/17（76%）的居民完成了预调查，9/17（53%）的居民完成了后调查。尽管调查前后没有统计学差异，但来自免费文本回复的主要主题包括(1)对PEH生活经验中系统和社区挑战的实践改变见解，以及(2)对专门针对街头医学的额外教育的兴趣。平均而言，居民认为该体验是有用的（平均值4.0，标准差[SD] 1.40）和有价值的（平均值4.4,SD 1.01），在体验后对PEH的照顾感到更舒适（平均值4.6,SD 0.73），并且对社区资源有更好的了解（平均值4.6,SD 0.73）。结论：我们证明了将街头医疗试点经验纳入新兴市场居民教育的可行性，并且，平均而言，居民认为这种经验是他们教育的宝贵和有用的补充。

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引用次数: 0

Simulation Resources in Emergency Medicine Residencies: A National Survey 急诊医学住院医师的模拟资源：一项全国性调查。

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-09-28 DOI: 10.1002/aet2.70098

Max Berger, Arlene S. Chung, Daniel J. Ackil, Ryan Clark, William E. Soares III, Jaime Jordan

Objectives

The American Board of Emergency Medicine's new Certifying Exam features simulation-based assessment. The current resources available to prepare residents to pass this high-stakes exam are unknown. We sought to assess the current state of simulation resources and utilization in EM residency programs.

Methods

This was a cross-sectional survey study of residency or simulation leadership at ACGME-accredited EM programs. We developed an online survey consisting of multiple-choice items, which was piloted before use. We collected data from August to December 2024. We calculated descriptive statistics, used chi-squared testing for categorical data comparisons, and Kruskal–Wallis for ordinal variables. Univariate logistic regression was used to examine associations between EM residency and simulation resource factors with annual simulation training hours.

Results

We identified contact information for 287 programs, and 194 completed the survey (67.6%). Most EM Residency programs had a simulation center (94.8%, 184/194). Fewer programs had simulation fellowship-trained physician faculty (44.3%, 86/194) or a division of simulation (40.7%, 79/194). Approximately 83% (161/194) of respondents felt that accessing simulation resources was easy or very easy. The median number of hours residents were engaged in simulation training per year was 40 (IQR 25–59). Univariate logistic regression found no association between EM program demographics and the annual number of hours of simulation training. The presence of simulation-trained faculty was associated with increased hours of simulation (OR 1.82, 95% CI 1.1–3.0, p = 0.05).

Conclusions

While most participating EM residency programs have access to simulation resources, variability exists in resources and implementation across programs, which may lead to inequities in preparing trainees for the new ABEM Certifying Exam.

目的：美国急诊医学委员会新认证考试的特点是基于模拟的评估。目前还不知道有哪些资源可以帮助住院医生准备通过这项高风险的考试。我们试图评估EM住院医师计划中模拟资源和利用的现状。方法：这是一项关于acgme认证的EM项目住院医师或模拟领导的横断面调查研究。我们开发了一个包含多项选择题的在线调查，在使用前进行了试点。我们收集了2024年8月至12月的数据。我们计算描述性统计，使用卡方检验进行分类数据比较，使用Kruskal-Wallis检验进行有序变量比较。使用单变量逻辑回归来检验EM驻留和模拟资源因素与年度模拟培训时数之间的关系。结果：我们确定了287个项目的联系方式，其中194个（67.6%）完成了调查。大多数急诊住院医师项目都有一个模拟中心（94.8%,184/194）。较少的项目有模拟研究员培训的医师教师（44.3%,86/194）或模拟部门（40.7%,79/194）。大约83%（161/194）的受访者认为访问模拟资源很容易或非常容易。住院医师每年参与模拟培训的中位数小时数为40 （IQR 25-59）。单变量逻辑回归发现，EM计划人口统计数据与每年模拟培训小时数之间没有关联。接受过模拟训练的教员的存在与模拟时间的增加有关（OR 1.82, 95% CI 1.1-3.0, p = 0.05）。结论：虽然大多数参与的EM住院医师项目都可以访问模拟资源，但不同项目之间的资源和实施存在可变性，这可能导致学员在准备新的ABEM认证考试方面存在不平等。

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引用次数: 0

Pre- and Post-Pandemic Trends in Emergency Medicine Resident Attrition 大流行前和大流行后急诊医学住院医师流失的趋势。

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-09-28 DOI: 10.1002/aet2.70089

Andrew R. Ketterer, Anne V. Grossestreuer, Jason J. Lewis

Introduction

Completion of EM residency is essential for the growth of the specialty and the strength of each residency program. Understanding resident attrition is paramount for program leadership and recruitment. We aimed to determine if there was a change in EM resident attrition rates after the COVID-19 pandemic. We also sought to determine whether residency attrition rates correlated to attending attrition rates or EM residency application numbers.

Methods

This was a retrospective cross-sectional study of publicly available data from the ACGME Data Resource Book from 2013 to 2023, NRMP Results and Data from 2014 to 2024, and the Medicare Physician and Other Practitioners database. When comparing the proportions of attrition between residents and attendings by year, the attending rate from 2 years prior was used, as we hypothesized a lag between attending and resident attrition based on structural factors in residency application and employment. To test whether attrition rates followed a similar pattern over time, slopes between residents and attendings were compared by year using a linear regression. A similar method was used to compare yearly resident attrition rate to annual application rates.

Results

Between 2014 and 2021, there was a general decline in EM resident attrition, followed by an increase in attrition in 2021–22. This pattern mirrored attending attrition rates with a two-year delay. Attending and resident attrition persisted at a higher-than-baseline rate in 2021 and the 2022–23 academic years, respectively. Lower-than-baseline application rates by these students persisted in the 2022–23 academic year, as did higher-than-baseline resident attrition rates.

Discussion

We found a spike in EM resident attrition for the 2021–22 academic year after a period of decline, mirroring trends in EM attending attrition, and an inverse correlation between EM residency application and attrition rates after 2021–22. Further studies are needed to elucidate the underlying factors determining resident attrition, attending attrition, and EM residency application.

简介：完成EM住院医师培训对专业的发展和每个住院医师项目的实力至关重要。了解住院医生的流失对项目领导和招聘是至关重要的。我们的目的是确定COVID-19大流行后新兴市场居民流失率是否发生变化。我们还试图确定住院医师流失率是否与住院医师流失率或EM住院医师申请数量相关。方法：这是一项回顾性横断面研究，收集了2013年至2023年ACGME数据资源书、2014年至2024年NRMP结果和数据以及医疗保险医师和其他从业者数据库中的公开数据。当按年比较住院医师和主治医师之间的流失率时，我们使用了2年前的住院率，因为我们假设住院医师和住院医师之间的流失率存在滞后，这是基于住院医师申请和就业的结构性因素。为了测试流失率是否随着时间的推移遵循类似的模式，使用线性回归按年比较了住院医生和主治医生之间的斜率。一个类似的方法被用来比较年度居民流失率和年度申请率。结果：2014年至2021年间，新兴市场居民的流失率普遍下降，随后在2021年至2022年期间流失率上升。这种模式反映了两年后的流失率。在2021年和2022-23学年，参加和住院人员的流失率分别高于基线率。在2022-23学年，这些学生低于基线的申请率持续存在，居民流失率也高于基线。讨论：我们发现，在经历了一段时间的下降之后，新兴市场住院医师的流失率在2021-22学年出现了飙升，反映了新兴市场住院医师的流失率趋势，并且在2021-22学年之后，新兴市场住院医师申请与流失率之间呈负相关关系。需要进一步的研究来阐明决定住院人员流失、主治人员流失和EM住院申请的潜在因素。

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引用次数: 0

EM Download: Giving Feedback in the Emergency Department EM下载：在急诊科给予反馈

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-09-22 DOI: 10.1002/aet2.70091

S. Natesan, M. Rivera, K. Gore, S. Natesan-Torres, M. Gottlieb

引用次数: 0

Establishing the Patient Task Facilitator Program: Redefining the Shadower Role 建立病人任务促进者计划：重新定义影子角色

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-09-22 DOI: 10.1002/aet2.70084

Adam Janicki, Stephanie Gonzalez, Michele L. Dorfsman

Background

Physician shadowing offers exposure to physicians' daily responsibilities, roles, and understanding of patient interactions. Given the pressure to maintain clinical productivity, including students in Emergency Department care may be difficult. Student impact on patient care and physician workflow is understudied, and novel programs seeking to incorporate students are warranted.

Methods

We created a longitudinal educational program that combines physician mentorship and an in-depth clinical experience by offering more direct patient-facing activities compared with traditional volunteering or shadowing. We aimed to improve patient Emergency Department experience, incorporate students into the care team to improve the patient and family experience, and allow faculty to benefit from enhanced workflow by reducing the need for physician and nursing attention. Students served as a patient care concierge by carrying a mobile phone and providing patients with a business card with their phone number so they could be reached for questions, needs, or concerns. Students were not permitted to discuss test results, answer medical questions, or discuss care plans. The program has been modified based on feedback, which is obtained semi-annually.

Results

The patient task facilitator program has been active since 2019. Forty-two students and eight attending physicians have participated. Three students (7%) with engagement below expectations were removed from the program. Adaptations include ensuring consistent mentor pairing, increased phone availability, and internal promotion of the program. Faculty and student satisfaction was high; 74% of students reported plans to pursue careers in medicine, and faculty reported improved productivity, patient satisfaction, and nursing availability. Patients mentioned their patient task facilitator on Press Ganey surveys on multiple occasions as being positive and helpful, with no negative experiences noted.

Conclusion

The Patient Task Facilitator program improved both students' and faculty's satisfaction with shadowing, and additionally improved attending productivity, nursing availability, and patient satisfaction.

医生见习提供了医生的日常职责、角色和对患者互动的理解。鉴于维持临床生产力的压力，包括学生在内的急诊科护理可能很困难。学生对病人护理和医生工作流程的影响还没有得到充分的研究，寻求将学生纳入其中的新项目是有必要的。方法：与传统的志愿服务或见习相比，我们创建了一个纵向教育项目，通过提供更多直接面向患者的活动，将医生指导和深入的临床经验结合起来。我们的目标是改善急诊科患者的体验，将学生纳入护理团队以改善患者和家属的体验，并通过减少对医生和护理人员的需求，使教师从改进的工作流程中受益。学生们充当了病人护理门房的角色，他们随身携带手机，给病人一张名片，上面有他们的电话号码，这样他们就可以在有问题、需要或担忧时找到他们。学生不允许讨论测试结果，回答医学问题，或讨论护理计划。根据半年一次的反馈对程序进行修改。结果患者任务促进者项目自2019年以来一直处于活跃状态。42名学生和8名主治医生参与了这项研究。三名参与度低于预期的学生（7%）被除名。调整包括确保一致的导师配对，增加电话可用性，以及项目的内部推广。教师和学生满意度高；74%的学生报告计划从事医学职业，教师报告提高了工作效率，患者满意度和护理可用性。在Press Ganey的调查中，患者多次提到他们的患者任务促进者是积极和乐于助人的，没有任何负面经历。结论患者任务促进者项目不仅提高了学生和教师对阴影的满意度，而且还提高了护理效率、护理可用性和患者满意度。

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引用次数: 0

Half a League Onward: A Medical Student's First Code 半个联盟向前：一个医科学生的第一准则

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-09-22 DOI: 10.1002/aet2.70094

Benjamin M. Stieren

引用次数: 0

The Association Between Performance on the Emergency Medical Services In-Training Exam and Passing the Emergency Medical Services Certifying Exam 急诊医疗服务培训考试成绩与通过急诊医疗服务资格考试的关系

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-08-28 DOI: 10.1002/aet2.70092

Brian M. Clemency, Susan J. Burnett, Johanna C. Innes, Michael O'Brien, Renoj Varughese, Nan Nan, Changxing Ma, Marta Plonka, Evan Shaw, Mohamud R. Daya, Marianne Gausche-Hill

Background

Prior studies have demonstrated a correlation between in-training exam performance and success on the certifying exam in various medical specialties. It is unknown if a relationship exists between performance on the Emergency Medical Services (EMS) In-Training Exam (EMSITE) and success on the EMS Certifying Exam (EMSCE); consequently, EMSITE score reports include percentile rankings to compare performance against other fellows, but do not offer a criterion score or prediction of success on the EMSCE. The goal of this study was to examine if an association exists between EMSITE score and success on the EMSCE.

Methods

This was a retrospective data review, linking data from EMSITE records and EMSCE records. Performances on the 2020 and 2021 EMSITE were compared to the 2021 EMSCE results. Fellows who took the EMSITE but did not take the EMSCE were excluded. EMSITE performance was examined based on overall score and for each of the four content areas. EMSCE results were dichotomized as “pass” or “fail.” Odds ratios were obtained using an unadjusted univariate logistic regression and reported with 95% confidence intervals.

Results

During the 2019–2020 and 2020–2021 academic years, 161 fellows took the EMSITE. This includes 132 (82.0%) who took the EMSCE in 2021. Among those who took the EMSCE, 117 (88.6%) passed. There was an association between the overall EMSITE score and passing the EMSCE (OR 1.17, 95% CI: 1.05–1.30). This association was demonstrated in the content areas of Medical Oversight of EMS (OR 1.14, 95% CI 1.05–1.23) and Quality Management and Research (OR 1.06, 95% CI 1.01–1.10). This association was not significant in the content areas of Clinical Aspects of EMS Medicine (OR 1.09, 95% CI 1.00–1.20) and Special Operations (OR 1.02, 95% CI 0.96–1.09).

Conclusion

These data demonstrate an association between performance on the EMSITE and success on the EMSCE.

背景先前的研究已经证明了培训考试成绩与各种医学专业认证考试的成功之间的相关性。目前尚不清楚急诊医疗服务（EMS）培训考试（EMSITE）的表现与EMS认证考试（EMSCE）的成功之间是否存在关系；因此，EMSITE分数报告包括百分位排名，以比较与其他研究员的表现，但不提供标准分数或预测成功的EMSCE。本研究的目的是检查EMSITE评分与EMSCE成功之间是否存在关联。方法回顾性分析EMSITE记录和EMSCE记录。将2020年和2021年EMSITE的性能与2021年EMSCE的结果进行了比较。参加了EMSITE但没有参加EMSCE的研究员被排除在外。EMSITE的表现是根据总分和四个内容领域中的每一个进行检查的。EMSCE结果分为“合格”和“不合格”。优势比采用未调整的单变量逻辑回归获得，报告的置信区间为95%。结果2019-2020学年和2020-2021学年，161名研究员参加了EMSITE。其中包括在2021年参加EMSCE考试的132人（82.0%）。参加高考的117人（88.6%）通过了考试。总体EMSITE评分与通过EMSCE之间存在关联（OR 1.17, 95% CI: 1.05-1.30）。这种关联在EMS的医疗监督（OR 1.14, 95% CI 1.05-1.23）和质量管理与研究（OR 1.06, 95% CI 1.01-1.10）的内容领域得到证实。这种关联在EMS医学临床方面（OR 1.09, 95% CI 1.00-1.20）和特殊手术（OR 1.02, 95% CI 0.96-1.09）的内容领域不显著。结论：这些数据证明了EMSITE的表现与EMSCE的成功之间存在关联。

{"title":"The Association Between Performance on the Emergency Medical Services In-Training Exam and Passing the Emergency Medical Services Certifying Exam","authors":"Brian M. Clemency, Susan J. Burnett, Johanna C. Innes, Michael O'Brien, Renoj Varughese, Nan Nan, Changxing Ma, Marta Plonka, Evan Shaw, Mohamud R. Daya, Marianne Gausche-Hill","doi":"10.1002/aet2.70092","DOIUrl":"https://doi.org/10.1002/aet2.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prior studies have demonstrated a correlation between in-training exam performance and success on the certifying exam in various medical specialties. It is unknown if a relationship exists between performance on the Emergency Medical Services (EMS) In-Training Exam (EMSITE) and success on the EMS Certifying Exam (EMSCE); consequently, EMSITE score reports include percentile rankings to compare performance against other fellows, but do not offer a criterion score or prediction of success on the EMSCE. The goal of this study was to examine if an association exists between EMSITE score and success on the EMSCE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective data review, linking data from EMSITE records and EMSCE records. Performances on the 2020 and 2021 EMSITE were compared to the 2021 EMSCE results. Fellows who took the EMSITE but did not take the EMSCE were excluded. EMSITE performance was examined based on overall score and for each of the four content areas. EMSCE results were dichotomized as “pass” or “fail.” Odds ratios were obtained using an unadjusted univariate logistic regression and reported with 95% confidence intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the 2019–2020 and 2020–2021 academic years, 161 fellows took the EMSITE. This includes 132 (82.0%) who took the EMSCE in 2021. Among those who took the EMSCE, 117 (88.6%) passed. There was an association between the overall EMSITE score and passing the EMSCE (OR 1.17, 95% CI: 1.05–1.30). This association was demonstrated in the content areas of Medical Oversight of EMS (OR 1.14, 95% CI 1.05–1.23) and Quality Management and Research (OR 1.06, 95% CI 1.01–1.10). This association was not significant in the content areas of Clinical Aspects of EMS Medicine (OR 1.09, 95% CI 1.00–1.20) and Special Operations (OR 1.02, 95% CI 0.96–1.09).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These data demonstrate an association between performance on the EMSITE and success on the EMSCE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144910488","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}

引用次数: 0

Sustained Impact: Long-Term Application of Diagnostic Uncertainty Communication Training. 持续影响：诊断不确定性沟通训练的长期应用。

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-08-06 eCollection Date: 2025-08-01 DOI: 10.1002/aet2.70086

Danielle M McCarthy, Jethel Hernandez, Dimitrios Papanagnou, Kenzie A Cameron, David H Salzman, Andrew W Long, Alexandra D Franiek, Kristin L Rising

Objectives: More than one-third of discharged emergency department (ED) patients leave without a clear diagnosis for their symptoms. In 2019-2020, we implemented a simulation-based mastery learning curriculum across two academic medical centers to train emergency medicine residents to discuss diagnostic uncertainty during ED discharge, guided by the Uncertainty Communication Checklist (UCC). We sought to assess if this cohort continues to apply skills learned and to obtain trainee insights into the most valuable checklist items.

Methods: A survey was emailed to all 109 participants who completed the training in 2019-2020. Questions assessed how often participants currently encountered uncertainty and used the skills learned in the curriculum. Additionally, participants rated how important it was to keep each of the 21 UCC items in future uncertainty communication training (4-point Likert scale: very important/important/low importance/not important). Means and proportions are reported.

Results: Sixty-five individuals responded (60%). Mean age was 33; and 30.8% were female. More than 90% encountered diagnostic uncertainty more than once per shift, and 74% applied skills learned in the training "often" or "all the time." Seven of the 21 UCC items received endorsement by more than 70% of respondents as "very important" to retain in future trainings. The item receiving the most endorsement as "very important" (90%) was to "Clearly state that either 'life-threatening' or 'dangerous' conditions have not been found." Items with lower rankings related to generally accepted communication best-practices (e.g., "make eye contact").

Conclusion: Four years following diagnostic uncertainty training completion, most respondents frequently employ skills learned from uncertainty communication training.

目的：超过三分之一的出院急诊科（ED）患者离开没有明确的诊断他们的症状。在2019-2020年，我们在两个学术医疗中心实施了基于模拟的掌握学习课程，以培训急诊医学住院医师在不确定性沟通清单（UCC）的指导下讨论急诊科出院时诊断的不确定性。我们试图评估这个队列是否继续应用所学的技能，并获得受训人员对最有价值的清单项目的见解。方法：通过电子邮件向2019-2020年完成培训的109名参与者发送调查问卷。问题评估了参与者目前遇到不确定性的频率，以及使用课程中学到的技能的频率。此外，参与者还评估了在未来不确定性沟通培训中保留21个UCC项目的重要性（4点李克特量表：非常重要/重要/低重要/不重要）。报告了平均值和比例。结果：65人有反应（60%）。平均年龄33岁；30.8%为女性。超过90%的人每班不止一次遇到诊断不确定性，74%的人“经常”或“一直”应用培训中学到的技能。在21个UCC项目中，有7个项目被超过70%的受访者认可为“非常重要”，需要在未来的培训中保留。被认为“非常重要”的项目中（90%）获得最多支持的是“明确声明没有发现‘危及生命’或‘危险’的情况”。排名较低的项目与普遍接受的沟通最佳实践有关（例如，“进行目光接触”）。结论：在诊断不确定性培训结束后的四年中，大多数受访者经常使用从不确定性沟通培训中学到的技能。

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引用次数: 0