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.
{"title":"Implementation of a Longitudinal Ultrasound Training Program for Senior Emergency Medicine Residents: Impact on Scan Volume and Accuracy","authors":"Jessica Baez, Olivia Urbanowicz, Heidi Sucharew, Laura Syori, Olivia Gobble, Arthur Broadstock, Patrick Minges, Lori Stolz","doi":"10.1002/aet2.70100","DOIUrl":"10.1002/aet2.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the impact of a longitudinal ultrasound curriculum implemented during the third year of residency (R3) on scan volume and competency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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; <i>p</i> < 0.01). Examination quality and diagnostic accuracy remained high, with no significant difference in advanced scan use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207934","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}
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.
{"title":"Development, Integration, and Evaluation of Street Medicine Into Emergency Medicine Resident Education","authors":"John Spartz, Sarah Axelrath, April Krall, Barbara Blok, W. Gannon Sungar, Bonnie Kaplan, Lara Rappaport, Jason Haukoos, Evangelia Murray, Kathleen Joseph","doi":"10.1002/aet2.70099","DOIUrl":"10.1002/aet2.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201577","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}
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。
{"title":"Simulation Resources in Emergency Medicine Residencies: A National Survey","authors":"Max Berger, Arlene S. Chung, Daniel J. Ackil, Ryan Clark, William E. Soares III, Jaime Jordan","doi":"10.1002/aet2.70098","DOIUrl":"10.1002/aet2.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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, <i>p</i> = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201716","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}
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.
{"title":"Pre- and Post-Pandemic Trends in Emergency Medicine Resident Attrition","authors":"Andrew R. Ketterer, Anne V. Grossestreuer, Jason J. Lewis","doi":"10.1002/aet2.70089","DOIUrl":"10.1002/aet2.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201757","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}
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.
{"title":"Establishing the Patient Task Facilitator Program: Redefining the Shadower Role","authors":"Adam Janicki, Stephanie Gonzalez, Michele L. Dorfsman","doi":"10.1002/aet2.70084","DOIUrl":"https://doi.org/10.1002/aet2.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Patient Task Facilitator program improved both students' and faculty's satisfaction with shadowing, and additionally improved attending productivity, nursing availability, and patient satisfaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111087","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":"Half a League Onward: A Medical Student's First Code","authors":"Benjamin M. Stieren","doi":"10.1002/aet2.70094","DOIUrl":"https://doi.org/10.1002/aet2.70094","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 5","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111153","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}
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}
Pub Date : 2025-08-06eCollection Date: 2025-08-01DOI: 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.
{"title":"Sustained Impact: Long-Term Application of Diagnostic Uncertainty Communication Training.","authors":"Danielle M McCarthy, Jethel Hernandez, Dimitrios Papanagnou, Kenzie A Cameron, David H Salzman, Andrew W Long, Alexandra D Franiek, Kristin L Rising","doi":"10.1002/aet2.70086","DOIUrl":"10.1002/aet2.70086","url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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\").</p><p><strong>Conclusion: </strong>Four years following diagnostic uncertainty training completion, most respondents frequently employ skills learned from uncertainty communication training.</p>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 4","pages":"e70086"},"PeriodicalIF":1.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795729","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}
Stella H. Yiu, Marianne Yeung, Warren Cheung, Edmund Kwok, Gurraman Mann, Allison Williams, Jason R. Frank
Introduction
Clinical handover (or handoff), the transfer of patient care between providers, is essential in Emergency Medicine. Poor communication during handover can threaten patient safety. Existing literature views handover as an information transfer; little research has examined the human interaction within handover and how it affects patient safety. We sought a more nuanced understanding of handover to improve this critical aspect of Emergency Medicine care.
Methods
We used constructivist grounded theory to explore handover as a social phenomenon. We invited staff emergency physicians in an academic, tertiary care hospital to participate in semi-structured interviews, which were recorded, de-identified, and transcribed. The research team analyzed the transcripts in multiple progressively interpretive analytical stages: initial, focused, and theoretical. Cultural-Historical Activity Theory (CHAT) provided a framework for our data analysis. CHAT situates an individual's action into an activity system in which components interact, producing tensions. We sought to attain theoretical sufficiency by revising the interview guide and recruiting participants for specific insights.
Results
We interviewed sixteen (16) participants. During handover, the object was for the incoming physician (IP) to accept the handover plan from the outgoing physician (OP). We identified a rule requiring minimal handover plans that were realistic and dichotomous. The divisions of labor were tasks. During the interaction, emotional reactions such as judgment or compassion, and behavioral reactions such as pushback or acceptance could have resulted. There were unintended consequences from the handover process that impacted members' self-worth and generated threats to patient safety.
Conclusions
We built a novel and more nuanced framework of handover in the emergency department that involves multiple interactions and tensions. Using this new model, emergency departments should adjust their handover processes to enhance group dynamics and patient safety.
{"title":"A Novel Model of Patient Handover in Emergency Medicine—Addressing Hidden Tensions in Culture","authors":"Stella H. Yiu, Marianne Yeung, Warren Cheung, Edmund Kwok, Gurraman Mann, Allison Williams, Jason R. Frank","doi":"10.1002/aet2.70087","DOIUrl":"https://doi.org/10.1002/aet2.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Clinical handover (or handoff), the transfer of patient care between providers, is essential in Emergency Medicine. Poor communication during handover can threaten patient safety. Existing literature views handover as an information transfer; little research has examined the human interaction within handover and how it affects patient safety. We sought a more nuanced understanding of handover to improve this critical aspect of Emergency Medicine care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used constructivist grounded theory to explore handover as a social phenomenon. We invited staff emergency physicians in an academic, tertiary care hospital to participate in semi-structured interviews, which were recorded, de-identified, and transcribed. The research team analyzed the transcripts in multiple progressively interpretive analytical stages: initial, focused, and theoretical. Cultural-Historical Activity Theory (CHAT) provided a framework for our data analysis. CHAT situates an individual's action into an activity system in which components interact, producing tensions. We sought to attain theoretical sufficiency by revising the interview guide and recruiting participants for specific insights.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We interviewed sixteen (16) participants. During handover, the object was for the incoming physician (IP) to accept the handover plan from the outgoing physician (OP). We identified a rule requiring minimal handover plans that were realistic and dichotomous. The divisions of labor were tasks. During the interaction, emotional reactions such as judgment or compassion, and behavioral reactions such as pushback or acceptance could have resulted. There were unintended consequences from the handover process that impacted members' self-worth and generated threats to patient safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We built a novel and more nuanced framework of handover in the emergency department that involves multiple interactions and tensions. Using this new model, emergency departments should adjust their handover processes to enhance group dynamics and patient safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740386","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号