Western Journal of Emergency Medicine最新文献

{"title":"Pediatric Outcomes of Emergency Medical Services Non-Transport Before and During the COVID-19 Pandemic.","authors":"Lori Pandya, Brandon Morshedi, Brian Miller, Halim Hennes, Mohamed Badawy","doi":"10.5811/westjem.18408","DOIUrl":"https://doi.org/10.5811/westjem.18408","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric patients account for 6-10% of emergency medical services (EMS) activations in the United States. Approximately 30% of these children are not transported to an emergency department (ED). Adult data in the literature reports higher hospitalization and complications following non-transport. Few studies discuss epidemiology and characteristics of pediatric non-transport; however, data on outcome is limited. Our primary aim was to determine outcomes of non-transported children within our urban EMS system before and during the COVID-19 pandemic. Our secondary objective was to explore reasons for non-transport.</p><p><strong>Methods: </strong>This was a prospective, descriptive pilot study. We compared EMS data for September 2019 (pre-COVID-19) to September 2020 (pandemic). Included were children aged 0-17 years who activated EMS and did not receive transport to the primary hospital for the EMS capture area. We defined outcomes as repeat EMS activation, ED visits, and hospital admissions, all within 72 hours. Data was obtained via electronic capture. We used descriptive statistics to analyze our data, chi square for categorical data, stepwise logistic regression, and univariate logistic regression to test for association of covariates with non-transport.</p><p><strong>Results: </strong>There were 1,089 pediatric EMS activations in September 2019 and 780 in September 2020. Non-transport occurred in 633 (58%) in September 2019 and 412 (53%) in September 2020. Emergency medical services was reactivated within 72 hours in the following: 9/633 (1.4%) in 2019; and 5/412 (1.2%) in 2020 (<i>P</i> = 0.77). Visits to the ED occurred in 57/633 (9%) in 2019 and 42/412 (10%) in 2020 (<i>P</i> = 0.53). Hospital admissions occurred in 10/633 (1.5%) in 2019 and 4/412 (0.97%) in 2020 (<i>P</i> = 0.19). One non-transported patient was admitted to the intensive care unit in September 2020 (<1%) and survived. Hispanic ethnicity, age >12 years, and fever were associated with repeat EMS activation. The most common reason for non-transport in both study periods was that the parent felt an ambulance was not necessary (47%).</p><p><strong>Conclusion: </strong>In our system, non-transport of pediatric patients occurred in >50% of EMS activations with no significant adverse outcome. Age >12 years, fever, and Hispanic ethnicity were more common in repeated EMS activations. The most common reason for non-transport was parents feeling it was not necessary. Future studies are needed to develop reliable EMS guidelines for pediatric non-transport.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"25 2","pages":"246-253"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Simulation-based Intervention on Emergency Medicine Resident Management of Early Pregnancy Loss.","authors":"Shawna D Bellew, Erica Lowing, Leah Holcomb","doi":"10.5811/westjem.18596","DOIUrl":"https://doi.org/10.5811/westjem.18596","url":null,"abstract":"<p><strong>Background: </strong>The evaluation of patients with first-trimester vaginal bleeding and concern for early pregnancy loss (EPL) frequently occurs in the emergency department (ED), accounting for approximately 1.6% of all ED visits.¹ Unfortunately, these patients consistently report negative experiences with ED care.²^-⁸ In addition to environmental concerns, such as long wait times, patients often describe negative interactions with staff, including a perceived lack of empathy, the use of insensitive language, and inadequate counseling.²^,³ These patients and their partners often view EPL as a traumatic loss of life and commonly experience prolonged grief reactions, including anxiety and depression.⁹^-¹¹ Poor satisfaction with care has been associated with worse mental health outcomes.¹² These complaints represent an important opportunity for improvement in emergency medicine (EM) training.¹³ While no published literature to date describes the performance of EM residents in managing patients presenting with EPL, studies suggest that even obstetrics and gynecology (OB/GYN) residents find these interactions challenging.¹⁴^,¹⁵ Simulation- and didactic-based training has been shown to be beneficial in improving OB/GYN resident EPL counseling and has been associated with improved patient outcomes.¹⁶ To our knowledge, this has yet to be replicated in EM residency training.</p><p><strong>Objectives: </strong>We aimed to develop and evaluate a simulation-based educational intervention to improve EM resident management of patients presenting with EPL.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"25 2","pages":"221-225"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation Improves Emergency Medicine Residents' Clinical Performance of Aorta Point-of-Care Ultrasound.","authors":"Brandon M Wubben, Cory Wittrock","doi":"10.5811/westjem.18449","DOIUrl":"https://doi.org/10.5811/westjem.18449","url":null,"abstract":"<p><strong>Purpose: </strong>Using point-of-care ultrasound (POCUS) to diagnose abdominal aortic aneurysm (AAA) is an essential skill in emergency medicine (EM). While simulation-based POCUS education is commonly used, the translation to performance in the emergency department (ED) is unknown. We investigated whether adding case-based simulation to an EM residency curriculum was associated with changes in the quantity and quality of aorta POCUS performed by residents in the ED.</p><p><strong>Methods: </strong>A case-based simulation was introduced to resident didactics at our academic, Level I trauma center. A case of undifferentiated abdominal pain was presented, which required examination of an ultrasound phantom to diagnose an AAA, with a hands-on didactic. We compared the quantity, quality, and descriptive analyses of aorta POCUS performed in the ED during the four months before and after the simulation.</p><p><strong>Results: </strong>For participating residents (17/32), there was an 86% increase in total studies and an 80% increase in clinical studies. On an opportunity-adjusted, per-resident basis, there was no significant difference in median total scans per 100 shifts (4.4 [interquartile range (IQR) 0-15.8 vs 8.3 [IQR] 3.3-23.6, <i>P</i> = 0.21) or average total quality scores (3.2 ± 0.6 vs 3.2 ± 0.5, <i>P</i> = 0.92). The total number of limited or inadequate studies decreased (43% vs 19%, <i>P</i> = 0.02), and the proportion of scans submitted by interns increased (7% vs 54%, <i>P</i> = < .001).</p><p><strong>Conclusion: </strong>After simulation training, aorta POCUS was performed more frequently, and ED interns contributed a higher proportion of scans. While there was no improvement in quantity or quality scores on a per-resident basis, there were significantly fewer incomplete or limited scans.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"25 2","pages":"205-208"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foundations of Emergency Medicine: Impact of a Standardized, Open-access, Core Content Curriculum on In-Training Exam Scores.","authors":"Jaime Jordan, Natasha Wheaton, Nicholas D Hartman, Dana Loke, Nathaniel Shekem, Anwar Osborne, P Logan Weygandt, Kristen Grabow Moore","doi":"10.5811/westjem.18387","DOIUrl":"https://doi.org/10.5811/westjem.18387","url":null,"abstract":"<p><strong>Introduction: </strong>Learners frequently benefit from modalities such as small-group, case-based teaching and interactive didactic experiences rather than passive learning methods. These contemporary techniques are features of Foundations of Emergency Medicine (FoEM) curricula, and particularly the Foundations I (F1) course, which targets first-year resident (PGY-1) learners. The American Board of Emergency Medicine administers the in-training exam (ITE) that provides an annual assessment of EM-specific medical knowledge. We sought to assess the effect of F1 implementation on ITE scores.</p><p><strong>Methods: </strong>We retrospectively analyzed data from interns at four EM residency programs accredited by the Accreditation Council for Graduate Medical Education. We collected data in 2021. Participating sites were geographically diverse and included three- and four-year training formats. We collected data from interns two years before (control group) and two years after (intervention group) implementation of F1 at each site. Year of F1 implementation ranged from 2015-2018 at participating sites. We abstracted data using a standard form including program, ITE raw score, year of ITE administration, US Medical Licensing Exam Step 1 score, Step 2 Clinical Knowledge (CK) score, and gender. We performed univariable and multivariable linear regression to explore differences between intervention and control groups.</p><p><strong>Results: </strong>We collected data for 180 PGY-1s. Step 1 and Step 2 CK scores were significant predictors of ITE in univariable analyses (both with <i>P</i> < 0.001). After accounting for Step 1 and Step 2 CK scores, we did not find F1 implementation to be a significant predictor of ITE score, <i>P</i> = 0.83.</p><p><strong>Conclusion: </strong>Implementation of F1 curricula did not show significant changes in performance on the ITE after controlling for important variables.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"25 2","pages":"209-212"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User Experience of Access to Sexual Assault Nurse Examiner and Emergency Contraception in Emergency Departments in the United States: A National Survey.","authors":"Colleen Cowdery, Diana Halloran, Rebecca Henderson, Ma Kathleen M Allen, Kelly O'Shea, Kristen Woodward, Susan Rifai, Scott A Cohen, Muhammad Abdul Baker Chowdhury, Cristina Zeretzke-Bien, Lauren A Walter, Marie-Carmelle Elie-Turenne","doi":"10.5811/westjem.18405","DOIUrl":"https://doi.org/10.5811/westjem.18405","url":null,"abstract":"<p><strong>Background: </strong>Despite the prevalence of sexual assault presentations to emergency departments (ED) in the United States, current access to sexual assault nurse examiners (SANE) and emergency contraception (EC) in EDs is unknown.</p><p><strong>Methods: </strong>In this study we employed a \"secret shopper,\" cross-sectional telephonic survey. A team attempted phone contact with a representative sample of EDs and asked respondents about the availability of SANEs and EC in their ED. Reported availability was correlated with variables including region, urban/rural status, hospital size, faith affiliation, academic affiliation, and existence of legislative requirements to offer EC.</p><p><strong>Results: </strong>Over a two-month period in 2019, 1,046 calls to hospitals were attempted and 960 were completed (91.7% response rate). Of the 4,360 eligible hospitals listed in a federal database, 960 (22.0%) were contacted. Access to SANEs and EC were reported to be available in 48.9% (95% confidence interval [CI] 45.5-52.0) and 42.5% (95% CI 39.4-45.7) of hospitals, respectively. Access to EC was positively correlated with SANE availability. The EDs reporting SANE and EC availability were more likely to be large, rural, and affiliated with an academic institution. Those reporting access to EC were more likely to be in the Northeast and in states with legislative requirements to offer EC.</p><p><strong>Conclusion: </strong>Our results suggest that perceived access to sexual assault services and emergency contraception in EDs in the United States remains poor with regional and legislative disparities. Results suggest disparities in perceived access to EC and SANE in the ED, which have implications for improving ED practices regarding care of sexual assault victims.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"25 2","pages":"291-300"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: Evaluation of an Electrocardiogram Curriculum for Advanced Practice Clinicians.","authors":"Steven Lindsey, Tim P Moran, Meredith A Stauch, Alexis L Lynch, Kristen Grabow Moore","doi":"10.5811/westjem.18085","DOIUrl":"https://doi.org/10.5811/westjem.18085","url":null,"abstract":"<p><strong>Background: </strong>Training programs for advanced practice providers (APP) often have significant variability in their curriculum, including electrocardiogram (ECG) education. Despite limitations in formal ECG training, APPs in the emergency department (ED) may be the first practitioner to interpret an ECG. Foundations of Emergency Medicine (FoEM) offers free, open-access curricula that are widely used for resident education. We sought to improve APP ECG interpretation skills by implementing the FoEM ECG I course.</p><p><strong>Methods: </strong>This was a single-site, pre- and post-intervention study of 23 APPs at our high-acuity, urban ED. In the fall of 2020, APP learners enrolled in a FoEM ECG I course led by faculty and senior resident instructors. The course consisted of six virtual, small-group, active-learning ECG workshops. Participants completed a 15-question multiple-choice test before, immediately after, and six months post-intervention to quantify knowledge acquisition. Additionally, a pre- and post-intervention knowledge, attitudes, and practices survey was administered on ECG interpretation skills and to evaluate the course. We evaluated change in ECG knowledge scores using a Wilcoxon signed-rank test. Changes in self-assessed knowledge were evaluated using an ordinal logistic mixed-effects regression.</p><p><strong>Results: </strong>A total of 23 APPs enrolled in the course. Knowledge assessments showed APPs improved from the pre-test (median 9/15, interquartile range [IQR] 7-11) to the post-test (median 12/15, IQR 10-13; <i>P</i> = 0.001). Test scores did not significantly change from the post-test to the delayed post-test (median 12/15, IQR 12-13; <i>P</i> = 0.30). Respondents' subjective rating of their skill did not significantly change (<i>P</i> = 0.06). Respondents reported no change in their likelihood of approaching an attending when uncertain of the correct interpretation of an ECG (<i>P</i> = 0.16). Overall, 91% were satisfied with the course and 96% agreed that the course difficulty was appropriate.</p><p><strong>Conclusion: </strong>The FoEM ECG course provided a standardized curriculum that improved APP knowledge for interpreting ECGs. Despite this, the course did not alter APPs' willingness to approach physicians for guidance with interpretation of abnormal ECGs. These findings may inform expansion of this concept for other programs who desire formalized APP ECG education.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"25 2","pages":"155-159"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Overutilization of Computed Tomography Cervical Spine Imaging.","authors":"Tessy La Torre Torres, Jonathan McGhee","doi":"10.5811/westjem.18570","DOIUrl":"https://doi.org/10.5811/westjem.18570","url":null,"abstract":"","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"25 2","pages":"301"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Scoring Scale for Quality Assessment of Lung Ultrasound in the Emergency Department.","authors":"Jessica R Balderston, Taylor Brittan, Bruce J Kimura, Chen Wang, Jordan Tozer","doi":"10.5811/westjem.18225","DOIUrl":"https://doi.org/10.5811/westjem.18225","url":null,"abstract":"<p><strong>Introduction: </strong>The use of a reliable scoring system for quality assessment (QA) is imperative to limit inconsistencies in measuring ultrasound acquisition skills. The current grading scale used for QA endorsed by the American College of Emergency Physicians (ACEP) is non-specific, applies irrespective of the type of study performed, and has not been rigorously validated. Our goal in this study was to determine whether a succinct, organ-specific grading scale designed for lung-specific QA would be more precise with better interobserver agreement.</p><p><strong>Methods: </strong>This was a prospective validation study of an objective QA scale for lung ultrasound (LUS) in the emergency department. We identified the first 100 LUS performed in normal clinical practice in the year 2020. Four reviewers at an urban academic center who were either emergency ultrasound fellowship-trained or current fellows with at least six months of QA experience scored each study, resulting in a total of 400. The primary outcome was the level of agreement between the reviewers. Our secondary outcome was the variability of the scores given to the studies. For the agreement between reviewers, we computed the intraclass correlation coefficient (ICC) based on a two-way random-effect model with a single rater for each grading scale. We generated 10,000 bootstrapped ICCs to construct 95% confidence intervals (CI) for both grading systems. A two-sided one-sample <i>t</i>-test was used to determine whether there were differences in the bootstrapped ICCs between the two grading systems.</p><p><strong>Results: </strong>The ICC between reviewers was 0.552 (95% CI 0.40-0.68) for the ACEP grading scale and 0.703 (95% CI 0.59-0.79) for the novel grading scale (<i>P</i> < 0.001), indicating significantly more interobserver agreement using the novel scale compared to the ACEP scale. The variance of scores was similar (0.93 and 0.92 for the novel and ACEP scales, respectively).</p><p><strong>Conclusion: </strong>We found an increased interobserver agreement between reviewers when using the novel, organ-specific scale when compared with the ACEP grading scale. Increased consistency in feedback based on objective criteria directed to the specific, targeted organ provides an opportunity to enhance learner education and satisfaction with their ultrasound education.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"25 2","pages":"264-267"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stage B Heart Failure Is Ubiquitous in Emergency Patients with Asymptomatic Hypertension.","authors":"Kimberly Souffront, Bret P Nelson, Megan Lukas, Hans Reyes Garay, Lauren Gordon, Thalia Matos, Isabella Hanesworth, Rebecca Mantel, Claire Shubeck, Cassidy Bernstein, George T Loo, Lynne D Richardson","doi":"10.5811/westjem.17990","DOIUrl":"https://doi.org/10.5811/westjem.17990","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is the leading risk factor for morbidity and mortality throughout the world and is pervasive in United States emergency departments (ED). This study documents the point prevalence of subclinical heart disease in emergency patients with asymptomatic hypertension.</p><p><strong>Method: </strong>This was a prospective observational study of ED patients with asymptomatic hypertension conducted at two urban academic EDs that belong to an eight-hospital healthcare organization in New York. Adult (≥18 years of age) English- or Spanish-speaking patients who had an initial blood pressure (BP) ≥160/100 millimeters of mercury (mmHg) and second BP ≥140/90 mm Hg, and pending discharge, were invited to participate in the study. We excluded patients with congestive heart failure, renal insufficiency, and atrial fibrillation, or who were pregnant, a prisoner, cognitively unable to provide informed consent, or experiencing symptoms of hypertension. We assessed echocardiographic evidence of subclinical heart disease (left ventricular hypertrophy, and diastolic and systolic dysfunction).</p><p><strong>Results: </strong>A total of 53 patients were included in the study; a majority were young (mean 49.5 years old, [SD 14-52]), self-identified as Black or Other (n = 39; 73.5%), and female (n = 30; 56.6%). Mean initial blood pressure was 172/100 mm Hg, and 24 patients (45.3%) self-reported a history of hypertension. Fifty patients completed an echocardiogram. All (100%) had evidence of subclinical heart disease, with 41 (77.4%) displaying left ventricular hypertrophy and 31 (58.5%) diastolic dysfunction. There was a significant relationship between diastolic dysfunction and female gender [x² (1, n = 53) = 3.98; <i>P</i> = 0.046]; Black or other race [x² (3, n = 53) = 9.138; <i>P</i> = 0.03] and Hispanic or other ethnicity [x² (2, n = 53) = 8.03; <i>P</i> = 0.02]. Less than one third of patients demonstrated systolic dysfunction on echocardiogram, and this was more likely to occur in patients with diabetes mellitus [x² (1, n = 51) = 4.84; <i>P</i> = 0.02].</p><p><strong>Conclusion: </strong>There is a high probability that Black, Hispanic, and female patients with asymptomatic hypertension are on the continuum for developing overt heart failure. Emergency clinicians should provide individualized care that considers their unique health needs, cultural backgrounds, and social determinants of health.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"25 2","pages":"160-165"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Scoring Rubric for Editorial Evaluation of Peer-review Quality: A Pilot Study.","authors":"Jeffrey N Love, Anne M Messman, Jonathan S Ilgen, Chris Merritt, Wendy C Coates, Douglas S Ander, David P Way","doi":"10.5811/westjem.18432","DOIUrl":"https://doi.org/10.5811/westjem.18432","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the importance of peer review to publications, there is no generally accepted approach for editorial evaluation of a peer review's value to a journal editor's decision-making. The graduate medical education editors of the <i>Western Journal of Emergency Medicine</i> Special Issue in Educational Research & Practice (Special Issue) developed and studied the holistic editor's scoring rubric (HESR) with the objective of assessing the quality of a review and an emphasis on the degree to which it informs a holistic appreciation for the submission under consideration.</p><p><strong>Methods: </strong>Using peer-review guidelines from several journals, the Special Issue's editors formulated the rubric as descriptions of peer reviews of varying degree of quality from the ideal to the unacceptable. Once a review was assessed by each editor using the rubric, the score was submitted to a third party for blinding purposes. We compared the performance of the new rubric to a previously used semantic differential scale instrument. Kane's validity framework guided the evaluation of the new scoring rubric around three basic assumptions: improved distribution of scores; relative consistency rather than absolute inter-rater reliability across editors; and statistical evidence that editors valued peer reviews that contributed most to their decision-making.</p><p><strong>Results: </strong>Ninety peer reviews were the subject of this study, all were assessed by two editors. Compared to the highly skewed distribution of the prior rating scale, the distribution of the new scoring rubric was bell shaped and demonstrated full use of the rubric scale. Absolute agreement between editors was low to moderate, while relative consistency between editor's rubric ratings was high. Finally, we showed that recommendations of higher rated peer reviews were more likely to concur with the editor's formal decision.</p><p><strong>Conclusion: </strong>Early evidence regarding the HESR supports the use of this instrument in determining the quality of peer reviews as well as its relative importance in informing editorial decision-making.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"25 2","pages":"254-263"},"PeriodicalIF":3.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}