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Board scores in the spotlight: Public reporting and the unintended consequences
IF 1.7
AEM Education and Training Pub Date : 2025-03-31 DOI: 10.1002/aet2.70006
Matthew E Kelleher MD, MEd, Sally A Santen MD, PhD, Christiana Draper MD, PhD, Jaime Jordan MD, MA, Michael Gottlieb MD, Benjamin Kinnear MD, MEd
{"title":"Board scores in the spotlight: Public reporting and the unintended consequences","authors":"Matthew E Kelleher MD, MEd, Sally A Santen MD, PhD, Christiana Draper MD, PhD, Jaime Jordan MD, MA, Michael Gottlieb MD, Benjamin Kinnear MD, MEd","doi":"10.1002/aet2.70006","DOIUrl":"https://doi.org/10.1002/aet2.70006","url":null,"abstract":"<p>The American Board of Emergency Medicine (ABEM) recently announced plans to publicly report program-level board certification examination pass rates.<span><sup>1</sup></span> This initiative will present program-level board pass rates for public viewing. Multiple arguments can be made for such a change. Medical education is increasingly seen as a service for which trainees have paid large sums of money and sacrifice a significant amount of time and effort. Transparency and accountability to learners that show services are high quality is important. Additionally, public reporting of program board pass rates provides a mechanism for accountability to society at large and aligns with ABEM's mission “To ensure the highest standards in the specialty of Emergency Medicine.”<span><sup>2</sup></span> Graduate medical education (GME) is largely funded through tax dollars, and an argument can be made that the public should be able to see the degree to which different training programs are helping their graduates pass certifying examinations.<span><sup>3</sup></span> Finally, this change would align ABEM with multiple other major American Board of Medical Specialties (ABMS) member boards who publicly report program pass rates, such as the American Board of Internal Medicine, American Board of Pediatrics, and American Board of Family Medicine.<span><sup>4</sup></span> These rationales have merit, but unintended consequences lurk around the corner. In this perspective, we describe the potential negative impact of publicly reporting program-level certifying examination pass rates. Specifically, we explore how public reporting could disincentivize holistic review of applicants during residency recruitment. We propose actionable strategies that various stakeholders may consider for balancing transparency with the broader mission of holistic review and inclusive recruitment practices in GME.</p><p>Humans are influenced by incentive structures. As rational actors, we tend to (either implicitly or explicitly) alter our thinking and behavior when different incentive structures are presented to us. When such structures lead to unwanted consequences, they are labeled “perverse incentives.” A colloquial term for the impact of a perverse incentive is sometimes called the <i>Cobra Effect</i>.<span><sup>5</sup></span> The Cobra Effect draws from an anecdote in which a governmental effort to reduce the number of cobras in Delhi, India, backfired. The initiative offered a bounty for dead cobras, so people began breeding cobras to turn in more dead snakes. The bounty was intended to incentivize the killing of cobras, hence decreasing the overall population. However, people quickly realized they could game the system for financial gain, leading to an overall increase in the cobra population. The incentive structure led to unwanted consequences that could potentially have been predicted by considering how people would respond.</p><p>We believe that publicly reporting progra","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741164","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}
引用次数: 0
Don't despair, not today
IF 1.7
AEM Education and Training Pub Date : 2025-03-31 DOI: 10.1002/aet2.70026
Zhaohui Su PhD
{"title":"Don't despair, not today","authors":"Zhaohui Su PhD","doi":"10.1002/aet2.70026","DOIUrl":"https://doi.org/10.1002/aet2.70026","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741166","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
Beyond mindscapes
IF 1.7
AEM Education and Training Pub Date : 2025-03-31 DOI: 10.1002/aet2.70033
Victor N. Oboli MD
{"title":"Beyond mindscapes","authors":"Victor N. Oboli MD","doi":"10.1002/aet2.70033","DOIUrl":"https://doi.org/10.1002/aet2.70033","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741163","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
Impact and Influence of a Teaching Resident Rotation on Emergency Medicine Resident Physicians
IF 1.7
AEM Education and Training Pub Date : 2025-03-31 DOI: 10.1002/aet2.70034
Catherine Yu MD, MEd, Rebecca Bavolek MD, Luigi Varilla, Jaime Jordan MD, MAEd, Steven Lai MD
{"title":"Impact and Influence of a Teaching Resident Rotation on Emergency Medicine Resident Physicians","authors":"Catherine Yu MD, MEd,&nbsp;Rebecca Bavolek MD,&nbsp;Luigi Varilla,&nbsp;Jaime Jordan MD, MAEd,&nbsp;Steven Lai MD","doi":"10.1002/aet2.70034","DOIUrl":"https://doi.org/10.1002/aet2.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Accreditation Council for Graduate Medical Education requires residency programs to train their residents to be teachers. Teaching resident (TR) rotations in emergency medicine (EM) residency programs provide both an opportunity to train residents in teaching skills and a dedicated teaching service for junior learners in the clinical setting. The impact that this experience has on the residents themselves is unknown. We sought to explore the impact of our residency program's TR rotation on our recent graduates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a qualitative study using semistructured interviews. We recruited our residency program's recent graduates and interviewed participants over a videoconferencing platform. We used a constructivist paradigm to guide our thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We interviewed 11 graduates and identified major themes regarding how the TR rotation impacted their comfort and preparedness to teach and supervise learners postgraduation: discovery of their teaching identity, communication skills, development of teaching and supervisory skills, and professional development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EM residents found TR rotations helpful in developing skills that prepared them to educate learners and supervise patient care postgraduation. The findings of this study may inform the use and development of TR rotations in EM and other specialties.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741165","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}
引用次数: 0
Expanding the scope of emergency care: The clinical forensic medicine fellowship at Kings County Hospital
IF 1.7
AEM Education and Training Pub Date : 2025-03-20 DOI: 10.1002/aet2.11062
Elias Youssef MD, Keesandra K. Agenor MD, Brigitte Alexander DO, Priyanka Datta MD, Brittany Choe MD, Rajesh Verma MD, Antonia Quinn DO, Richard Sinert DO
{"title":"Expanding the scope of emergency care: The clinical forensic medicine fellowship at Kings County Hospital","authors":"Elias Youssef MD,&nbsp;Keesandra K. Agenor MD,&nbsp;Brigitte Alexander DO,&nbsp;Priyanka Datta MD,&nbsp;Brittany Choe MD,&nbsp;Rajesh Verma MD,&nbsp;Antonia Quinn DO,&nbsp;Richard Sinert DO","doi":"10.1002/aet2.11062","DOIUrl":"https://doi.org/10.1002/aet2.11062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Most victims of trauma and abuse will seek care in an emergency department (ED) within hours of their violence-related injuries. Medical training has produced well-trained physicians to evaluate, stabilize, and treat these patients in the acute setting. Unfortunately, in an ED without forensic staff, lack of timely forensic care can result in delays in treatment, loss of evidence, and hope of any justice being achieved. Emergency physicians are in a unique position to provide critical medical and forensic care to these patients, especially in health care facilities without 24-h coverage of forensic staff and social workers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In 2022, Kings County Hospital developed a clinical forensics medicine fellowship to provide specialized care to victims of trauma and provide additional training to emergency medicine (EM) residents. A clinical forensic medicine (CFM) curriculum was created to introduce trauma-informed care in adult and pediatric EM training programs. It demonstrated how forensic medicine can play an integral role in the road to recovery for victims, without interfering with the delivery of critical medical care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This article describes the development of a clinical forensics medicine fellowship at Kings County Hospital using Kern's six-step approach to curriculum design. It includes the problem identification, targeted needs assessment, goals and objectives, educational strategies, implementation, and evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This article elaborates on the importance of CFM in EM residency training and provides the framework to replicate the fellowship at any institution.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689395","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
Sono-starters: A qualitative study of pioneers in the field of point-of-care ultrasound
IF 1.7
AEM Education and Training Pub Date : 2025-03-20 DOI: 10.1002/aet2.70029
Judy Lin MD, Michelle Hernandez MD, Shiraz Saleem DO, Arthur Au MD, Ryan Bellinger MD, Jaime Jordan MD, MAEd, Michael Gottlieb MD
{"title":"Sono-starters: A qualitative study of pioneers in the field of point-of-care ultrasound","authors":"Judy Lin MD,&nbsp;Michelle Hernandez MD,&nbsp;Shiraz Saleem DO,&nbsp;Arthur Au MD,&nbsp;Ryan Bellinger MD,&nbsp;Jaime Jordan MD, MAEd,&nbsp;Michael Gottlieb MD","doi":"10.1002/aet2.70029","DOIUrl":"https://doi.org/10.1002/aet2.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Point-of-care ultrasound (POCUS) within emergency medicine (EM) was a new field that has since developed into a robust discipline through the efforts of early EM POCUS pioneers. This study explored the experiences that led to POCUS pioneers' success. These data can inform emerging fields of study including non-EM specialties adopting POCUS as well as other new subspecialties within medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a qualitative study using semistructured interviews with physician pioneers in the field of EM POCUS. EM POCUS pioneers were defined as early key contributors to the field of EM POCUS and were identified using combined author networks and purposive, stratified sampling with a snowball sampling technique. A thematic analysis of interviews was performed using a modified grounded theory approach with a constructivist–interpretivist paradigm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve physicians were interviewed in this study. We identified four major themes: career motivators, barriers encountered, promoters of success, and advancement of the field. Career motivators included the need for representation and the ability to impact a new and growing field. Barriers encountered included discouragement by other colleagues, political battles, lack of funding, and rudimentary technology. Participants felt their career success was attributed to guidance from mentors, demonstration of initiative, work ethic, and skills in active listening. Participants felt the field advanced through the creation of national organizations, publication of training and credentialing guidelines, generation of research, and investment into the next generation of POCUS leaders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study identified several key themes in EM POCUS pioneers' careers including motivators, barriers, and methods used to overcome obstacles. Based on these data, we recommend a comprehensive set of strategies to support the advancement of an emerging field. These include early content exposure, mentorship, funding, research and industry collaboration, diversity, national organization involvement, and investment into future leaders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689085","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
Design and implementation of an automated patient-care dashboard to provide individualized patient care data and quality metrics to emergency medicine residents
IF 1.7
AEM Education and Training Pub Date : 2025-03-20 DOI: 10.1002/aet2.70031
Danielle T. Miller MD, MEd, Sean S. Michael MD, MBA, Sarah H. Michael DO, Kelly Bookman MD, Cody Brevik MD, William Dewispelaere MD, Christopher Johns MD, Bonnie Kaplan MD, Dong Nguyen, Daniel Owens MD, Gannon Sungar DO, John Kendall MD
{"title":"Design and implementation of an automated patient-care dashboard to provide individualized patient care data and quality metrics to emergency medicine residents","authors":"Danielle T. Miller MD, MEd,&nbsp;Sean S. Michael MD, MBA,&nbsp;Sarah H. Michael DO,&nbsp;Kelly Bookman MD,&nbsp;Cody Brevik MD,&nbsp;William Dewispelaere MD,&nbsp;Christopher Johns MD,&nbsp;Bonnie Kaplan MD,&nbsp;Dong Nguyen,&nbsp;Daniel Owens MD,&nbsp;Gannon Sungar DO,&nbsp;John Kendall MD","doi":"10.1002/aet2.70031","DOIUrl":"https://doi.org/10.1002/aet2.70031","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The emergency department (ED) is a high-stakes training environment for emergency medicine (EM) residents and residents' ability to reflect and self-evaluate patient care is of critical importance. Patient care dashboards have been shown to increase adherence to quality guidelines and improve patient outcomes. The objectives of this study were: (1) to create a comprehensive list of evidence-based, psychologically safe patient care and quality metrics to include in a patient care dashboard for EM residents; (2) to design an EM patient care residency dashboard in a secure, cloud-based environment integrated with the electronic health record (EHR); and (3) to pilot the usability and acceptability of the dashboard among EM residents.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We created a list of potential EM resident patient care metrics using ACGME Emergency Medicine Defined Key Index Procedure Minimums, leading EM quality indicators, and current EM dashboard literature. We surveyed PGY-1 to -4 EM residents at a single residency program for their recommendations about inclusion, exclusion, and the psychological safety of each metric. We then developed a dashboard utilizing Power BI software integrated with Epic EHR. After development, we conducted a 2-month pilot evaluation for usability and acceptability among EM residents utilizing a mixed-methods approach.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We identified 41 metrics within five domains (productivity metrics, patient safety and leading quality indicators, key procedures, complex/high-acuity cases, and uncertain diagnosis) to consider for inclusion in the dashboard. Residents (&lt;i&gt;n&lt;/i&gt; = 32/68; 47% survey completion rate) recommended inclusion of 33 metrics; among these, three were identified as moderate–high psychological risk (ED length of stay, patients per hour, death within 24 h) whereas the rest were considered low psychological risk. Based on these survey results, we created an EM resident patient dashboard using Microsoft Power BI. Over a 2-month pilot period with 16 residents, user data showed a change between each resident's prior patient care review practices and review practices when using a dashboard; specifically, there were notable variations in frequency of use, time spent per review session, number of patients reviewed per session, and data categories reviewed. Eleven of 16 residents completed the technology usability and acceptability survey, with general acceptability and few concerns on usability.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our dashboard provides individualized patient care data to EM re","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689394","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
Implementation of regional anesthesia education for emergency medicine residents and faculty
IF 1.7
AEM Education and Training Pub Date : 2025-03-11 DOI: 10.1002/aet2.70007
Anthony Rauschenbach MD, Glenn Paetow MD, Hayley Musial MD, Andrew Laudenbach MD, Daniel Parsons-Moss MD, Sarah Knack MD, Andrea Dreyfuss MD
{"title":"Implementation of regional anesthesia education for emergency medicine residents and faculty","authors":"Anthony Rauschenbach MD,&nbsp;Glenn Paetow MD,&nbsp;Hayley Musial MD,&nbsp;Andrew Laudenbach MD,&nbsp;Daniel Parsons-Moss MD,&nbsp;Sarah Knack MD,&nbsp;Andrea Dreyfuss MD","doi":"10.1002/aet2.70007","DOIUrl":"https://doi.org/10.1002/aet2.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Using opioids for pain management in emergency departments (ED) poses risks such as respiratory depression and addiction. Ultrasound-guided regional anesthesia (UGRA) offers an alternative to opioids and procedural sedation, yet many emergency medicine (EM) residencies lack formal training for this skill. It is crucial to develop education initiatives aimed at incorporating UGRA techniques into clinical practice for emergency physicians (EPs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A regional anesthesia education program for EM residents and faculty was piloted. The intervention comprised a 25-min video on safe UGRA practices followed by a 4-h hands-on course using cadaveric and live models. Participant knowledge was tested before the course and 6 weeks afterward. Test results were analyzed via paired <i>t</i>-test. The electronic health record was reviewed for UGRA blocks performed in the ED 2 months before and after the intervention. Efficacy was evaluated through patient-reported pain improvement and ultrasound image review. Immediate complications are reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six residents and 11 faculty completed the video review, hands-on course, and the pre/posttests. With a maximum score of 30, median (IQR) pretest scores were 14 (12–17) and increased to 21 (18–23) 6 weeks postcourse, with a median 8 (95% CI 4.1–9.0) points improvement. One-hundred percent of participants found the training helpful. Clinical data were collected from August 26, 2023, to December 25, 2023, and the number of UGRA blocks performed rose from 55 before to 102 after the intervention. Pain improvement was similar before and after the intervention. Review of recorded images indicated proper needle position and anesthetic spread in 91% of blocks precourse and 82% postcourse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This educational intervention increased UGRA blocks with few complications and a high success rate. Provider knowledge significantly improved, but needle positioning and anesthetic spread were inappropriate in 18% of blocks postcourse, emphasizing the need for ongoing education to enhance UGRA competency among EPs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595615","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
Identifying emergency medicine program directors’ expectations of competence upon entry into residency: Bridging the distance from the Association of American Medical Colleges Core Entrustable Professional Activities
IF 1.7
AEM Education and Training Pub Date : 2025-03-11 DOI: 10.1002/aet2.70024
Holly A. Caretta-Weyer MD, MHPE, Yoon Soo Park PhD, Ara Tekian PhD, MHPE, Stefanie S. Sebok-Syer PhD
{"title":"Identifying emergency medicine program directors’ expectations of competence upon entry into residency: Bridging the distance from the Association of American Medical Colleges Core Entrustable Professional Activities","authors":"Holly A. Caretta-Weyer MD, MHPE,&nbsp;Yoon Soo Park PhD,&nbsp;Ara Tekian PhD, MHPE,&nbsp;Stefanie S. Sebok-Syer PhD","doi":"10.1002/aet2.70024","DOIUrl":"https://doi.org/10.1002/aet2.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Residency program directors (PDs) frequently describe students as unprepared for the patient care responsibilities expected of them upon entry into residency. The Association of American Medical Colleges (AAMC) developed the Core Entrustable Professional Activities (Core EPAs) to address this concern by defining 13 tasks students should be able to do with minimal supervision upon graduation. However, the Core EPAs remain difficult for PDs to use due to their breadth and lack of granularity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using Delphi consensus methodology, we identified granular observable practice activities (OPAs) that PDs expect of entering interns derived from the Core EPAs. Twelve emergency medicine education experts drafted OPAs based on the Core EPAs and their associated core functions described in one-page schematics. A separate group of 12 PDs underwent three rounds of voting, and consensus for inclusion was set at 70%. Thematic analysis of comments discussing votes was performed using an inductive approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 321 OPAs were drafted and 127 adopted as expectations for entering interns based on the Core EPAs. The adopted OPAs were all general expectations; none were specialty-specific. Four main themes were identified from the comments: Schools are not responsible for specialty-specific training, PDs do not fully trust schools’ assessments, supervision expectations of graduates should be lowered for higher-order EPAs, and the context in which the student performs a task and its associated complexity matter greatly in entrustment decisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PDs agree with the generalist focus of the AAMC Core EPAs and feel strongly that specialty training should be left to residency programs. They also have mechanisms in place to verify entrustment within their local context. Transparency in assessment and summative entrustment processes in UME may unify expectations. Finally, the granularity of OPAs may aid in a post-Match handover to further operationalize the EPAs and optimize the UME-to-GME transition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595525","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
A descriptive analysis of emergency medicine residency scholarly tracks faculty workforce
IF 1.7
AEM Education and Training Pub Date : 2025-02-21 DOI: 10.1002/aet2.70002
Amy Mariorenzi MD, Allison Beaulieu MD, MAEd, Seth Lotterman MD, Vytas Karalius MD, Emad Awad PhD, Arlene Chung MD, MACM, Jaime Jordan MD, MA
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