AEM Education and Training最新文献

{"title":"Clinical duties and compensation for U.S. emergency medicine fellows at academic centers: A descriptive, cross-sectional survey","authors":"Alexander J. Ulintz MD,&nbsp;Alyssa Tyransky,&nbsp;Gregory M. Archual MBA,&nbsp;Chelsea B. Kadish MD,&nbsp;Ashish R. Panchal MD, PhD","doi":"10.1002/aet2.10959","DOIUrl":"https://doi.org/10.1002/aet2.10959","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Fellowship training is increasingly popular among residency graduates and critical to the advancement of academic emergency medicine (EM). Little is known about the clinical hours worked and financial compensation received by fellows during training. We sought to describe the clinical duties and financial compensation of EM fellows at U.S. academic centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study surveyed U.S. academic EM department administrators who were members of the Society for Academic Emergency Medicine's Academy of Administrators in Academic Emergency Medicine (AAAEM) regarding their fellowship programs and fellows. We electronically distributed the validated survey instrument to 73 member sites between October 2022 and January 2023. Survey domains included fellow and fellowship demographics, base and total annual clinical hours, and base and total annual compensation. We calculated descriptive statistics and compared fellows by accreditation (Accreditation Council for Graduate Medical Education [ACGME] or non-ACGME) using chi-square and Wilcoxon rank-sum testing. We conducted a secondary analysis of base and total salary by gender and accreditation using Wilcoxon rank-sum testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We received 38 institutional responses (response rate 52%), which represented 217 individual fellows. Nearly three-fourths (<i>n</i> = 158, 72.8%) of fellows enrolled in non-ACGME fellowships, worked 33% more base hours annually than ACGME fellows (median 571 h vs. 768 h, <i>p</i> &lt; 0.001), and received base compensation 20% higher than ACGME fellows ($88,540 vs. $70,777, <i>p</i> &lt; 0.001). Accounting for additional compensation, the median total annual compensation for non-ACGME fellows remained 11% higher than ACGME fellows ($105,000 vs. $93,853, <i>p</i> = 0.004). We observed no significant differences salary when stratified by gender.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most EM fellows at U.S. academic institutions enrolled in non-ACGME fellowships with significantly higher base hours and financial compensation than ACGME fellowships. These results represent the first description of the clinical hours and financial compensation of academic EM fellows and should be considered in ongoing benchmarking efforts by AAAEM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.10959","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140181709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel online training program for sexual and gender minority health increases allyship in cisgender, heterosexual paramedics","authors":"Michael I. Kruse MD, CCFP(EM),&nbsp;Blair L. Bigham MD, MSc,&nbsp;Susan P. Phillips MD, CCFP, MSc (Epid)","doi":"10.1002/aet2.10958","DOIUrl":"https://doi.org/10.1002/aet2.10958","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Sexual and gender minorities (SGM) make up 4% of the Canadian population. Due to existing barriers to care in the community, SGM patients may seek more help and be sicker at presentation to hospital. Paramedics occupy a unique role and can remove or decrease these barriers. There are no existing evaluations of training programs in SGM health for prehospital providers. A training program to develop better allyship in paramedics toward SGM populations was developed and assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 70- to 90-min mandatory, asynchronous, online training module in SGM health in the prehospital environment was developed and delivered via the emergency medical service (EMS) system's learning management system. A before-and-after study of cisgender, heterosexual, frontline paramedics was performed to measure the impact of the training module on the care of SGM patients. The validated Ally Identity Measure (AIM) tool was used to identify success of training and includes subscales of knowledge and skills, openness and support, and oppression awareness. Demographics and satisfaction scores were collected in the posttraining survey. Matched and unmatched pairs of surveys and demographic associations were analyzed using nonparametric statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 609 paramedics, 571 completed the training, and 239 surveys were completed before and 105 (<i>n</i> = 344) surveys after the training; 60 surveys were paired. Overall AIM scores of matched pairs (<i>n</i> = 60) improved by 12% (<i>p</i> &lt; 0.001), with knowledge and skills accounting for most of the increase (21%, <i>p</i> &lt; 0.001). Unmatched pairs (<i>n</i> = 344) were similar in demographics and scores. Rural paramedics also had significantly lower pretraining oppression awareness scores and had lower posttraining AIM scores compared to suburban paramedics (6% difference). Satisfaction scores rated the training as relevant and applicable (87% and 82%, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A novel prehospital training program in the care of SGM patients resulted in a statistically significant increase in allyship in cisgender, heterosexual-identified frontline paramedics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.10958","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140164393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulating empathy: A qualitative experiential study of embedded resident learners in an empathy curriculum","authors":"Anna Culhane MD,&nbsp;Jerome Martin MD,&nbsp;Zachary Huston,&nbsp;Sara M. Hock MD","doi":"10.1002/aet2.10957","DOIUrl":"https://doi.org/10.1002/aet2.10957","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Physician empathy and communication skills are crucial parts of a successful emergency department (ED) interaction. This study aimed to evaluate whether these skills can be improved through a novel curriculum where interns act as patients for their senior residents during simulated ED cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-five residents participated in the curriculum. Prior to the cases, participants filled out the Toronto Empathy Questionnaire (TEQ). They then completed three simulated cases, with the 11 interns portraying the patients and the 14 seniors (postgraduate year [PGY]-2 and PGY-3 residents) in the physician role. Following the cases, the residents participated in a recorded, structured focus group. At the conclusion of the session participants again filled out the TEQ and answered a Likert questionnaire on their thoughts about the curriculum. Qualitative analysis was used to determine themes from the debriefs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two residents completed all components of the study. The mean (±SD) TEQ scores pre- and postcurriculum for all residents were 46.2 (±4.64) pre and 47.9 (±6.03) post (<i>ns</i>). On qualitative analysis, we derived four major themes: empathy, communication, feedback, and physician experience. The most common subthemes discussed were empathy for the patient situation and the importance of communicating visit expectations. On a 5-point Likert survey related to the simulated cases, respondents rated comfort providing feedback to their peers (mean ± SD 4.41 ± 0.95) and gaining insight into the patient experience (mean ± SD 4.27 ± 0.83).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The embedded intern exercise was rated well by resident participants, with no observed change in empathy scores. Qualitative analysis identified empathy and communication as major themes. Residents enjoyed this style of simulation and found it realistic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140164427","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":"Suicidal ideation, perception of personal safety, and career regret among emergency medicine residents during the COVID-19 pandemic","authors":"Arvin R. Akhavan MD, MPA,&nbsp;Tiannan Zhan MS,&nbsp;Michelle D. Lall MD, MHS,&nbsp;Melissa A. Barton MD,&nbsp;Earl J. Reisdorff MD,&nbsp;Yue-Yung Hu MD, MPH,&nbsp;Karl Y. Bilimoria MD, MS,&nbsp;Dave W. Lu MD, MS","doi":"10.1002/aet2.10955","DOIUrl":"https://doi.org/10.1002/aet2.10955","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The COVID-19 pandemic was disruptive for trainees and may have affected career decisions for some learners. This study examined the impact of the pandemic on emergency medicine (EM) resident perceptions of their mental health, perceptions of personal safety, and career choice regret.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a cross-sectional survey study administered following the 2021 American Board of Emergency Medicine In-Training Examination (ITE). Survey measures included suicidal ideation (SI), COVID concerns in terms of infection prevention and control (IPC) training, COVID risk to self and/or COVID risk to family, and COVID-related career regret. COVID concerns were compared by gender and race/ethnicity using Pearson's chi-square tests. Multivariable logistic regression models were used to test the association between SI and COVID concerns, resident characteristics, and program characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 6980 out of 8491 EM residents (82.2%) from 244 programs completed the survey. Only 1.1% of participants reported insufficient training in COVID IPC practices. Participants were concerned about COVID risk to themselves (40.3%) and to their families (63.3%) due to their job roles. These concerns were more common among women or nonbinary (vs. men); all other races/ethnicities (vs. non-Hispanic Whites); senior residents (vs. PGY-1, PGY-2 residents); and residents who were married or in relationships (vs. single or divorced). A total of 6.1% of participants reported that COVID made them reconsider choosing EM as their career. Career regret in this cohort was higher than that in the proportion (3.2%) expressing career regret in the 2020 ITE (<i>p</i> &lt; 0.001). Career regret was more common among women or nonbinary (vs. men); all other races/ethnicities (vs. non-Hispanic Whites); and senior residents (vs. PGY-1, PGY-2 residents). The overall SI rate was 2.6%, which did not differ from that of the 2020 sample of EM residents (2.5%, <i>p</i> = 0.88).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Many EM residents reported concerns about COVID risks to themselves and their families. Although the rate of SI remained unchanged, more EM residents reported career regret during the COVID pandemic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140164425","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":"Oh, the places you'll go! A qualitative study of resident career decisions in emergency medicine","authors":"Jaime Jordan MD, MAEd,&nbsp;Jack Buckanavage BS,&nbsp;Jonathan Ilgen MD, PhD,&nbsp;Michael Gottlieb MD,&nbsp;Laura R. Hopson MD, MEd,&nbsp;Adam Janicki MD, MS,&nbsp;Mark Curato DO,&nbsp;Anne K. Chipman MD, MS,&nbsp;Samuel O. Clarke MD, MAS","doi":"10.1002/aet2.10956","DOIUrl":"https://doi.org/10.1002/aet2.10956","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Postresidency career choices are complex decisions that involve personal, professional, and financial preferences and may be influenced by training programs. It is unknown how residents navigate these decisions during emergency medicine (EM) residency. We explored EM residents’ perspectives on career decision making and how residency programs can support career planning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semistructured interviews at seven accredited EM residency programs from diverse locations and training formats. We used purposive sampling to reflect the diversity of trainees with regard to gender, level of training, and career plans. Two researchers independently coded the transcripts. We used a constructivist–interpretivist paradigm to guide our thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We interviewed 11 residents and identified major themes in three categories. Residents described being exposed to career options through formalized curricula such as required rotations, career fairs, and subspeciality tracks, highlighting the importance of access to faculty with diverse areas of clinical and academic expertise. Many noted that exposure was often self-driven. We identified three major themes regarding career decisions: instrumental factors, people involved, and processes of decision making. Instrumental factors included personal interests, goals, and values as well as practice characteristics, financial considerations, timing, and opportunity costs. Mentors and family were highly involved in resident career decisions. Residents often utilized reflection and conversations with mentors and peers in their decision-making process. Participants recommended that programs provide exposure to diverse career options early in training, protect time for career education, and ensure adequate mentorship and a supportive community. Participants suggested specific curricular content and strategies to support career decisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study illuminates important factors involved in resident career decision making and how programs can support their trainees. Essential components include diverse experiences and building a reflective mentorship environment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140164426","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":"Proximity to vulnerability","authors":"Mitra Sadigh","doi":"10.1002/aet2.10949","DOIUrl":"https://doi.org/10.1002/aet2.10949","url":null,"abstract":"&lt;p&gt;With every shift in the emergency department (ED), I am reminded that each of us is only one or two steps from being extremely vulnerable.&lt;/p&gt;&lt;p&gt;My difficult moments have not been as colored by patient stories as by their stories being lost and misconstrued; spun and respun to maintain distance between staff for whom it's another “day on the job” and patient for whom it may be the worst day or era of their life. The protective barrier transforming an individual in need of help into a problem to be dealt with.&lt;/p&gt;&lt;p&gt;&lt;i&gt;My difficult moments have not been as colored by patient stories as by the ways that another “day on the job” for health care workers can easily become either the worst day or worst era of their life. Sometimes that protective barrier can make us feel more safe&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;It wasn't the woman who arrived obtunded after ingesting an unknown substance in an attempt to end her life, but the disgruntled complaints that she not only needed resuscitation, but had also “sh*t herself.” The sighs of exasperation when she soiled herself again.&lt;/p&gt;&lt;p&gt;&lt;i&gt;It wasn't the process of uncovering what medication had been overingested, but watching the nurse meticulously wipe the dried, pressed fecal matter from the completely unconscious patient who hours ago had decided this life was not worth living&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;It wasn't the survivor of gun violence who repeatedly screamed in pain when the leg the bullet had lodged in was poked and prodded. It was staff rolling their eyes as she continued to vocalize and emote. The disbelief that she could be in so much pain against the belief that she shouldn't have been “out in the streets.”&lt;/p&gt;&lt;p&gt;&lt;i&gt;It wasn't seeing a leg swell up with such tension that it might burst, but watching a resident rush out of the room in tears with the patient's scratch marks across her abdomen&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;It wasn't the teenage survivor of sex trafficking who was brought to the ED against her will because she lacked a safe place to sleep. It was hearing the passing of her story from EMS to nursing to residents about how “difficult” she was and “good luck dealing with her.” That she had “probably spent every night with a new man, ‘getting some.’”&lt;/p&gt;&lt;p&gt;&lt;i&gt;It wasn't the physician returning disappointed after being unable to appease a teenage survivor of sex trafficking. It was hearing her say that the patient had called her a “bitch” and watching her remove herself from the care team&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;I ask you to reflect with me. What is more frightening?&lt;/p&gt;&lt;p&gt;The “agitated” patient who might raise their voice and threaten or losing the ability to recognize a desperately frightened human staring back?&lt;/p&gt;&lt;p&gt;&lt;i&gt;Losing compassion for a desperately scared human staring back or being another survivor of workplace violence&lt;/i&gt;?&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Resuscitating someone who has attempted to end their life or being comfortable publicly humiliating them in their most vulnerable moment as they are being pulled back from the brink of death?","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.10949","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139987360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“If I don't, who will?”","authors":"Frosso Adamakos MD","doi":"10.1002/aet2.10952","DOIUrl":"https://doi.org/10.1002/aet2.10952","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139937290","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":"Program director longevity in emergency medicine residencies: A 40-year analysis","authors":"Arlene S. Chung MD, MACM,&nbsp;Katherine L. Pattee MD,&nbsp;Rachel Bass MD, MPH,&nbsp;Adam N. Frisch MD, MS,&nbsp;Jaime Jordan MD, MAEd","doi":"10.1002/aet2.10951","DOIUrl":"https://doi.org/10.1002/aet2.10951","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We sought to assess trends in emergency medicine residency program director (PD) length of service over the past 40 years and evaluate relationships between duration of service and important factors such as PD start year, geographic region, and year of program initial accreditation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed program data from the American Medical Association Graduate Medical Education Directory and Emergency Medicine Residents’ Association Match database. We calculated descriptive statistics and used linear regression to assess the impact of PD start year, region, and year of program initial accreditation on PD duration of service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We gathered data on 783 unique PDs between 1983 and 2023. The overall mean ± SD PD duration of service was 6.19 ± 4.72 years (range 1–29 years). The mean duration of service by decade of start date was 6.49 years in the 1980s, 7.39 years in the 1990s, 5.92 years in the 2000s, 4.08 years in the 2010s, and 2 years in the 2020s. Both PD start year (<i>p</i> = 0.002) and program initial accreditation year (<i>p</i> = 0.001) significantly predicted duration of PD service. Region did not significantly predict duration of PD service (<i>p</i> = 0.225).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Duration of service as a PD is decreasing in recent decades. Both PD start year and year of initial program accreditation significantly predict duration of service as PD. Future research must be done to better understand this phenomenon and uncover strategies to promote PD longevity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139937312","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":"Comparison of nurse and resident physician paging frequency by sex in the emergency department","authors":"Deesha Sarma MD,&nbsp;Bryan Stenson MD,&nbsp;Gordon MacDougall MD,&nbsp;Alyssa Mangino MD,&nbsp;Leon D. Sanchez MD, MPH,&nbsp;David T. Chiu MD, MPH","doi":"10.1002/aet2.10948","DOIUrl":"https://doi.org/10.1002/aet2.10948","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The role of biological sex in interprofessional relationships is an important factor in collaborative health care settings such as the emergency department (ED) but one that has been sparsely studied. While there is anecdotal evidence on gender-based differences in communication, little research has focused on this topic. The goal of this study was to determine whether there are differences in paging frequency between nurses and male and female residents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective review of patient visits to our urban, tertiary care academic ED between January 1 and April 1, 2021. Only pages from nurses to emergency medicine (EM) residents were included. Outcome variables included number of pages received by sex, number of unique ED visits, and mean number of pages per unique visit. Pearson's chi-square tests were used to analyze differences between observed and expected results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 15,617 pages from nurses to residents over 6843 unique patient visits to the ED were analyzed. This included 187 nurses, 162 (87%) of whom were female and 25 (13%) were male. Of the 39 residents, 12 (31%) were female and 27 (69%) were male. Female residents received 4500 pages over 2228 unique patient ED visits, or a mean of two pages per patient with a mean of 186 unique ED visits per female resident. Male residents received 11,117 pages over 4615 unique patient ED visits, or a mean of 2.4 pages per patient, with a mean of 171 unique ED visits per male resident. This difference in pages per patient was statistically significant (χ²(1) = 369, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found that male residents received significantly more pages per patient than their female colleagues. Overall, further research is required to understand the factors, such as characteristics of patients or preferred communication methods of providers, that drive this disparity and what the implications are for patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139942922","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":"What the experts see: A qualitative analysis of the behaviors of master adaptive learners in emergency medicine","authors":"Laura R. Hopson MD,&nbsp;Jeremy Branzetti MD, MHPE,&nbsp;Michael A. Gisondi MD,&nbsp;Linda Regan MD, MEd","doi":"10.1002/aet2.10943","DOIUrl":"https://doi.org/10.1002/aet2.10943","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The Master Adaptive Learner (MAL) model postulates that learners develop adaptive expertise through cycles of self-regulated learning. Despite a robust theoretical basis, the actual observable behaviors of MALs are not well characterized. We sought to define behaviors that characterize MALs within emergency medicine (EM) training.&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;Using a constructivist grounded theory approach, we analyzed semistructured interviews with expert EM educators. These experts reflected on observable behaviors as well as factors in the clinical learning environment that may modulate these behaviors. We recruited using purposive sampling until thematic saturation.&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 four overall themes, of which three described groups of learner behaviors and a fourth described modifiers of these behaviors. Learner behaviors include: (1) critical interrogation of practice, (2) intellectual risk-taking, and (3) intentional curation of a learning network. Critical interrogation of practice encompasses several observable behaviors including learner-driven feedback conversations, independent synthesis of clinical information, appropriate deviation from algorithms based on their conceptual understanding of core principles, intentional use of case variation and hypothetical questioning, and continuous refinement of decisions. MALs also engage in intellectual risk-taking for their development by communicating clinical decision-making processes even at the risk of being wrong, openly addressing errors and gaps, and intentionally seeking out uncomfortable experiences. Intentional curation of a learning network is the deliberate development of a consortium of trusted individuals who serve as mentors and sounding boards. We also identified a fourth theme related to the expression of learner behaviors: learning environment modulates behaviors. Active promotion of psychological safety is necessary for learners to express these behaviors. This safety is mediated through trusting relationships and expert supervisors who serve as colearners and role models.&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;We present several behaviors that allow identification of MALs among EM trainees. These data expand our understanding of MALs and the critical influence of the learning environment. Identification of these behaviors may allow for more precise categorization of targeted curricular interventions and meaningful learning outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.10943","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139916699","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}