AEM Education and Training最新文献

{"title":"Mastering Pediatric Airway Skills: A Procedural Simulation Using Rapid Cycle Deliberate Practice for Emergency Medicine Residents.","authors":"Kei U Wong, Isabel T Gross","doi":"10.1002/aet2.70180","DOIUrl":"10.1002/aet2.70180","url":null,"abstract":"<p><strong>Background: </strong>Pediatric emergency medicine (PEM) training within emergency medicine (EM) residency programs varies widely in preceptor expertise, critical care exposure, and procedural opportunities. Despite the importance of pediatric airway management, real-world exposure to critically ill children remains limited and inconsistent across training sites. Current ACGME guidelines provide minimal direction on pediatric-specific content or mandatory procedures, leaving gaps in emergent airway training.</p><p><strong>Objective of the innovation: </strong>To address perceived deficiencies in pediatric airway skills among EM residents, we implemented a longitudinal, simulation-based pediatric airway curriculum. The primary goal was to improve pediatric airway knowledge, confidence, procedural competency in airway equipment setup, bag-valve-mask (BVM) ventilation, troubleshooting, intubation techniques using a flipped classroom model, and rapid cycle deliberate practice (RCDP).</p><p><strong>Development process and implementation: </strong>Guided by Kern's curriculum design framework and selected components of Sawyer's six-step procedural learning model, the curriculum incorporated asynchronous learning and eight interactive simulation sessions over a 12-month period. 40 residents in four postgraduate years participated in two individualized RCDP sessions annually, supported by faculty trained in pediatric airway management. A novel checklist was used for objective performance assessment.</p><p><strong>Outcomes: </strong>Thirty-one residents completed baseline and post-intervention procedural assessments. Significant improvements were observed in equipment setup and intubation steps (<i>p</i> < 0.05), with first-pass intubation time reduced from 9 min and 12 s to 7 min and 9 s (<i>p</i> < 0.05). Self-reported confidence in pediatric airway management increased across all PGY levels (<i>p</i> < 0.05), and knowledge scores improved (7.8 vs. 9.7, <i>p</i> < 0.05). Resident feedback strongly endorsed the curriculum's value in building skills and confidence.</p><p><strong>Conclusion: </strong>A structured, simulation-based pediatric airway curriculum using RCDP effectively enhances EM residents' procedural performance and confidence. This model offers a scalable approach for addressing critical skill gaps in PEM training. Future directions include integrating advanced airway techniques and longitudinal retention assessments.</p>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 ","pages":"e70180"},"PeriodicalIF":1.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934220","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148075648","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":"Preparing Emergency Medicine Residents for the Certifying Exam: A Pilot Study of a Longitudinal Simulation-Based Assessment Program.","authors":"Jennifer Yee, Christopher E San Miguel, Krystin N Miller, Simiao Li-Sauerwine, Geremiha Emerson, Jennifer M Mitzman, Cynthia G Leung, Colin G Kaide, Benjamin M Ostro, Andrew P Kendle, Ashish R Panchal, Sally A Santen, Kelsey H Jordan, Sorabh Khandelwal","doi":"10.1002/aet2.70172","DOIUrl":"10.1002/aet2.70172","url":null,"abstract":"<p><strong>Background: </strong>The American Board of Emergency Medicine (ABEM) has recently introduced a new Certifying Exam, which incorporates assessment of performance in a simulated clinical environment. Simulation-based assessments allow for reproducible, controlled evaluations. The residency program has a responsibility to prepare residents for the Certifying Exam and to verify resident competency. We sought to determine the feasibility of a simulation-based assessment program encompassing three domains (resuscitation, procedural skills, and communication) with assessments against pre-determined Minimum Competency Scores (MCS) to provide evidence for program director attestations of competence.</p><p><strong>Methods: </strong>Eight stations were chosen based on ABEM's Certifying Exam content, the Accreditation Council for Graduate Medical Education (ACGME) Milestones, and proposed Entrustable Professional Activities. Simulation-based case scenarios and assessment checklists were created with standard settings performed using the Mastery Angoff process. These stations were categorized into three different domains: resuscitation (Adult Medical, Pediatric Medical, Trauma, and Neonatal), procedural skills (Direct Laryngoscopy, Cricothyrotomy, and Central Venous Catheter Placement), and communication (Breaking Bad News). Results were summarized with descriptive statistics.</p><p><strong>Results: </strong>Thirty emergency medicine residents at an academic Midwestern residency program underwent assessments over one year. None of the residents achieved the MCS on all eight assessments. Residents achieved the MCS on an average of 4.24 stations. There was large performance variability, particularly for the Pediatric Medical (27%-100% items correct), Neonatal Resuscitation (30%-100%), and Breaking Bad News (31%-100%) scenarios. A greater percentage of residents met the MCS for procedural assessments.</p><p><strong>Conclusions: </strong>This pilot study demonstrated the feasibility of a simulation-based assessment program designed to provide objective evidence of clinical competency. Assessment outcomes and associated feedback can be used by learners to guide the development of educational plans for performance improvement. Educators can use the resulting data to assess readiness for independent practice, prepare for the Certifying Exam, and identify content areas that may require additional program-wide education.</p>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 ","pages":"e70172"},"PeriodicalIF":1.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934183","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148075649","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148075651","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":"Emergency Departments Need to Train and Hire More Sub-Specialists in Addiction Medicine.","authors":"Anthony Spadaro, Timothy Kelly, Jason Morris, Megan E Heeney","doi":"10.1002/aet2.70184","DOIUrl":"10.1002/aet2.70184","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 ","pages":"e70184"},"PeriodicalIF":1.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934238","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 Approach to Cadaver-Based Soiled Airway Simulation.","authors":"Adam Parks, Sean Hurley, Patricia Marks, James Gould","doi":"10.1002/aet2.70182","DOIUrl":"10.1002/aet2.70182","url":null,"abstract":"<p><p>Effective management of heavily soiled airways is a critical and challenging skill across multiple clinical settings. Existing training methods rely largely on manikin-based simulators, which often lack sufficient anatomical realism and haptic fidelity. Here, we describe a novel, low-cost, and practical technique for simulating soiled airways in clinical-grade cadavers. The method employs readily available equipment, including a bougie, Foley catheter, and continuous bladder irrigation system, to rapidly deliver simulated bloody emesis into the proximal esophagus and oropharynx. This technique was successfully implemented on nine clinical-grade cadavers during emergency medicine (EM) and anesthesiology physician airway training sessions. All surveyed instructors reported marked improvements in realism and haptic fidelity compared with traditional manikin-based approaches, and no adverse events occurred during cadaver preparation or course delivery. This novel, cadaver-based soiled airway simulation technique offers a practical and reproducible approach to enhance soiled airway education and research.</p>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 ","pages":"e70182"},"PeriodicalIF":1.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934225","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148068405","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148068406","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":"Uncertainty in Standardized Letter of Evaluation Authorship: A Qualitative Study of Emergency Medicine Faculty.","authors":"Caitlin Schrepel, Eric Shappell, Morgan Sehdev, Nicole M Dubosh, Benjamin H Schnapp, Alexis Pelletier-Bui, Cullen Hegarty, Sharon Bord","doi":"10.1002/aet2.70175","DOIUrl":"10.1002/aet2.70175","url":null,"abstract":"<p><strong>Background: </strong>The standardized letter of evaluation (SLOE) is a cornerstone of emergency medicine (EM) residency selection. While prior research has focused on how SLOEs are interpreted by reviewers, less is known about the considerations and strategies faculty employ when authoring these high-stakes evaluations.</p><p><strong>Methods: </strong>Using a constructivist grounded theory approach, we conducted semi-structured interviews with EM faculty experienced in SLOE authorship between April and October 2025. Interviews were audio-recorded, transcribed, and iteratively analyzed using constant comparative methods and team-based reflexive analysis until thematic sufficiency was achieved.</p><p><strong>Results: </strong>Participants described SLOE authorship as a process of navigating uncertainty arising from the interaction of structural challenges, cultural pressures, and moral tensions. Structurally, authors described difficulty mapping incomplete or imperfect evaluation data onto standardized SLOE items, often requiring interpretive judgment and use of proxies. Culturally, participants reported pressure to calibrate ratings to perceived national norms to avoid disadvantaging students, contributing to grade inflation and narrative justification strategies. Morally, authors experienced tension between transparency and advocacy, balancing honest assessment with concern for learner success and professional credibility.</p><p><strong>Conclusion: </strong>Recognizing uncertainty as a central feature of SLOE authorship underscores the need for improved alignment between clerkship evaluations and SLOE formats, clearer national calibration practices, and faculty development that supports authors in their dual roles as evaluators and mentors. Collectively, these efforts may improve the credibility and consistency of this crucial part of the EM residency application.</p>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 ","pages":"e70175"},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869715","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}