AEM Education and Training最新文献

{"title":"Assessor Personality Traits Are Not Educationally Important Drivers of Assessor Stringency/Leniency","authors":"Sebastian Dewhirst,&nbsp;Nora D. Szabo,&nbsp;Jason R. Frank","doi":"10.1002/aet2.70074","DOIUrl":"https://doi.org/10.1002/aet2.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Assessor stringency/leniency (ASL), the tendency for an assessor to consistently provide low or high scores, has been shown to have educationally important effects on learner assessment scores in multiple settings. To date, there is no clear understanding of the underlying drivers of ASL in the context of medical education. Some authors have hypothesized a link between personality traits and ASL, but there is currently insufficient data to reach any conclusions. This study seeks to determine whether there is a significant association between physician assessors' personality traits and ASL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort study was conducted at an academic emergency department in Ottawa, Canada. Participating assessors volunteered to complete the IPIP-Neo 120, a personality questionnaire based on the five-factor model. All end-of-shift assessments completed between July 1, 2021, and June 30, 2022, were collected, and ASL was quantified for each assessor using the mean delta method. Linear regression was used to assess the correlation between personality scores and ASL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2127 assessments, representing 184 learners, were analyzed. Twenty-five assessors were enrolled, with a wide distribution of assessor personality scores for each trait. While there was a trend toward leniency with increasing assessor extraversion, this did not reach statistical significance (<i>p</i> = 0.07, <i>R</i>² = 0.13). There was no significant link between other personality traits and ASL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Integrating our findings with the existing literature, we conclude that personality traits are likely not educationally important drivers of ASL in medicine. Future research should examine other possible contributors to ASL in medical education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687974","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":"The Challenges of a Necessary Increase in Pediatric Training During Emergency Medicine Residency","authors":"Eva M. Delgado,&nbsp;Regina L. Toto","doi":"10.1002/aet2.70079","DOIUrl":"https://doi.org/10.1002/aet2.70079","url":null,"abstract":"&lt;p&gt;Included in the major revisions recently proposed by the Accreditation Council for Graduate Medical Education (ACGME) to the program requirements for residency training in Emergency Medicine (EM) are recommendations for increased training in pediatric emergency care [&lt;span&gt;1&lt;/span&gt;]. Currently, most children seeking emergency care in the United States present to general emergency departments (EDs), where they are cared for by the graduates of residency programs that require only 5 months of pediatric training [&lt;span&gt;2&lt;/span&gt;]. Making the case for this attention to pediatric education are needs assessments and case logs, in which graduates report feeling unprepared or are found to lack exposure to pediatric ages or conditions that they might encounter in practice [&lt;span&gt;3, 4&lt;/span&gt;]. The ACGME's emphasis on infants and children under 12 years, with a specific aim to achieve exposure to neonatal resuscitation, seems to address reports that younger ages are the most anxiety provoking for EM physicians [&lt;span&gt;5, 6&lt;/span&gt;]. Everything proposed by the ACGME is logical and important, but the feasibility of attainment is another matter. The reality is that exposure to specific aspects of pediatric EM is impossible to guarantee, and varied interpretation of the suggestions incites confusion and concern in the medical educators responsible for making these changes. Compliance with the new recommendations poses challenges that we must recognize and address in order to do what is right for future trainees and the young patients they will care for.&lt;/p&gt;&lt;p&gt;The first challenge many programs will encounter is reliable access to both sufficient pediatric patients and sufficient pediatric expertise. While residents will be able to count pediatric patients seen in community ED settings toward the total time required, most EDs care for fewer than 15 children per day and more rural settings see fewer than five children per day [&lt;span&gt;7, 8&lt;/span&gt;]. In a proposed edit to the ACGME recommendations, the Emergency Medicine Residents' Association (EMRA), which is supportive of the recommendation for 24 weeks of pediatrics during training, suggests 1000 pediatric encounters and 18 weeks of pediatric ED time [&lt;span&gt;9&lt;/span&gt;]. They note that this amounts to 1.23 children per hour over 18 weeks. It remains to be seen if either metric is achievable in a variety of settings, especially if the new focus is on children under 12 years old.&lt;/p&gt;&lt;p&gt;Furthermore, many communities lack access to inpatient pediatric care, leaving EM residencies in these areas a dearth of learning opportunities [&lt;span&gt;10&lt;/span&gt;]. As a result, both travel to and volume of trainees at certain pediatric sites will increase, which creates its own set of challenges. The ACGME is aware that being away from home during training is a burden: there is language in the program requirements advising that accredited rotation sites over 60 miles, or 30 min, from the home institution must be approved by the Residency R","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687976","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":"Epinephrine Dosing by Emergency Medicine Residents During a Simulated Prehospital Pediatric Cardiac Arrest","authors":"Henry J. Higby,&nbsp;John D. Hoyle Jr.,&nbsp;Joshua D. Mastenbrook,&nbsp;Philip A. Pazderka,&nbsp;Sarah Fichuk,&nbsp;Austin Wilkinson,&nbsp;Caleb Porter","doi":"10.1002/aet2.70073","DOIUrl":"https://doi.org/10.1002/aet2.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pediatric prehospital dosing errors occur at high rates, up to 60% for epinephrine. Senior emergency medicine residents (EMR) in the Western Michigan University Homer Stryker MD School of Medicine (WMed) residency respond as EMS physicians to cardiac arrests in Kalamazoo County. We sought to determine error rates for weight estimation, epinephrine doses, dose administration mechanics, and esophageal intubation (EI) recognition by EMRs at the end of the PGY-1 year, during EMS physician training summative testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixteen PGY-1 EMRs were observed during a simulation: 5-year-old with an EMS EI in asystole requiring multiple epinephrine administrations by the EMR. All EMRs had completed Pediatric Advanced Life Support (PALS). Two observers scored performance. Scenarios were recorded. Recordings and scores were reviewed and discussed by observers. Any disagreements were resolved by consensus. Dosing error was defined as &gt; 20% difference from the correct dose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All EMRs obtained correct weight with 15 (94%; 72.0%, 99.0%) using length-based tape (LBT) and one (6%) guessing. Four near-miss errors occurred with the LBT. Four (25%) and two (12.5%) of the first and second epinephrine doses, respectively, were incorrect. Five (50%) errors occurred using graduations on the preloaded syringe, and five (50%) were due to air bubbles in the administration syringe. There were no ten-fold errors. Three (19%) EMRs took 3 attempts to assemble the preloaded syringe, six (38%) did not screw the preloaded syringe together correctly, seven (44%) had difficulty attaching a stopcock to the preloaded syringe, and 14 (88%) did not prime the stopcock. One (6%) failed to recognize EI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PALS-certified PGY-1 EMRs, accurately estimated patient weight, had a high rate of epinephrine dosing errors and frequent difficulty assembling preloaded syringes. To address these errors, training will be developed that includes a checklist, LBT use, weight determination hierarchy, assembling epinephrine preloaded syringes, techniques for appropriate dose administration, and recognition of EI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687911","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":"Correction to “Evaluating the Role of Traditional and Nontraditional Educational Resources in Point-of-Care Ultrasound Training: A Cross-Sectional Survey of Educator Preferences and Practices”","authors":"","doi":"10.1002/aet2.70075","DOIUrl":"https://doi.org/10.1002/aet2.70075","url":null,"abstract":"<p>Broadstock A, Kalantari A, Dessie AS, et al. Evaluating the role of traditional and nontraditional educational resources in point-of-care ultrasound training: A cross-sectional survey of educator preferences and practices. <i>AEM Educ Train</i>. 2025; 9:e70039. doi:10.1002/aet2.70039</p><p>In the article cited above, the affiliation for Dr. Resa Lewiss is incorrectly listed as “Departments of Emergency Medicine and Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.”</p><p>The correct affiliation should be “Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.”</p>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503258","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":"Development and Initial Validity Evidence for the EvaLeR Tool: Assessing Quality of Emergency Medicine Educational Resources","authors":"Carl Preiksaitis,&nbsp;Rachel Barber,&nbsp;Holly Caretta-Weyer,&nbsp;Sara Krzyzaniak,&nbsp;Teresa M. Chan,&nbsp;Michael A. Gisondi","doi":"10.1002/aet2.70063","DOIUrl":"https://doi.org/10.1002/aet2.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emergency medicine (EM) residents increasingly favor digital educational resources over traditional textbooks, with studies showing over 90% regularly using blogs, podcasts, and other online platforms. No standardized instruments exist to comparatively assess quality across both formats, leading to uncertainty in resource selection and potential inconsistencies in learning. We developed the Evaluation of Learning Resources (EvaLeR) tool and gathered initial validity evidence for its use in assessing both textbooks and digital EM educational resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This two-phase mixed-methods study developed the EvaLeR tool and gathered validity evidence for its use. Phase 1 comprised a systematic literature review, quality indicator analysis, and expert consultation. In Phase 2, 34 EM faculty evaluated 20 resources (10 textbook chapters, 10 blog posts) using EvaLeR. We collected evidence for reliability, internal consistency, and relationships with other variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The EvaLeR tool showed excellent average-measure reliability (Intraclass correlation coefficient = 0.97, 95% CI [0.94–0.99]). We found high internal consistency (Cronbach's <i>α</i> = 0.86) and moderate correlation with educator gestalt ratings (<i>r</i> = 0.53, <i>p</i> &lt; 0.001). The tool performed similarly across resource types, with no significant differences between textbook chapters (13.34/18, SD 3.41) and digital resources (13.21/18, SD 3.25; <i>p</i> = 0.62).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Initial validity evidence supports the use of EvaLeR for quality assessment of both textbooks and digital EM educational resources. This tool provides educators with an evidence-based approach to resource selection, moving beyond format-based assumptions to focus on content quality, and represents the first standardized instrument for comparative evaluation across educational resource formats.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482365","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":"Educational Download: Examinations Over Time by the Numbers","authors":"Sally A. Santen,&nbsp;Jessica Baez,&nbsp;Susan Promes,&nbsp;Anne Messman","doi":"10.1002/aet2.70061","DOIUrl":"https://doi.org/10.1002/aet2.70061","url":null,"abstract":"<p>Standardized examinations such as the United States Medical Licensing Examination (USMLE) and American Board of Emergency Medicine Qualifying Examination (ABEM-QE), the written examinations, serve as measures of medical knowledge and application of knowledge to patient care. These are intended to serve as gateways to licensure and practice and thus serve as key outcomes for training in Emergency Medicine (EM).</p><p>Flynn observed that over the past decades, there has been an increase in scores on some standardized tests, such as the Intelligence Quotient (IQ) tests [<span>1</span>]. Similarly, USMLE Step 2 scores have been rising [<span>2</span>]. Starting before COVID and amplified during COVID, EM has seen a decrease in scores on EM-specific first-time examinations, which is concerning [<span>3</span>].</p><p>The purpose of this Educational Download is to provide a <i>snapshot</i> of examination scores over the continuum of training. Thus, we follow a cohort of trainees from USMLE Steps 1 and 2 (and COMLEX 1 and 2) [<span>4</span>], through In-Training Examination (ITE) scores to board qualification (the written ABEM-QE). We followed the index cohort through their series of examinations (assuming a 3-year residency program).</p><p>Since the change of Step 1 to pass/fail, pass rates have decreased while Step 2 pass rates and scores are high. Importantly, there are decreases in EM ITE and ABEM-QE scores and pass rates during and since COVID.</p><p>One caveat is that the majority of these examinations are equated, a process by which scores from one test may be weighted so as to have equal meaning with scores from another test. Another limitation is that some examinations report on the calendar year (December–January) while others report on the academic year (July–June); exact alignment of the scores for cohorts is not possible versus scaled scores. Scoring of examinations is imprecise, and the fluctuations in scores could be within the standard error of measurement [<span>6</span>]. Finally, some examinations have equating changes or standard settings related cut score changes that are not reflected here.</p><p><b>Sally A. Santen:</b> conceptualization; writing – original draft; visualization; writing – review and editing. <b>Jessica Baez:</b> conceptualization; writing – original draft. <b>Susan Promes:</b> conceptualization; writing – original draft; writing – review and editing. <b>Anne Messman:</b> writing – original draft; conceptualization; writing – review and editing.</p><p>Dr. Sally A. Santen is an ABEM oral board examiner and serves on a NBME committee. Dr. Anne Messman is on the NBME Council.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482369","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":"Patient Volume Requirements: Evaluation of the 2025 ACGME Proposal for Emergency Medicine Residency Programs","authors":"Carlisle E. W. Topping,&nbsp;Craig Rothenberg,&nbsp;Cameron J. Gettel,&nbsp;Rohit B. Sangal,&nbsp;Katja Goldflam,&nbsp;Andrew Ulrich,&nbsp;Pooja Agrawal,&nbsp;D. Mark Courtney,&nbsp;Arjun K. Venkatesh","doi":"10.1002/aet2.70071","DOIUrl":"https://doi.org/10.1002/aet2.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The 2025 ACGME proposed that all EM residency programs must be 4 years and achieve a minimum of 3000 patients per resident. We characterize the current residency program patient volume per resident based on the proposed requirements. Secondarily, we describe the number of programs that meet the proposed visit volume requirement and the estimated impact of the 4-year length mandate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional analysis utilizing a linked dataset of the 2023 American Hospital Association Annual Survey and 2025 EM program information from ACGME's website. Hospital zip codes were linked with Rural-Urban Commuting Area Codes. We calculated the estimated residency program patient volume per resident as proposed by ACGME. Secondarily, we calculated the estimated change in patient volume if 3-year programs converted to 4 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 286 programs, the median program patient volume was 7300 (IQR: 5190–10,207). Among the 232 (81%) 3-year programs, the median volume was 7616 (IQR: 5292–10,639), while the 54 (19%) 4-year programs demonstrated a median of 6520 (IQR: 4930–9304). Rural programs (3%) had a median patient volume of 7744 (IQR: 5453–13,209), compared to 7300 (IQR: 5190–10,207) for urban programs (97%). Nine programs (3%) were below the 3000-patient volume threshold; 7 of these were 3-year programs, and transitioning to 4 years could bring 6 above the threshold.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Currently, 97% of EM programs meet the proposed 3000-patient volume threshold, with a median volume well over double this value and similar volumes across program lengths and rurality. Transitioning from 3 to 4 years may enable all but one current 3-year program to meet the new volume requirement. Therefore, the proposed ACGME changes may not increase the minimum required clinical exposure for EM residents as originally intended and should prompt re-examination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482041","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":"Comparing Emergency Medicine and Neurology Residents in Assessing Stroke Severity Using the NIHSS","authors":"Trinidad Alcala-Arcos,&nbsp;Esther H. Chen,&nbsp;Newton Addo,&nbsp;Matthew Roces,&nbsp;Michael J. Boyle,&nbsp;Meghan Hewlett,&nbsp;Reginald Nguyen,&nbsp;Angela Wong,&nbsp;Debbie Y. Madhok","doi":"10.1002/aet2.70069","DOIUrl":"https://doi.org/10.1002/aet2.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The National Institutes of Health Stroke Scale (NIHSS) is used to assess acute stroke severity and plays a critical role in guiding treatment. There is no requirement for emergency medicine (EM) residents to be certified in NIHSS determination to assess acute stroke severity, even though they may be the primary stroke providers in future practice. We implemented NIHSS training and certification into the residency's core content in neurological emergencies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In April 2022, all EM residents and attending physicians completed a faculty-moderated, interactive NIHSS training module. In the 6-month pilot, we prospectively assessed EM and neurology residents in their NIHSS assignment, indication for thrombolytic therapy, and large vessel occlusion (LVO) diagnosis using a Qualtrics survey completed for each acute stroke activation. Mean overall NIHSS scores from EM and neurology residents were compared using Spearman's correlation. Inter-rater agreement for each clinical category and treatment decision was calculated using Cohen's <i>κ</i> coefficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-nine matched EM and neurology surveys were analyzed. Mean overall NIHSS scores were similar between EM and neurology residents, 6.6 (IQR = 2, 10) and 6.7 (IQR = 1, 10), (<i>p</i> &lt; 0.001), respectively, with substantial agreement between groups (84.4%, <i>κ</i> = 0.63). Individual NIHSS scores showed moderate to substantial agreement, except for horizontal extraocular movement (75.9%, <i>κ</i> = 0.30). There was fair agreement for indication for thrombolytic therapy (75.9%, <i>κ</i> = 0.39) and moderate agreement for LVO diagnosis and indication for embolization (82.8%, <i>κ</i> = 0.51).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Dedicated NIHSS training was effective in teaching EM residents to assess stroke severity, with moderate to substantial agreement in individual and overall NIHSS scores, except for horizontal eye movement assessment. EM residents may benefit from focused NIHSS training to support their rapid assessment of suspected stroke patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482323","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 Signaling in Emergency Medicine: Applicant Trends and Outcomes From the 2023 and 2024 Match","authors":"Andrew D. Luo,&nbsp;Christopher Zeuthen,&nbsp;Elizabeth Barrall Werley,&nbsp;Eric Shappell,&nbsp;Alexis Pelletier-Bui,&nbsp;Molly Estes,&nbsp;Megan Fix,&nbsp;Carl Preiksaitis,&nbsp;Angela P. Mihalic,&nbsp;Daniel J. Egan","doi":"10.1002/aet2.70070","DOIUrl":"https://doi.org/10.1002/aet2.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Program signals were introduced to the emergency medicine (EM) residency application process during the 2022–2023 and 2023–2024 application cycles, allowing applicants to express interest in specific programs. Despite widespread adoption, the relationship between signal usage and applicant outcomes remains poorly understood. This study evaluates patterns of signal utilization and their association with interview offers and match outcomes during the initial implementation in EM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of the Texas Seeking Transparency in Application to Residency (Texas STAR) database, examining US allopathic and osteopathic senior medical students applying to EM residency programs during two application cycles (2022–2023 and 2023–2024). We analyzed program signal (PS) distribution patterns using <i>χ</i>² testing and employed multivariable logistic regression to assess the relationship between PS usage and both interview offers and match outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 967 EM applicants across two application cycles (478 in 2022–2023, 489 in 2023–2024), who sent 1919 signals in 2022–2023 and 3170 in 2023–2024. Signal distribution was highly concentrated, with the top 10% of programs receiving 35% of all signals in both application cycles. Interview yield was higher at signaled programs (2023 cycle: 76.3%, 2024 cycle: 78.9%) compared to programs overall (2023 cycle: 51.3%, 2024 cycle: 43.5%). In logistic regression analysis, sending a program signal was associated with increased odds of receiving an interview offer (2023 cycle: OR 4.40, 95% CI 3.90–4.92; 2024 cycle: OR 3.79, 95% CI 3.42–4.14), and matching after interviewing (2023 cycle: OR 5.13, 95% CI 4.08–6.47; 2024 cycle: OR 4.94, 95% CI 3.98–6.15).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Program signals are associated with improved odds of receiving interviews and matching at EM programs. Future studies should investigate how signals affect the likelihood of receiving interview offers for applicants across different levels of competitiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482324","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":"Bridging the language gap: Simulation-based education improves communication, confidence, and knowledge for emergency medicine residents working with interpreters","authors":"William Mundo MD, MPH,&nbsp;Jacqueline Ward-Gaines MD,&nbsp;Molly Thiessen MD,&nbsp;Benjamin Li MD, MS,&nbsp;Maria Pamboukis MD,&nbsp;Emily Hopkins MSPH,&nbsp;Jean Hoffman MD,&nbsp;Maria Moreira MD,&nbsp;Jason Haukoos MD, MSc,&nbsp;Steven Lowenstein MD, MPH","doi":"10.1002/aet2.70056","DOIUrl":"https://doi.org/10.1002/aet2.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Language barriers present unique challenges to health care delivery in emergency medicine (EM). There is a gap in understanding the impact of education and training on EM residents’ ability to work effectively with interpreters. We developed and piloted a simulation to improve residents' knowledge and confidence in working with medical interpreters (MIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a pre–post quasi-experiment involving Denver Health EM residents. Participants engaged in a 120-min simulation exercise, including five 20-min scenarios involving Spanish-, American Sign Language–, Russian-, and Vietnamese-speaking standardized patients. Learning objectives focused on acquiring essential skills needed to communicate effectively with patients while working with MIs. We compared pre- and postsimulation knowledge and self-rated confidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 68 eligible EM residents, 17 (25%) participated in the elective simulation, including mostly female (71%) and non-Hispanic White (77%) individuals; most were members of the PGY-1 and PGY-2 classes (82% and 12%, respectively). English-only proficiency was reported in 82% of residents. After the simulation, participants reported increased confidence in working with MIs, accessing MIs promptly, identifying the optimal mode of interpretation, and addressing common barriers to MI use. There was improvement in identifying when family and another ad hoc interpreter may be used and understanding the differences between interpretation and translation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among EM residents, simulation-based training enhanced understanding of, and confidence with, working effectively with MIs. These results demonstrate the utility of using simulation-based learning to impart important communication skills for working with various language groups in medical training.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473009","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}