AEM Education and Training最新文献

{"title":"From Refresher Training to Longitudinal Readiness for High-Acuity, Low-Occurrence Procedures","authors":"Megan Pilcher, Weerapong Lilitwat","doi":"10.1002/aet2.70261","DOIUrl":"10.1002/aet2.70261","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025632","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":"Assessing Residency Readiness: Patterns of “Not Yet Level 1” Milestone Ratings in Emergency Medicine Interns","authors":"Sally A. Santen,&nbsp;Guiliano L. Melki,&nbsp;Amanda R. Emke,&nbsp;Yoon Soo Park,&nbsp;Michael S. Ryan,&nbsp;Sean O. Hogan,&nbsp;Anita Wilson Scott,&nbsp;Katherine Berg,&nbsp;Adnan Alseidi,&nbsp;Luan Lawson","doi":"10.1002/aet2.70259","DOIUrl":"10.1002/aet2.70259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To characterize the extent and domains of variability in Emergency Medicine (EM) residency preparedness by evaluating “Not Yet Level 1” (NotYL1) Accreditation Council for Graduate Medical Education (ACGME) Milestones ratings among US MD-graduated interns at mid-year and end-of-year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This was a national retrospective analysis of ACGME Milestone assessments for 6893 US MD-graduated EM interns from 2021 through 2024. For each of the 22 EM sub-competencies, we calculated the percentages of interns assigned a NotYL1 rating at both the mid-year and end-of-year assessment periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, NotYL1 ratings were &lt; 4%. At mid-year, the mean NotYL1 percentage across sub-competencies was 2.5% (range: 1.8%–3.3%), decreasing to 0.4% (range: 0.2%–1.0%) at end-of-year. At mid-year, the highest proportions of NotYL1 ratings were concentrated in all Systems-Based Practice (SBP) sub-competencies—including Patient Safety (SBP1; 3.0%), Quality Improvement (SBP2; 3.2%), System Navigation (SBP3; 3.0%), and the Physician Role in Health Care Systems (SBP4; 3.3%)—as well as Pharmacotherapy (PC5; 3.1%) and Accountability/Conscientiousness (PROF2; 3.2%). By end-of-year, nearly all interns achieved Level 1 or higher, though PROF2 remained the highest outlier at 1.0%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>US MD graduates demonstrate strong overall readiness for EM residency, with most initial gaps resolving by the end of the first year. However, consistent mid-year deficits in systems-based practice and professionalism (accountability/conscientiousness) highlight critical targets for undergraduate medical school accountability, transition-to-residency curricula, and targeted residency onboarding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026185","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":"Running to Stand Still: EHR Efficiency and Workload Across Emergency Medicine Residency","authors":"Carl Preiksaitis,&nbsp;Josh Hughes,&nbsp;Mark Iscoe,&nbsp;Michael Makutonin,&nbsp;Ashley Rider,&nbsp;Edward R. Melnick,&nbsp;Christian Rose","doi":"10.1002/aet2.70253","DOIUrl":"10.1002/aet2.70253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The evolution of electronic health record (EHR) burden throughout emergency medicine (EM) residency remains poorly understood. We aimed to quantify EHR use, the composition of work performed outside scheduled hours, and the development of EHR efficiency across EM training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort study of EM residents (postgraduate year [PGY] 1–4) using 5.5 years of EHR audit log data (January 2020—June 2025) at a single academic institution. We analyzed EHR time per new patient encounter by PGY, categorized by activity and work during and after scheduled shifts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis included 155,885 resident-encounters from 133 residents across 14,811 shifts. Encounter-attributed EHR time per encounter decreased by 51% from PGY-1 to PGY-4 (median 19.7 to 9.7 min, <i>p</i> &lt; 0.001) while patient volume per shift increased 71% (median 7 to 12 encounters). Concurrently, documentation time decreased 69% (9.3 to 2.9 min). Total EHR time per shift increased across training. Per-shift documentation time fell (69.2 to 37.0 min), while tracking board time nearly doubled (43.8 to 81.5 min), driven by on-shift use rising from 41.0 to 78.6 min. Work occurring outside any scheduled shift was modest and did not increase monotonically with training (median 7.8, 13.7, 12.3, and 7.3 min per shift for PGY-1 through PGY-4; <i>p</i> = 0.027), and was predominantly documentation (41%–51% of unscheduled minutes). Counting all activity in the 48 h after a shift, without excluding time the resident was scheduled to work, yielded substantially higher estimates (61.9 to 103.5 min per shift).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EM residents achieve substantial gains in per-encounter EHR efficiency, largest in documentation, but rising patient volume means total EHR time per shift increases rather than falls. Work performed outside scheduled hours is limited and is principally documentation, at least at this single institution. Monitoring these metrics may help programs identify struggling learners and evaluate interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009037","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":"Letter to the Editor: “Physician-Led Teams: A Model Curriculum for Emergency Medicine Residency”","authors":"Fatima Tahir,&nbsp;Shayan Haider","doi":"10.1002/aet2.70218","DOIUrl":"10.1002/aet2.70218","url":null,"abstract":"<div>\u0000 \u0000 <p>We read with interest the article by Kalantari et al. proposing a physician-led team curriculum for emergency medicine residency training. While the curriculum addresses an important gap in leadership and supervision training and aligns with competency-based medical education principles, several methodological limitations warrant consideration. The curriculum was not piloted or prospectively evaluated, limiting evidence of its effectiveness in improving leadership behaviors, team communication, or patient safety outcomes. In addition, the absence of interprofessional stakeholder involvement during curriculum development may reduce its applicability to real-world team-based emergency care. Furthermore, the lack of validated assessment tools raises concerns regarding the reliability and standardization of competency evaluation across training programs. We suggest that future studies implement multicenter prospective evaluations using validated assessment instruments and objective performance metrics to establish educational impact and enhance generalizability.</p>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008984","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":"Establishment of Core Entrustable Professional Activities for Advanced Emergency Medicine Ultrasonography Fellowship Using a Nominal Group Technique","authors":"Di Coneybeare,&nbsp;Stephen Alerhand,&nbsp;John Bailitz,&nbsp;Onyinyechi Eke,&nbsp;Rachel Liu,&nbsp;Holly Caretta-Weyer,&nbsp;Lindsay Taylor,&nbsp;Lori Stolz,&nbsp;Srikar Adhikari,&nbsp;Petra Duran-Gehring,&nbsp;Teresa Liu,&nbsp;Michael Gottlieb","doi":"10.1002/aet2.70254","DOIUrl":"10.1002/aet2.70254","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Advanced Emergency Medicine Ultrasonography (AEMUS) has become a recognized subspecialty within Emergency Medicine, yet no unified national curriculum or assessment framework exists for fellowship training. As competency-based medical education develops, entrustable professional activities (EPAs) offer a structured approach to defining essential tasks, guiding curriculum design, and standardizing assessment. To support high-quality, equitable AEMUS fellowship training, the Education Committee of the Society of Clinical Ultrasound Fellowships (SCUF) convened a diverse expert panel to develop core EPAs for AEMUS fellows.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We employed a modified virtual nominal group technique (vNGT) to achieve expert consensus. Eleven AEMUS education leaders participated between July 2024 and June 2025. Prior to the initial session, panelists reviewed curated literature and independently generated EPA ideas. During structured virtual meetings, participants engaged in round-robin idea sharing, clarification, and discussion, guided by existing national AEMUS standards of certification and program accreditation. Ideas were subsequently subjected to iterative voting, with ≥ 80% agreement required for acceptance. Three vNGT rounds were conducted. Accepted EPAs were further refined by assigned primary editors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The expert panel produced 15 core EPAs spanning four established domains: Administration, education, sonography skills, and scholarship. Professionalism was designated as its own domain. Panel deliberations focused on feasibility within a one-year fellowship, post-graduation scope of practice, and variability in program resources. The group endorsed a modified entrustment scale tailored to AEMUS to guide assessment across EPAs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Using a structured consensus process, we developed the first EPA-based framework for AEMUS fellowship training. These EPAs provide a foundational curriculum and assessment structure intended to support program rigor, promote national consistency, and prepare fellows for independent advanced practice and leadership in clinical ultrasound.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991689","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":"Serious Illness Communication in Emergency Medicine: A Badge Card for Practice and Teaching","authors":"Margaret Putman","doi":"10.1002/aet2.70252","DOIUrl":"https://doi.org/10.1002/aet2.70252","url":null,"abstract":"&lt;p&gt;Emergency physicians regularly encounter patients with life-limiting illness who need support navigating complex medical decisions. Serious illness communication (SIC) to elicit preferences, clarify values, and promote shared decision making is integral to emergency medicine (EM) practice, and the American Board of Emergency Medicine (ABEM) 2026 certifying exam now includes dedicated communication cases [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Existing SIC frameworks including REMAP and the Serious Illness Conversation Guide were originally designed for established relationships and scheduled conversations [&lt;span&gt;2, 3&lt;/span&gt;]. EM-specific conversation guides exist but function as detailed protocols for specific clinical scenarios [&lt;span&gt;4&lt;/span&gt;]. This two-sided badge card distills evidence-based SIC frameworks [&lt;span&gt;2-4&lt;/span&gt;] into a portable clinical and teaching tool for any SIC, aligned with EM palliative care competencies [&lt;span&gt;5, 6&lt;/span&gt;]. (Figure 1).&lt;/p&gt;&lt;p&gt;The framework is described below:&lt;/p&gt;&lt;p&gt;Before delivering difficult news, ask the patient or family what they already know [&lt;span&gt;7&lt;/span&gt;]. This orients the clinician and identifies knowledge gaps (“What have you been told about your illness?”).&lt;/p&gt;&lt;p&gt;Deliver the news using a headline—a concise statement pairing the medical information with its meaning for the patient [&lt;span&gt;2&lt;/span&gt;]. This should be free of jargon and include the impact on the patient's life. (“Your dad has a serious infection and his organs are shutting down. I'm worried he is dying.”).&lt;/p&gt;&lt;p&gt;Respond to emotion using NURSE statements (Naming, Understanding, Respecting, Supporting, Exploring) [&lt;span&gt;7&lt;/span&gt;]. After delivering difficult news, the first response from the patient/family is likely emotion, even if it sounds like a cognitive statement or question. Respond to the underlying emotion first, as it is difficult to process information in a heightened emotional state.&lt;/p&gt;&lt;p&gt;Explore values by asking questions until you understand what matters most to the patient. “I wish/I worry” is language that can be used anywhere in the conversation: to align with the patient while delivering difficult news honestly, to respond when someone says “there must be more you can do,” and to bridge into values exploration [&lt;span&gt;3, 7&lt;/span&gt;] (“I wish things were different. I worry that if we don't talk about this now, we won't be prepared.”).&lt;/p&gt;&lt;p&gt;Summarize before recommending. Reflect back what you heard and confirm before moving forward (“I heard you say… is that right?”).&lt;/p&gt;&lt;p&gt;Make a recommendation grounded in the patient's values. Lead with what you will do before saying what you won't [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The card has been distributed at national conference events (AAEM Scientific Assembly, 2023) and incorporated into didactic curricula at multiple institutions, though formal evaluation of its impact has not been conducted. Before a family meeting, the learner can review the card and identify one skill to practice; afterward, the ","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.70252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943220","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":"Observing Clinical Efficiency: A First Step to Fill a Clinical Education Gap in Emergency Medicine","authors":"Michael C. Overbeck,&nbsp;Bonnie Kaplan,&nbsp;Gannon Sungar,&nbsp;Christy Angerhofer,&nbsp;Shilpa Raju,&nbsp;Megan Fix,&nbsp;Jeff Druck","doi":"10.1002/aet2.70247","DOIUrl":"10.1002/aet2.70247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emergency medicine (EM) demands high levels of clinical efficiency in dynamic clinical environments, yet few tools exist to support educators in assessing and coaching residents on efficiency behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To develop and pilot an observational domain-based assessment to characterize and assess individual resident clinical efficiency behaviors during emergency department (ED) shifts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Innovation</h3>\u0000 \u0000 <p>We created and refined a structured clinical efficiency audit tool through expert consensus and direct observation of EM residents during clinical shifts. The tool was designed to identify specific, observable domains of efficient behavior for use in coaching and formative feedback.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Impact</h3>\u0000 \u0000 <p>The domain-based assessment revealed common patterns of time use and facilitated targeted feedback. It offers promise as a framework for assessing and discussing resident efficiency behaviors. Further validation is required, but this model can support educators seeking structured, behavior-based clinical feedback tools.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931682","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":"Scholarly Productivity of Emergency Ultrasound Fellowship Directors: A National Cross-Sectional Analysis","authors":"Lachlan Driver,&nbsp;Leland Perice,&nbsp;Trent She,&nbsp;Joseph R. Pare","doi":"10.1002/aet2.70251","DOIUrl":"10.1002/aet2.70251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The updated 2026 American Board of Emergency Medicine (ABEM) approved Advanced Emergency Medicine Ultrasonography requirements specify that fellowship directors must demonstrate scholarly activity through ≥ 5 first-, second-, or last-author publications. Contemporary data describing scholarly productivity among emergency ultrasound fellowship directors (EUSFDs) is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a cross-sectional study of U.S. emergency ultrasound fellowship programs listed by the Society of Clinical Ultrasound Fellowships (SCUF). Publication histories were identified through PubMed, the SCUF website, MedEdPORTAL, and ACEP (American College of Emergency Physicians) Sonoguide. Qualifying publications included original research, reviews, editorials, educational scholarship, and other PubMed-indexed work. The primary outcome was the proportion of EUSFDs meeting the 2026 publication benchmark of ≥ 5 first-, second-, or last-author emergency ultrasound publications. Multivariable logistic regression evaluated factors associated with meeting this threshold.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 134 eligible programs, EUSFDs had a median of 3 years in their role (IQR 1–6) and 1 qualifying publication (IQR 0–4). Twenty-six directors (19.4%) met the 2026 publication benchmark based on identified publications. Fifty-seven (42.5%) had at least one first-author publication, and 70 (52.2%) had at least one first- or last-author publication. Under the 2011 requirements, 56 directors (41.8%) met publication criteria. Interrater agreement was high (kappa = 0.895). Each additional year as a fellowship director was associated with 12% greater odds of meeting the publication threshold (aOR 1.12, 95% CI 1.02–1.24).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among U.S. EUS fellowship programs, one in five EUSFDs met the 2026 publication benchmark based on identified publications. Longer-serving directors were more likely to meet the publication benchmark, although this association may reflect career duration or prior scholarly productivity. As expectations for fellowship leadership evolve, national efforts focused on mentorship, support, collaboration, and protected time may help support scholarly development and facilitate attainment of these standards.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913431","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":"Financial Implications of the Updated ACGME Requirements for Emergency Medicine Residency Programs","authors":"Douglas McGee,&nbsp;Mary Jo Wagner","doi":"10.1002/aet2.70245","DOIUrl":"10.1002/aet2.70245","url":null,"abstract":"<p>The newly posted 2026 Emergency Medicine (EM) Program Requirements by the Accreditation Council of Graduate Medical Education (ACGME) creates both financial challenges and opportunities for programs and hospitals. The complexity of the federal government funding of GME through Centers for Medicare and Medicaid Services (CMS) makes it difficult for program and institutional Graduate Medical Education (GME) leaders to identify the financial implications of changes in clinical EM operations and curriculum design. Institutional initiation of a change in program format is best implemented with an understanding of the hospital's financial priorities. In this concept paper, we discuss steps to clearly identify the financial impact of the EM residency program format on CMS funding and program complement size. We also provide clarifications on the new ACGME required programmatic changes and their impact on EM residency funding.</p>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907443","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":"Looking Inward: Examining Intrinsic Motivators and Barriers to POCUS Among High and Low Utilizers","authors":"Elizabeth J. Yetter,&nbsp;Elizabeth Singer,&nbsp;Adrienne Yarnish,&nbsp;Trent She,&nbsp;Bret Nelson,&nbsp;Pascal W. M. van Gerven,&nbsp;Sanne Schreurs,&nbsp;Michael Gottlieb","doi":"10.1002/aet2.70248","DOIUrl":"10.1002/aet2.70248","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Point-of-care ultrasound (POCUS) is an integral component of patient care in the emergency department. However, there is wide variation in POCUS utilization among residents, with some struggling to achieve the amount required for their education. We conducted a qualitative study of emergency medicine residents to identify barriers and strategies for POCUS use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a constructivist approach with a deductive framework based on self-determination theory (SDT), we performed semi-structured qualitative interviews with 16 PGY 2–4 residents divided into high versus low utilizers from four different training programs. A codebook was iteratively developed with two coders, and thematic saturation was reached.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both high and low utilizers experienced competence, autonomy, and relatedness, but also incompetence, feeling like a burden on the team, and lack of autonomy. Notably, respondents who experienced incompetence associated a lack of mentorship and exposure with this feeling. Low-utilizer participants who experienced incompetence suggested they would avoid opportunities for deliberate practice. Junior low-utilizer residents were concerned that they were a burden to the team if they asked for guidance, compounding feelings of incompetence and making the pursuit of feedback in deliberate practice less likely. However, learners acknowledged the importance of performing POCUS and the benefits it could bring to the team.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Several key themes were identified regarding intrinsic motivation, with differences between high and low utilizers. Programs would benefit from tailoring POCUS curricula to bolster the SDT needs, with a focus on increased faculty support, hands-on experiences, and enhanced exposure to pathology, providing opportunities for deliberate practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"10 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897883","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}