AEM Education and Training最新文献

{"title":"Directed image review technique (DIRT): A framework for ultrasound image assessment and interpretation","authors":"Arthur T. Broadstock MD,&nbsp;Jessica Baez MD,&nbsp;Patrick G. Minges MD,&nbsp;Meaghan Frederick MD,&nbsp;Lori A. Stolz MD","doi":"10.1002/aet2.11036","DOIUrl":"10.1002/aet2.11036","url":null,"abstract":"<p>Use of point-of-care ultrasound (POCUS) is integral to the practice of emergency medicine, and POCUS education is a required component of emergency medicine training. Developing POCUS skills requires iterative deliberate practice of image acquisition and interpretation. Providing feedback to learners regarding ultrasound image interpretation can be challenging for emergency medicine clinician educators. We present a framework called the directed image review technique. This framework guides learner ultrasound image interpretation and provides educators with a similar structured approach to evaluate a learner's ultrasound competency and provide targeted feedback regarding image acquisition and interpretation.</p>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509752","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":"The impact of a prehospital simulation on medical students’ resourcefulness, personal growth initiative, and uncertainty tolerance","authors":"Rebekah Cole PhD, MEd,&nbsp;Elizabeth Pearce MA,&nbsp;Amy F. Hildreth MD, MHPE,&nbsp;Xiao Ren MS, FACHE,&nbsp;Leslie Vojta MD","doi":"10.1002/aet2.11032","DOIUrl":"https://doi.org/10.1002/aet2.11032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emergency medicine (EM) physicians often practice in dynamic, high-stress, and uncertain settings with limited resources. Although simulation has been shown to enhance various aspects of student development, its impact on medical students' personal growth initiative, resourcefulness, and tolerance of uncertainty—crucial traits for managing future crises as emergency physicians—remain unclear. The purpose of this study, therefore, was to determine a high-fidelity prehospital simulation's impact on medical students' resourcefulness, personal growth, and tolerance of uncertainty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We surveyed 107 fourth-year medical students before and after a multiday, high-fidelity prehospital simulation. The survey included items from the Intolerance of Uncertainty Scale-12 Item Form, the Personal Growth Initiative Scale, and the Resourcefulness Skills Scale. We compared students' pre- and post-simulation responses to investigate any change in their uncertainty intolerance, personal growth initiative, and resourcefulness following simulation participation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Students’ scores significantly increased following the simulation for both resourcefulness (<i>t</i>(106) = −6.89, <i>p</i> &lt; 0.001, <i>d</i> = −0.67) and personal growth initiative (<i>t</i>(106) = −6.22, <i>p</i> &lt; 0.001, <i>d</i> = −0.60). Effect size calculations suggest that participating in the simulation had a medium to large effect on participants’ resourcefulness and personal growth initiative. However, participants’ tolerance of uncertainty scores prior to and following the simulation did not significantly differ (<i>t</i>(106) = 1.66, <i>p</i> = 0.100, <i>d</i> = 0.16), indicating that the simulation had little effect on participants’ tolerance of uncertainty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results indicate that simulation is a promising educational tool for developing students' resourcefulness and personal growth initiative so they can navigate high-stress, low-resource environments. Follow-on research is needed to determine how to leverage simulation to enhance students’ uncertainty tolerance in high-stress, low-resource environments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142449216","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":"Beyond the symptoms: Team-based learning for social determinants in emergency medicine training","authors":"Layla S. Abubshait MD,&nbsp;Sandra Guirguis MD,&nbsp;Savannah Pocquette DO,&nbsp;Timothy Cofer DO,&nbsp;Angelina Omodt-Lopez MD","doi":"10.1002/aet2.11030","DOIUrl":"https://doi.org/10.1002/aet2.11030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emergency departments serve as the front line for individuals facing acute health needs, often compounded by social determinants of health (SDoH). Integrating SDoH into emergency medicine care is vital for promptly addressing health concerns and averting future crises. This curriculum adopts a team-based approach to train emergency medicine residents in identifying and addressing SDoH, thereby delivering comprehensive and equitable care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The curriculum employs various educational strategies, including presession readings, SDoH introductions, case simulations, debriefing sessions, panel discussions, and collaboration with other health care professionals. Evaluation via pre- and postcurriculum surveys revealed substantial enhancements in residents' comprehension, identification, and familiarity with local resources related to SDoH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings indicated an uptick in residents' grasp and acknowledgment of SDoH, alongside their capacity to address these factors. Posttraining Likert scores exhibited notable improvements across all domains, underscoring an augmented ability to manage SDoH in clinical practice. This curriculum amplifies residents' capability to deliver patient-centric care and advocate for health equity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Continuous refinement and assessment are paramount for ensuring residents' readiness to navigate the intricate social determinants affecting patients' well-being. Ultimately, this curriculum heralds a pivotal stride toward fostering health equity and refining patient care standards within emergency medicine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435744","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":"Gamification in cost awareness education: Promising approach, methodological considerations","authors":"Altuğ Kanbakan MD","doi":"10.1002/aet2.11033","DOIUrl":"https://doi.org/10.1002/aet2.11033","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142430010","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":"Pendulating pain","authors":"Antonio Yaghy MD","doi":"10.1002/aet2.11031","DOIUrl":"https://doi.org/10.1002/aet2.11031","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142429979","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 evaluation of video-assisted debriefing for improving performance in simulated medical student resuscitations","authors":"James VandenBerg MD, MSc,&nbsp;Henry Moss DO,&nbsp;Courtney Wechsler MD,&nbsp;Chelsea Johnson MD,&nbsp;Matthew McRae MD,&nbsp;Shawn Sloan MD,&nbsp;Trifun Dimitrijevski MD,&nbsp;Sarkis Kouyoumjian MD,&nbsp;Jeffrey A. Kline MD,&nbsp;Anne Messman MD, MHPE","doi":"10.1002/aet2.11029","DOIUrl":"https://doi.org/10.1002/aet2.11029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Simulation-based training is commonly used in medical education. However, there is a gap in knowledge regarding best practices in debriefing. We aimed to identify novel solutions to this by adapting video-assisted debriefing (VAD) methodologies used in athletic training. We hypothesized that utilizing VAD would lead to improvements in performance during advanced cardiac life support (ACLS)-based simulations compared to traditional verbal debriefing (VD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was conducted at a single medical school. Participants were fourth-year medical students engaging in ACLS simulation-based training as part of their emergency medicine rotation. After completing an ACLS-based simulation, participants received either VD or VAD and then completed a second simulation scenario. Our primary outcome was ACLS performance, graded by blinded reviewers utilizing a previously developed modified checklist. Secondary outcomes included time from cardiac arrest to initiation of cardiopulmonary resuscitation (CPR) and first defibrillation. Measurements were made before and after the interventional debrief, referred to as pre- and postdebrief. A modified Likert-scale survey was used to subjectively assess the student's overall experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-six groups of 275 students were included in the study. Mean ACLS performance score for VD and VAD postdebrief were 85% and 82%, respectively (<i>p</i> = 0.27). Mean time from arrest to CPR initiation for VD and VAD postdebrief groups were 20 and 24 s, respectively (<i>p</i> = 0.46). Mean time from arrest to defibrillation for VD and VAD postdebrief groups were 50 and 59 s, respectively (<i>p</i> = 0.39). For the Likert surveys, 85% or more of participants in both groups indicated that the session was “very helpful” in all survey categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VD and VAD both led to improvements in ACLS performance, time to initiation of CPR, and defibrillation among fourth-year medical students. Though postdebrief results were not statistically significantly different by comparison, overall VD led to greater improvement overall across all outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142430009","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":"PGY-2 emergency medicine residents are more efficient when paired with an early clinical medical student","authors":"Nicole Liang,&nbsp;Corlin M. Jewell MD,&nbsp;Dann J. Hekman MS,&nbsp;Christopher Shank MA,&nbsp;Benjamin H. Schnapp MD, Med","doi":"10.1002/aet2.11028","DOIUrl":"10.1002/aet2.11028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>There is a concern that provide increased extraneous cognitive load when paired with residents on shift. However, this may be offset by the decrease in extraneous load they may provide to the residents they are paired with by offloading basic patient care tasks. We hypothesized that these forces may not be balanced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective observational analysis of PGY-2 emergency medicine residents and junior medical students at a single academic emergency department (ED) in the Midwest. A series of efficiency metrics (relative value unit [RVUs], patients per hour [PPH], time to note completion, and resident assignment to disposition [RATD]) as well as one quality metric (number of return ED visits; “bouncebacks”) were compared for resident shifts in which a student was paired with the resident as well those in which no student was paired utilizing a regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1844 records met the inclusion criteria (214 shifts with a paired medical student and 1630 without). After covariates were adjusted for, medical student shift status was a statistically significant predictor of increases in PPH (<i>p</i> &lt; 0.0001) and RVUs (<i>p</i> = 0.0161) but was not significantly associated with RATD (<i>p</i> = 0.6941), log-time to note completion (<i>p</i> = 0.1604), or bounceback status (<i>p</i> = 0.9840). Shifts where residents were paired with medical students were predicted to see an additional 1.131 (95% confidence interval [CI] 0.660–1.602) PPH and produce an additional 1.923 RVUs (95% CI 1.130–3.273) per shift relative to shifts without medical students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>When junior medical students were paired with a PGY-2 resident on ED shifts, there was a significant increase in the PPH and RVUs generated when compared with shifts in which no medical student was paired with them.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381888","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":"SPARK mentorship program for emergency services assistants underrepresented in medicine interested in physician assistant programs","authors":"Aline Snietka MS, PA-C,&nbsp;Carl Preiksaitis MD,&nbsp;Catalina González-Marqués MD, MPH,&nbsp;Adaira Landry MD, MEd","doi":"10.1002/aet2.11025","DOIUrl":"https://doi.org/10.1002/aet2.11025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Increasing diversity in the health care workforce has been shown to improve patient health care and create psychological safety for employees who feel marginalized and underrepresented. While several measures exist for increasing racial and ethnic diversity in the physician workforce, few programs target expanding representation among physician assistants (PAs). Despite increasing the role and responsibility of PAs in the emergency department (ED), there remains a significant lack of diversity within this group. The SPARK mentorship program, a combined mentorship and educational opportunity for emergency services assistants (ESAs; also called aides and technicians) who are underrepresented in medicine (UiM), may create a pathway to recruiting diverse individuals to PA careers in emergency medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our goal was to implement and evaluate a combined didactic and mentorship curriculum focused on recruiting ESAs UIM to become PAs in the ED. Using Kern's framework, an interprofessional group created a 3-month mentorship program including individualized mentorship from senior PAs, didactic content covering the roles of PAs in the ED, and strategies to apply to PA school. This curriculum was implemented in 2022 for five ESAs following an application process. Outcomes were measured using the NIH Mentoring Evaluation Form and Munich Evaluation of Mentoring Questionnaire as well as longitudinal monitoring after the program to determine progress of ESAs toward a career as PAs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All five mentees completed the mentorship program. Postprogram surveys showed all participants described the program as meeting their expectations and being goal oriented. One-year follow-up demonstrated progress in all participants along their desired career path.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The SPARK mentorship program appears to be a feasible approach to creating a pathway for recruitment of ESAs UIM into the PA profession. Preliminary outcome data suggest that this curriculum was highly acceptable to participants and may have a positive impact on recruiting ESAs to become PAs. Continued evaluation is needed to determine what effect programs such as this one have on increasing diversity in the PA workforce.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316880","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":"Educator's blueprint: Key considerations for using social media in survey-based medical education research","authors":"Kathleen Y. Ogle MD,&nbsp;Jeffery Hill MD, MEd,&nbsp;Sally A. Santen MD, PhD,&nbsp;Michael Gottlieb MD,&nbsp;Anthony R. Artino Jr. PhD,&nbsp;Brent Thoma MD, PhD","doi":"10.1002/aet2.11026","DOIUrl":"https://doi.org/10.1002/aet2.11026","url":null,"abstract":"<p>In this paper, we present a set of recommendations for using social media as a tool for participant recruitment in survey-based medical education research. Drawing from a limited but growing body of literature, we discuss the opportunities and challenges inherent to social media recruitment. This article builds on the authors’ previous educator's blueprints about survey design and administration. We highlight the advantages of social media, including its wide reach, cost-effectiveness, and capability to access diverse and geographically dispersed populations, which can significantly enhance the representativeness of research samples. However, we also caution against potential pitfalls, such as ethical concerns, sampling bias, and the fluid nature of social media platforms. Our recommendations are informed by both empirical evidence and best practices, aiming to provide researchers with practical advice for effectively leveraging social media in survey-based medical education research. We emphasize the importance of selecting suitable platforms and engaging with targeted demographics thoughtfully. By sharing our insights, we hope to assist fellow medical education researchers in navigating the complexities of social media recruitment, thereby enriching the quality and impact of survey-based research in this field.</p>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316671","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":"Evaluation of learning in emergency medicine: An umbrella IRB protocol for education outcomes research","authors":"Robbie Paulsen MD,&nbsp;Jeffery Hill MD,&nbsp;Erin McDonough MD,&nbsp;Natalie Kreitzer MD,&nbsp;Emily Werff,&nbsp;Brittney Hahn,&nbsp;Sally A. Santen MD, PhD","doi":"10.1002/aet2.11027","DOIUrl":"https://doi.org/10.1002/aet2.11027","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142313377","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}