AEM Education and Training最新文献

{"title":"ChatG-PD? Comparing large language model artificial intelligence and faculty rankings of the competitiveness of standardized letters of evaluation","authors":"Benjamin Schnapp MD, MEd,&nbsp;Morgan Sehdev MD,&nbsp;Caitlin Schrepel MD,&nbsp;Sharon Bord MD,&nbsp;Alexis Pelletier-Bui MD,&nbsp;Al’ai Alvarez MD,&nbsp;Nicole M. Dubosh MD,&nbsp;Yoon Soo Park PhD,&nbsp;Eric Shappell MD, MHPE","doi":"10.1002/aet2.11052","DOIUrl":"10.1002/aet2.11052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While faculty have previously been shown to have high levels of agreement about the competitiveness of emergency medicine (EM) standardized letters of evaluation (SLOEs), reviewing SLOEs remains a highly time-intensive process for faculty. Artificial intelligence large language models (LLMs) have shown promise for effectively analyzing large volumes of data across a variety of contexts, but their ability to interpret SLOEs is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective was to evaluate the ability of LLMs to rate EM SLOEs on competitiveness compared to faculty consensus and previously developed algorithms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty mock SLOE letters were drafted and analyzed seven times by a data-focused LLM with instructions to rank them based on desirability for residency. The LLM was also asked to use its own criteria to decide which characteristics are most important for residency and revise its ranking of the SLOEs. LLM-generated rank lists were compared with faculty consensus rankings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a high degree of correlation (<i>r =</i> 0.96) between the rank list initially generated by LLM consensus and the rank list generated by trained faculty. The correlation between the revised list generated by the LLM and the faculty consensus was lower (<i>r =</i> 0.86).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The LLM generated rankings showed strong correlation with expert faculty consensus rankings with minimal input of faculty time and effort.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808282","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":"Generalizability of consensus regarding standardized letters of evaluation competitiveness: A validity study in a national sample of emergency medicine faculty","authors":"Sharon Bord MD,&nbsp;Morgan Sehdev MD,&nbsp;Alexis Pelletier-Bui MD,&nbsp;Al'ai Alvarez MD,&nbsp;Benjamin Schnapp MD, MEd,&nbsp;Nicole Dubosh MD,&nbsp;Caitlin Schrepel MD,&nbsp;Yoon Soo Park PhD,&nbsp;Eric Shappell MD, MHPE","doi":"10.1002/aet2.11049","DOIUrl":"10.1002/aet2.11049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Standardized letters of evaluation (SLOEs) are an important part of residency recruitment, particularly given the limited availability of other discerning factors in residency applications. While consensus regarding SLOE competitiveness has been studied within a small group of academic faculty, it remains unexplored how a more diverse group of letter readers interpret SLOEs in terms of competitiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A sample of 50 real SLOEs in the new SLOE format (2022 eSLOE 2.0) were selected to match the national rating distribution and anonymized. These SLOEs were ranked in order of competitiveness by 25 faculty members representing diverse demographics, geographic regions, and practice settings. Consensus levels were assessed using previously defined criteria and compared to prior results using a cutoff of ±10% to define a significant difference in consensus levels. Two models were tested to determine their ability to predict consensus rankings: a point-based system and a linear regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Faculty consensus in this diverse cohort was slightly below the level measured among academic emergency medicine faculty in the prior study, though no differences were greater than the ±10% cutoff. Prediction models also performed similarly to a previous study except at the <i>tight</i> level of agreement, where consensus was stronger in this study compared to previous results. There is greater consensus among faculty at academic institutions than at community institutions, and years of experience was not correlated with higher consensus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The degree of consensus regarding competitiveness using real SLOEs was similar in this diverse national sample compared to a prior study in a smaller and more homogenous group ranking mock SLOEs. Consensus ranks were predicted with good accuracy using both the point system and the regression model.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814508","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":"Adaptive methods for bedside teaching: Integrating cognitive apprenticeship model and social cognitive theory to elevate workplace learning","authors":"Christie Lech MD, MHPE,&nbsp;Christopher Reisig MD, MA,&nbsp;Kaushal Shah MD,&nbsp;Sara Zaidi MD,&nbsp;Di Coneybeare MD, MHPE","doi":"10.1002/aet2.11046","DOIUrl":"https://doi.org/10.1002/aet2.11046","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762497","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 requirement: A novel patient follow-up report","authors":"Jack A. Allan MD, MBA,&nbsp;Zachary Repanshek MD,&nbsp;Megan E. Healy MD,&nbsp;Michael DeAngelis MD,&nbsp;Wayne A. Satz MD,&nbsp;Jacob W. Ufberg MD,&nbsp;Kraftin E. Schreyer MD, MBA","doi":"10.1002/aet2.11042","DOIUrl":"https://doi.org/10.1002/aet2.11042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Residents are required to participate in practice-based learning and improvement. Most commonly, a resident-initiated patient follow-up log is used to meet the requirement. We sought to provide residents with follow-up information in an efficient, value-added manner via a patient follow-up report (PFUR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The PFUR is an automated monthly report sent to individual residents via email. It was generated from the electronic medical record and included five categories of cases: patients who were discharged and returned for admission within 72 h, diagnosis-based criteria, patients who expired during the hospital stay, patients who were admitted to or upgraded to the intensive care unit (ICU) within 24 h of admission, and patients independently flagged by the care team for follow-up. The PFURs were analyzed for 6 months after implementation for number and categorization of cases included as well as via survey of the residents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 6 months, 1078 patients, generating 1155 follow-ups, were included on the PFUR. ICU upgrades were the most represented category (41%), followed by diagnosis-based criteria (30%). Patients who were discharged and admitted within 72 h were least commonly represented on the PFUR (2%). Seventy-eight percent of residents felt that patient follow-ups were valuable to their education and 82% felt that the PFUR impacted the clinical care they provided. The PFUR was preferred by 90% of resident respondents and had an average value rating of 4.38 out of 5.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall numbers of patient follow-ups significantly increased after implementation of the PFUR. Certain categories were more represented overall and within each class, which has implications for future educational initiatives. After a pilot period, the novel PFUR appears to be more efficient, accessible, and highly valued than the log used previously. Programs looking to maximize the educational benefits of patient follow-ups may consider a similar initiative.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762498","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":"Development and Initial Validity Evidence for a Pregnancy Disclosure and Options Counseling Checklist in Emergency Medicine","authors":"Carl Preiksaitis MD, MEd,&nbsp;Isabel Beshar MD, MPhil,&nbsp;Valerie Dobiesz MD, MPH,&nbsp;Stacey Frisch MD, MHPE,&nbsp;Andrea Henkel MD, MS,&nbsp;Ashley Rider MD, MEHP,&nbsp;Monica Saxena MD, JD,&nbsp;Michael A. Gisondi MD","doi":"10.1002/aet2.11043","DOIUrl":"https://doi.org/10.1002/aet2.11043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many patients first learn of a pregnancy in the emergency department (ED). However, limited ED physician knowledge in pregnancy disclosure and options counseling may contribute to challenges in patient care and potential missed opportunities for timely access to reproductive care. No standardized instruments exist to teach or assess this important communication skill for the ED physicians. This study aimed to develop and collect validity evidence for a checklist for effective pregnancy disclosure and options counseling by ED physicians in an environment with unrestricted access to comprehensive reproductive care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective checklist creation and validity evidence collection study was conducted, involving literature review, expert input through a modified Delphi process, and pilot testing with ED faculty and residents at an urban academic medical center. We structured the validity evidence collection process using Messick's criteria for construct validity, addressing content, response process, internal structure, and relations to other variables. Data analysis focused on collecting validity evidence, including inter-rater reliability and participant performance assessment based on faculty or resident status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study resulted in a final 17-item checklist for pregnancy disclosure and options counseling in the ED. Pilot testing with 20 participants (eight faculty members and 12 residents) revealed high overall inter-rater reliability with almost perfect agreement (kappa = 0.81) and acceptable internal consistency (Cronbach's alpha = 0.88). Checklist scores showed no significant difference across standardized patients, indicating consistency. Faculty members outperformed residents, suggesting concurrent validity based on levels of clinical experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preliminary validity evidence supports the use of this novel checklist to assess physician competency in pregnancy disclosure and options counseling in the ED. Given the frequency of new pregnancy encounters in the ED and the dynamic changes to pregnant patients’ reproductive rights, enhancing physician education in these areas is critical for optimizing patient care and autonomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749139","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":"Changing behavior and promoting clinical empathy through a patient experience curriculum for health profession students","authors":"Sara W. Nelson MD, MHPE,&nbsp;Carl Germann MD, MHPE,&nbsp;Rachel Yudkowsky MD, MHPE,&nbsp;Benjamin Pare DO,&nbsp;Lauren Wendell MD,&nbsp;Michael Blackie PhD,&nbsp;Tania Strout PhD, RN, MS,&nbsp;Laura E. Hirshfield PhD","doi":"10.1002/aet2.11048","DOIUrl":"https://doi.org/10.1002/aet2.11048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The authors sought to explore how a curriculum that uses a patient experience simulation followed by reflection can lead to clinical empathy in learners and whether this experience leads to behavioral change. Further, in response to critiques of common pragmatic approaches to clinical empathy teaching in which empathy is operationalized and taught through formal trainings and checklists, the study aimed to contribute insights regarding how clinical empathy may best be taught to health profession students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-six senior medical students participated in an in situ patient experience simulation during a 4-month period in 2021–2022 in an academic emergency department. The simulation was followed by a written reflection and a structured debrief. A thematic analysis was performed on transcripts of the group debriefs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the group debriefs, learners described several empathetic behavioral changes they made after this intervention. First, learners discussed performing more small acts of kindness to improve patient care and humanize the patient experience. Second, learners discussed seeking to improve their communication through acknowledgment and validation of the patient experience. Finally, learners described actions to keep patients informed through frequent check-ins and setting expectations on time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings suggest that empathy may not be simply transactional for health profession students and that an understanding of the patient experience leads to actions that improve the patient experience and alleviate suffering.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708032","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":"Leadership training in emergency medicine: A national survey","authors":"Shea Palmer PhD,&nbsp;Amanda Rodrigues Amorim Adegboye PhD,&nbsp;Gareth Hooper PhD,&nbsp;Aanika Khan MSc,&nbsp;Caroline Leech MD,&nbsp;Amanda Moore PhD,&nbsp;Bhupinder Pawar PhD,&nbsp;Ala Szczepura Dphil(Oxon),&nbsp;Chris Turner MD,&nbsp;Rosie Kneafsey PhD","doi":"10.1002/aet2.11047","DOIUrl":"https://doi.org/10.1002/aet2.11047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emergency medicine (EM) is a uniquely stressful environment in which leadership training could improve individual and team performance, patient outcomes, well-being, and EM career intentions. The primary aim was to evaluate EM-specific leadership training (EMLeaders) compared to no leadership training. A secondary comparison was with other forms of leadership training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online survey was distributed to Royal College of Emergency Medicine (RCEM) members in England. Three groups were recruited: those who reported receiving EMLeaders training, no training, and other training. Information was collected on group demographics, job roles, responses to 14 leadership knowledge and skills items, well-being at work, and EM career intentions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 417 responders (177 EMLeaders, 148 no training, 92 other training) were largely representative of RCEM members, although the EMLeaders group were at less senior career grades. Although all groups provided generally positive responses, EMLeaders demonstrated more positive ratings for seven of 14 leadership items relative to no training (all <i>p</i> &lt; 0.05): knowledge about clinical leadership, application of clinical leadership, empowerment to make decisions, managing the emergency department environment, ability to influence the EM environment, confidence in leadership, and confidence in facilitating teams. The other training group demonstrated superior ratings for five of seven of the same items, except empowerment to make decisions and ability to influence the EM environment. Direct comparison of EMLeaders with other training identified ability to influence the EM environment as a unique benefit of EMLeaders (<i>p</i> &lt; 0.05), while knowledge about clinical leadership favored other training (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EMLeaders improved many aspects of perceived leadership knowledge and skills, but there was little evidence of impact on well-being or EM career intentions. EMLeaders particularly appears to enhance perceived ability to influence the EM environment. Considering that the EMLeaders group were generally earlier in their career, the findings are promising and can inform the refinement of future EM-specific training.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aet2.11047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707752","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":"AI passed the test, but can it make the rounds?","authors":"Christian Rose MD,&nbsp;Carl Preiksaitis MD, MEd","doi":"10.1002/aet2.11044","DOIUrl":"10.1002/aet2.11044","url":null,"abstract":"","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689125","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":"Effects of opening a vertical care area on emergency medicine resident clinical experience","authors":"Alina Tsyrulnik MD,&nbsp;Craig Rothenberg MPH,&nbsp;Wendy W. Sun MD,&nbsp;Arjun Venkatesh MD, MBA, MHS,&nbsp;Ryan F. Coughlin MD,&nbsp;Katja Goldflam MD,&nbsp;Rohit B. Sangal MD, MBA","doi":"10.1002/aet2.11040","DOIUrl":"10.1002/aet2.11040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Challenging clinical environments faced by emergency departments (EDs) have led to operational changes including implementation of vertical care units and fast-track units. Little is known regarding the impact of such units on resident physician clinical education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective, observational study was performed at an urban quaternary care ED evaluating the effect of opening a vertical care unit with a triage physician directing lower acuity patients to be seen by physician associates (PAs)/advanced practice registered nurses (APRNs) on the following parameters: (1) percentage of patients seen by residents, (2) Emergency Severity Index (ESI) of patients seen by residents, (3) number of procedures performed by residents, (4) number of patients per shift seen by residents, (5) percentage of critical care patients seen by residents, and (6) percentage of behavioral health patients seen by residents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Comparing the implementation of the vertical care unit to the prior 3 months, postgraduate year (PGY)-1 residents had greater exposure to ESI Levels 1 and 2 (odds ratio [OR] 2.15) and more critical care (OR 2.58). PGY-2 and PGY-3 residents had a lower exposure to ESI 1 and 2 patients (PGY-2 OR 0.63, PGY-3 OR 0.61) and less critical care exposure (OR 0.64 for PGY-2 and OR 0.62 for PGY-3) after implementation. PGY-1 residents saw fewer behavioral health patients (OR 0.65) while the other two classes saw more (PGY-2 OR 1.64, PGY-3 OR 2.74). ESI 4 and 5 exposure decreased for all classes (PGY-1 OR 0.15, PGY-2 OR 0.86, PGY-3 OR 0.72). No significant difference was found in the proportion of patients treated by residents (<i>p</i> = 0.85) or the number of procedures performed by residents (<i>p</i> = 0.25) comparing the implementation of a vertical care unit to the prior 3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests no detrimental effects of vertical care unit implementation on multiple resident education outcomes including the number and acuity level of patients seen as well as procedure numbers of resident trainees. While the outcomes measured did not show significant negative effect for the resident compliment as a whole, we noted changes to the distribution of patient acuity based on PGY level. Similar assessments are recommended to determine the educational impact of comparable operational changes in other EDs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689128","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":"Precision education in medicine: A necessary transformation to better prepare physicians to meet the needs of their patients","authors":"Sally A. Santen MD PhD,&nbsp;Kimberly Lomis MD,&nbsp;Judee Richardson PhD,&nbsp;John S. Andrews MD,&nbsp;David Henderson MD,&nbsp;Sanjay V. Desai MD","doi":"10.1002/aet2.11041","DOIUrl":"10.1002/aet2.11041","url":null,"abstract":"&lt;p&gt;Across the continuum of emergency medicine (EM) education, physicians strive to continuously develop their skills while navigating multiple demands. To achieve the aim of learning amidst exponential growth in medical knowledge and increasingly complex medical care, a new system of accessible, personalized, and continuous learning is needed. In this commentary, we describe the model of precision medical education (PME),&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; which includes using data and technology to transform lifelong learning by improving data inputs, personalization, and efficiency.&lt;/p&gt;&lt;p&gt;Innovation creates transformation in medical education. In other spheres, the arc of innovation empowers users and builds value.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; For example, Amazon shifted purchasing power from local stores to consumers.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Netflix transferred power of choice to viewers, creating an industry for asynchronous content. Google shifted power of information from the few to many.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Generative AI (artificial and augmented intelligence) similarly has shifted the ability to gain and apply knowledge from experts to the people. While it takes time to fully realize their potential, these innovations largely meet the needs of consumers and society by shifting the locus of control to the end users. We believe medical education should create similar transformational shifts for learning to bring the locus of control to individual—student, emergency medicine (EM) resident, and practicing physician in the arc of lifelong learning.&lt;/p&gt;&lt;p&gt;The goal of training is to produce an EM physician workforce capable of delivering high-quality care to patients and communities. Explosive growth in medical knowledge and remarkable procedural advances have underscored physicians’ need for continuous and effective lifelong learning. The need to make this learning simple and accessible so that it weaves within existing workflows is also an imperative. Yet how do physicians maintain and advance their knowledge?&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; The gap between the need and process of learning, including resources, time, and methods, can contribute to the challenges of ongoing learning, contributing to burnout and moral distress as physicians struggle to keep up.&lt;/p&gt;&lt;p&gt;Medical education for medical students, residents, and practicing physicians has not evolved sufficiently with the pace of change in technology and remains encumbered by inflexibility, inefficiency, and inequity. This gap enhances the struggle to meet the current and future needs of physicians.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; There is little emphasis on the process of lifelong learning or maintaining competency in the rapidly expanding universe of medical knowledge and new procedures.&lt;/p&gt;&lt;p&gt;Because of resource constraints and the need to deliver training at scale, structured medical education (undergraduate medical education, graduate medical education, and continuing professional development [CPD]) are ","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629533","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}