Core Disaster Medicine Education (CDME) for Emergency Medicine Residents in the United States

2019 ◽  
Vol 34 (05) ◽  
pp. 473-480
Author(s):  
Ritu R. Sarin ◽  
Paul Biddinger ◽  
John Brown ◽  
Jonathan L. Burstein ◽  
Frederick M. Burkle ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Core Curriculum ◽  
Core Competencies ◽  
The United States ◽  
Disaster Medicine ◽  
Disaster Mitigation ◽  
Professional Organization ◽  
Residency Programs ◽  
Preparedness Planning ◽  
Hospital Response

AbstractObjectives:Disaster Medicine (DM) education for Emergency Medicine (EM) residents is highly variable due to time constraints, competing priorities, and program expertise. The investigators’ aim was to define and prioritize DM core competencies for EM residency programs through consensus opinion of experts and EM professional organization representatives.Methods:Investigators utilized a modified Delphi methodology to generate a recommended, prioritized core curriculum of 40 DM educational topics for EM residencies.Results:The DM topics recommended and outlined for inclusion in EM residency training included: patient triage in disasters, surge capacity, introduction to disaster nomenclature, blast injuries, hospital disaster mitigation, preparedness, planning and response, hospital response to chemical mass-casualty incident (MCI), decontamination indications and issues, trauma MCI, disaster exercises and training, biological agents, personal protective equipment, and hospital response to radiation MCI.Conclusions:This expert-consensus-driven, prioritized ranking of DM topics may serve as the core curriculum for US EM residency programs.

Disaster Education: A Survey Study to Analyze Disaster Medicine Training in Emergency Medicine Residency Programs in the United States

2017 ◽  
Vol 32 (4) ◽  
pp. 368-373 ◽  
Author(s):  
Ritu R. Sarin ◽  
Srihari Cattamanchi ◽  
Abdulrahman Alqahtani ◽  
Majed Aljohani ◽  
Mark Keim ◽  
...  
Keyword(s):  
United States ◽  
Emergency Medicine ◽  
Online Survey ◽  
The United States ◽  
Disaster Medicine ◽  
Survey Study ◽  
Educational Approach ◽  
Educational Models ◽  
Residency Programs ◽  
Disaster Education

AbstractBackgroundThe increase in natural and man-made disasters occurring worldwide places Emergency Medicine (EM) physicians at the forefront of responding to these crises. Despite the growing interest in Disaster Medicine, it is unclear if resident training has been able to include these educational goals.HypothesisThis study surveys EM residencies in the United States to assess the level of education in Disaster Medicine, to identify competencies least and most addressed, and to highlight effective educational models already in place.MethodsThe authors distributed an online survey of multiple-choice and free-response questions to EM residency Program Directors in the United States between February 7 and September 24, 2014. Questions assessed residency background and details on specific Disaster Medicine competencies addressed during training.ResultsOut of 183 programs, 75 (41%) responded to the survey and completed all required questions. Almost all programs reported having some level of Disaster Medicine training in their residency. The most common Disaster Medicine educational competencies taught were patient triage and decontamination. The least commonly taught competencies were volunteer management, working with response teams, and special needs populations. The most commonly identified methods to teach Disaster Medicine were drills and lectures/seminars.ConclusionThere are a variety of educational tools used to teach Disaster Medicine in EM residencies today, with a larger focus on the use of lectures and hospital drills. There is no indication of a uniform educational approach across all residencies. The results of this survey demonstrate an opportunity for the creation of a standardized model for resident education in Disaster Medicine.SarinRR, CattamanchiS, AlqahtaniA, AljohaniM, KeimM, CiottoneGR. Disaster education: a survey study to analyze disaster medicine training in emergency medicine residency programs in the United States. Prehosp Disaster Med. 2017;32(4):368–373.

Stick and Tell A Survey of Emergency Medicine Residents and Needlestick Exposures

2013 ◽  
Vol 34 (10) ◽  
pp. 1116-1118 ◽  
Author(s):  
Jessica Zuraw ◽  
Gretchen Sanford ◽  
Lori Winston ◽  
Shu Chan
Keyword(s):  
Emergency Medicine ◽  
Healthcare Workers ◽  
The United States ◽  
Perceived Barriers ◽  
Health Departments ◽  
Needlestick Injuries ◽  
Residency Programs ◽  
Paper Version ◽  
E Mail ◽  
New Procedures

An estimated 400,000–800,000 sharps-related injuries occur among healthcare workers (HCWs) annually in the United States. The risk of needlestick exposure may be particularly high among emergency medicine (EM) residents, who are learning new procedures in a relatively uncontrolled environment. Despite the potentially serious consequences of percutaneous injuries (PCIs), practitioners in training often down-play the occurrence of PCIs and do not report exposures.Current literature implies that underreporting of needlestick injuries is multifactorial. By not seeking care after needlesticks occur and thereby delaying treatment, residents incur more risk from exposures. We sought to elucidate the underlying issues that might contribute to this lack of reporting needlestick injuries. Using an anonymous survey, we collected information regarding factors that contributed to sustaining a PCI as well as perceived barriers that prevented residents from reporting these exposures. This information is desirable for both residency programs and employee health departments to reduce the occurrence of unreported exposures.The survey contained 19 questions, and all subjects were EM residents from the 8 Accreditation Council for Graduate Medical Education–accredited programs in the state of Illinois during the period January–February 2011. The voluntary survey was distributed via e-mail and through a paper version distributed at a regional EM residency conference.

Air-Medical Transport Experience in Emergency Medicine Residencies: Then and Now

2009 ◽  
Vol 24 (3) ◽  
pp. 247-252 ◽  
Author(s):  
Nelson Tang ◽  
Kim Fredericksen ◽  
Lauren Sauer ◽  
Buddy Kozen ◽  
Horace Liang ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
The United States ◽  
Resident Training ◽  
Effective Utilization ◽  
Residency Programs ◽  
Medical Transport ◽  
Two Phases ◽  
Training Opportunities ◽  
Geographical Locations

AbstractObjective:The appropriate activation and effective utilization of air-medical transport (AMT) services is an important skill for emergency medicine physicians in the United States.Previous studies have demonstrated variability with regards to emergency medical services (EMS) experience during residency training. This study was designed to evaluate the nature and extent of AMT training of the emergency medicine residency programs in the United States.Methods:An identity-unlinked survey of the program directors of all Accreditation Committee for Graduate Medical Education (ACGME) approved emergency medicine residency programs was conducted.The survey focused on EMS and AMT resident training opportunities and was conducted in two phases (1999 and 2006) using near-identical methodologies.Results:Response rates of 82% and 84% were achieved in 1999 and 2006, respectively. Percentages of programs offering AMT experiences were similar between the two study phases (76% in 1999 and 65% in 2006). The roles of residents during AMT experiences ranged widely between observer-only, active team member, and medical director/team leader in both 1999 and 2006. Compared to those in 1999, programs in 2006 demonstrated a greater frequency of EMS rotations being provided earlier, by year of training during emergency medicine residency. Residencies located in non-metropolitan centers only were slightly more likely to offer AMT training than were those in metropolitan locations.Conclusions:A majority of emergency medicine residency programs offer AMT experience that includes both scene responses and inter-facility transports. The role of residents during AMT training varies widely, as does the timing of their experiences during residency. The geographical locations of programs do not appear to impact the availability of AMT training.

scholarly journals The Impact of Due Process and Disruptions on Emergency Medicine Education in the United States

2020 ◽  
Vol 21 (2) ◽  
pp. 423-428
Author(s):  
Al'ai Alvarez ◽  
Anne Messman ◽  
Melissa Platt ◽  
Megan Healy ◽  
Elaine Josephson ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Students ◽  
Natural Disasters ◽  
Due Process ◽  
Training Programs ◽  
The United States ◽  
Educational Mission ◽  
Residency Programs ◽  
The Impact ◽  
Due Process Rights

Introduction: Academic Emergency Medicine (EM) departments are not immune to natural disasters, economic or political forces that disrupt a training program’s operations and educational mission. Due process concerns are closely intertwined with the challenges that program disruption brings. Due process is a protection whereby an individual will not lose rights without access to a fair procedural process. Effects of natural disasters similarly create disruptions in the physical structure of training programs that at times have led to the displacement of faculty and trainees. Variation exists in the implementation of transitions amongst training sites across the country, and its impact on residency programs, faculty, residents and medical students. Methods: We reviewed the available literature regarding due process in emergency medicine. We also reviewed recent examples of training programs that underwent disruptions. We used this data to create a set of best practices regarding the handling of disruptions and due process in academic EM. Results: Despite recommendations from organized medicine, there is currently no standard to protect due process rights for faculty in emergency medicine training programs. Especially at times of disruption, the due process rights of the faculty become relevant, as the multiple parties involved in a transition work together to protect the best interests of the faculty, program, residents and students. Amongst training sites across the country, there exist variations in the scope and impact of due process on residency programs, faculty, residents and medical students. Conclusion: We report on the current climate of due process for training programs, individual faculty, residents and medical students that may be affected by disruptions in management. We outline recommendations that hospitals, training programs, institutions and academic societies can implement to enhance due process and ensure the educational mission of a residency program is given due consideration during times of transition.

scholarly journals Radiology Education Among Emergency Medicine Residencies: A National Needs Assessment

2021 ◽  
Vol 22 (5) ◽  
pp. 1110-1116
Author(s):  
Stephen Villa ◽  
Natasha Wheaton ◽  
Steven Lai ◽  
Jaime Jordan
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Needs Assessment ◽  
Graduate Medical Education ◽  
Central Region ◽  
The United States ◽  
Residency Programs ◽  
Radiology Education ◽  
Graduate Medical ◽  
Program Leadership

Introduction: Radiology training is an important component of emergency medicine (EM) education, but its delivery has been variable. Program directors have reported a lack of radiology skills in incoming interns. A needs assessment is a crucial first step toward improving radiology education among EM residencies. Our objective was to explore the current state of radiology education in EM residency programs. Methods: This was a cross-sectional survey study of all Accreditation Council for Graduate Medical Education-accredited EM programs in the United States. Program leadership completed an online survey consisting of multiple choice, Likert scale, and free-response items. We calculated and reported descriptive statistics. Results: Of eligible EM programs, 142/252 (56%) completed the survey including 105 postgraduate year (PGY) 1-3 and 36 PGY 1-4 programs. One respondent opted out of answering demographic questions. 23/141 (16%) were from the Western region, 29/141 (21%) were from the North Central region, 14/141 (10%) were from the South-Central region, 28/141 (20%) were from the Southeast region, and 47/141 (33%) were from the Northeast region. A total of 88/142 (62%) of responding programs did not have formal radiology instruction. Of the education that is provided, 127/142 (89%) provide it via didactics/lectures and 115/142 (81%) rely on instruction during clinical shifts. Only 51/142 (36%) provide asynchronous opportunities, and 23/142 (16%) have a dedicated radiology rotation. The majority of respondents reported spending 0-2 hours per month on radiology instruction (108/142; 76%); 95/141 (67%) reported that EM faculty “often” or “always” provide radiology instruction; 134/142 (95%), felt that it was “extremely” or “very important” for ED providers to be able to independently interpret radiograph results; and 129/142 (90.84%) either “sometimes” or “always” rely on their independent radiograph interpretations to make clinical decisions. The radiology studies identified as most important to be able to independently interpret were radiographs obtained for lines/tubes, chest radiographs, and radiographs obtained for musculoskeletal-related complaints. Conclusion: A minority of EM residency programs have formal instruction in radiology despite the majority of responding program leadership believing that these are important skills. The most important curricular areas were identified. These results may inform the development of formal radiology curricula in EM graduate medical education.

Video-Based Learning vs Traditional Lecture for Instructing Emergency Medicine Residents in Disaster Medicine Principles of Mass Triage, Decontamination, and Personal Protective Equipment

2018 ◽  
Vol 33 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Henry A. Curtis ◽  
Karen Trang ◽  
Kevin W. Chason ◽  
Paul D. Biddinger
Keyword(s):  
Emergency Medicine ◽  
Personal Protective Equipment ◽  
Core Competencies ◽  
Disaster Medicine ◽  
Protective Equipment ◽  
Emergency Physicians ◽  
Traditional Lecture ◽  
Score Improvement ◽  
Video Based Learning ◽  
Post Hoc

AbstractIntroductionGreat demands have been placed on disaster medicine educators. There is a need to develop innovative methods to educate Emergency Physicians in the ever-expanding body of disaster medicine knowledge. The authors sought to demonstrate that video-based learning (VBL) could be a promising alternative to traditional learning methods for teaching disaster medicine core competencies.Hypothesis/ProblemThe objective was to compare VBL to traditional lecture (TL) for instructing Emergency Medicine residents in the American College of Emergency Physicians (ACEP; Irving, Texas USA) disaster medicine core competencies of patient triage and decontamination.MethodsA randomized, controlled pilot study compared two methods of instruction for mass triage, decontamination, and personal protective equipment (PPE). Emergency Medicine resident learning was measured with a knowledge quiz, a Likert scale measuring comfort, and a practical exercise. An independent samples t-test compared the scoring of the VBL with the TL group.ResultsTwenty-six residents were randomized to VBL (n=13) or TL (n=13). Knowledge score improvement following video (14.9%) versus lecture (14.1%) did not differ significantly between the groups (P=.74). Comfort score improvement also did not differ (P=.64) between video (18.3%) and lecture groups (15.8%). In the practical skills assessment, the VBL group outperformed the TL group overall (70.4% vs 55.5%; P<.0001), with significantly better performance in donning PPE and decontamination. Although not part of the original study design, a three-month post-hoc analysis was performed. When comparing the pre-intervention and three-month post-hoc performances, there were no significant differences in knowledge increases between VBL versus TL (P=.41) or in comfort (P=.39).ConclusionVideo modules can be as effective as TL when utilized to train Emergency Medicine residents in the ACEP disaster medicine core competencies of patient triage and decontamination.CurtisHA, TrangK, ChasonKW, BiddingerPD. Video-based learning vs traditional lecture for instructing emergency medicine residents in disaster medicine principles of mass triage, decontamination, and personal protective equipment. Prehosp Disaster Med. 2018;33(1):7–12.

Characteristics of postgraduate year 2 ambulatory care pharmacy residency programs in the United States

2020 ◽  
Vol 77 (Supplement_2) ◽  
pp. S34-S40
Author(s):  
Kellie L E Musch ◽  
Tara E Schreck ◽  
Kristin A Casper ◽  
Jennifer L Rodis
Keyword(s):  
United States ◽  
Ambulatory Care ◽  
The United States ◽  
Single Site ◽  
Professional Organization ◽  
Residency Programs ◽  
Primary Practice ◽  
Conference Attendance ◽  
Program Characteristics ◽  
Staffing Requirements

Abstract Purpose A survey was conducted to evaluate the characteristics and structures of postgraduate year 2 (PGY2) ambulatory care pharmacy residency programs in the United States. The survey results can serve as a guide for current and newly emerging programs. Methods A 24-question survey was sent to 138 US PGY2 residency program directors (RPDs) in February 2017 to identify key program characteristics, including program type (single-site or multisite), primary practice site, number of residents, length and type of rotations, staffing requirements, additional residency activities, precepting and teaching opportunities, RPD training and credentials, and number and qualifications of preceptors. Descriptive statistics were used to analyze the findings. Results A 40.6% response rate was achieved. Well over half (57%) of programs had been established within the preceding 5 years. A majority of RPDs reported that their program had 1 (53%) or 2 residents (31%) and/or was a single-site program (80%). Overall, 44 different types of rotations or experiences were offered by the programs. All surveyed programs offered additional teaching opportunities. There were no formal staffing duties in 29% of programs; professional organization membership and conference attendance were highly encouraged but typically not required of residents. Qualifications of the RPD and preceptors closely mirrored those delineated in residency accreditation standards. Conclusion There is an increased need for specialized training in ambulatory care in order to prepare pharmacists for the changing landscape in healthcare. The profession is adapting to this need, as evidenced by the rapid growth of PGY2 ambulatory care residency programs. Understanding characteristics can benefit continued growth to meet the needs of the profession.

scholarly journals Objective predictors of intern performance

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amanda C. Filiberto ◽  
Lou Ann Cooper ◽  
Tyler J. Loftus ◽  
Sonja S. Samant ◽  
George A. Sarosi ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Core Competencies ◽  
Cohort Analysis ◽  
The United States ◽  
Grade Point ◽  
Class Rank ◽  
Residency Programs ◽  
Usmle Step 1 ◽  
Usmle Step

Abstract Background Residency programs select medical students for interviews and employment using metrics such as the United States Medical Licensing Examination (USMLE) scores, grade-point average (GPA), and class rank/quartile. It is unclear whether these metrics predict performance as an intern. This study tested the hypothesis that performance on these metrics would predict intern performance. Methods This single institution, retrospective cohort analysis included 244 graduates from four classes (2015–2018) who completed an Accreditation Council for Graduate Medical Education (ACGME) certified internship and were evaluated by program directors (PDs) at the end of the year. PDs provided a global assessment rating and ratings addressing ACGME competencies (response rate = 47%) with five response options: excellent = 5, very good = 4, acceptable = 3, marginal = 2, unacceptable = 1. PDs also classified interns as outstanding = 4, above average = 3, average = 2, and below average = 1 relative to other interns from the same residency program. Mean USMLE scores (Step 1 and Step 2CK), third-year GPA, class rank, and core competency ratings were compared using Welch’s ANOVA and follow-up pairwise t-tests. Results Better performance on PD evaluations at the end of intern year was associated with higher USMLE Step 1 (p = 0.006), Step 2CK (p = 0.030), medical school GPA (p = 0.020) and class rank (p = 0.016). Interns rated as average had lower USMLE scores, GPA, and class rank than those rated as above average or outstanding; there were no significant differences between above average and outstanding interns. Higher rating in each of the ACGME core competencies was associated with better intern performance (p < 0.01). Conclusions Better performance as an intern was associated with higher USMLE scores, medical school GPA and class rank. When USMLE Step 1 reporting changes from numeric scores to pass/fail, residency programs can use other metrics to select medical students for interviews and employment.

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