scholarly journals What is the motivation of young emergency physicians to pursue an academic career in Emergency Medicine?

2021 ◽  
Author(s):  
Delphine Douillet ◽  
François Javaudin ◽  
Saïd Laribi ◽  
Philippe Le Conte ◽  
Emmanuel Montassier ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Academic Career ◽  
Research Training ◽  
Demographic Data ◽  
Participation Rate ◽  
Motivational Factors ◽  
University Hospital ◽  
Clinical Activity ◽  
Emergency Physicians ◽  
Multicenter Prospective Observational Study

Abstract Background The study aims were to assess the motivation behind embarking on a university hospital career in Emergency Medicine, as well as any potential motivational barriers and levers. Methods We carried out a multicenter prospective observational study. All interns from the first year to the fourth year of a residency program in Emergency Medicine as well as young emergency physicians at 5 universities in the west of France were interviewed. A questionnaire with 37 questions was developed based on the literature and in line with the Delphi method. The questionnaires were self-administered online. This questionnaire assessed 4 aspects: demographic data, overall motivational factors, specific motivational factors, and motivational barriers and levers. Results The participation rate was 70%, with 193 answers. A median of 3 (2–4) out of 6 was the result for motivation to pursue an academic career in Emergency Medicine. Twenty respondents (10%) showed a genuine motivation for an academic career, rating this item at 5 or 6 (out of 6). The most motivated students were those who had received research training (first-level master’s degree, Master 1) (OR, 3.2 [95%CI: 1.3 to 3.9]). Among them, the most important potential levers were the possibility to devote at least 50% of the time to clinical activity, the time dedicated to missions, clear recruitment prospects, and supervision/guidance in preparing for an academic career. Conclusions Ten percent of the young emergency physicians who responded to this questionnaire have a high motivation for an academic career, which suggests that there is a large potential reserve of academics in emergency medicine. There are several levels to maintain this motivation and transform it into commitment in the academic course.

scholarly journals Assessing the effectiveness of pediatric emergency medicine education in emergency medicine residency training: A national survey

2020 ◽  
pp. 102490792092631
Author(s):  
Wei-Chen Chen ◽  
Chung-Hsien Chaou ◽  
Chip-Jin Ng ◽  
Yueh-Ping Liu ◽  
Yu-Che Chang
Keyword(s):  
Emergency Medicine ◽  
Residency Training ◽  
Clinical Supervision ◽  
Pediatric Patients ◽  
Training Programs ◽  
Demographic Data ◽  
Pediatric Emergency ◽  
Point Of Care Ultrasound ◽  
Pediatric Emergency Medicine ◽  
Emergency Physicians

Background: Evaluating the effectiveness of pediatric emergency medicine training is essential to ensure that emergency physicians and emergency medicine residents have sufficient knowledge, skill, and confidence in optimizing care for acute pediatric visits. Although the field of pediatric emergency medicine has experienced phenomenal growth in past decades, it still faces challenges in how to best implement the curriculums in emergency medicine residency training programs. Objectives: Exploring emergency physicians’ and emergency residents’ perspectives on pediatric emergency medicine training in emergency residency training programs in Taiwan through a nationwide survey. Methods: The survey was distributed to 1281 emergency physicians and emergency medicine residents in 43 teaching hospitals. The survey inquired about demographic data, hospital type, rank of proctored trainers and assessors, and the setting of pediatric emergency medicine training. Participants’ confidence in managing acute pediatric visits and their satisfaction and reflections of their pediatric emergency medicine training were explored. Results: In all, 258 responses were received from 117 residents and 141 emergency physicians. Seventy-seven percent reported working in medical centers. Clinical supervision was primarily performed by pediatric attending physicians and emergency physicians. Fifty-eight percent of participants felt satisfied with their pediatric emergency medicine training. However, only 52.3% felt confident managing acute pediatric visits, which was attributed to inadequate exposure to pediatric patients. Residents noted lack of confidence in managing newborns, infants, and clinical procedures. Therefore, simulation training and point-of-care ultrasound learning were considered advantageous. Conclusion: The pediatric emergency medicine training in emergency medicine residency programs is diverse in intensive care training, supervisors, and assessors. Surveys demonstrate that learning experience in pediatric wards and emergency department rotations is associated with overall satisfaction with pediatric emergency medicine training; inadequate exposure to pediatric patients contributed to learners having less confidence. Emergency medicine residency program reform might focus on adequate hands-on pediatric patient care.

scholarly journals P073: The GridlockED board game: using serious games for medical education

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S82-S83
Author(s):  
S. Y. Huang ◽  
P. Sneath ◽  
D. Tsoy ◽  
J. Rempel ◽  
M. Mercuri ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Medical Students ◽  
Serious Games ◽  
Patient Flow ◽  
Demographic Data ◽  
Real Life ◽  
Teaching Tool ◽  
Board Game ◽  
Emergency Physicians

Introduction: The management of patient flow in the emergency department (ED) is crucial for the practice of emergency medicine (EM). However, this skill is difficult to teach didactically and is learned implicitly in the latter half of residency training. To help expedite the learning process, we developed the GridlockED board game as an educational tool to simulate ED patient flow. By having junior medical trainees play this game, we believe that they will develop a greater understanding of patient flow and resource management in the ED. Additionally, since GridlockED is a cooperative game, players may also benefit by improving their communication and teamwork skills. Methods: GridlockED was developed over twenty months of iterative gameplay and review. Feedback from attending emergency physicians, residents, and medical students was integrated into the game through a Plan-Do-Study-Act (PDSA) model. Emergency medicine nurses, physicians and residents at McMaster University were recruited to play GridlockED. Each player completed a pre-survey to collect demographic data and to assess their prior experience with playing board games. All play sessions were recorded for data collection purposes. Following each game session, a member of the research team conducted an exit interview with the players to gather information about their play experience and the educational value of the game. A post-survey was also sent to each participant for further feedback. Results: Eighteen gameplay sessions were conducted from June to August 2017. A total of thirty-two participants played the game (13 emergency physicians, 15 residents, and four nurses). Overall responses to the post-gameplay survey showed that players endorsed GridlockED as a useful potential teaching tool (75%, n=24/32) and the majority felt that it had the potential to improve patient flow in the ED (56%, n=18/32). Most participants found that the game was easy to play (91%, n=27/29), and that the instructions were clear (87.5%, n=28/32). Respondents also felt that the game reflected real life scenarios (56%, n=18) and that cases reflected the types of patients that they saw in the ED (78%, n=25). Conclusion: Our results have shown an overall positive response to GridlockED, with most participants supporting it as both an engaging board game and potential teaching tool. We believe that future studies with larger sample sizes and medical students will further validate the use of serious games in medical education.

Suicides and Suicide Attempts in Emergency Medicine

Crisis ◽  
2002 ◽  
Vol 23 (2) ◽  
pp. 68-73 ◽  
Author(s):  
Frank-Gerald Pajonk ◽  
Kai Arist Simon Gruenberg ◽  
Heinzpeter Moecke ◽  
Dieter Naber
Keyword(s):  
Emergency Medicine ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Demographic Data ◽  
Age Groups ◽  
Severity Of Illness ◽  
Emergency Physicians ◽  
Completed Suicide ◽  
The City ◽  
Commit Suicide

Summary: Objective: In emergency medicine, suicides and attempted suicides represent a major challenge for emergency physicians (EPs) and paramedics, both in terms of psychiatric and somatic treatment. To date no investigations have been performed to determine prevalence rates, method of suicide or attempted suicide, and the problems faced by EPs when treating these patients. This investigation presents a first evaluation of the complete emergency protocols from a major German city focusing on suicide and parasuicide. Methods: A retrospective analysis of all EP protocols from 1995 in the city of Hamburg was performed. All protocols were evaluated with respect to suicide parasuicide and suicidal ideation. Demographic data and information on method of suicide or attempted suicide, severity of illness, and underlying psychiatric disorder were extracted from the protocols. Results: A total of 26,347 emergency protocols were evaluated. Suicide and attempted suicide were considered either certain, probable, or possible in 743 cases (2.8%). Suicide was committed in 171 cases and attempted were made by 572 individuals. More men committed suicide in all age groups. By far the highest number of suicide attempts were by young men between 18 and 39 years of age. Hanging was the most commonly used method of completed suicide (41%), followed by jumping from a height (21%). The methods of intoxication with medication (54%) and illegal drugs (17%) clearly prevailed in suicide attempts. Documentation of suicides and attempted suicides was revealed to be unsatisfactory. Underlying psychiatric disorders were scarcely recorded. Conclusion: In emergency medicine, the incidence of suicide or the attempt to commit suicide is small, yet disturbing. The frequency assessed may be too low as result of methodology. There is a need to improve the education of emergency physicians and paramedics in this area, and there is a need for data to be collected in a prospective design.

scholarly journals Health-related quality of life in different trimesters during pregnancy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Huailiang Wu ◽  
Weiwei Sun ◽  
Hanqing Chen ◽  
Yanxin Wu ◽  
Wenjing Ding ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

Abstract Background Pregnant women experience physical, physiological, and mental changes. Health-related quality of life (HRQoL) is a relevant indicator of psychological and physical behaviours, changing over the course of pregnancy. This study aims to assess HRQoL of pregnant women during different stages of pregnancy. Methods This cross-sectional study was performed using the The EuroQoL Group’s five-dimension five-level questionnaire (EQ-5D-5L) to assess the HRQoL of pregnant women, and demographic data were collected. This study was conducted in a regional university hospital in Guangzhou, China. Results A total of 908 pregnant women were included in this study. Pregnant women in the early 2nd trimester had the highest HRQoL. The HRQoL of pregnant women rose from the 1st trimester to the early 2nd trimester, and dropped to the bottom at the late 3rd trimester due to some physical and mental changes. Reports of pain/discomfort problem were the most common (46.0%) while self-care were the least concern. More than 10% of pregnant women in the 1st trimester had health-related problems in at least one dimension of whole five dimensions. In the whole sample, the EuroQoL Group’s visual analog scale (EQ-VAS) was 87.86 ± 9.16. Across the gestational stages, the HRQoL remained stable during the pregnancy but the highest value was observed in the 1st trimester (89.65 ± 10.13) while the lowest was in the late 3rd trimester (87.28 ± 9.13). Conclusions During pregnancy, HRQoL were associated with gestational trimesters in a certain degree. HRQoL was the highest in the early 2nd trimester and then decreased to the lowest in the late 3rd trimester due to a series of physical and psychological changes. Therefore, obstetric doctors and medical institutions should give more attention and care to pregnant women in the late 3rd trimester.

scholarly journals The epidemiology of Moebius syndrome in Italy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Arturo Carta ◽  
Stefania Favilla ◽  
Giacomo Calzetti ◽  
Maria Cristina Casalini ◽  
Pier Francesco Ferrari ◽  
...  
Keyword(s):  
Demographic Data ◽  
Geographical Area ◽  
National Level ◽  
Age At Diagnosis ◽  
University Hospital ◽  
Italian Population ◽  
Moebius Syndrome ◽  
Cross Sectional ◽  
Geographical Regions ◽  
Chi Square Analysis

Abstract Background The epidemiology of Moebius syndrome (MBS) is difficult to assess. In the present study, we investigated the epidemiology of MBS in a well-defined population within a precise geographical area. Materials and methods Our university hospital is the only national referral center for the diagnosis and treatment of MBS. Participants in this cross-sectional study were patients affected by MBS who had been periodically followed by our medical staff since 1998. Most of the patients were referred to our hospital by the Italian Association of Moebius Syndrome (AISMO). Demographic data necessary for study purposes were made available in the AISMO database, updated to April 2018. Subjects were assigned to geographical macroareas that are conventionally used in surveys and epidemiological investigations by the Italian National Institute of Statistics. The rates and prevalence of MBS cases were calculated on the basis of the last available survey of the Italian population. Each study parameter was then calculated with reference to the whole country and macroarea partition. The sex rate and the corresponding prevalence were calculated with respect to the weighted whole population and to the respective sex population. Chi-square analysis was adopted to investigate possible differences among geographical regions and/or sexes. A p value < 0.05 was considered statistically significant. Results One hundred and sixty-four out of 212 MBS patients fulfilled our inclusion criteria. All cases occurred in Caucasian patients and were sporadic. The median age at diagnosis was 3.6 years, ranging from 0 to 55 years; this range was significantly reduced to 0–5 years (median age at diagnosis: 2.2 years) in patients included after 2007. The calculated prevalence at birth was 0.06 cases per 10,000 live births, with an overall prevalence of 0.27/100,000, without any sex or geographical predominance. Conclusions The prevalence of MBS observed herein, rounded for possible underestimation, was 0.3/100,000 people, without any regional difference in the distribution of cases. Our data confirm the rarity of the disease on a national level.

scholarly journals The International Federation for Emergency Medicine report on emergency department crowding and access block: a brief summary

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
A. P. Javidan ◽  
◽  
K. Hansen ◽  
I. Higginson ◽  
P. Jones ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Task Force ◽  
Video Conferencing ◽  
International Federation ◽  
Emergency Physicians ◽  
Emergency Department Crowding ◽  
Comprehensive Guidance ◽  
The World ◽  
Ed Crowding

Abstract Objective To develop comprehensive guidance that captures international impacts, causes, and solutions related to emergency department crowding and access block Methods Emergency physicians representing 15 countries from all IFEM regions composed the Task Force. Monthly meetings were held via video-conferencing software to achieve consensus for report content. The report was submitted and approved by the IFEM Board on June 1, 2020. Results A total of 14 topic dossiers, each relating to an aspect of ED crowding, were researched and completed collaboratively by members of the Task Force. Conclusions The IFEM report is a comprehensive document intended to be used in whole or by section to inform and address aspects of ED crowding and access block. Overall, ED crowding is a multifactorial issue requiring systems-wide solutions applied at local, regional, and national levels. Access block is the predominant contributor of ED crowding in most parts of the world.

scholarly journals P026: Need for training in medical education: staff emergency physician perspectives

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S86
Author(s):  
J. Bryan ◽  
F. Al Rawi ◽  
T. Bhandari ◽  
J. Chu ◽  
S. Hansen ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Adult Education ◽  
Family Medicine ◽  
Graduate Training ◽  
Formal Training ◽  
Emergency Physicians ◽  
Allied Health Professionals ◽  
Evaluation Time ◽  
Post Graduate Training

Introduction: Emergency medicine physicians in our urban/suburban area have a range of training in medical education; some have no formal training in medical education, whereas others have completed Master’s level training in adult education. Not all staff have a university appointment; of those who are affiliated with our university, 87 have appointments through the Department of Medicine, 21 through the Department of Pediatrics, and 117 through the Department of Family Medicine. Emergency physicians in our area are a diverse group of physicians in terms of both formal training in adult education and in the variety of settings in which we work. The purpose of this study was to gauge interest in formal training in adult education among emergency medicine physicians. Methods: With research ethics board approval, we created and sent a 10-item electronic questionnaire to emergency medicine staff in our area. The questionnaire included items on demographics, experience in emergency medicine, additional post-graduate training, current teaching activities and interest in short (30-60 minute) adult education sessions. Results: Of a potential 360 active emergency physicians in our area, 120 responded to the questionnaire (33.3%), representing 12 area hospitals. Nearly half of respondents had been in practice over 10 years (48.44%). Respondents were mainly FRCP (50%) or CCFP-EM (47.50%) trained. 33.3% of respondents had masters degrees, of which 15% were MEd. Most physicians were involved in teaching medical students (98.33%), FRCP residents (80%) and family medicine residents (88.3%), though many were also teaching off-service residents, and allied health professionals. More than half of respondents (60%) were interested in attending short sessions to improve their skills as adult educators. The topics of most interest were feedback and evaluation, time-efficient teaching, the learner in difficulty, case-based teaching and bedside teaching. Conclusion: Emergency physicians in our area have a wide variety of experience and training in medical education. They are involved in teaching learners from a range of training levels and backgrounds. Physicians who responded to our survey expressed an interest in additional formal teaching on adult education topics geared toward emergency medicine.

Low frequency of request for liaison psychiatry: A difficulty in the early detection of mental disorders by medical assistants?

2017 ◽  
Vol 41 (S1) ◽  
pp. S487-S487
Author(s):  
M. Aguiar Machado ◽  
J. Gonçalves Oliveira ◽  
E. Oliveira Cunha ◽  
E. Vieira de Melo ◽  
E. Oliva-Costa
Keyword(s):  
Depressive Symptoms ◽  
Mental Disorders ◽  
Early Detection ◽  
Clinical Medicine ◽  
Demographic Data ◽  
Low Frequency ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Liaison Psychiatry ◽  
Epidemiological Profile

IntroductionThe liaison psychiatry (LP) is a feature used by the psychiatrist in order to improve the management of patients with mental suffering and/or mental disorder admitted to general hospital.ObjectivesTo characterize the epidemiological profile of hospitalized patients at the university hospital of the federal university of Sergipe (HU-UFS) submitted to LP.Methodsretrospective and observational study, through analysis of medical records of patients admitted in the wards of clinical medicine and surgery from the HU-UFS, in the period from January to December 2015, submitted to LP. The information collected fed a specific questionnaire developed by the authors, intended for research of socio-demographic data and clinical profile.Resultsthe frequency of request for IP was of 3.5%, with the majority of applications was performed by clinical medicine (71.2%), while the surgical clinic was responsible for 28.8%. The main reason for the request of LP was the presence of depressive symptoms (49.1%). There was a predominance of females (52.5%) and the mean age was 45.9 ± 14.6 years.ConclusionsThe frequency of request for LP was very low, suggesting a difficulty in the early detection of mental disorders by physicians. This finding points to an underreporting of cases, since the prevalence of depressive symptoms in hospitalized patients is over 50% in this institution.Disclosure of interestThe authors have not supplied their declaration of competing interest.

American Board of Emergency Medicine Longitudinal Study of Emergency Physicians

1999 ◽  
Vol 33 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Mary Ann Reinhart ◽  
Benson S Munger ◽  
Douglas A Rund
Keyword(s):  
Emergency Medicine ◽  
Longitudinal Study ◽  
Emergency Physicians

scholarly journals AB1027 EFFECTIVENESS OF SUBCUTANEOUS ANTI-INTERLEUCINE 6 TREATMENT IN PATIENTS WITH ACTIVE MODERATE-SEVERE GRAVES’ ORBITOPATHY REFRACTORY TO CONVENTIONAL THERAPY.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1806.2-1806
Author(s):  
L. Fernández de la Fuente Bursón ◽  
F. J. Toyos Sáenz de Miera ◽  
D. Ruiz-Montesinos ◽  
M. Gessa Sorroche ◽  
M. C. Díaz Ruiz ◽  
...  
Keyword(s):  
Demographic Data ◽  
Case Series ◽  
Multicenter Trial ◽  
Smoking History ◽  
Clinical Aspects ◽  
Clinical Activity ◽  
Nonsurgical Management ◽  
Usual Clinical Practice ◽  
Antithyroid Treatment ◽  
Graves Orbitopathy

Background:Graves’ Orbitopathy (OG) is the main extrathyroid manifestation of Graves’ disease (GD). Up to 25% of patients have moderate-severe inflammatory activity with a risk of major sequelae. Intravenous (i.v.) glucocorticoids (GC) pulses are the standard therapy. In refractory cases, several classic and some biological immunosuppressantsare used, obtaining variable responses. Interleukin 6 (IL6) is involved in the pathogenesis of OG, which has justified the off-label treatment with Tocilizumab (TCZ)1, whose use by route i.v. has shown favorable results in published small case series and a single multicenter trial2.Objectives:To analyse the ocular effectiveness of anti-IL6 therapy used subcutaneously (s.c.) in patients with moderate-severe active refractory OG in usual clinical practice.Methods:Retrospective descriptive observational study of a series of cases of moderate-severe OG patients treated with anti-IL6 s.c. The patient medical records of those who had received at least 1 cycle of anti-IL6 treatment were reviewed (December 2013-December 2019). The primary effectiveness outcome was the change of the Clinical Activity Score (CAS). Favorable response was considered: reduction of CAS≥2 points together with obtaining inactivity (CAS <3). Demographic data, personal medical history, clinical aspects of GD, previous therapies and data on the use and safety of anti-IL6 were collected. The SPSS11 package was used for statistical analysis, using non-parametric tests for quantitative variables. The study was approved by the local Ethical Committee.Results:12 of the 15 patients (80%) were women with a mean of 50.27 years (21-72). 60% (n=9) had smoking history, 40% (n=6) active. 26.7% (n=4) were diabetic, all without retinopathy. 100% of patients received imidazole antithyroid treatment. 46.7% (n=7) required β-blockers and 20% (n=3) diuretics. 66.7% thyroidectomy (n=10) and 20% (n=3) decompressive eye surgery and/or blepharoplasty were performed. Thyroid and ocular radiotherapy were used in 2 patients. 3 patients received botox. 80% (n=12) of them had previously received GC. 93.3% (n=14) were naïve to biological therapy, only 1 patient previously used Rituximab. All except one patient who was treated with SRL received TCZ as IL6 therapy. A significant favorable response was obtained in 100% of the patients (p=0.008), decreasing CAS average from 4.9 (2-7) to 1.7 (0-2) at the end of the therapy [Figure 1]. The severity of the OG changed from being moderate in 72.7% of the patients to mild in 66.7% of the total. The median time to inactivity was 8 months (2-15). 73.3% (n=11) of the patients finished the treatment reaching inactive OG, the rest (although inactive) maintained therapy. After 6 months, 100% of those who completed the treatment remained inactive with average CAS of 1.3 (0-2). Smoking did not influence the response, nor any other variable collected. Adverse events appeared in 26.7% (n=4) of the cases, all of them mild and without widrawal.Conclusion:Treatment with anti-IL6 s.c. steadily decreases the clinical activity measured by CAS in patients with moderate-severe refractory OG, despite poor prognosis factors (such as smoking), with a good safety profile.References:[1]Taylor PN, Zhang L, Lee RWJ, Muller I, Ezra DG, Dayan CM, et al. New insights into the pathogenesis and nonsurgical management of Graves’ orbitopathy. Nat Rev Endocrinol. 2020 Feb;16(2):104-116.[2]Perez-Moreiras JV, Gomez-Reino JJ, Maneiro JR, Perez-Pampin E, Romo Lopez A, Rodríguez Álvarez FM, et al. Efficacy of Tocilizumab in Patients With Moderate-to-Severe Corticosteroid-Resistant Gravesˊ Orbitopathy: A Randomized Clinical Trial. Am J Ophthalmol. 2018;195:181–90.Disclosure of Interests:None declared

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