scholarly journals Development, Implementation, and Evaluation of an Open Access, Level-Specific, Core Content Curriculum for Emergency Medicine Residents

2021 ◽  
Vol 13 (5) ◽  
pp. 699-710
Author(s):  
Kristen Grabow Moore ◽  
Andrew Ketterer ◽  
Natasha Wheaton ◽  
Paul Logan Weygandt ◽  
Holly A. Caretta-Weyer ◽  
...  

ABSTRACT Background Leaders in graduate medical education must provide robust clinical and didactic experiences to prepare residents for independent practice. Programs traditionally create didactic experiences individually, requiring tremendous resources with variable content exposure and quality. Objective We sought to create and implement a free, open access, learner-centric, level-specific, emergency medicine (EM) residency curriculum. Methods We developed Foundations of Emergency Medicine (FoEM) Foundations I and II courses using Kern's model of curriculum development. Fundamental topics were identified through content guidelines from the American Board of Emergency Medicine. We incorporated learner-centric strategies into 2 flipped classroom, case-based courses targeting postgraduate year (PGY) 1 and PGY-2 residents. The curriculum was made freely available online in 2016. Faculty and resident users were surveyed annually for feedback, which informed iterative refinement of the curriculum. Results Between 2016 and 2020, registration for FoEM expanded from 2 sites with 36 learners to 154 sites and 4453 learners. In 2019, 98 of 102 (96%) site leaders and 1618 of 2996 (54%) learners completed the evaluative survey. One hundred percent of responding leaders and 93% of learners were “satisfied” or “very satisfied” with FoEM content. Faculty and residents valued FoEM's usability, large volume of content, quality, adaptability, organization, resident-faculty interaction, and resident-as-teacher opportunities. Challenges to implementation included resident attendance, conference structure, technology limitations, and faculty engagement. Conclusions We developed and implemented a learner-centric, level-specific, national EM curriculum that has been widely adopted in the United States.

2019 ◽  
Vol 21 (1) ◽  
pp. 52-57 ◽  
Author(s):  
William Burns ◽  
Nicholas Hartman ◽  
P. Weygandt ◽  
Shanna Jones ◽  
Holly Caretta-Weyer ◽  
...  

Introduction: Electrocardiogram (EKG) interpretation is integral to emergency medicine (EM).1 In 2003 Ginde et al. found 48% of emergency medicine (EM) residency directors supported creating a national EKG curriculum.2 No formal national curriculum exists, and it is unknown whether residents gain sufficient skill from clinical exposure alone. Methods: The authors sought to assess the value of this EKG curriculum, which provides exposure to critical EKG patterns, a framework for EKG interpretation when the diagnosis is not obvious, and implementation guidelines and open access to any interested residency. The Foundations of Emergency Medicine (FoEM) EKG I course launched in January 2016, followed by EKG II in July 2017; they are benchmarked to post-graduate year 1 (PGY) and PGY2 level learners, respectively. Selected topics included 15 published critical EKG diagnoses and 33 selected by the authors.5 Cases included presenting symptoms, EKGs, and Free Open Access Medical Education (FOAM) links. Full EKG interpretations and question answers were provided. Results: Enrollment during 2017-2018 included 37 EM residencies with 663 learners in EKG I and 22 EM residencies with 438 learners in EKG II. Program leaders and learners were surveyed annually. Leaders indicated that content was appropriate for intended PGY levels. Leaders and learners indicated the curriculum improved the ability of learners to interpret EKGs while working in the emergency department (ED). Conclusion: There is an unmet need for standardization and improvement of EM resident EKG training. Leaders and learners exposed to FoEM EKG courses report improved ability of learners to interpret EKGs in the ED.


2011 ◽  
Vol 6 (3) ◽  
pp. 71 ◽  
Author(s):  
Lisa Shen

Objective – To determine reasons authors choose to publish in open access (OA) education journals, which provides readers with unrestricted free online access to published articles, and investigate ways in which publishing practices in the discipline of education affects authors’ willingness to publish in these journals. Design – Web-based survey questionnaire. Setting – The survey was conducted over the Internet through email invitations. Subjects – A total of 309 authors who published in OA journals in education participated in this survey for a response rate of 27.9%. Methods – Researchers surveyed authors who published in selected education journals from 2007 to 2008. The journal titles where generated from the Directory of Open Access Journals (DOAJ). All chosen journals were peer-reviewed and published either original research or overviews of research results. In addition, all were in English and published in the United States. A total of 1,107 authors were invited to participate via email. The survey was delivered through commercial online survey tool SurveyMonkey and consisted of multiple choice and open-ended questions. It was open from early March to April 16, 2009. Main Results – The survey had a response rate of 27.9%. The majority of participants were tenured faculty (42.0%), tenure-track faculty (25.9%), and non-tenure track faculty (12.1%). The rest of participants (20%) consisted of adjunct instructors, graduate students, administrators, and individuals working in non-academic institutions such as government agencies. Most authors surveyed have published between 10 and 20 articles (20.6%), or over 20 articles (30.4%) in print and electronic journals (e-journals). The majority of authors also reported that one (23.3%) or between 2 to 5 (54%) of their articles was published in OA format. When choosing a journal for publications, authors surveyed ranked peer-review to be the most important determinant. Other important determinants included “good match” (ranked second most important) for authors’ manuscripts and reputation of the journal (third) and editorial board (fourth). Citation impact, such as the ISI impact factor (eighth), and copyright retention (tenth) were ranked as some of the least important factors. Researcher also noted a “surprisingly low” (p. 124) correlation between authors’ interest in copyright retention and practices of self-archiving. Thirty-seven percent of authors surveyed reported self-archiving at least one of their publications, but just over 35% of the same group considered copyright retention a determinant when choosing journals for publication. Overall, only 22% of the authors surveyed deemed e-journals to be “less desirable” than print journals. The majority of both tenured faculty (77.4%) and tenure-track faculty (72%) surveyed found e-journals “acceptable” or difference between print and electronic journal format “not an issue.” Only 16.8% of authors surveyed had published in journals that required author fees. Moreover, over 56% of authors indicated they would not publish in journals requiring such fees. Most authors reported they were either very aware (45.1%) or somewhat aware (38.9%) of the concept of OA publishing. However, their perceptions of OA publishing varied: • 47.7% believed OA journals have faster publication times, while 33.6% disagreed and 18.5% offered no opinion. • 57.3% of authors believed OA journals have larger readerships. However, when asked whether OA articles would be cited more frequently than others, only one third of authors agreed, while one third disagreed and one third offered no opinion. • Just under half of the authors (49.4%) thought OA journals are not less prestigious than subscription based journals, while 18.8% had no opinion. Lastly, it should be noted that only 7.1% of authors credited their institution’s library for making them aware of the OA publishing concept. Most credited their colleagues (42.1%), Google searches for publishing opportunities (40.4%), and professional societies (29.3%) for raising their awareness of OA. Moreover, based on voluntary general comments left at end of the survey, researchers observed that some authors viewed the terms open access and electronic “synonymously” and thought of OA publishing only as a “format change” (p.125). Conclusion – The study revealed some discipline-based differences in authors’ attitudes toward scholarly publishing and the concept of OA. The majority of authors publishing in education viewed author fees, a common OA publishing practice in life and medical sciences, as undesirable. On the other hand, citation impact, a major determinant for life and medical sciences publishing, was only a minor factor for authors in education. These findings provide useful insights for future research on discipline-based publication differences. The findings also indicated peer review is the primary determinant for authors publishing in education. Moreover, while the majority of authors surveyed considered both print and e-journal format to be equally acceptable, almost one third viewed OA journals as less prestigious than subscription-based publications. Some authors also seemed to confuse the concept between OA and electronic publishing. These findings could generate fresh discussion points between academic librarians and faculty members regarding OA publishing.


2014 ◽  
Vol 9 (3) ◽  
pp. 83
Author(s):  
Richard Hayman

A Review of: Cirasella, J., & Bowdoin, S. (2013). Just roll with it? Rolling volumes vs. discrete issues in open access library and information science journals. Journal of Librarianship and Scholarly Communication, 1(4). http://dx.doi.org/10.7710/2162-3309.1086 Abstract Objective – To understand the prevalence of, motivations for, and satisfaction with using a rolling-volume publishing model, as opposed to publishing discrete issues, across open access academic journals in library and information science. Design – A 12 question survey questionnaire. Setting – English-language, open access library and information science (LIS) journals published in the United States of America. Subjects – A total of 21 open access LIS journals identified via the Directory of Open Access Journals that were actively publishing, and that also met the authors’ standard of scholarliness, which they established by identifying a journal’s peer-review process or other evidence of rigorous review. Based on responses, 12 journals published using discrete issues, while 9 published as rolling volumes or as rolling volumes with some discrete issues. Methods – In late 2011, the study’s authors invited lead editors or primary journal contacts to complete the survey. Survey participants were asked to identify whether their journal published in discrete issues, rolling volumes, or rolling volumes with occasional discrete issues, with the latter two categories combined as one for ease of results analysis. Survey logic split respondents into two groups, either discrete-issue or rolling-volume. Respondents in both categories were posed similar sets of questions, with the key difference being that the questions directed at each category accounted for the publication model the journals themselves identified as using. Editors from both groups were asked about the reasons for using the publication model they identified for their journal: within the survey tool, authors provided 16 potential reasons for using a discrete-issue model, and 13 potential reasons for using a rolling-volume model. Respondents from both groups were asked to mark all reasons that applied for their respective journals. The survey also included questions about whether the journal had ever used the alternate publishing model, the editor’s satisfaction with their current model, and the likelihood of the journal switching to the alternate publishing model in the foreseeable future. Main Results – The authors collected complete responses from 21 of the original 29 journals invited to participate in the study, a response rate of 72%. For the 12 journals that identified as using discrete issues, ease of production workflow (91.7%), clear production deadlines (75.0%), and journal publicity and promotion (75.0%) were the three most common reasons for using a discrete-issue model. For the nine journals using rolling volumes, improved production workflow (77.8%), decreased dependence on production deadlines (77.8%), and increased speed of research dissemination (66.7%) were the three most common reasons cited for using a rolling-volume model. Findings show that overall satisfaction with a journal’s particular publication model was a common factor regardless of publishing model in use, though only the rolling-volume editors unanimously reported being very satisfied with their model. This high satisfaction rate is reflected in editors’ positions that they were very unlikely to switch away from the rolling-volume method. While a majority of editors of discrete-issue journals also reported being very satisfied or somewhat satisfied with their current model, the mixed responses to whether they would contemplate switching to the alternate model suggests that awareness of the benefits of rolling-volume publishing is increasing. Conclusion – Researchers discovered a greater incidence of rolling-volume model journals with open access LIS journals than anticipated, suggesting that this is an area where additional research is necessary. The relative newness of the rolling-volume model may be a contributing factor to the high satisfaction rate among editors of journals using this model, as journal editors are likely to be more deliberate in selecting this model over the traditional discrete-issue publishing model. Workflow and production practices were identified as key characteristics for selecting a publishing model regardless of the model selected, and therefore this is another area in need of further investigation.


PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262215
Author(s):  
Anna Tupetz ◽  
Loren K. Barcenas ◽  
Ashley J. Phillips ◽  
Joao Ricardo Nickenig Vissoci ◽  
Charles J. Gerardo

Introduction Antivenom is currently considered standard treatment across the full spectrum of severity for snake envenomation in the United States. Although safe and effective antivenoms exist, their use in clinical practice is not universal. Objective This study explored physicians’ perceptions of antivenom use and experience with snake envenomation treatment in order to identify factors that influence treatment decisions and willingness to administer. Methods We conducted a qualitative study including in-depth interviews via online video conferencing with physicians practicing in emergency departments across the United States. Participants were selected based on purposive sampling methods. Data analysis followed inductive strategies, conducted by two researchers. The codebook and findings were discussed within the research team. Findings Sixteen in-depth interviews with physicians from nine states across the US were conducted. The participants’ specialties include emergency medicine (EM), pediatric EM, and toxicology. The experience of treating snakebites ranged from only didactic education to having treated over 100 cases. Emergent themes for this manuscript from the interview data included perceptions of antivenom, willingness to administer antivenom and influencing factors to antivenom usage. Overall, cost-related concerns were a major barrier to antivenom administration, especially in cases where the indications and effectiveness did not clearly outweigh the potential financial burden on the patient in non-life- or limb-threatening cases. The potential to decrease recovery time and long-term functional impairments was not commonly reported by participants as an indication for antivenom. In addition, level of exposure and perceived competence, based on prior education and clinical experience, further impacted the decision to treat. Resources such as Poison Center Call lines were well received and commonly used to guide the treatment plan. The need for better clinical guidelines and updated treatment algorithms with clinical and measurable indicators was stated to help the decision-making process, especially among those with low exposure to snake envenomation patients. Conclusions A major barrier to physician use of antivenom is a concern about cost, cost transparency and cost–benefit for the patients. Those concerns, in addition to the varying degrees of awareness of potential long-term benefits, further influence inconsistent clinical treatment practices.


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