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Background The Emergency Medicine In-Training Examination (EMITE) is one of the few validated instruments for medical knowledge assessment of emergency medicine (EM) residents. The EMITE is administered only once annually, with results available just 2 months before the end of the academic year. An earlier predictor of EMITE scores would be helpful for educators to institute timely remediation plans. A previous single-site study found that only 69% of faculty predictions of EMITE scores were accurate. Objective The goal of this article was to measure the accuracy with which EM faculty at five residency programs could predict EMITE scores for resident physicians. Methods We asked EM faculty at five different residency programs to predict the 2014 EMITE scores for all their respective resident physicians. The primary outcome was prediction accuracy, defined as the proportion of predictions within 6% of the actual scores. The secondary outcome was prediction precision, defined as the mean deviation of predictions from the actual scores. We assessed faculty background variables for correlation with the two outcomes. Results One hundred and eleven faculty participated in the study (response rate 68.9%). Mean prediction accuracy for all faculty was 60.0%. Mean prediction precision was 6.3%. Participants were slightly more accurate at predicting scores of noninterns compared to interns. No faculty background variable correlated with the primary or secondary outcomes. Eight participants predicted scores with high accuracy (>80%). Conclusions In this multicenter study, EM faculty possessed only moderate accuracy at predicting resident EMITE scores. A very small subset of faculty members is highly accurate.

Despite sufficient literature analyzing macroscopic and microscopic methods of addressing emergency department (ED) operations, there is a paucity of studies that analyze methods between these extremes.We conducted a quasi-experimental study incorporating a pre/post-intervention comparison to determine whether interdepartmental cooperation is effective at improving ED operations by combining microscopic and macroscopic concepts.We performed an analysis of operational and financial data from a cooperative investment in imaging transport personnel between the emergency and radiology departments. Our primary outcome, order to table time (OTT), measured imaging times by modality (computed tomography [CT], ultrasound [US], magnetic resonance imaging [MRI]). These were compared for statistically significant change before and after the intervention. Our secondary outcome, gross profit, was calculated using the revenue generated from gained outpatient studies minus the associated direct personnel costs.Transporters improved OTTs by decreasing median imaging times from 132 min to 116 min (p 0.0005). Efficiency improved for CT scans with median time decreasing from 142 min to 114 min (p 0.0005). Transport hires had adverse effects on US, with an increase in median OTT from 91 min to 99 min (p 0.018). MRI experienced a similar trend in OTT, as median times worsened from 215 min to 235 min (p 0.225). The investment in transporters generated a gross profit of $1.03 million for the radiology department over 9 months.Interdepartmental cooperation is a broadly applicable macroscopic method that is effective at achieving microscopic, site-specific gains in ED efficiency. Transporters provided operational gains for the ED and financial gains for the radiology department.

Background The Emergency Medicine In-Training Examination (EMITE) is one of the only valid tools for medical knowledge assessment in current use by emergency medicine (EM) residencies. However, EMITE results return late in the academic year, providing little time to institute potential remediation. Objective The goal of this study was to determine the ability of EM faculty to accurately predict resident EMITE scores prior to results return. Methods We asked EM faculty at the study site to predict the 2012 EMITE scores of the 50 EM residents 2 weeks prior to results being available. The primary outcome was prediction accuracy, defined as the proportion of predictions within 6% of the actual score. The secondary outcome was prediction precision, defined as the mean deviation of predictions from the actual scores. We assessed several faculty background variables, including years of experience, educational leadership status, and clinical hours worked, for correlation with the two outcomes. Results Thirty-two of the 38 faculty (84.2%, 95% confidence interval [CI] 69.6–92.6) participated in the study, rendering a total of 1600 predictions for 50 residents. Mean resident EMITE score was 81.1% (95% CI 79.5–82.8%). Mean prediction accuracy for all faculty participants was 69% (95% CI 65.9–72.1%). Mean prediction precision was 5.2% (95% CI 4.9–5.5%). Education leadership status was the only background variable correlated with the primary and secondary outcomes (Spearman's ρ = 0.51 and −0.53, respectively). Conclusion Faculty possess only moderate accuracy at predicting resident EMITE scores. We recommend a multicenter study to evaluate the generalizability of the present results.

This study was conducted to determine whether electronic mail (e-mail) increases contact rates after patients are discharged from the emergency department (ED). Following discharge, patients were randomized to be contacted by telephone or e-mail. The main outcome was success of contact. Secondary outcome was the median time of response. There were 1561 patients initially screened. Of these, 444 had e-mail and were included in the study. Half were contacted by telephone and the rest via e-mail. Our telephone contact rate was 58% (129/222) after two calls in a 48-h period and our e-mail contact was 41% (90/222). The telephone was nearly two times better than e-mail. The median time of response was 48 h for e-mail and 18 h for telephone. It is concluded that the telephone is a better modality of contact than e-mail for patients discharged from the ED.