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Objective Methods Results Conclusion To assess the impact of an oocyte retrieval simulation training program (ORSTP) on the clinical performance of residents.We performed a prospective comparative study. The Simulation (S) group included oocyte retrieval (OR) performed by residents who had undergone an ORSTP before performing them on patients (n = 422 OR), and the control (C) group included OR performed by residents who had not received prior simulation training (n = 329 OR). Our main outcome measure was the OR rate (ORR) (number of oocytes collected/number of follicles aspirated) during the first 3 months of the rotation.In the S group, six residents aspirated 657 ovaries, while in the C group, five residents aspirated 508 ovaries. The mean ORR during the first 3 months of rotation were comparable between the S and C groups (59% vs. 58%, P = 0.68). ORR during the first and second month, and at the end of the rotation were also comparable between the S and C groups (54% vs. 63% [P = 0.13], 58% vs. 59% [P = 0.82], and 58% vs. 58% [P = 0.90], respectively). There was no significant difference in the rate of failed OR (ORR = 0%) (3.3% vs. 1.8%, P = 0.13) between the S and C groups. Finally, 16% of residents in the S group reported being stressed before their first OR compared to 40% in the C group (P = 0.85), and 83% of residents in the S group felt confident about the results of their retrievals compared to 20% in the C group (P = 0.13).The ORSTP does not improve the residents' clinical performance, but it could decrease their stress and improve their confidence in clinical practice. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusions Attrition in surgical residencies remains a significant issue, with traditional research focusing mainly on individual and programme factors. This study explores the role of clinical teachers (CTs) in influencing attrition rates. CTs are essential in moulding residents' training, serving both as enablers of workplace learning and guardians of their medical fields.We employed a hermeneutic phenomenology framework to understand the sociocultural impacts on attrition. Data were collected through semi‐structured interviews involving 19 CTs, 3 residents who left the programme and 2 who underwent remediation, following a six‐step hermeneutic phenomenological analysis process.The entrenched ‘good surgeon’ narrative within the department demanded selflessness and total dedication, which CTs reinforced, thereby normalising a rigorous and challenging environment. This has led to attrition when residents fail to meet these challenges or choose to disengage from the system. We illustrated that CTs were pivotal in perpetuating these expectations, contributing significantly to resident attrition.CTs played a crucial role in resident attrition by enforcing a stringent cultural norm within surgical training programmes. Addressing this issue requires a visible change in CTs' role to foster a more supportive educational environment. Emphasising the beneficial aspects of the ‘good surgeon’ narrative and mitigating its adverse impacts is essential for reducing attrition rates and assisting all residents, including those facing challenges, in successfully completing their training. [ABSTRACT FROM AUTHOR]

Background: We analyzed online rating scores and comments of head and neck surgeons to understand factors that contribute to higher ratings. Methods: Numerical ratings and comments for American Head and Neck Society physicians were extracted from Healthgrades, Vitals, RateMDs, and Yelp, with narrative comments categorized based on content. Physician practice location, education, and residency training were also compiled. Results: Patient ratings were significantly higher with supportive staff and affable physician demeanor but showed significant drops with longer wait times and difficulties scheduling appointments or follow‐ups. Physician education and postgraduate training did not significantly affect ratings. Conclusion: Online ratings and comments correlated to modifiable factors in clinical practice and may be informative in understanding patient needs. [ABSTRACT FROM AUTHOR]

Background: Percutaneous dilatational tracheostomy (PDT) is the preferred method for managing critically ill patients requiring prolonged mechanical ventilation. We aimed to compare the safety of PDT performed by intensivists versus surgeons. Methods: This retrospective, single center, cohort study included all the patients who underwent PDT from 2014 to 2023. Propensity score matching was performed to adjust the imbalances of covariates between the groups. The primary outcome was the occurrence of early complications after PDT. Secondary outcomes were the development of late complications of PDT and mortality directly related to tracheostomy. Results: 1685 consecutive patients with critical illness were included in the analysis. Of these, 1396 (82.8%) PDTs were performed by surgeons and 289 (17.2%) by intensivists with background residency training in internal medicine. Early complications were reported in 80 (5.7%) of the patients in the surgeon group and in 13 (4.5%) patients in the intensivist group (p = 0.40). Minor hemorrhage was the most common early complication. Secondary outcomes were comparable in both groups. In a propensity score‐matched cohort, the findings remained consistent. Conclusions: This study suggests that PDT can be performed by intensivists, as well as surgeons, with the same safety profile. Our findings underscore the importance of incorporating PDT into the intensive care unit (ICU) training syllabus, ensuring the procedure is readily accessible with reliance on the expertise of ICU staff. [ABSTRACT FROM AUTHOR]

Background: Children with chronic medical conditions and their families have significant emotional health concerns, yet paediatricians are often ill‐equipped to address these needs. The American Board of Pediatrics launched the Roadmap Project to better support emotional health as part of routine care. We present pilot work in paediatric training programmes to test educational approaches and explore lessons learned. Approach: Four institutions implemented Roadmap tools into their paediatric training programmes, either incorporating them into existing educational structures or embedding them into the clinical workplace. One programme utilised an existing longitudinal curriculum, and another incorporated into a block rotation. Two programmes embedded training for residents into a larger programme for the healthcare team within the clinical space, one in outpatient clinics and one in an inpatient service. Evaluation: Evaluation strategies at each site matched the intended outcomes. Sites working within education programmes evaluated learners, demonstrating increases in resident skills and confidence on pre‐/post‐self‐assessments. Sites embedding tools into the practice context measured changes in the clinical practice of the healthcare team. Despite variability in implementation, all approaches improved trainee skills; sites embedding education into a clinical setting saw greater changes in clinical practice. Implications: Our pilot provided structure yet allowed for flexibility, and all sites improved trainee skills. Engaging the entire healthcare team within practice settings appears advantageous, thus embedding education into clinical practice may be preferable to a separate education programme. Similar to outcomes found in interprofessional education (IPE), educating clinical teams together may be more impactful for cultural shifts needed for changing clinical practice. [ABSTRACT FROM AUTHOR]

Summary: Primary care physicians (PCPs) report insufficient knowledge and training gaps in obesity care. Internal Medicine (IM) residency offers an opportunity to address this educational gap for future PCPs. We designed an innovative, multicomponent curriculum on obesity medicine (OM) in the primary care setting for IM residents. We then conducted a prospective, 6‐month, two‐arm study within two residency programs in Maryland evaluating feasibility (use, appropriateness for IM training, and satisfaction) of the curriculum as well as changes in self‐efficacy within seven obesity care domains, assessed on 4‐point scales (1—not at all confident to 4—very confident). One residency program received the curriculum and the other served as the control group. We recruited 35 IM residents to participate (17 intervention, 18 control). Among intervention residents, 42% used all curricular components; appropriateness and satisfaction with the curriculum were high. Compared with controls, intervention residents had statistically significant increases in five obesity care self‐efficacy domains: nutrition (intervention 0.8 vs. control 0.2, p =.02), behaviour change (1.2 vs. 0.4, p <.01), weight‐gain‐promoting medications (0.8 vs. 0.1, p =.01), anti‐obesity medications (1.2 vs. 0.5, p =.03), and bariatric surgical counselling (0.9 vs. 0.4, p =.03). There were no significant changes in physical activity or post‐bariatric surgical care domains. Our OM curriculum is feasible with IM residents and increases residents' obesity care self‐efficacy beyond what is achieved with usual IM training. [ABSTRACT FROM AUTHOR]

Summary: Obesity is the most common chronic condition in the United States (US), yet primary care physicians face barriers in providing obesity treatment. This study examines the prevalence of American Board of Obesity Medicine (ABOM) certified obesity specialists on the faculty of US Family Medicine residency training programmes, the preparedness of graduating resident physicians to treat obesity, and residency training programme director preferences for supporting faculty development to improve residency education in obesity management. This cross‐sectional on‐line survey of programme directors addressed the number of ABOM‐certified faculty, perceived graduate preparedness to treat obesity, and priorities to improve faculty expertise and obesity curriculum. Of 672 eligible programme directors, 298 (44%) responded to our survey. Most programmes (76%) had no ABOM‐certified faculty. The proportion of programme directors assessing their graduates as prepared to care for patients with obesity has significantly decreased in the last 5 years (2018: 74%, 2022: 58%, p =.016). Residents in programmes with ABOM‐certified faculty member were more likely to be assessed as very prepared to provide medical care (18% vs. 7.8% p =.047). A majority (54%) of programme directors identified limited faculty training and expertise as the biggest faculty and resident‐level barrier to quality obesity care. This study demonstrates an important trend towards increasing ABOM‐certification among Family Medicine residency programme faculty and an urgent need to prioritise faculty development to improve faculty expertise and resident training to address the obesity epidemic. [ABSTRACT FROM AUTHOR]

Background: The transition from medical student to emergency medicine resident is a critical point in training. Medical students start residency with different levels of understanding and some are not meeting the emergency medicine (EM) Level 1 milestones. Residency preparation courses (RPCs) were created to fill this gap and prepare medical students for residency. Objectives: The objective was to review content from current RPC curricula to determine the content that should be included in an EM‐specific transition to residency preparation course. Methods: We collected curricula from RPC course directors at different institutions and reviewed and coded the topics into categories: (1) didactics, (2) procedures, and (3) unique topics (defined as nontraditional topics that did not fit squarely into didactics or procedures). Results: We obtained content from 13 different RPC curricula. Length of the courses ranged from one to 8 weeks with the mean being three weeks. Most courses were taught within a larger medical school course and were not specific to EM (62%). The most frequently taught didactic topics were airway interventions (85%), critical care (69%), and chest pain/shortness of breath (62%). Most programs included a simulation component (92%) and the most common procedures included airway interventions (69%); lines—central, arterial, and Cordis (69%); lumbar puncture (62%); and ultrasound (62%). Many of the courses had unique or special features taught within the curriculum. The most frequently taught unique content were sessions on self‐awareness and self‐regulation (85%) and advanced communication (69%). Conclusions: After multiple RPC curricula content was reviewed, a set of basic curriculum has been determined and supported by the content analysis. By including a standardized curriculum within RPC's, this will help better prepare medical students and create a standard for medical students entering EM residency and may allow intern orientations to focus on higher level skills. [ABSTRACT FROM AUTHOR]

This article discusses the integration of narrative medicine into dermatology residency training. Narrative medicine is the practice of recognizing and interpreting the stories of illness, allowing for a more holistic understanding of patients and their experiences. The article emphasizes the importance of listening, empathy, and non-judgment in building a narrative from patient interactions. It also explores how narrative medicine can complement the use of artificial intelligence in healthcare. The article highlights the significance of understanding the individual stories of those with skin diseases and calls for the implementation of a narrative medicine curriculum in dermatology training. It provides goals for such a curriculum, including enhancing observational skills, incorporating arts and humanities, and exploring social and cultural issues affecting skin health. The article suggests a pedagogic approach to developing narrative competence and addresses challenges and solutions for integrating narrative medicine into healthcare. It concludes by emphasizing the transformative power of narrative medicine in patient care and the need for a more inclusive and understanding medical practice. [Extracted from the article]

Background and Aims: Association of American Medical Colleges (AAMC) and Accreditation Council for Graduate Medical Education (ACGME) mandate training in handoff delivery for students and residents. Communication errors, including errors during handoffs of patient care, account for over 2/3 of sentinel events. This study aims to assess the effectiveness of peer‐assisted learning (PAL) in handoff education within a longitudinal framework. Methods: This study involved the analysis of fourth‐year medical students (n = 67) enrolled in a transition to residency program designed to reinforce skills essential for success in internal medicine residencies. We modified the I‐PASS handoff rubric for a single‐encounter evaluation. Before attending the transitions of care workshop, students submitted one written handoff report. During high‐fidelity simulation sessions, peers evaluated the written document as well as verbal handoffs, while faculty evaluated a recorded verbal version. The primary outcome measured was improvement in handoff quality and accuracy over time and secondary outcomes compared peer‐ and self‐evaluations to faculty assessments. Results: Overall, students demonstrated a statistically significant improvement in handoff quality and accuracy across all scoring criteria after completing the peer evaluation process. Peer evaluations did not demonstrate statistically significant differences in scores for quality or accuracy questions as compared to faculty. Conclusion: Peer evaluators effectively assessed handoff reports using the modified I‐PASS checklist yielding outcomes similar to faculty while providing feedback. These findings provide exciting evidence that should prompt training programs to consider incorporating standardized peer review into handoff education for medical students and, potentially, residents. The detailed evaluation of individual handoff events fosters feedback skills essential for ongoing professional growth and clinical excellence. [ABSTRACT FROM AUTHOR]

The article discusses the revisions made to the program requirements for Physical Medicine and Rehabilitation (PM&R) residency programs by the Accreditation Council for Graduate Medical Education (ACGME). The revisions were developed through collaboration between various organizations in the field and involved data analysis, interviews, and feedback from practicing physiatrists. The recommendations focused on themes such as flexibility and inclusion of multiple practice settings. The revisions have been submitted to the ACGME for review and revision of PM&R residency standards. [Extracted from the article]

Purpose: This study aimed to evaluate the effects and interactions of training level and different joints on the outcomes of cadaveric arthroscopic training courses for orthopaedic residents. Methods: This prospective study enrolled 16 orthopaedic residents who voluntarily participated in a cadaveric training programme involving the shoulder, elbow, wrist, knee and ankle joints. Outcomes were quantitatively assessed using task‐specific checklists and the Arthroscopic Surgery Skill Evaluation Tool. Two‐way analysis of variance (ANOVA) was conducted to determine the significance of the interactions between joint and years of training. Results: Resident scores significantly increased after the dedicated lectures in all five joints (p = 0.003 for the shoulder module, p < 0.001 for the other joints). Two‐way ANOVA revealed that the progress made after the dedicated lectures was significantly impacted by the joint (p = 0.006) and training level × joint interaction (p = 0.005) but not by the training level (p = 0.47). The simple effect of the joint was examined using Sidak's multiple comparison test. Among junior residents, the dedicated lectures resulted in more substantial progress in elbow and wrist arthroscopy when compared to shoulder arthroscopy (p = 0.020 and p = 0.043, respectively). Conclusions: The results suggest that, in cadaveric arthroscopic training courses for orthopaedic residents, training outcomes are primarily impacted by the specific joint being trained rather than the training level. Specifically, junior residents demonstrated greater improvement with training in procedures that are less commonly encountered during on‐the‐job training, such as elbow and wrist arthroscopy. Clinical Relevance: These findings suggest the need to prioritise wrist and elbow arthroscopic training for junior residents to optimise educational outcomes. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Background: Despite rising costs of health care, physician awareness of costs remains poor. Educational initiatives to remedy this have shown promise, with gamification specifically having success, but actual improvements in physician estimation capabilities have yet to be evaluated. Objectives: The objective of the study was to assess a gamified educational session for emergency medicine residents that improved their ability to estimate the costs of tests or services commonly performed in their department. Methods: Participants completed an anonymous presession survey consisting of demographic data, self‐analysis on cost awareness, and a 10‐item cost estimation list. This was followed by a 1‐h interactive gamified education session utilizing rules from the television show The Price is Right. During this session, only three of the survey items had their cost directly discussed such that the remaining seven were able to be assessed solely on estimation improvement instead of short‐term knowledge retention. Participants then completed the same survey to assess for improvement in cost awareness. Results: Sixteen residents at the PGY‐2 or PGY‐3 level completed the surveys and education session. All self‐analysis questions showed significant improvement in the postsession survey. Eight out of the 10 items had significant differences in cost estimation. Conclusions: A gamified teaching session using The Price is Right rules can improve a resident's estimation capabilities, even on items not directly taught during the session. [ABSTRACT FROM AUTHOR]

Objectives: This needs assessment aimed to improve understanding of flexible endoscopic intubation training and practice in emergency medicine (EM), providing insights to educators and practice leaders seeking to improve education and practices. Methods: We conducted a multicenter, mixed‐methods needs assessment of emergency physicians (EPs) incorporating focus groups and a survey. Focus groups comprised community EPs, academic EPs, and resident EPs. We analyzed focus group transcripts using grounded theory, qualitatively describing EM endoscopic intubation. The qualitative analysis shaped our survey instrument, which we deployed in cross‐sectional fashion. We report survey data with descriptive statistics. Results: Focus groups with 13 EPs identified three themes: indications for use of endoscopic intubation, factors impacting a physician's decision to endoscopically intubate, and attaining and maintaining endoscopic intubation competency. Of 257 surveyed EPs (33% response rate), 79% had received endoscopic intubation training during residency, though 82% had performed this procedure 10 or fewer times in their career. Despite 97% acknowledging the necessity of competency, only 23% felt highly confident in their ability to perform endoscopic intubation. Participants (93%) reported scarce opportunities to perform the procedure and identified factors believed to facilitate competency acquisition and maintenance, including opportunities to perform endoscopic intubation in practice (98%), local champions (93%), and performing nasopharyngoscopy (87%). Conclusions: While most EPs acknowledged the importance of competency in endoscopic intubation, they reported scarce procedural opportunities and commonly expressed low confidence. Further research is needed on this topic, and we propose avenues to enhance education and practices related to endoscopic intubation. These include development of robust procedural curricula, support of local champions, and incorporating nasopharyngoscopy into EM practice. [ABSTRACT FROM AUTHOR]

Objective: The core content of emergency medicine (EM) residency training includes the management of oncologic emergencies; however, documented knowledge gaps continue to exist in this subtopic. This study represents a targeted needs assessment as indicated by Step 2 of Kern's curriculum design to determine the specific training gaps to be addressed within the oncologic EM curriculum. Methods: A multi‐institutional cross‐sectional survey of oncologists (surgical and medical) and emergency physicians (attendings and residents) was conducted during 2023 at five institutions. The voluntary survey consisted of general and specialty‐specific questions exploring gaps in oncologic emergency–specific training/education topics. Descriptive statistics reported responses as frequencies and percentages. Results: Of the 833 surveys sent across the five sites, 302 (36.3%) were accessed by link; of these, 271 (89.7%) surveys were completed. There were no differences in the responses between early and later respondents and no differences in the characteristics of respondents between sites. A vast majority of the oncologist and EM groups (91.2% and 83.0%, respectively) reported a belief that emergency physicians would benefit from additional oncologic emergency training. Our survey identified 16 important topics for inclusion in an oncologic EM curriculum, including five topics not present on the 2022 Model of Clinical Practice of Emergency Medicine. Conclusions: Based on this needs assessment, an oncologic EM curriculum should include the topics listed under oncologic emergencies in the 2022 Model of the Clinical Practice of Emergency Medicine along with our respondent‐identified topics of radiation therapy adverse effects, stem cell transplant complications, and the management of cancer‐specific postsurgical complications, pain, and common diseases in patients with cancer. [ABSTRACT FROM AUTHOR]

Background: With a rise in mass casualty incidents, training in hemorrhage control using tourniquets has been championed as a basic—and lifesaving—procedure for bystanders and medical professionals alike. The current standard for training is in‐person (IP) courses, which can be limited based on instructor availability. Virtual reality (VR) has demonstrated the potential to improve the accuracy of certain medical tasks but has not yet been developed for hemorrhage control. The objective of this study was to evaluate the efficacy of a VR hemorrhage trainer in learner retention of tourniquet application when compared to traditional IP instructor teaching among a cohort of emergency medicine residents practicing in a Level I trauma center. Methods: This was a prospective, observational study of 53 emergency medicine residents at an inner‐city program. Participants were randomly assigned to either the control or the VR group. On Day 0, all residents underwent a training session (IP vs. VR) for the proper, stepwise application of a tourniquet, as defined by the American College of Trauma Surgeons. Each participant was then assessed on the application of a tourniquet by a blinded instructor using the National Registry Hemorrhage Control Skills Lab rubric. After 3 months, each resident was reevaluated on the same rubric, with subsequent data analysis on successful tourniquet placement (measured as under 90 s) and time to completion. Results: Of the 53 participants, the IP training group had an initial pass rate of 97% (28/29) compared to 92% (22/24) in the VR group (p = 0.58). On retention testing, the IP training group had a pass rate of 95% (20/21) compared to 90% (18/20) in the VR group (p = 0.62). Stratifying the success of tourniquet placement by level of resident training did not demonstrate any statistically significant differences. Conclusions: In this pilot study of emergency medicine residents, we found no significant differences in successful hemorrhage control by tourniquet placement between those trained with VR compared to a traditional IP course among emergency medicine residents. While more studies with greater power are needed, the results suggest that VR may be a useful adjunct to traditional IP medical training. [ABSTRACT FROM AUTHOR]

This article discusses the challenges and uncertainties that medical students face when applying to emergency medicine (EM) residency programs in the United States. It emphasizes the importance of reliable and objective information in guiding students' decision-making process. The article provides evidence-informed responses to common questions that students have about applying to EM residency programs, such as where to find trustworthy resources and how to select potential programs. It also highlights the factors that EM programs consider when evaluating applicants, including clinical performance, grades, and exam scores. The authors stress the need for students to stay updated on current trends and seek individualized advising to navigate the complex residency application process successfully. [Extracted from the article]

This document explores the benefits and challenges of incorporating ultrasound (US) training into obstetrics and gynecology (OB/GYN) education. It suggests that simulation-based medical education (SBME) and point-of-care US (POCUS) can enhance trainees' skills and knowledge in a safe environment. However, there are concerns about the cost and availability of SBME, as well as the potential over-reliance on US for clinical decision-making. Skill assessment methods, such as virtual reality simulators and standardized assessments, can provide valuable feedback for trainees. While there are differing opinions, investing in comprehensive OB/GYN US training has the potential to improve patient outcomes and produce competent practitioners. Further research is needed to optimize OB/GYN US education. [Extracted from the article]

Introduction: Generation Z learners are entering emergency medicine (EM) residency training, bringing unique learning preferences that influence their engagement with residency education. To optimally teach and motivate this incoming generation of learners, EM educators must understand and adapt to the changing instructional landscape. Methodology: The Simulation Leaders Advancing the Next Generation in Emergency Medicine (SLANG‐EM) Workgroup was created to identify effective educational strategies for Generation Z learners entering EM. Members were faculty in the Society for Academic Emergency Medicine (SAEM) Simulation Academy, well versed in learning theory supporting simulation‐based education (SBE) and actively involved in EM residency education. Unique treatment/analysis: Through primary and secondary literature searches, the SLANG‐EM Workgroup identified four distinctive learning preferences of Generation Z learners: (1) individualized and self‐paced learning, (2) engaging and visual learning environments, (3) immediate and actionable feedback, and (4) combined personal and academic support. Workgroup members evaluated these learning preferences using a novel conceptual framework informed by the theoretical principles underpinning SBE, recommending instructional strategies for Generation Z EM residency learners across multiple educational environments. Implications for educators: Instructional strategies were described for the didactic, simulation, and clinical learning environments. In the didactic environment, identified instructional strategies included meaningful asynchronous education, interactive small‐group learning, and improved multimedia design. In the simulation environment, educational innovations particularly suitable for Generation Z learners included learner‐centered debriefing, rapid‐cycle deliberate practice, and virtual simulation. In the clinical environment, described instructional strategies involved setting learner‐centered goals and delivering facilitative feedback in the context of an educational alliance. Overall, these instructional strategies were clustered around themes of student‐centered education and the educator as facilitator, which align well with Generation Z learning preferences. These findings were synthesized and presented as an advanced workshop, "Delivering Effective Education to the Next Generation," at the 2023 SAEM Annual Meeting. [ABSTRACT FROM AUTHOR]

Background: Precision medicine, sometimes referred to as personalized medicine, is rapidly changing the possibilities for how people will engage health care in the near future. As technology to support precision medicine exponentially develops, there is an urgent need to proactively improve our understanding of precision medicine and pose important research questions (RQs) related to its inclusion in the education and training of future emergency physicians. Methods: A seven‐step process was employed to develop a research agenda exploring the intersection of precision and emergency medicine education/training. A literature search of articles about precision medicine was conducted first, which informed the creation of future four scenarios in which trainees and practicing physicians regularly discuss and incorporate precision medicine tools into their discussions and work. Based on these futurist narratives, potential education RQs were generated by an expert panel. A total of 59 initial questions were subsequently categorized and refined to a priority list through a nominal group voting method. The top/priority questions were presented at the 2023 SAEM Consensus Conference on Precision Medicine, Austin, Texas, for further input. Results: Eight high‐value education RQs were developed, reflecting a holistic view of the challenges and opportunities for precision medicine education in the knowledge, skills, and attitudes relevant to emergency medicine. These questions contend with topics such as most effective pedagogical methods; intended resulting outcomes and behaviors; the generational differences between practicing emergency physicians, educators, and future trainees; and the desires and expectations of patients. Conclusions: Emergency medicine and emergency physicians must be prepared to understand precision medicine and incorporate this information into their "toolbox" of thinking, problem solving, and communication with patients and colleagues. This research agenda on how best to educate future emergency physicians in the use of personalized data to provide optimal health care is the focus of this article. [ABSTRACT FROM AUTHOR]

Background: Community engagement is increasingly recognized as a necessity in addressing intractable racial and ethnic health disparities in the United States. However, institutions have not adequately trained resident physicians in developing symbiotic community partnerships that preserve community autonomy and identity without exploitation. Our goals were to highlight the experiences of expert academic emergency physicians in creating innovative, community‐driven, and anti‐racist solutions to achieving measurable equity in health outcomes and to introduce a novel framework entitled the Social Change Method to take a community‐embedded intervention from concept to creation. Methods: The methodology was based on the development of a didactic session at the 2023 SAEM Annual Meeting. The three novel initiatives discussed were Emergency Medicine Remix (EMR); Trust, Research, Access, and Prevention (TRAP) Medicine; and The Health Equity Accelerator (HEA). A team of multi‐institutional experts convened to develop the session objectives through priority setting. Results: Our expert panel discussed successes and challenges encountered while using evidence‐informed strategies to conduct their community‐based programming. Participant questions were centered on fostering sustainability, emphasizing the importance of carefully crafted interventions in the face of uncertain legislative challenges and strategies to empower others. Conclusions: Emergency medicine residency education should incorporate training on methods to leverage community partnerships to improve individual and community health outcomes. The Social Change Method can be used as a conceptual framework to generate easily re‐creatable and scalable partnerships that establish trust and forge relationships that honor identity and autonomy without exploiting community members. [ABSTRACT FROM AUTHOR]

This article discusses the importance of peer review in the medical community and the need to train residents in this skill. Peer review is crucial for maintaining the quality and integrity of scientific research, but there is a concern about a potential shortage of peer reviewers. The article suggests that more clinicians and scientists should participate in the peer review process to combat medical misinformation and inaccurate research. The Accreditation Council for Graduate Medical Education (ACGME) has recognized peer review as a scholarly activity and has recently added it as a requirement for some specialties. The article proposes various methods for training residents in peer review, such as didactic teaching, hands-on teaching, and mentorship models. Teaching trainees to produce peer reviews can have multiple benefits, including improving critical appraisal skills, understanding the academic publishing process, and honing constructive feedback skills. Peer review can also fulfill regulatory requirements and be considered in promotion decisions. The article concludes by emphasizing the importance of training the next generation of peer reviewers and integrating peer review into graduate medical education programs. [Extracted from the article]

This article addresses the shortage of rheumatology providers in the US and the role of clinician educators in addressing this issue. It highlights the projected worsening of the shortage by 2030 and proposes solutions such as increasing fellowship training spots, utilizing advanced practice providers, and integrating telehealth. The article emphasizes the importance of educating and empowering primary care providers in managing rheumatic diseases and calls for recognizing and valuing the work of medical education. It also discusses the challenges faced by fellows-in-training in developing their medical education skills and proposes potential solutions to support their career development. [Extracted from the article]

Background: Intern preparation courses are often broad in scope; there are few published specialty‐specific programs outside of General Surgery and Obstetrics. We designed an internal medicine (IM) residency preparatory course at the University of Maryland School of Medicine, which aimed to prepare graduating medical students for the rigours of IM residency training, mapped to Entrustable Professional Activities (EPAs). Methods: Fourteen fourth‐year medical students who were matriculating into IM residency programs enrolled in a 4‐week long residency preparation course. The course was designed to teach skills using case‐based learning modules, specialty topic seminars, simulation laboratories, procedure laboratories and clinical practice. Participants were surveyed before and after the course on their perceived knowledge and ability with the skills tested. Results: With the exception of 'giving signout to a colleague', there was a significant difference in the participant's perceived ability for each skill taught within the course (P < 0.03 for each), with mean pre‐course scores of 1.4–3.7 (SD = 0.5–1.2) and mean post‐course scores of 3.2–4.2 (SD = 0.5–1.3). A second survey on course evaluation and perceived impact, completed 3 months after starting intern year, resulted in all respondents reporting that the information learned during the course had directly affected their care of patients on a daily or weekly basis. The modified Ottawa scale was the primary assessment means for the EPAs, with participants approaching entrustment at the conclusion of the course. Conclusions: Implementation of an IM‐specific residency preparation course is a useful adjunct in the fourth year of medical school. [ABSTRACT FROM AUTHOR]

Background: Currently, the Accreditation Council of Graduate Medical Education requires time‐based pediatric experiences for emergency medicine (EM) residents in both pediatric emergency medicine (PEM) and critical care settings. The American Board of Emergency Medicine has published the Model of the Clinical Practice of Emergency Medicine, which is a list of content an EM resident should learn. However, this list is large and without prioritization and therefore can be difficult to incorporate into time‐limited curricula. Objectives: The primary objective of this study was to develop comprehensive categorization of PEM content using an EM lens. The second objective was to suggest a prioritization for the EM learner of the enumerated PEM elements. Methods: We first assembled a comprehensive list of PEM concepts, diagnoses, and procedures that might be taught to EM residents. We then convened focus groups composed of key stakeholders to help formulate content and concept themes important for EM resident training. Once the themes were identified, we divided the list of PEM topics into appropriate themes and then carried out a second round of focus groups expanded to include more diverse expert input for prioritizing the elements of the comprehensive list within each theme. Results: We prioritized 168 important PEM concepts from previous standards and emerging PEM literature among 10 identified themes: the pediatric normal, the bottom‐line boil‐it‐down approach, common presentations, high‐acuity pediatric cases and procedures, differences between children and adults, same between children and adults, red flags, infrequency of caring for a child compared with an adult, keep breadth but promote self‐directed depth, and triage and disposition. Conclusions: Based on input from stakeholders in EM resident education, we identified key themes within PEM education and created a framework for the hierarchical categorization of PEM content for within an EM residency. [ABSTRACT FROM AUTHOR]

Background: Boarding patients in the emergency department (ED) potentially affects resident education. Program director (PD) perceptions of the impact of boarding on their trainees have not been previously described. Methods: We surveyed a cross‐sectional convenience sample of emergency medicine PDs using a mixed‐methods approach to explore their perceptions of how boarding has affected their residents' training. Descriptive data were reported as percentages and differences were calculated using Pearson's chi‐square test, with p < 0.05 considered significant. A framework model was used to qualitatively analyze free‐text responses. Results: A total of 170 responses were collected, for a response rate of 63%. Most respondents felt that boarding had at least some effect on resident education with 29%, 35%, 18%, and 12% noting "a little," "a moderate amount," "a lot," and "a great deal," respectively, and 5% noting "no effect at all." Respondents perceived a negative impact of boarding on resident education and training, with 80% reporting a "somewhat" or "extremely negative" effect, 18% feeling neutral, and 2% noting a "somewhat positive" effect. Most noted a "somewhat" or "extremely negative" effect on resident education in managing ED throughput (70%) and high patient volumes (66%). Fifty‐four percent noted a "somewhat" or "extremely negative" impact on being involved in the initial workup of undifferentiated patients. Thirty‐two percent saw a "somewhat" or "extremely positive" effect on learning the management of critically ill patients. Qualitative analysis of challenges, mitigation strategies, and resident feedback emphasized the lack of exposure to managing departmental patient flow, impact on bedside teaching, and need for flexibility in resident staffing. Conclusions: Most PDs agree that boarding negatively affects resident education and identify several strategies to mitigate the impact. These findings can help inform future interventions to optimize resident learning in the complex educational landscape of high ED boarding. [ABSTRACT FROM AUTHOR]

Introduction: Emergency medicine (EM) has historically been among the most competitive specialties in the United States. However, in 2022 and 2023, 219 of 2921 and 554 of 3010 respective National Resident Matching Program positions were initially unfilled. Medical students' selection of a medical specialty is a complex process. To better understand recent trends in the EM residency match, this qualitative study explored through one‐on‐one interviews the rationale of senior medical students who seriously considered EM but ultimately pursued another specialty. Methods: A convenience sample of senior medical students from across the United States was recruited via multiple mechanisms after the 2023 match. Participant characteristics were collected via an online survey. Qualitative data were generated through a series of one‐on‐one semistructured interviews and thematic analysis of the data was performed using a constant comparative approach. Results: Sixteen senior medical students from 12 different institutions participated in the study. Thematic saturation was reached after 12 interviews but data from all 16 interviews were included for qualitative analyses. Five major themes emerged as important in students' consideration but ultimate rejection of EM as a career: (1) innate features of EM attracted or dissuaded students, (2) widespread awareness of a recent workforce report, (3) burnout in EM, (4) their perception of EM's standing in the health care landscape, and (5) early EM experience and exposure. Conclusions: This qualitative study identified five major themes in the career decisions of senior medical students who seriously considered EM but chose another specialty. These findings may help inform the perceptions of students and guide future EM recruitment efforts. [ABSTRACT FROM AUTHOR]

The emergency medicine specialty experienced a significant increase in unfilled residency positions in the 2022 and 2023 National Resident Matching Program (NRMP) Main Residency Match. This was attributed to an excess supply of positions, a decrease in student demand for emergency medicine, and issues with the recruitment process. Data from various sources indicate that there is a mismatch between the number of applicants and available positions. Proposed solutions include addressing the pipeline problem, modifying interview behaviors, considering program contractions, and making policy changes. It is important to educate applicants about the benefits of a career in emergency medicine and address concerns about workforce projections and work environment. [Extracted from the article]

Objectives: Our study aims to better understand and describe the current state of diversity, equity, and inclusion (DEI) leadership in emergency medicine (EM) by identifying the prevalence of department DEI leadership positions, their demographics, and their job duty characteristics. Methods: We disseminated an electronic survey from April to July 2022 to Society for Academic Emergency Medicine (SAEM) Association of Academic Chairs of Emergency Medicine, Academy for Diversity and Inclusion in Emergency Medicine, and the Equity and Inclusion Committee to identify department DEI leads. From July to August 2022, a 45‐question survey was sent to all identified DEI leaders on individual characteristics, DEI experience, and DEI lead job description. Results: We received a response from 79 out of 120 academic EM departments identified (65.8%). Of the responding institutions, 59 (74.7%) reported a DEI leader. A total of 74.6% of these DEI leaders responded at least partially to our survey and 57.6% responded in full. The most common titles were vice/associate chair of DEI (34.4%), director of DEI (28.1%), and DEI committee chair (18.8%). Most respondents (84.4%) were the inaugural DEI lead in their department and 84.4% of respondents did not have a formal DEI role in their department previously. On average, respondents have had their DEI title for 2 years (range 0–7 years) with an average of 7 years (range 0–30 years) of experience performing DEI work. Many (63.4%) do not receive any funded effort for their DEI roles. Most DEI leads were not tenure track (72.2%) and most commonly at the rank of assistant professor (47.2%) followed by associate professor (33.3%), full professor (16.7%), and instructor (2.8%). Conclusions: This is the first known study to assess the characteristics of DEI department leaders in EM. EM DEI leadership positions are new, common, and led by diverse personal identities and are often not funded. Future directions could gain qualitative insight into this workforce to guide best practices in EM DEI leadership. [ABSTRACT FROM AUTHOR]

Objective: Fellowship training is increasingly popular among residency graduates and critical to the advancement of academic emergency medicine (EM). Little is known about the clinical hours worked and financial compensation received by fellows during training. We sought to describe the clinical duties and financial compensation of EM fellows at U.S. academic centers. Methods: This cross‐sectional study surveyed U.S. academic EM department administrators who were members of the Society for Academic Emergency Medicine's Academy of Administrators in Academic Emergency Medicine (AAAEM) regarding their fellowship programs and fellows. We electronically distributed the validated survey instrument to 73 member sites between October 2022 and January 2023. Survey domains included fellow and fellowship demographics, base and total annual clinical hours, and base and total annual compensation. We calculated descriptive statistics and compared fellows by accreditation (Accreditation Council for Graduate Medical Education [ACGME] or non‐ACGME) using chi‐square and Wilcoxon rank‐sum testing. We conducted a secondary analysis of base and total salary by gender and accreditation using Wilcoxon rank‐sum testing. Results: We received 38 institutional responses (response rate 52%), which represented 217 individual fellows. Nearly three‐fourths (n = 158, 72.8%) of fellows enrolled in non‐ACGME fellowships, worked 33% more base hours annually than ACGME fellows (median 571 h vs. 768 h, p < 0.001), and received base compensation 20% higher than ACGME fellows ($88,540 vs. $70,777, p < 0.001). Accounting for additional compensation, the median total annual compensation for non‐ACGME fellows remained 11% higher than ACGME fellows ($105,000 vs. $93,853, p = 0.004). We observed no significant differences salary when stratified by gender. Conclusions: Most EM fellows at U.S. academic institutions enrolled in non‐ACGME fellowships with significantly higher base hours and financial compensation than ACGME fellowships. These results represent the first description of the clinical hours and financial compensation of academic EM fellows and should be considered in ongoing benchmarking efforts by AAAEM. [ABSTRACT FROM AUTHOR]

Objectives: Postresidency career choices are complex decisions that involve personal, professional, and financial preferences and may be influenced by training programs. It is unknown how residents navigate these decisions during emergency medicine (EM) residency. We explored EM residents' perspectives on career decision making and how residency programs can support career planning. Methods: We conducted semistructured interviews at seven accredited EM residency programs from diverse locations and training formats. We used purposive sampling to reflect the diversity of trainees with regard to gender, level of training, and career plans. Two researchers independently coded the transcripts. We used a constructivist–interpretivist paradigm to guide our thematic analysis. Results: We interviewed 11 residents and identified major themes in three categories. Residents described being exposed to career options through formalized curricula such as required rotations, career fairs, and subspeciality tracks, highlighting the importance of access to faculty with diverse areas of clinical and academic expertise. Many noted that exposure was often self‐driven. We identified three major themes regarding career decisions: instrumental factors, people involved, and processes of decision making. Instrumental factors included personal interests, goals, and values as well as practice characteristics, financial considerations, timing, and opportunity costs. Mentors and family were highly involved in resident career decisions. Residents often utilized reflection and conversations with mentors and peers in their decision‐making process. Participants recommended that programs provide exposure to diverse career options early in training, protect time for career education, and ensure adequate mentorship and a supportive community. Participants suggested specific curricular content and strategies to support career decisions. Conclusions: This study illuminates important factors involved in resident career decision making and how programs can support their trainees. Essential components include diverse experiences and building a reflective mentorship environment. [ABSTRACT FROM AUTHOR]

This document is a curriculum for training in orthobiologics, which provides a framework for education and training in the field. It is primarily targeted towards physiatrists, but can be modified for physicians from other specialties. The curriculum focuses on orthobiologic treatments that align with current U.S. Food and Drug Administration guidelines and does not advocate for any specific treatment modality. It includes core and specialized competencies, and is designed to be adaptable to diverse training needs. The curriculum was developed by a group of subject matter experts and will be updated as the field of orthobiologics evolves. [Extracted from the article]

This article discusses the concept of posttraumatic growth (PTG) and its potential for supporting residents in the aftermath of medical errors. It highlights the emotional distress experienced by resident physicians following an error, which can lead to burnout and negatively impact their training and patient care. The article suggests strategies for supporting residents after an error, including the formalization of a peer response network, restructuring morbidity and mortality conferences, developing medicolegal curricula, and teaching error disclosure. The goal is to create a growth culture that promotes learning and resilience among residents in emergency medicine. [Extracted from the article]

Introduction: Resident‐as‐teacher (RAT) curricula have improved teaching behavior, ability, and confidence among resident participants. However, there are limited data on the appropriate format, length, and content. With teaching being a core residency competency and residents delivering one‐third of student teaching in the clinical setting, properly training residents in clinical teaching is essential. We created a formal, scalable, asynchronous RAT curriculum. We report the pilot implementation of this curriculum along with feasibility, user acceptability, and preliminary knowledge outcomes. Methods: In this pilot pre–post interventional study, senior emergency medicine residents completed a formalized online education curriculum during their "teach month." The curriculum consisted of three online modules completed weekly over a 4‐week rotation. Topics included adult learning, assessment and feedback, and group teaching. Several surveys were sent to residents before and after curriculum implementation. The surveys rated satisfaction and asked several education‐specific knowledge questions to assess learning. Ratings were analyzed using means and confidence intervals (95%). Knowledge questions were graded and then analyzed by ANOVA and Fisher's LSD test. Results: After the online modules were completed, the intervention group residents' mean score on knowledge questions was significantly higher than that prior to the curriculum and significantly higher than that the control group (previous graduated residents; 6.00 vs. 2.70, p = 0.0001; and 6.00 vs. 3.00, p = 0.0003, respectively). This score was maintained 3 months after completing the online modules. Intervention group residents were more satisfied with the online education resources than the control group (p = 0.048). Conclusions: Residents participating in a formalized online curriculum during their teach month demonstrate a high comprehension of education concepts and increased satisfaction with the provided educational resources and report high satisfaction with the teach month. Our pilot study suggests that a short online education‐focused curriculum is an effective method of providing RAT training and may be applicable to clinical teachers across specialties and experience levels. [ABSTRACT FROM AUTHOR]

Background: It is essential that medical education (MedEd) fellows achieve desired outcomes prior to graduation. Despite the increase in postgraduate MedEd fellowships in emergency medicine (EM), there is no consistently applied competency framework. We sought to develop entrustable professional activities (EPAs) for EM MedEd fellows. Methods: From 2021 to 2022, we used a modified Delphi method to achieve consensus for EPAs. EM education experts generated an initial list of 173 EPAs after literature review. In each Delphi round, panelists were asked to make a binary choice of whether to include the EPA. We determined an inclusion threshold of 70% agreement a priori. After the first round, given the large number of EPAs meeting inclusion threshold, panelists were instructed to vote whether each EPA should be included in the "20 most important" EPAs for a MedEd fellowship. Modifications were made between rounds based on expert feedback. We calculated descriptive statistics. Results: Seventeen experts completed four Delphi rounds each with 100% response. After Round 1, 87 EPAs were eliminated and two were combined. Following Round 2, 46 EPAs were eliminated, seven were combined, and three were included in the final list. After the third round, one EPA was eliminated and 13 were included. After the fourth round, 11 EPAs were eliminated. The final list consisted of 16 EPAs in domains of career development, education theory and methods, research and scholarship, and educational program administration. Conclusions: We developed a list of 16 EPAs for EM MedEd fellowships, the first step in implementing competency‐based MedEd. [ABSTRACT FROM AUTHOR]

Objectives: The specialty of emergency medicine (EM) is experiencing a significant decrease in student interest. In addition, women are historically underrepresented within the specialty at all levels of training and practice. We sought to understand how clinical experiences and perceptions of EM influence specialty selection by medical students, particularly women. Methods: Using a constructivist grounded theory approach, we analyzed semistructured interviews with senior medical students who considered EM as a specialty. We used purposive sampling to recruit from diverse learning environments and represent a variety of experiences. Participants reflected on their specialty selection process and experiences in EM including their perceived acceptance in the work environment. Results: Twenty‐five medical students from 11 geographically diverse schools participated. A total of 68% (17/25) identified as women. The majority (21/25, 84%) planned on applying to EM residency. We identified four major themes: (1) distressing interpersonal interactions with patients and the ED care team negatively affect students; (2) EM culture includes behaviors that are perceived as exclusionary; (3) beliefs about the attributes of an ideal EM physician and the specialty itself have a gendered nature; and (4) ease of access to mentors, representation, and early exposure to EM environment increased interest in specialty. Conclusions: Our participants express that EM causes challenges for students to accept the norms of behavior in the field, which is an essential element in joining a group and professional identity formation. In addition, we raise concern that gendered perceptions and language may send exclusionary environmental cues that may negatively impact recruitment of a diverse physician workforce. [ABSTRACT FROM AUTHOR]

Background and Aims: The National Standardized Training for Resident Doctors (STRD) in mainland China encounters many challenges in its implementation. To investigate whether outpatients are willing to undergo indirect ophthalmoscopy examination conducted by ophthalmology residents in the ophthalmology STRD program in China. Methods: This study conducted a cross‐sectional survey at the Eye Hospital of Wenzhou Medical University between September 2021 and September 2023. A cohort of 300 initial outpatients requiring indirect ophthalmoscopy examinations were enlisted from the outpatient department. Based on whether the patients are willing to undergo an indirect ophthalmoscopy examination by resident doctors, patients were divided into two groups: Group 1 (willing) and Group 2 (unwilling), and their questionnaire responses were comparatively analyzed. Results: A total of 261/300 (87%) valid questionnaires were returned in the survey, which included 149 males and 112 females. No notable gender difference (p = 0.400) or disparity in medical expense categories (p = 0.786) was observed between the two groups. However, variables such as outpatient marital status (p = 0.002), the presence of training faculty during fundus examinations with residents and outpatients (p < 0.001), the demeanor of training residents toward patients (p < 0.001), and the quality of doctor–patient communication (p < 0.001) significantly varied between the groups. Conclusion: The level of outpatients' cooperation with ophthalmology residents during fundus examinations in the Chinese ophthalmology STRD program was observed to be low. Enhancing the presence of training faculty during examinations and enhancing the communication skills of training residents could significantly improve this situation. [ABSTRACT FROM AUTHOR]

This article explores the creation and implementation of a Medical Education Track within a Physical Medicine and Rehabilitation (PM&R) residency program. The track was designed to equip residents with teaching, mentoring, and educational skills. The study found that residents who participated in the track reported increased confidence in these areas compared to those who did not participate. The program was well-received by participants and resulted in an increase in medical education-related scholarly activities. Overall, the Medical Education Track successfully provided PM&R residents with a solid foundation in medical education. [Extracted from the article]

Introduction: Many emergency medicine (EM) residency programs include clinical rotations in rural emergency departments ("rural rotations") as part of their curriculum. These rotations are designed to expose residents to clinical scenarios that are less frequently encountered in tertiary centers. The objective of this study was to determine the rate at which residents were exposed to certain clinical and procedural experiences (CPEs) while on rural rotations compared to their usual academic training hospital. Methods: We conducted a retrospective chart review of all patient encounters involving EM residents at a large academic hospital in Rochester, Minnesota, compared with two rural hospitals in Austin, Minnesota, and Albert Lea, Minnesota, from July 1, 2019, to June 30, 2020. The frequency of each CPE was calculated and expressed as the number of CPEs encountered per 100 clinical hours worked. These values were compared between the rural and academic sites. Results: A total of 33,417 patient encounters over a total of 41,700 resident clinical hours were analyzed between the three study sites. The two settings (rural vs. academic) had significant differences in baseline patient demographics including age, acuity, and admission rates. Several CPEs were found to occur at a higher frequency in the rural hospitals versus the academic hospital: ambulance necessity documentation (9.3/100 h rural vs. 0.07/100 h academic, p ≤ 0.0001), laceration repair (3.39/100 h rural vs. 2.0/100 h academic, p = 0.0004), and splint/cast application (1.53/100 h rural vs. 0.07/100 h academic, p ≤ 0.0001). Conclusions: Rural EM rotations provide residents exposure to a variety of valuable educational experiences. These rotations may provide residents with superior exposures to some clinical experiences compared to academic hospitals, particularly out‐of‐ED transfers and orthopedic procedures. Residency programs without a current rural rotation should consider creating this as an option for their trainees. [ABSTRACT FROM AUTHOR]

Background: More than 90% of pediatric patients presenting to emergency departments (EDs) in the United States are evaluated and treated in community‐based EDs. Recent evidence suggests that mortality outcomes may be worse for critically ill pediatric patients treated at community EDs. The disparate mortality outcomes may be due to inconsistency in pediatric‐specific education provided to emergency medicine (EM) trainees during residency training. There are few studies surveying recently graduated EM physicians assessing perceived gaps in the pediatric emergency medicine (PEM) education they received during residency. Methods: This was a prospective, survey‐based, descriptive cohort study of EM residency graduates from 10 institutions across the United States who were <5 years out from residency training. Deidentified surveys were distributed via email. Results: A total of 222 responses were obtained from 570 eligible participants (39.1%). Non‐ED pediatric rotations during residency training included pediatric intensive care (60%), pediatric anesthesia (32.4%), neonatal intensive care unit (26.1%), and pediatric wards (17.1%). A large percentage (42.8%) of respondents felt uncomfortable managing neonates and performing tube thoracostomy on pediatric patients (56.3%). The EM graduate's satisfaction with pediatric simulation–based training during residency was positively associated with comfort caring for neonates and infants (p < 0.0070 and p < 0.0002) and performing endotracheal intubation (p < 0.0027), lumbar puncture (p < 0.0004), and Pediatric Advanced Life Support resuscitation (p < 0.0001). Conclusions/discussion: This survey‐based cohort study found considerable variation in pediatric‐specific experiences during EM residency training and in perceived comfort managing pediatric patients. In general, participants were more comfortable managing older children. This study suggests that the greatest perceived knowledge gaps in PEM were neonatal medicine/resuscitation and pediatric cardiac arrest. Future research will continue to address larger cohorts, representative of the PEM education provided to EM physicians in the United States to promote future educational initiatives. [ABSTRACT FROM AUTHOR]

Objectives: Cricothyrotomy is a high‐stakes emergency procedure. Because the procedure is rare, simulation is often used to train residents. The Accreditation Council for Graduate Medical Education (ACGME) requires performance of three cricothyrotomies during residency, but the optimal number of training repetitions is unknown. Additional repetitions beyond three could increase proficiency, though it is unknown whether there is a threshold beyond which there is no benefit to additional repetition. The objective of this study was to establish a minimum number of simulated cricothyrotomy attempts beyond which additional attempts did not increase proficiency. Methods: This was a prospective, observational study conducted over 3 years at the simulation center of an academic emergency medicine residency program. Participants were residents participating in a cricothyrotomy training as part of a longitudinal airway curriculum course. The primary outcome was time to successful completion of the procedure as first‐year residents. Secondary outcomes included time to completion as second‐ and third‐year residents. Procedure times were plotted as a function of attempt number. Data were analyzed using descriptive statistics, repeated‐measures analysis of variance, and correlation analysis. Preprocedure surveys collected further data regarding procedure experience, confidence, and comfort. Results: Sixty‐nine first‐year residents participated in the study. Steady improvement in time to completion was seen through the first six attempts (from a mean of 75 to 41 sec), after which no further significant improvement was found. Second‐ and third‐year residents initially demonstrated slower performance than first‐year residents but rapidly improved to surpass their first‐year performance. Resident mean times at five attempts were faster with each year of residency (first‐year 48 sec, second‐year 30 sec, third‐year 24 sec). There was no statistically significant correlation between confidence and time to complete the procedure. Conclusions: Additional repetition beyond the ACGME‐endorsed three cricothyrotomy attempts may help increase proficiency. Periodic retraining may be important to maintain skills. [ABSTRACT FROM AUTHOR]

Background: Cultural sensitivity (CS) training is vital to pediatric emergency medicine (PEM) curricula. This study aimed to explore CS in Yale PEM fellows and emergency medicine (EM) residents at Indus Hospital and Health Network (IHHN) in Pakistan through distance simulation activities. Methods: This mixed‐methods analysis of an educational intervention was conducted at Yale University in collaboration with IHHN. We approached seven U.S. PEM fellows and 22 Pakistani EM residents. We performed a baseline CS assessment using the Clinical Cultural Competency Questionnaire (CCCQ). Afterward, the U.S. PEM fellows facilitated the Pakistani EM residents through six distance simulation sessions. Qualitative data were collected through online focus groups. The CCCQ was analyzed using descriptive statistics, and content analysis was used to analyze the data from the focus groups. Results: Seven U.S. PEM fellows and 18 of 22 Pakistani EM residents responded to the CCCQ at the beginning of the module. The mean (±SD) CCCQ domain scores for the U.S. PEM fellows versus the Pakistani EM residents were 2.56 (±0.37) versus 2.87 (±0.72) for knowledge, 3.02 (±0.41) versus 3.33 (±0.71) for skill, 2.86 (±0.32) versus 3.17 (±0.73) for encounter/situation, and 3.80 (±0.30) versus 3.47 (±0.47) for attitude (each out of 5 points). Our qualitative data analysis showed that intercultural interactions were valuable. There is a common language of medicine among the U.S. PEM fellows and Pakistani EM residents. The data also highlighted a power distance between the facilitators and learners, as the United States was seen as the standard of "how to practice PEM." The challenges identified were time differences, cultural practices such as prayer times, the internet, and technology. The use of local language during debriefing was perceived to enhance engagement. Conclusion: The distance simulation involving U.S. PEM fellows and Pakistani EM residents was an effective approach in assessing various aspects of intercultural education, such as language barriers, technical challenges, and religious considerations. [ABSTRACT FROM AUTHOR]

This article discusses the importance of nontechnical skills (NTS) in emergency medicine training and the need for their integration into medical education. NTS include leadership, team management, situational awareness, decision making, communication, and adaptive expertise. The article provides an overview of these skills, indicators of growth opportunities, teaching strategies, and assessment tools. It emphasizes the role of faculty in identifying and teaching NTS to improve clinical experiences for learners and optimize patient outcomes. The article also mentions various assessment tools, such as the NTS Score (NOTECHS+), TEAM, Clinical Teamwork Scale (CTS), NASA-Task Load Index (TLX), case-based assessment, biomarkers, and video review/eye-tracking technology. The authors acknowledge that these tools are not comprehensive or prescriptive, and faculty should use them flexibly based on their expertise and experience. Overall, the integration of NTS into emergency medical education has the potential to transform the field and improve patient care. [Extracted from the article]

The article discusses the use of the Self-Assessment Feedback Encouragement Direction (SFED) model in academic emergency medicine. Feedback is important for professional development and should be timely, specific, and based on direct observation. The SFED model incorporates elements from other feedback models and includes protected time for learner self-assessment and encouragement. It can be adjusted for different learner types and training levels. The article provides a step-by-step process for using the SFED model effectively and emphasizes the importance of creating a supportive and psychologically safe environment for feedback. Overall, the SFED model is a useful tool for giving effective feedback in the emergency department. [Extracted from the article]

Objectives: There is no unified approach for training residents to be teachers. Foundations of Emergency Medicine (FoEM) is a national program that provides free resident education in emergency medicine (EM) utilizing small‐group, case‐based instruction delivered by individual program faculty and residents. This study seeks to explore the FoEM resident‐as‐teacher (RaT) experience. Methods: We conducted a mixed‐methods study of FoEM faculty site leaders and resident teachers in 2022. Site leaders completed an online survey consisting of multiple‐choice, completion, and free‐response items. We calculated descriptive statistics and applied a thematic qualitative analysis to free‐response items. We conducted semistructured interviews with resident teachers. Interview transcripts were analyzed using a thematic approach with a constructivist–interpretivist paradigm. Results: A total of 133 of 180 (74%) site leaders completed the survey and 11 resident teachers were interviewed. Forty‐nine (37%) programs utilize resident instructors. The frequency of residents teaching and degree of faculty supervision varied. Commonly identified advantages include reinforcement of core content for resident teachers (44/49), structured format (35/49), and reduced need for faculty instructors (30/49). The most commonly identified challenges include variable instruction by residents (33/49) and challenge to providing feedback on teaching (20/49). Resident teachers identified benefits including strengthening residency community, improved EM knowledge, and greater teaching skills. For nearly all resident participants, FoEM RaT impacted their career goals by affirming their interest in teaching. Conclusions: The FoEM curricular model appears to be a valuable and feasible method to incorporate a RaT experience into EM residency training programs. [ABSTRACT FROM AUTHOR]

Recent insights into the frequency of occurrence and the genetic and mechanistic basis of nervous system disease have demonstrated that neurologic disorders occur as a spectrum across all ages. To meet future needs of patients with neurologic disease of all ages and prepare for increasing implementaton of precision therapies, greater integration of child and adult neurology residency training is needed. ANN NEUROL 2023;94:1005–1007 [ABSTRACT FROM AUTHOR]

Background: Emergency medicine (EM) residents face unique affective challenges and barriers to interpersonal connection in their clinical environment which may contribute to decreased empathy and increased burnout. Narrative medicine (NM) might address these barriers and has had beneficial impacts in various populations but has never been studied in EM residents. In this study, we sought to evaluate the effect of NM workshops on burnout and empathy and to assess resident perceptions of the workshops. Methods: We performed a quasi-experimental study at two EM residencies from June to October 2020. Residents at the intervention site participated in two NM workshops led by EM faculty that were composed of a close reading of a literary text, reflective writing, and group discussion. Residents were asked to complete the abbreviated Interpersonal Reactivity Index (IRI) and a single-item burnout measure pre-and postintervention. We fitted linear regression models to IRI subscores; we treated burnout as an ordinal variable and fitted a conditional logistic regression model. Residents completed a postintervention survey that we analyzed using summary statistics. Results: A total of 46.7% of control (28/60) and 100% of intervention (48/48) residents responded (n = 76). While all respondents demonstrated worsening burnout with time (p = 0.001), residents at the intervention site exhibited less severe increases (interaction p < 0.001). Empathy remained unchanged. A total of 50% of intervention residents (24/48) responded to the postintervention survey; most (n = 20, 83.3%) agreed that the workshops should be a standard part of EM didactics. Conclusions: These findings establish the feasibility and desirability of NM in residency education and offers a model for EM-centered narrative workshops. Additionally, while our outcomes are limited, we found that exposure to an NM curriculum may be protective against worsening burnout. [ABSTRACT FROM AUTHOR]

Objective: To evaluate a novel curriculum to enhance knowledge and preparedness of emergency medicine (EM) residents in the management of postpartum hemorrhage (PPH). Methods: A randomized controlled trial examining two pedagogical approaches. Following baseline testing of knowledge and confidence in respect of PPH management, participants were randomized to receive a didactic lecture on PPH management (group A, n = 14) or a didactic lecture followed by simulation‐based training on PPH management and debriefing (group B, n = 16). Post‐intervention, proficiency in PPH management was evaluated by clinical skills simulation and post‐intervention assessment for participants. The change in the mean test and clinical skills scores were compared using Student's t‐test. Linear regression examined the effects of covariates. Results: Both forms of intervention increased participants' knowledge of (group A: mean = 2.50, 95% confidence interval [CI] 1.63–3.37, P < 0.001; group B: mean = 1.56, 95% CI 0.89–2.24, P < 0.001) and confidence in PPH management (group A: mean = 1.00, 95% CI 0.46–1.54, P = 0.003; group B: mean = 1.00, 95% CI 0.52–1.48, P = 0.001), relative to baseline. However, addition of simulation and debriefing to the didactic session did not offer any advantage (knowledge: mean = −0.94, 95% CI –1.97 to 0.10, P = 0.074; confidence: mean = 0.00, 95% CI –0.66 to 0.66, P = 1.000). Conclusion: Delivery of a structured curriculum led to improvement of knowledge and confidence with regard to the management of PPH by EM residents. Synopsis: The present study demonstrated that, through the delivery of a curriculum, we can improve confidence and knowledge of emergency medicine residents in the management of postpartum hemorrhage. [ABSTRACT FROM AUTHOR]

Background: Pediatric requirements include procedural skills training such as peripheral intravenous (PIV) catheter placement and bag–mask ventilation (BMV). Clinical experiences may be limited and temporally remote from scheduled teaching. Just‐in‐time (JIT) training prior to utilization can promote skill development and mitigate learning decay. Our objective was to assess the impact of JIT training on pediatric residents' procedural performance, knowledge, and confidence with PIV placement and BMV. Methods: Residents received standardized baseline training in both PIV placement and BMV during scheduled educational programming. Between 3 and 6 months later, participants were randomized and received JIT training for either PIV placement or BMV. JIT training included a brief video and coached practice, totaling <5 min. Each participant was videotaped performing both procedures on skills trainers. Blinded investigators scored performance using skills checklists. Pre‐ and postintervention knowledge was assessed using multiple‐choice and short‐answer items, and confidence was reported using Likert scores. Results: Seventy‐two residents completed baseline training sessions: 36 were randomized to receive JIT training for PIV and 36 for BMV. Thirty‐five residents in each cohort completed the curriculum. There were no significant differences between the cohorts with regard to demographics, baseline knowledge, or prior simulation experience. JIT training was associated with improved procedural performance for PIV (median 87% vs. 70%, p < 0.001) and for BMV (mean 83% vs. 57%, p < 0.001). Results remained significant after using regression models to adjust for differences in prior clinical experience. Improvements in knowledge or confidence were not associated with JIT training in either cohort. Conclusions: JIT training resulted in a significant improvement in resident procedural performance with PIV placement and BMV in a simulated environment. There were no differences in outcome with regard to knowledge or confidence. Future work might explore how the demonstrated benefit translates into the clinical setting. [ABSTRACT FROM AUTHOR]