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Emergency Medicine Resident

Santi Di Pietro, Francesco Falaschi, Alice Bruno, Tiziano Perrone, Valeria Musella, Stefano Perlini
PURPOSE: The sonographic evaluation of inferior vena cava diameters and its collapsibility-that is also defined as the caval index-has become a popular way to easily obtain a noninvasive estimate of central venous pressure. This is generally considered an easy sonographic task to perform, and according to the American College of Emergency Physicians (ACEP) Guidelines 25 repetitions of this procedure should be sufficient to reach proficiency. However, little is known about the learning process for this sonographic technique...
March 21, 2018: Journal of Ultrasound
Kristin L Rising, Dimitrios Papanagnou, Danielle McCarthy, Alexzandra Gentsch, Rhea Powell
Introduction Diagnostic uncertainty is common in healthcare encounters. Effective communication is important to help patients and providers navigate diagnostic uncertainty, especially at transitions of care. This study sought to assess the experience and training of emergency medicine (EM) residents with communication of diagnostic uncertainty. Methods This was a survey study of a national sample of EM residents. The survey questions elicited quantitative and qualitative responses about experiences with and educational preparation for communication with patients in the setting of diagnostic uncertainty...
January 19, 2018: Curēus
Fareen Zaver, Nicole Battaglioli, William Denq, Anne Messman, Arlene Chung, Michelle Lin, Emberlynn L Liu
Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs...
March 2018: Western Journal of Emergency Medicine
Jacob Arnold, Jennifer Tango, Ian Walker, Chris Waranch, Joshua McKamie, Zafrina Poonja, Anne Messman
Introduction: Physicians are at much higher risk for burnout, depression, and suicide than their non-medical peers. One of the working groups from the May 2017 Resident Wellness Consensus Summit (RWCS) addressed this issue through the development of a longitudinal residency curriculum to address resident wellness and burnout. Methods: A 30-person (27 residents, three attending physicians) Wellness Curriculum Development workgroup developed the curriculum in two phases...
March 2018: Western Journal of Emergency Medicine
Nicole Battaglioli, Felix Ankel, Christopher I Doty, Arlene Chung, Michelle Lin
Introduction: Physician wellness has recently become a popular topic of conversation and publication within the house of medicine and specifically within emergency medicine (EM). Through a joint collaboration involving Academic Life in Emergency Medicine's (ALiEM) Wellness Think Tank, Essentials of Emergency Medicine (EEM), and the Emergency Medicine Residents' Association (EMRA), a one-day Resident Wellness Consensus Summit (RWCS) was organized. Methods: The RWCS was held on May 15, 2017, as a pre-day event prior to the 2017 EEM conference in Las Vegas, Nevada...
March 2018: Western Journal of Emergency Medicine
Christopher Sampson, Marc Borenstein
Background The impact of resident work hours on resident well-being and patient safety has long been a controversial issue. Objectives What has not been considered in resident work hour limitations is whether resident commuting time has any impact on a resident's total work hours or well-being. Methods A self-administered electronic survey was distributed to emergency medicine residents in 2016. Results The survey response was 8% (569/6828). Commuter time was 30 minutes or less in 70%. Two residents reported a commuter time of 76 to 90 minutes and one resident had a commuter time of 91 to 105 minutes...
January 12, 2018: Curēus
Sarah Edgerley, Conor McKaigney, Devon Boyne, Darrell Ginsberg, Jeffrey Damon Dagnone, Andrew Koch Hall
AIM: Emergency medicine (EM) trainees often work nightshifts. We sought to measure how this circadian disruption affects EM resident performance during simulated resuscitations. METHODS: This retrospective cohort study enrolled EM residents at a single Canadian academic centre over a six-year period. Residents completed twice-annual simulation-based resuscitation-focused objective structured clinical examinations (OSCEs) with assessment in four domains (primary assessment, diagnostic actions, therapeutic actions and communication), and a global assessment score (GAS)...
March 12, 2018: Resuscitation
Vineet M Arora
With the advent of electronic medical records (EMRs) fueling the rise of big data, the use of predictive analytics, machine learning, and artificial intelligence are touted as transformational tools to improve clinical care. While major investments are being made in using big data to transform health care delivery, little effort has been directed toward exploiting big data to improve graduate medical education (GME). Because our current system relies on faculty observations of competence, it is not unreasonable to ask whether big data in the form of clinical EMRs and other novel data sources can answer questions of importance in GME such as when is a resident ready for independent practice...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Steven Lin, Cathina Nguyen, Emily Walters, Paul Gordon
BACKGROUND AND OBJECTIVES: Worsening faculty shortages in medical schools and residency programs are threatening the US medical education infrastructure. Little is known about the factors that influence the decision of family medicine residents to choose or not choose academic careers. Our study objective was to answer the following question among family medicine residents: "What is your greatest concern or fear about pursuing a career in academic family medicine?" METHODS: Participants were family medicine residents who attended the Faculty for Tomorrow Workshop at the Society of Teachers of Family Medicine Annual Spring Conference in 2016 and 2017...
March 2018: Family Medicine
Ahmad Khobrani, Nirali H Patel, Richard L George, Neil L McNinch, Rami A Ahmed
Trauma is a leading cause of morbidity and mortality in infants and children worldwide. Trauma education is one of the most commonly reported deficiencies in pediatric emergency medicine (PEM) training. In this study, we describe the creation of a pediatric trauma boot camp in which trainees' basic knowledge, level of confidence, teamwork, and communication skills are assessed. The primary goal of this pilot study was to create a simulation-based pediatric trauma curriculum for PEM fellows and emergency medicine residents utilizing Kern's curricular conceptual framework...
2018: Emergency Medicine International
Patrick G Chan, Lara W Schaheen, Ernest G Chan, Chris C Cook, James D Luketich, Jonathan D'Cunha
OBJECTIVE: Transitioning from medical school and general surgery training to cardiothoracic (CT) surgical training poses unique challenges for trainees and patient care. We hypothesized that participation in technology-enhanced simulation modules that provided early exposure to urgent/emergent CT patient problems would improve cognitive skills and readiness to manage common urgencies/emergencies. DESIGN: Traditional and integrated cardiothoracic residents at our institution participated in a technology-enhanced simulation curriculum...
March 9, 2018: Journal of Surgical Education
Robert Soegtrop, Matthew Douglas-Vail, Taylor Bechamp, Melanie P Columbus, Kevin Wood, Kristine Van Aarsen, Robert Sedran
An increase in physical activity has been shown to improve outcomes in many diseases. An estimated 600,000 Canadians receive their primary health care from emergency departments (ED). This study aims to examine physical activity prescription by emergency medicine physicians (EPs) to determine factors that influence decisions to prescribe physical activity. A survey was distributed to EPs via email using the Canadian Association of Emergency Physicians (CAEP) survey distribution protocol. Responses from 20% (n=332) of emergency physician/residents in Canada were analyzed...
March 9, 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
Katarzyna Klysik, Aneta Pietraszek, Anna Karewicz, Maria Nowakowska
BACKGROUND: Herpes simplex (HSV) viruses are widely spread, highly contagious human pathogens. The statistics indicate that 50-90% of adults worldwide are seropositive for these viruses, mainly HSV-1 and HSV-2. The primary infection results in the appearance of watery blisters (cold sores) on the skin, lips, tongue, buccal mucosa or genitals. The ocular infection is the major cause of corneal blindness in the Western World. Once the HSV virus enters human body it cannot be completely eradicated because HSV viruses are able to change into their latent form which can survive the treatment...
March 8, 2018: Current Medicinal Chemistry
Austin T Smith
In the midst of a typical emergency medicine resident schedule packed with clinical shifts, resident scheduling, scholarly projects, conference scheduling, and family needs, I took time to visit my grandparents. They are in their 90s and because they live so far away, they had yet to meet my 1 year old daughter. Age has caught up to them over the last five years; particularly my grandfather who is in the final stages of Alzheimer's disease. He has lost the ability to recognize even his family over the last few years which has been difficult for us to experience...
March 9, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jessica M Goldonowicz, Michael S Runyon, Mark J Bullard
BACKGROUND: To investigate the value of a novel simulation-based palliative care educational intervention within an emergency medicine (EM) residency curriculum. METHODS: A palliative care scenario was designed and implemented in the simulation program at an urban academic emergency department (ED) with a 3-year EM residency program. EM residents attended one of eight high-fidelity simulation sessions, in groups of 5-6. A standardized participant portrayed the patient's family member...
March 7, 2018: BMC Palliative Care
Felix Zhou, Robert Jong, Aron Heroux, Adam Dubrowski
Patients presenting with hypothermia in a rural emergency department can be quite challenging to manage without significant mortality and morbidity. Standard medical school curricula do not fully prepare trainees for the unique aspects of practice in northern rural and remote communities. Training opportunities on site may provide a solution to this lack of experience. However, these communities often have limited simulation-based resources and expertise for conducting and developing simulation scenarios. In this technical report, we outline a hypothermia simulation that utilizes only basic resources and is, thus, practical for rural and remote facilities...
December 28, 2017: Curēus
Matthew L Wong, Jared Anderson, Thomas Knorr, Joshua W Joseph, Leon D Sanchez
INTRODUCTION: The personality traits of emergency physicians are infrequently studied, though interest in physician wellness is increasing. The objective of this study is to acquire pilot data about the amount of grit, anxiety, and stress in emergency physicians using established psychological survey instruments, and to examine their associations of each of these traits with each other. METHODS: Thirty-six emergency medicine resident and attending physicians from an urban academic medical center consented for enrollment...
February 26, 2018: American Journal of Emergency Medicine
Niran Argintaru, Jared Baylis, Jodie Pritchard, Ali Mulla, Alice Gray, Alexander Hart, Christina Bova, Teri-Leigh Armstrong, Ahmed Taher
Canadian emergency medicine Royal College residency training allows for pursuing extra training in enhanced competency areas. A wealth of enhanced competency training opportunities exist nationally. However, the search for the right fit is a challenging one because there is no centralized resource that catalogues all of these opportunities. A working group of the Canadian Association of Emergency Physicians (CAEP) Resident Section was assembled in 2016 to create a freely accessible and comprehensive directory of Canadian enhanced competency areas...
March 4, 2018: CJEM
Caroline R Paul, Meg G Keeley, Gregory S Rebella, John Frohna
OBJECTIVES: To evaluate a pediatric otoscopy curriculum with use of outcome measures that included assessment of skills with real patients. METHODS: Thirty-three residents in an intervention group from two institutions received the curriculum. In the prior year, 21 residents in a non-intervention group did not receive the curriculum. Both groups were evaluated at the beginning and end of their internship year with the same outcome assessments: 1) a written test 2) an Objective Standardized Clinical Examination (OSCE), and 3) direct observation of skills in real patients using a checklist with established validity...
February 27, 2018: Academic Pediatrics
Francesco Petrella, Lorenzo Spaggiari
Two main fields of clinical applications of stem cells in thoracic surgery have been explored: (a) regenerative medicine, that is a branch of translational research in tissue engineering and molecular biology dealing with the replacement, engineering or regeneration of cells, tissues and organs to restore normal function; (b) drug loading and delivery, that is an emerging field proposing stem cells as vectors to deliver anti-cancer agents for targeted therapies.Bronchopleural fistula is a pathological connection between the bronchus and the pleural cavity that may develop after lung resection, thus causing pleural empyema due to colonization by resident airway bacteria; stem cells and regenerative medicine approach can effectively contribute to impaired bronchial healing, thus preventive a septic and ventilator catastrophe...
March 1, 2018: Advances in Experimental Medicine and Biology
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