The 2014 Academic College of Emergency Experts in India's Education Development Committee (EDC) White Paper on establishing an academic department of Emergency Medicine in India - Guidelines for Staffing, Infrastructure, Resources, Curriculum and Training.

Science.gov (United States)

Aggarwal, Praveen; Galwankar, Sagar; Kalra, Om Prakash; Bhalla, Ashish; Bhoi, Sanjeev; Sundarakumar, Sundarajan

2014-07-01

Emergency medicine services and training in Emergency Medicine (EM) has developed to a large extent in developed countries but its establishment is far from optimal in developing countries. In India, Medical Council of India (MCI) has taken great steps by notifying EM as a separate specialty and so far 20 medical colleges have already initiated 3-year training program in EM. However, there has been shortage of trained faculty, and ambiguity regarding curriculum, rotation policy, infrastructure, teachers' eligibility qualifications and scheme of examination. Academic College of Emergency Experts in India (ACEE-India) has been a powerful advocate for developing Academic EM in India. The ACEE's Education Development Committee (EDC) was created to chalk out guidelines for staffing, infrastructure, resources, curriculum, and training which may be of help to the MCI and the National Board of Examinations (NBE) to set standards for starting 3-year training program in EM and develop the departments of EM as centers of quality education, research, and treatment across India. This paper has made an attempt to give recommendations so as to provide a uniform framework to the institutions, thus guiding them towards establishing an academic Department of EM for starting the 3-year training program in the specialty of EM.

Qualitative Research on Emergency Medicine Physicians

DEFF Research Database (Denmark)

Paltved, Charlotte; Musaeus, Peter

2012-01-01

Aim: This study aims to systematically review the qualitative research studying Emergency Medicine (EM) physicians in Emergency Departments (ED). Background: Qualitative research aims to study complex social phenomena. EM is a highly complex medical and social environment that can be investigated...... with qualitative research. Methods: Electronic databases of English peer-reviewed articles were searched from 1971 to 2012 using Medline through PubMed and PsychINFO. This search was supplemented with hand-searches of Academic Emergency Medicine and Emergency Medicine Journal from 1999 to 2012 and cross references...... and training, communication, professional roles, and organizational factors, and into 12 sub-themes. Conclusion: The strength of qualitative research is its ability to grasp and operationalize complex relations within EM. Although qualitative research methodologies have gained in rigour in recent years and few...

The 2014 Academic College of Emergency Experts in India′s Education Development Committee (EDC White Paper on establishing an academic department of Emergency Medicine in India - Guidelines for Staffing, Infrastructure, Resources, Curriculum and Training

Directory of Open Access Journals (Sweden)

Praveen Aggarwal

2014-01-01

Full Text Available Emergency medicine services and training in Emergency Medicine (EM has developed to a large extent in developed countries but its establishment is far from optimal in developing countries. In India, Medical Council of India (MCI has taken great steps by notifying EM as a separate specialty and so far 20 medical colleges have already initiated 3-year training program in EM. However, there has been shortage of trained faculty, and ambiguity regarding curriculum, rotation policy, infrastructure, teachers′ eligibility qualifications and scheme of examination. Academic College of Emergency Experts in India (ACEE-India has been a powerful advocate for developing Academic EM in India. The ACEE′s Education Development Committee (EDC was created to chalk out guidelines for staffing, infrastructure, resources, curriculum, and training which may be of help to the MCI and the National Board of Examinations (NBE to set standards for starting 3-year training program in EM and develop the departments of EM as centers of quality education, research, and treatment across India. This paper has made an attempt to give recommendations so as to provide a uniform framework to the institutions, thus guiding them towards establishing an academic Department of EM for starting the 3-year training program in the specialty of EM.

The Biology of Emergency Medicine: what have 30 years meant for Rosen's original concepts?

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Zink, Brian J

2011-03-01

In 1979 Peter Rosen, MD, a leading academic figure in the developing field of emergency medicine (EM), wrote an article, "The Biology of Emergency Medicine," in response to criticism from other specialties and medical leaders that there was no unique biology of EM that would qualify it as a legitimate medical specialty. This essay received much attention at the time and served as rallying cry for emergency physicians (EPs) who were trying to find their places in the house of medicine and especially in medical schools and academic teaching hospitals. Thirty years later, the opposition that prompted many of Rosen's strongly worded impressions and observations on the biology of EM, clinical emergency department (ED) practice, education, and research has largely faded. Many of Rosen's predictions on the eventual success of EM have come true. However, core issues that existed then continue to present challenges for academic EM and clinical emergency practice. © 2011 by the Society for Academic Emergency Medicine.

Emergency department discharge prescription interventions by emergency medicine pharmacists.

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Cesarz, Joseph L; Steffenhagen, Aaron L; Svenson, James; Hamedani, Azita G

2013-02-01

We determine the rate and details of interventions associated with emergency medicine pharmacist review of discharge prescriptions for patients discharged from the emergency department (ED). Additionally, we evaluate care providers' satisfaction with such services provided by emergency medicine pharmacists. This was a prospective observational study in the ED of an academic medical center that serves both adult and pediatric patients. Details of emergency medicine pharmacist interventions on discharge prescriptions were compiled with a standardized form. Interventions were categorized as error prevention or optimization of therapy. The staff of the ED was surveyed related to the influence and satisfaction of this new emergency medicine pharmacist-provided service. The 674 discharge prescriptions reviewed by emergency medicine pharmacists during the study period included 602 (89.3%) for adult patients and 72 (10.7%) for pediatric patients. Emergency medicine pharmacists intervened on 68 prescriptions, resulting in an intervention rate of 10.1% (95% confidence interval [CI] 8.0% to 12.7%). The intervention rate was 8.5% (95% CI 6.4% to 11.1%) for adult prescriptions and 23.6% for pediatric prescriptions (95% CI 14.7% to 35.3%) (difference 15.1%; 95% CI 5.1% to 25.2%). There were a similar number of interventions categorized as error prevention and optimization of medication therapy, 37 (54%) and 31 (46%), respectively. More than 95% of survey respondents believed that the new pharmacist services improved patient safety, optimized medication regimens, and improved patient satisfaction. Emergency medicine pharmacist review of discharge prescriptions for discharged ED patients has the potential to significantly improve patient care associated with suboptimal prescriptions and is highly valued by ED care providers. Copyright © 2012. Published by Mosby, Inc.

Assessing interpersonal and communication skills in emergency medicine.

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Chan, Teresa M; Wallner, Clare; Swoboda, Thomas K; Leone, Katrina A; Kessler, Chad

2012-12-01

Interpersonal and communication skills (ICS) are a key component of several competency-based schemata and key competency in the set of six Accreditation Council for Graduate Medical Education (ACGME) core competencies. With the shift toward a competency-based educational framework, the importance of robust learner assessment becomes paramount. The journal Academic Emergency Medicine (AEM) hosted a consensus conference to discuss education research in emergency medicine (EM). This article summarizes the initial preparatory research that was conducted to brief consensus conference attendees and reports the results of the consensus conference breakout session as it pertains to ICS assessment of learners. The goals of this consensus conference session were to twofold: 1) to determine the state of assessment of observable learner performance and 2) to determine a research agenda within the ICS field for medical educators. The working group identified six key recommendations for medical educators and researchers. © 2012 by the Society for Academic Emergency Medicine.

Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section.

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Musey, Paul I; Linnstaedt, Sarah D; Platts-Mills, Timothy F; Miner, James R; Bortsov, Andrey V; Safdar, Basmah; Bijur, Polly; Rosenau, Alex; Tsze, Daniel S; Chang, Andrew K; Dorai, Suprina; Engel, Kirsten G; Feldman, James A; Fusaro, Angela M; Lee, David C; Rosenberg, Mark; Keefe, Francis J; Peak, David A; Nam, Catherine S; Patel, Roma G; Fillingim, Roger B; McLean, Samuel A

2014-12-01

Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender

Organization, execution and evaluation of the 2014 Academic Emergency Medicine consensus conference on Gender-Specific Research in Emergency Care - an executive summary.

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Safdar, Basmah; Greenberg, Marna R

2014-12-01

With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex- and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the

Authorship Trends of Emergency Medicine Publications over the Last Two Decades.

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Lammers, Richard; Simunich, Thomas; Ashurst, John

2016-05-01

With the recent merger of the American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME) a heightened pressure for publication may become evident. Our objective was to determine whether there was a gap in the type of both medical degree designation and advanced degree designation among authorship in three United States-based academic emergency medicine journals. We reviewed the Journal of Emergency Medicine, Academic Emergency Medicine and Annals of Emergency Medicine for the type of degree designation that the first and senior authors had obtained for the years 1995, 2000, 2005, 2010 and 2014. A total of 2.48% of all authors held a degree in osteopathic medicine. Osteopathic physician first authors contributed to 3.26% of all publications while osteopathic physician senior authors contributed 1.53%. No statistical trend could be established for the years studied for osteopathic physicians. However, we noted an overall trend for increased publication for allopathic senior authors (p=0.001), allopathic first authors with a dual degree (p=0.003) and allopathic senior authors with a dual degree (p=0.005). For each journal studied, no statistical trend could be established for osteopathic first or senior authors but a trend was noted for allopathic first and senior authors in the Journal of Emergency Medicine (p-value=0.020 and 0.006). Of those with dual degrees, osteopathic physicians were in the minority with 1.85% of osteopathic first authors and 0.60% of osteopathic senior authors attaining a dual degree. No statistical trend could be established for increased dual degree publications for osteopathic physicians over the study period, nor could a statistical trend be established for any of the journals studied. Very few osteopathic physicians have published in the Journal of Emergency Medicine, Academic Emergency Medicine or Annals of Emergency Medicine over the last two decades. Despite a trend for increased

If At First You Don't Succeed: The Fate of Manuscripts Rejected by Academic Emergency Medicine.

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Grant, William D; Cone, David C

2015-10-01

The purpose of this study was to characterize the publication fate of a recent 2-year sample of manuscripts declined by Academic Emergency Medicine (AEM), the journal of the Society for Academic Emergency Medicine. This was a retrospective analysis of manuscripts submitted to AEM in 2010 and 2011 that were declined by the AEM editorial review process. An online search was conducted for each declined paper, to determine whether or not it was published in another clinical/scientific journal after being declined by AEM. The investigators used Scopus and Google Scholar, using the submitting author's name, the verbatim title, and key words and phrases from the title, to search for subsequent publication of each paper. Of 1,542 manuscript submissions to the journal in 2010 and 2011, 1,052 papers were declined. Of these, 693 (65.9%) were subsequently published elsewhere, in a total of 229 journals: 362 papers in 22 different EM journals, 81 in 14 EM subspecialty journals, 237 in 185 non-EM journals, and 13 in eight nursing journals. Papers were published a median of 16.7 months (interquartile range [IQR] = 11.8 to 22.0 months) after being declined at AEM. Of the 229 journals, 19 do not have h-indices. The median h-index of the remaining 210 journals is 36 (IQR = 17 to 64; maximum = 229; AEM's h-index is 78). Thirty of these 210 journals, publishing 43 papers, have higher h-indices than AEM; the other 650 papers were published in journals either with lower h-indices than AEM's (n = 180 journals) or in journals without h-indices (n = 19 journals). U.S. and non-U.S. authors had similar rates of subsequent publication (65.3% vs 66.6%, p = 0.69) for papers initially declined by AEM. Papers in the educational advances category were less likely to be subsequently published than those in the original contributions (p journal are eventually published elsewhere, in a large number and wide variety of both EM and non-EM journals, in a median of 16.7 months. Authors of manuscripts

Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education.

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Sricharoen, Pungkava; Yuksen, Chaiyaporn; Sittichanbuncha, Yuwares; Sawanyawisuth, Kittisak

2015-01-01

There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Teaching EM with workshops improved student satisfaction in EM education for medical students.

Reflections on the consensus process: a leadership role for emergency medicine in educational scholarship and practice across health care.

Science.gov (United States)

Gordon, James A

2012-12-01

In just a few decades, emergency medicine (EM) has assumed a leadership role in medical education across many academic medical centers. This rapid evolution suggests medical education as a natural priority area for EM scholarship. This year's Academic Emergency Medicine consensus conference provides an ideal forum to focus on educational research as a core element of the specialty's academic portfolio. © 2012 by the Society for Academic Emergency Medicine.

[The evaluation of academic emergency department design].

Science.gov (United States)

Deniz, Turgut; Aydinuraz, Kuzey; Oktay, Cem; Saygun, Meral; Ağalar, Fatih

2007-01-01

In our study which was based upon a questionnaire, the inner and outer architectural designs of emergency services of Emergency Medicine Departments were investigated. In this descriptive study, a standard questionnaire was sent to 26 Emergency Medicine Departments which were operating at that time. In the questionnaire, the internal, external architectural and functional features were questioned. Answers of 22 Emergency Medicine Departments were analysed. Two Emergency Medicine Departments that were not operating at that time were not included in the study. The analysis of the replies revealed that only 59% (n=13) of the Emergency Medicine Departments were designed as an emergency service prior to the construction. The ambulance parking areas were not suitable in 77% of the emergency units while only 54.5% (n=12) had protection against adverse weather conditions. In only 59% (n=13) of the emergency units, a triage unit was present and in only one of the in only one (4.5%), a decontamination room was available. It was understood that only 32% (n=8) of the emergency units were appropriate in enlarging their capacity taking the local risk factors into consideration. There was a toilette for disabled patients in only 18% (n=4) of the units as well. Considering a 12-year of history of the Emergency Medicine in Turkey, the presence of a lecture room is still 68% (n=15) in emergency departments which reflects that academic efforts in this field is emerging in challenging physical conditions. The results of our study revealed that emergency service architecture was neglected in Turkey and medical care given was precluded by the insufficient architecture. The design of emergency services has to be accomplished under guidance of scientific data and rules taking advices of architects who have knowledge and experience on this field.

Social Media in the Emergency Medicine Residency Curriculum: Social Media Responses to the Residents' Perspective Article

OpenAIRE

Hayes, BD; Kobner, S; Trueger, NS; Yiu, S; Lin, M

2015-01-01

© 2015 American College of Emergency Physicians. In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Integration of Social Media in Emergency Medicine Residency Curriculum" by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant i...

Osteopathic emergency medicine programs infrequently publish in high-impact emergency medicine journals.

Science.gov (United States)

Baskin, Sean M; Lin, Christina; Carlson, Jestin N

2014-11-01

Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. We performed a retrospective literature review using the Journal Citation Report database and identified the top five journals in the category of 'Emergency Medicine' by their 2011 Impact Factor. We examined all publications from each journal for 2011. For each article we recorded article type, authors' names, position of authorship (first, senior or other), the author's degree and affiliated institution. We present the data in raw numbers and percentages. The 2011 EM journals with the highest impact factor were the following: Annals of Emergency Medicine, Resuscitation, Journal of Trauma, Injury, and Academic Emergency Medicine. Of the 9,298 authors published in these journals in 2011; 1,309 (15%) claimed affiliation with U.S.-based EM programs, of which 16 (1%) listed their affiliations with eight different osteopathic EM programs. The 16 authors claimed affiliation with 8 of 46 osteopathic EM programs (17%), while 1,301 authors claimed affiliation with 104 of 148 (70%) U.S.-based allopathic programs. Authors from osteopathic EM programs are under-represented in the top EM journals. With the pending ACGME/AOA merger, there is a significant opportunity for improvement in the rate of publication of osteopathic EM programs in top tier EM journals.

Whistleblowing in academic medicine

Science.gov (United States)

Rhodes, R; Strain, J

2004-01-01

The authors present and discuss cases of academic medicine failing to address unethical behaviour in academic science and, thereby, illustrate the scope and seriousness of the problem. The Olivieri/Apotex affair is just another instance of academic medicine's dereliction in a case of scientific fraud and misconduct. Instead of vigorously supporting their faculty member in her efforts to honestly communicate her findings and to protect patients from the risks associated with the use of the study drug, the University of Toronto collaborated with the Apotex company's "stalling tactics," closed down Dr Olivieri's laboratory, harassed her, and ultimately dismissed her. The authors argue that the incentives for addressing problematic behaviour have to be revised in order to effect a change in the current pattern of response that occurs in academic medicine. An externally imposed realignment of incentives could convert the perception of the whistleblower, from their present caste as the enemy within, into a new position, as valued friend of the institution. The authors explain how such a correction could encourage appropriate reactions to scientific misconduct from academic medicine. PMID:14872069

Gender-specific research for emergency diagnosis and management of ischemic heart disease: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

Science.gov (United States)

Safdar, Basmah; Nagurney, John T; Anise, Ayodola; DeVon, Holli A; D'Onofrio, Gail; Hess, Erik P; Hollander, Judd E; Legato, Mariane J; McGregor, Alyson J; Scott, Jane; Tewelde, Semhar; Diercks, Deborah B

2014-12-01

Coronary artery disease (CAD) is the most common cause of death for both men and women. However, over the years, emergency physicians, cardiologists, and other health care practitioners have observed varying outcomes in men and women with symptomatic CAD. Women in general are 10 to 15 years older than men when they develop CAD, but suffer worse postinfarction outcomes compared to age-matched men. This article was developed by the cardiovascular workgroup at the 2014 Academic Emergency Medicine (AEM) consensus conference to identify sex- and gender-specific gaps in the key themes and research questions related to emergency cardiac ischemia care. The workgroup had diverse stakeholder representation from emergency medicine, cardiology, critical care, nursing, emergency medical services, patients, and major policy-makers in government, academia, and patient care. We implemented the nominal group technique to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Through three rounds of nomination and refinement, followed by an in-person meeting on May 13, 2014, we achieved consensus on five priority themes and 30 research questions. The overarching themes were as follows: 1) the full spectrum of sex-specific risk as well as presentation of cardiac ischemia may not be captured by our standard definition of CAD and needs to incorporate other forms of ischemic heart disease (IHD); 2) diagnosis is further challenged by sex/gender differences in presentation and variable sensitivity of cardiac biomarkers, imaging, and risk scores; 3) sex-specific pathophysiology of cardiac ischemia extends beyond conventional obstructive CAD to include other causes such as microvascular dysfunction, takotsubo, and coronary artery dissection, better recognized as IHD; 4) treatment and prognosis are influenced by sex-specific variations in biology, as well as patient

Whistleblowing in academic medicine.

Science.gov (United States)

Rhodes, R; Strain, J J

2004-02-01

Although medical centres have established boards, special committees, and offices for the review and redress of breaches in ethical behaviour, these mechanisms repeatedly prove themselves ineffective in addressing research misconduct within the institutions of academic medicine. As the authors see it, institutional design: (1) systematically ignores serious ethical problems, (2) makes whistleblowers into institutional enemies and punishes them, and (3) thereby fails to provide an ethical environment. The authors present and discuss cases of academic medicine failing to address unethical behaviour in academic science and, thereby, illustrate the scope and seriousness of the problem. The Olivieri/Apotex affair is just another instance of academic medicine's dereliction in a case of scientific fraud and misconduct. Instead of vigorously supporting their faculty member in her efforts to honestly communicate her findings and to protect patients from the risks associated with the use of the study drug, the University of Toronto collaborated with the Apotex company's "stalling tactics," closed down Dr Olivieri's laboratory, harassed her, and ultimately dismissed her. The authors argue that the incentives for addressing problematic behaviour have to be revised in order to effect a change in the current pattern of response that occurs in academic medicine. An externally imposed realignment of incentives could convert the perception of the whistleblower, from their present caste as the enemy within, into a new position, as valued friend of the institution. The authors explain how such a correction could encourage appropriate reactions to scientific misconduct from academic medicine.

Burnout among female emergency medicine physicians: A nationwide study.

Science.gov (United States)

Soltanifar, Atefeh; Pishbin, Elham; Attaran Mashhadi, Negin; Najaf Najafi, Mona; Siahtir, Maryam

2018-02-13

The challenging and stressful nature of emergency medicine place the practitioners of this young branch of medicine at risk of burnout. In Iran, the number of women choosing the specialty of emergency medicine has been increasing in recent years. No studies have focused on burnout among female emergency medicine physicians. We conducted this study to evaluate the level of burnout in female emergency medicine physicians in Iran. In this cross-sectional study, all Iranian female emergency medicine physicians with more than 2 years of work experience as specialists, received a questionnaire containing 22-item Maslach Burnout Inventory scales and 7-item Cassidy social support scale, as well as questions about workload and career satisfaction. In total, 77 questionnaires were analysed (response rate: 75%; median age: 36 years, median for work experience = 3 years). A total of 34% of participants were academic faculties. The level of burnout in three subscales of emotional exhaustion, depersonalisation and perceived low personal accomplishment was moderate to high in 84.5, 48.1 and 80.5% of participants respectively. A total of 94.8% of female emergency medicine physicians perceived their workload to be moderate to high and only 1.3% of them had high job satisfaction. Alarming high rate of burnout and job dissatisfaction among female emergency medicine physicians in our study requires careful attention. Further investigations are suggested to identify the contributory factors to burnout and the probability of some gender disparities in this field. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Global Emergency Medicine: A Review of the Literature From 2016.

Science.gov (United States)

Becker, Torben K; Hansoti, Bhakti; Bartels, Susan; Hayward, Alison Schroth; Hexom, Braden J; Lunney, Kevin M; Marsh, Regan H; Osei-Ampofo, Maxwell; Trehan, Indi; Chang, Julia; Levine, Adam C

2017-09-01

The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. This year 13,890 articles written in four languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 716 articles met our inclusion criteria and underwent full review. Fifty-nine percent were categorized as emergency care in resource-limited settings, 17% as EM development, and 24% as disaster and humanitarian response. Nineteen articles received scores of 18.5 or higher out of a maximum score of 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed Cohen's kappa of 0.441. In 2016, the total number of articles identified by our search continued to increase. The proportion of articles in each of the three categories remained stable. Studies and reviews with a focus on infectious diseases, pediatrics, and the use of ultrasound in resource-limited settings represented the majority of articles selected for final review. © 2017 The Authors. Academic Emergency Medicine published by Wiley Periodicals, Inc. on behalf of the Society for Academic Emergency Medicine (SAEM).

Residents' Perspectives on Careers in Academic Medicine: Obstacles and Opportunities.

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Lin, Steven; Nguyen, Cathina; Walters, Emily; Gordon, Paul

2018-03-01

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?" 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. Free responses to the aforementioned prompt were analyzed using a constant comparative method and grounded theory approach. A total of 156 participants registered for the workshops and 95 (61%) answered the free response question. Eight distinct themes emerged from the analysis. The most frequently recurring theme was "lack of readiness or mentorship," which accounted for nearly one-third (31%) of the codes. Other themes included work-life balance and burnout (17%), job availability and logistics (15%), lack of autonomy or flexibility (11%), competing pressures/roles (10%), lower financial rewards (4%), politics and bureaucracy (4%), and research (3%). To our knowledge, this is the first study to identify barriers and disincentives to pursuing a career in academic medicine from the perspective of family medicine residents. There may be at least eight major obstacles, for which we summarize and consider potential interventions. More research is needed to understand why residents choose, or don't choose, academic careers.

Combined residency training in emergency medicine and internal medicine: an update on career outcomes and job satisfaction.

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Kessler, Chad S; Stallings, Leonard A; Gonzalez, Andrew A; Templeman, Todd A

2009-09-01

This study was designed to provide an update on the career outcomes and experiences of graduates of combined emergency medicine-internal medicine (EM-IM) residency programs. The graduates of the American Board of Emergency Medicine (ABEM) and American Board of Internal Medicine (ABIM)-accredited EM-IM residencies from 1998 to 2008 were contacted and asked to complete a survey concerning demographics, board certification, fellowships completed, practice setting, academic affiliation, and perceptions about EM-IM training and careers. There were 127 respondents of a possible 163 total graduates for a response rate of 78%. Seventy graduates (55%) practice EM only, 47 graduates (37%) practice both EM and IM, and nine graduates (7%) practice IM or an IM subspecialty only. Thirty-one graduates (24%) pursued formal fellowship training in either EM or IM. Graduates spend the majority of their time practicing clinical EM in an urban (72%) and academic (60%) environment. Eighty-seven graduates (69%) spend at least 10% of their time in an academic setting. Most graduates (64%) believe it practical to practice both EM and IM. A total of 112 graduates (88%) would complete EM-IM training again. Dual training in EM-IM affords a great deal of career opportunities, particularly in academics and clinical practice, in a number of environments. Graduates hold their training in high esteem and would do it again if given the opportunity.

The evolution of academic performance in emergency medicine journals: viewpoint from 2000 to 2009 journal citation reports.

Science.gov (United States)

Lee, Ching-Hsing; Shih, Chia-Pang; Chang, Yu-Che; Chaou, Chung-Hsien

2011-08-01

Emergency medicine (EM) is a young but rapidly growing field. An evaluation of academic performance and the growing impact of EM journals would help to elucidate the increase in the number of EM scientific studies. The authors used the Journal Citation Reports (JCR) database to investigate the scientific achievements of EM journals in the past 10 years. This was a literature review study. All data were collected from the JCR database. Journals listed in the EM category from 2000 to 2009 were included. Eleven categories that were considered most closely related to EM by a consensus of the authors were chosen for comparison, including cardiac and cardiovascular systems, clinical neurology, critical care medicine, gastroenterology and hepatology, infectious diseases, general and internal medicine, pediatrics, respiratory system, surgery, toxicology, and urology and nephrology. Data on journals in the EM category were collected, including journal title, language, journal country or territory, impact factor for each year, total number of EM journals for each year, and the EM category aggregate impact factor (available from 2003 to 2009). The variables in the comparison group included the number of journals in each of the 11 clinical medicine categories from 2000 to 2009 and the aggregate impact factors for 2003 to 2009. The category aggregate impact factor and journal impact factor were adopted as representative of category and journal academic performance. Linear regression was used to assess the trend of aggregate impact factor and journal impact factor. The slope (β) of the linear regression was used to represent the evolution of performance. The relationship between the 2000 EM journal impact factor and the impact factor trend of EM journals between 2000 and 2009 was measured by Pearson correlation coefficient to evaluate the evolution difference between journals with different initial impact factors. In 2000, all 12 EM journals were published in the United States

Women Physicians: Choosing a Career in Academic Medicine

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Borges, Nicole J.; Navarro, Anita M.; Grover, Amelia C.

2011-01-01

Purpose Despite recent efforts to understand the complex process of physician career development, the medical education community has a poor understanding of why, how, and when women physicians embark on a career in academic medicine. Method In 2010, the authors phone-interviewed women physicians in academic medicine regarding why, how, and when they chose an academic medicine career. Project investigators first individually and then collectively analyzed transcripts to identify themes in the data. Results Through analyzing the transcripts of the 53 interviews, the investigators identified five themes related to why women choose careers in academic medicine: fit, aspects of the academic health center environment, people, exposure, and clincial medicine. They identified five themes related to how women make the decision to enter academic medicine: change in specialty, dissatisfaction with former career, emotionality, parental influence, and decision-making styles. The authors also identified four themes regarding when women decide to enter academic medicine: as a practicing phyisican, fellow, resident, or medical student. Conclusions Choosing a career in academic medicine is greatly influenced by the environment in which one trains and by people—be they faculty, mentors, role models, or family. An interest in teaching is a primary reason women choose a career in academic medicine. Many women physicians entering acadmic medicine chose this after or during fellowship, which is when they became more aware of academic medicine as a possible career. For many women, choosing academic medicine was not necessarily an active, planned decision; rather it was serendipitous or circumstantial. PMID:22104052

Race, Disadvantage and Faculty Experiences in Academic Medicine

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Cooper, Lisa A.; Carr, Phyllis

2010-01-01

ABSTRACT Background Despite compelling reasons to draw on the contributions of under-represented minority (URM) faculty members, US medical schools lack these faculty, particularly in leadership and senior roles. Objective The study’s purpose was to document URM faculty perceptions and experience of the culture of academic medicine in the US and to raise awareness of obstacles to achieving the goal of having people of color in positions of leadership in academic medicine. Design The authors conducted a qualitative interview study in 2006–2007 of faculty in five US medical schools chosen for their diverse regional and organizational attributes. Participants Using purposeful sampling of medical faculty, 96 faculty were interviewed from four different career stages (early, plateaued, leaders and left academic medicine) and diverse specialties with an oversampling of URM faculty. Approach We identified patterns and themes emergent in the coded data. Analysis was inductive and data driven. Results Predominant themes underscored during analyses regarding the experience of URM faculty were: difficulty of cross-cultural relationships; isolation and feeling invisible; lack of mentoring, role models and social capital; disrespect, overt and covert bias/discrimination; different performance expectations related to race/ethnicity; devaluing of research on community health care and health disparities; the unfair burden of being identified with affirmative action and responsibility for diversity efforts; leadership’s role in diversity goals; and financial hardship. Conclusions Achieving an inclusive culture for diverse medical school faculty would help meet the mission of academic medicine to train a physician and research workforce that meets the disparate needs of our multicultural society. Medical school leaders need to value the inclusion of URM faculty. Failure to fully engage the skills and insights of URM faculty impairs our ability to provide the best science

Race, disadvantage and faculty experiences in academic medicine.

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Pololi, Linda; Cooper, Lisa A; Carr, Phyllis

2010-12-01

Despite compelling reasons to draw on the contributions of under-represented minority (URM) faculty members, US medical schools lack these faculty, particularly in leadership and senior roles. The study's purpose was to document URM faculty perceptions and experience of the culture of academic medicine in the US and to raise awareness of obstacles to achieving the goal of having people of color in positions of leadership in academic medicine. The authors conducted a qualitative interview study in 2006-2007 of faculty in five US medical schools chosen for their diverse regional and organizational attributes. Using purposeful sampling of medical faculty, 96 faculty were interviewed from four different career stages (early, plateaued, leaders and left academic medicine) and diverse specialties with an oversampling of URM faculty. We identified patterns and themes emergent in the coded data. Analysis was inductive and data driven. Predominant themes underscored during analyses regarding the experience of URM faculty were: difficulty of cross-cultural relationships; isolation and feeling invisible; lack of mentoring, role models and social capital; disrespect, overt and covert bias/discrimination; different performance expectations related to race/ethnicity; devaluing of research on community health care and health disparities; the unfair burden of being identified with affirmative action and responsibility for diversity efforts; leadership's role in diversity goals; and financial hardship. Achieving an inclusive culture for diverse medical school faculty would help meet the mission of academic medicine to train a physician and research workforce that meets the disparate needs of our multicultural society. Medical school leaders need to value the inclusion of URM faculty. Failure to fully engage the skills and insights of URM faculty impairs our ability to provide the best science, education or medical care.

Quantifying federal funding and scholarly output related to the academic emergency medicine consensus conferences.

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Nishijima, Daniel K; Dinh, Tu; May, Larissa; Yadav, Kabir; Gaddis, Gary M; Cone, David C

2014-01-01

Every year since 2000, Academic Emergency Medicine (AEM) has presented a one-day consensus conference to generate a research agenda for advancement of a scientific topic. One of the 12 annual issues of AEM is reserved for the proceedings of these conferences. The purpose of this study was to measure academic productivity of these conferences by evaluating subsequent federal research funding received by authors of conference manuscripts and calculating citation counts of conference papers. This was a cross-sectional study. In 2012, the NIH RePORTER system was searched to identify subsequent federal funding obtained by authors of the consensus conference issues from 2000 to 2010. Funded projects were coded as related or unrelated to conference topic. Citation counts for all conference manuscripts were quantified using Scopus and Google Scholar. Simple descriptive statistics were reported. Eight hundred fifty-two individual authors contributed to 280 papers published in the 11 consensus conference issues. One hundred thirty-seven authors (16%) obtained funding for 318 projects. A median of 22 topic-related projects per conference (range 10-97) accounted for a median of $20,488,331 per conference (range $7,779,512 to $122,918,205). The average (± SD) number of citations per paper was 15.7 ± 20.5 in Scopus and 23.7 ± 32.6 in Google Scholar. The authors of consensus conference manuscripts obtained significant federal grant support for follow-up research related to conference themes. In addition, the manuscripts generated by these conferences were frequently cited. Conferences devoted to research agenda development appear to be an academically worthwhile endeavor.

Ethical issues in the response to Ebola virus disease in US emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association and the Society for Academic Emergency Medicine.

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Venkat, Arvind; Wolf, Lisa; Geiderman, Joel M; Asher, Shellie L; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

2015-03-01

The 2014 outbreak of Ebola Virus Disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged US emergency departments to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to US acute care facilities, ethical questions have been raised in both the press and medical literature as to how US emergency departments, emergency physicians, emergency nurses and other stakeholders in the healthcare system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to US emergency physicians, emergency nurses and other stakeholders in the healthcare system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to US emergency departments in how they approach preparation for and management of potential patients with EVD. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

THE SPECIALTY OF EMERGENCY MEDICINE IN CHILE: 20 YEARS OF HISTORY

Directory of Open Access Journals (Sweden)

WK Mallon

2017-03-01

Full Text Available Chile is uniquely situated to be a leader in South American development of the specialty of Emergency Medicine. Chilean emergency medicine has successfully transitioned from a novelty training idea to a nationally and internationally recognized entity with serious public health goals. There are more residency training programs in Chile than in any other South American or Latin American country, and the specialty is formally recognized by the Ministry of Health. Chilean emergency medicine thought leaders have networked internationally with multiple groups, intelligently used outside resources, and created durable academic relationships. While focusing on locally important issues and patient care they have successfully advanced their agenda. Despite this, the specialty faces many new challenges and remains fragile but sustainable. Policy makers and the Chilean MOH need to be acutely aware of this fragility to preserve the progress achieved so far, and support ongoing maturation of the specialty of Emergency Medicine.

Trends in National Emergency Medicine Conference Didactic Lectures Over a 6-Year Period.

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Gottlieb, Michael; Riddell, Jeff; Njie, Abdoulie

2017-01-01

National conference didactic lectures have traditionally featured hour-long lecture-based presentations. However, there is evidence that longer lectures can lead to both decreased attention and retention of information. The authors sought to identify trends in lecture duration, lecture types, and number of speakers at four national emergency medicine (EM) conferences over a 6-year period. The authors performed a retrospective analysis of the length, number of speakers, and format of didactic lectures at four different national EM conferences over 6 years. The authors abstracted data from the national academic assemblies for the four largest not-for-profit EM organizations in the United States: American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine. There was a significant yearly decrease in the mean lecture lengths for three of the four conferences. There was an increase in the percentage of rapid fire sessions over the preceding 2 years with a corresponding decrease in the percentage of general educational sessions. There was no significant difference in the mean number of speakers per lecture. An analysis of 4210 didactic lecture sessions from the annual meetings of four national EM organizations over a 6-year period showed significant decreases in mean lecture length. These findings can help to guide EM continuing medical education conference planning and research.

The search for common ground: developing emergency medicine in Iran.

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Smith, Jeffrey P; Shokoohi, Hamid; Holliman, James C

2007-05-01

Academic ties between Iran and the United States were extensive before the 1979 revolution in Iran. After 20 years of negligible academic exchanges, there has been a growing trend of professional contacts between the two countries over the past few years. The genuine warmth of friendship and commitment to excellence in emergency medicine (EM) among Iranians has transcended the political barriers to allow international contribution of EM development in the country. Since 1999, there has been a successful academic collaboration between Iranian and U.S. universities to help develop EM in Iran. Today, remarkable progresses have been achieved through recognition of EM as a distinct profession, developing EM residency programs, improving emergency medical services, establishing qualified emergency departments, training faculty and staff, starting physician exchange programs, and building mutual contributions with professionals throughout the world. A supportive policy environment and a high-quality health care system have had incredible impacts on EM development in the country.

Does stereotype threat affect women in academic medicine?

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Burgess, Diana Jill; Joseph, Anne; van Ryn, Michelle; Carnes, Molly

2012-04-01

Multiple complex factors contribute to the slow pace of women's advancement into leadership positions in academic medicine. In this article, the authors propose that stereotype threat--under which individuals who are members of a group characterized by negative stereotypes in a particular domain perform below their actual abilities in that domain when group membership is emphasized--may play an important role in the underrepresentation of women in leadership positions in academic medicine. Research to objectively assess the impact of stereotype threat for women in academic medicine is feasible and necessary to confirm this hypothesis. Still, a number of conditions present in the academic medicine community today have been shown to trigger stereotype threat in other settings, and stereotype threat fits with existing research on gender in academic medicine. In the meantime, academic health centers should implement relatively simple measures supported by experimental evidence from other settings to reduce the risk of stereotype threat, including (1) introducing the concept of stereotype threat to the academic medicine community, (2) engaging all stakeholders, male and female, to promote identity safety by enacting and making faculty aware of policies to monitor potential instances of discrimination, and training faculty to provide performance feedback that is free of gender bias, (3) counteracting the effects of sex segregation at academic health centers by increasing exposure to successful female leaders, (4) reducing gender stereotype priming by avoiding stereotypically male criteria for promotion, grants, and awards, and (5) building leadership efficacy among female physicians and scientists.

Does Stereotype Threat Affect Women in Academic Medicine?

Science.gov (United States)

Burgess, Diana Jill; Joseph, Anne; van Ryn, Michelle; Carnes, Molly

2012-01-01

Multiple complex factors contribute to the slow pace of women’s advancement into leadership positions in academic medicine. In this article, the authors propose that stereotype threat--under which individuals who are members of a group characterized by negative stereotypes in a particular domain perform below their actual abilities in that domain when group membership is emphasized--may play an important role in the underrepresentation of women in leadership positions in academic medicine. Research to objectively assess the impact of stereotype threat for women in academic medicine is feasible and necessary to confirm this hypothesis. Still, a number of conditions present in the academic medicine community today have been shown to trigger stereotype threat in other settings, and stereotype threat fits with existing research on gender in academic medicine. In the meantime, academic health centers should implement relatively simple measures supported by experimental evidence from other settings to reduce the risk of stereotype threat, including: (1) introducing the concept of stereotype threat to the academic medicine community; (2) engaging all stakeholders, male and female, to promote identity safety by enacting and making faculty aware of policies to monitor potential instances of discrimination, and training faculty to provide performance feedback that is free of gender bias; (3) counteracting the effects of sex segregation at academic health centers by increasing exposure to successful female leaders; (4) reducing gender stereotype priming by avoiding stereotypically male criteria for promotion, grants, and awards; and (5) building leadership efficacy among female physicians and scientists. PMID:22361794

The women in emergency medicine mentoring program: an innovative approach to mentoring.

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Welch, Julie L; Jimenez, Heather L; Walthall, Jennifer; Allen, Sheryl E

2012-09-01

Women in medicine report many gender-specific barriers to their career success and satisfaction, including a lack of mentors and role models. The literature calls for innovative strategies to enhance mentorship for women in medicine. To describe the content, perceived value, and ongoing achievements of a mentoring program for women in emergency medicine. The program offered mentoring for female faculty and residents in an academic emergency medicine department. Volunteers participated in group mentoring sessions using a mosaic of vertical and peer mentoring. Sessions focused on topics specific to women in medicine. An anonymous, electronic survey was sent to women who participated during 2004-2010 to assess the perceived value of the program and to collect qualitative feedback. Preliminary achievements fulfilling the program's goals were tracked. A total of 46 women (64%) completed the survey. The results showed a positive perceived value of the program (average, 4.65 on a 5-point Likert scale) in providing mentors and role models (4.41), in offering a supportive environment (4.39), in providing discussions pertinent to both personal (4.22) and professional development (4.22), while expanding networking opportunities (4.07). Notable achievements included work on the creation of a family leave policy, establishing lactation space, collaboration on projects, awards, and academic advancement. This innovative model for mentoring women is perceived as a valuable asset to the academic department and residency. It offers the unique combination of expanding a female mentor pool by recruiting alumni and using a mosaic of vertical and peer mentoring.

CAEP 2016 Academic Symposium: How to have an impact as an emergency medicine educator and scholar.

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Frank, Jason R; Cheung, Warren J; Sherbino, Jonathan; Primavesi, Robert; Woods, Robert A; Bandiera, Glen; LeBlanc, Constance

2017-05-01

In a time of major medical education transformation, emergency medicine (EM) needs to nurture education scholars who will influence EM education practice. However, the essential ingredients to ensure a career with impact in EM education are not clear. To describe how to prepare EM educators for a high-impact career. The Canadian Association of Emergency Physicians (CAEP) Academic Section commissioned an "Education Impact" working group (IWG) to guide the creation of consensus recommendations from the EM community. EM educators from across Canada were initially recruited from the networks of the IWG members, and additional educators were recruited via snowball sampling. "High impact educators" were nominated by this network. The high impact educators were then interviewed using a structured question guide. These interviews were transcribed and coded for themes using qualitative methods. The process continued until no new themes were identified. Proposed themes and recommendations were presented to the EM community at the CAEP 2016 Academic Symposium. Feedback was then incorporated into a final set of recommendations. Fifty-five (71%) of 77 of identified Canadian EM educators participated, and 170 names of high impact educators were submitted and ranked by frequency. The IWG achieved sufficiency of themes after nine interviews. Five recommendations were made: 1) EM educators can pursue a high impact career by leveraging either traditional or innovative career pathways; 2) EM educators starting their education careers should have multiple senior mentors; 3) Early-career EM educators should immerse themselves in their area of interest and cultivate a community of practice, not limited to EM; 4) Every academic EM department and EM teaching site should have access to an EM educator with protected time and recognition for their EM education scholarship; and 5) Educators at all stages should continuously compile an impact portfolio. We describe a unique set of

Stories from early-career women physicians who have left academic medicine: a qualitative study at a single institution.

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Levine, Rachel B; Lin, Fenny; Kern, David E; Wright, Scott M; Carrese, Joseph

2011-06-01

The number of women in academic medicine has steadily increased, although gender parity still does not exist and women leave academics at somewhat higher rates than men. The authors investigated the reasons why women leave careers in academic medicine. Semistructured, one-on-one interviews were conducted in 2007-2008 with 20 women physicians who had left a single academic institution to explore their reasons for opting out of academic careers. Data analysis was iterative, and an editing analysis style was used to derive themes. A lack of role models for combining career and family responsibilities, frustrations with research (funding difficulties, poor mentorship, competition), work-life balance, and the institutional environment (described as noncollaborative and biased in favor of male faculty) emerged as key factors associated with a decision to leave academic medicine for respondents. Faced with these challenges, respondents reevaluated their priorities and concluded that a discrepancy existed between their own and institutional priorities. Many respondents expressed divergent views with the institutional norms on how to measure success and, as a consequence, felt that they were undervalued at work. Participants report a disconnection between their own priorities and those of the dominant culture in academic medicine. Efforts to retain women faculty in academic medicine may include exploring the aspects of an academic career that they value most and providing support and recognition accordingly.

Professional Competencies of Cuban Specialists in Intensive Care and Emergency Medicine.

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Véliz-Martínez, Pedro L; Jorna-Calixto, Ana R; Oramas-González, René

2016-10-01

INTRODUCTION The quality of medical training and practice reflects the competency level of the professionals involved. The intensive care and emergency medicine specialty in Cuba has not defined its competencies. OBJECTIVE Identify the competencies required for specialty practice in intensive care and emergency medicine. METHODS The study was conducted from January 2014 to December 2015, using qualitative techniques; 48 professionals participated. We undertook functional occupational analysis, based on functions defined in a previous study. Three expert groups were utilized: the first used various group techniques; the second, the Delphi method; and the third, the Delphi method and a Likert questionnaire. RESULTS A total of 73 specific competencies were defined, grouped in 11 units: 44 in the patient care function, 16 in management, 7 in teaching and 6 in research. A competency map is provided. CONCLUSIONS The intensive care and emergency medicine specialty competencies identified will help improve professional standards, ensure health workforce quality, improve patient care and academic performance, and enable objective evaluation of specialists' competence and performance. KEYWORDS Clinical competency, competency-based education, professional education, intensive care, emergency medicine, urgent care, continuing medical education, curriculum, medical residency, Cuba.

Gender- and sex-specific sports-related injury research in emergency medicine: a consensus on future research direction and focused application.

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Raukar, Neha P; Zonfrillo, Mark R; Kane, Kathleen; Davenport, Moira; Espinoza, Tamara R; Weiland, Jessica; Franco, Vanessa; Vaca, Federico E

2014-12-01

Title IX, the commercialization of sports, the social change in sports participation, and the response to the obesity epidemic have contributed to the rapid proliferation of participation in both competitive organized sports and nontraditional athletic events. As a consequence, emergency physicians are regularly involved in the acute diagnosis, management, disposition, and counseling of a broad range of sports-related pathology. Three important and highly publicized mechanisms of injury in sports relevant to emergency medicine (EM) include concussion, heat illness, and sudden cardiac death. In conjunction with the 2014 Academic Emergency Medicine consensus conference "Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," a consensus group consisting of experts in EM, emergency neurology, sports medicine, and public health convened to deliberate and develop research questions that could ultimately advance the field of sports medicine and allow for meaningful application in the emergency department (ED) clinical setting. Sex differences in injury risk, diagnosis, ED treatment, and counseling are identified in each of these themes. This article presents the consensus-based priority research agenda. © 2014 by the Society for Academic Emergency Medicine.

Toward a definition of teamwork in emergency medicine.

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Fernandez, Rosemarie; Kozlowski, Steve W J; Shapiro, Marc J; Salas, Eduardo

2008-11-01

The patient safety literature from the past decade emphasizes the importance of teamwork skills and human factors in preventing medical errors. Simulation has been used within aviation, the military, and now health care domains to effectively teach and assess teamwork skills. However, attempts to expand and generalize research and training principles have been limited due to a lack of a well-defined, well-researched taxonomy. As part of the 2008 Academic Emergency Medicine Consensus Conference on "The Science of Simulation in Healthcare," a subset of the group expertise and group assessment breakout sections identified evidence-based recommendations for an emergency medicine (EM) team taxonomy and performance model. This material was disseminated within the morning session and was discussed both during breakout sessions and via online messaging. Below we present a well-defined, well-described taxonomy that will help guide design, implementation, and assessment of simulation-based team training programs.

Development of a clinical forensic medicine curriculum for emergency physicians in the USA.

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Smock, W S

1994-06-01

To address the forensic needs of living patients, the Department of Emergency Medicine at the University of Louisville School of Medicine in Louisville, Kentucky, USA initiated the first clinical forensic medicine training programme in the USA. In July 1991, formal training in clinical forensic medicine was incorporated into the core curriculum of the USA's second oldest academic emergency medicine training programme. The University of Louisville, in cooperation with the Kentucky Medical Examiner's Office, developed the curriculum to provide the emergency physician with the knowledge base and technical skills to perform forensic evaluations of living patients. Forensic lectures are given monthly by local and regional forensic experts including: forensic pathologists, prosecuting attorneys, firearm and ballistics examiners, law enforcement officers, forensic chemists and forensic odontologists. Topics which are presented include: forensic pathology, forensic photography, ballistics and firearms analysis, paediatric physical and sexual assault, crime scene investigation, forensic odontology, courtroom and expert testimony and the forensic evaluation of penetrating trauma. As a result of the introduction of clinical forensic medicine into the core curriculum of an emergency medicine training programme the residents are now actively addressing the forensic issues encountered in the Emergency department. Key, often short-lived forensic evidence, which was frequently overlooked or discarded while delivering patient care is now recognized, documented and preserved. The development and introduction of a clinical forensic medicine curriculum into emergency medicine training has greatly enhanced the emergency physician's ability to recognize, document and address the forensic needs of their patients who are victims of violent and non-fatal trauma.

Systematic Molecular Phenotyping: A Path Toward Precision Emergency Medicine?

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Limkakeng, Alexander T; Monte, Andrew A; Kabrhel, Christopher; Puskarich, Michael; Heitsch, Laura; Tsalik, Ephraim L; Shapiro, Nathan I

2016-10-01

Precision medicine is an emerging approach to disease treatment and prevention that considers variability in patient genes, environment, and lifestyle. However, little has been written about how such research impacts emergency care. Recent advances in analytical techniques have made it possible to characterize patients in a more comprehensive and sophisticated fashion at the molecular level, promising highly individualized diagnosis and treatment. Among these techniques are various systematic molecular phenotyping analyses (e.g., genomics, transcriptomics, proteomics, and metabolomics). Although a number of emergency physicians use such techniques in their research, widespread discussion of these approaches has been lacking in the emergency care literature and many emergency physicians may be unfamiliar with them. In this article, we briefly review the underpinnings of such studies, note how they already impact acute care, discuss areas in which they might soon be applied, and identify challenges in translation to the emergency department (ED). While such techniques hold much promise, it is unclear whether the obstacles to translating their findings to the ED will be overcome in the near future. Such obstacles include validation, cost, turnaround time, user interface, decision support, standardization, and adoption by end-users. © 2016 by the Society for Academic Emergency Medicine.

Career choice in academic medicine: systematic review.

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Straus, Sharon E; Straus, Christine; Tzanetos, Katina

2006-12-01

To review systematically the evidence about what factors influence the decision to choose or not choose a career in academic medicine. A systematic review of relevant literature from 1990 to May 2005. Searches of The Cochrane Library, Medline (using Ovid and PubMed) from 1990 to May 2005, and EMBASE from 1990 to May 2005 were completed to identify relevant studies that explored the influential factors. Additional articles were identified from searching the bibliographies of retrieved articles. We attempted to identify studies that included residents, fellows, or staff physicians. No restrictions were placed on the study methodologies identified and all articles presenting empirical evidence were retrieved. For cohort, case-control, and cross-sectional studies, minimum inclusion criteria were the presence of defined groups, and the ability to extract relevant data. For surveys that involved case series, minimum inclusion criteria were a description of the population, and the availability of extractable data. Minimum inclusion criteria for qualitative studies were descriptions of the sampling strategy and methods. The search identified 251 abstracts; 25 articles were included in this review. Completion of an MD with a graduate degree or fellowship program is associated with a career in academic medicine. Of the articles identified in this review, this finding is supported by the highest quality of evidence. Similarly, the completion of research and publication of this research in medical school and residency are associated with a career in academic medicine. The desire to teach, conduct research, and the intellectual stimulation and challenge provided in academia may also persuade people to choose this career path. The influence of a role model or a mentor was reported by physicians to impact their decision making. Trainees' interest in academic medicine wanes as they progress through their residency. In order to revitalize academic medicine, we must engage trainees

Oiling the gate: a mobile application to improve the admissions process from the emergency department to an academic community hospital inpatient medicine service.

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Fung, Russell; Hyde, Jensen Hart; Davis, Mike

2018-01-01

The process of admitting patients from the emergency department (ED) to an academic internal medicine (AIM) service in a community teaching hospital is one fraught with variability and disorder. This results in an inconsistent volume of patients admitted to academic versus private hospitalist services and results in frustration of both ED and AIM clinicians. We postulated that implementation of a mobile application (app) would improve provider satisfaction and increase admissions to the academic service. The app was designed and implemented to be easily accessible to ED physicians, regularly updated by academic residents on call, and a real-time source of the number of open AIM admission spots. We found a significant improvement in ED and AIM provider satisfaction with the admission process. There was also a significant increase in admissions to the AIM service after implementation of the app. We submit that the implementation of a mobile app is a viable, cost-efficient, and effective method to streamline the admission process from the ED to AIM services at community-based hospitals.

Social media in the emergency medicine residency curriculum: social media responses to the residents' perspective article.

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Hayes, Bryan D; Kobner, Scott; Trueger, N Seth; Yiu, Stella; Lin, Michelle

2015-05-01

In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Integration of Social Media in Emergency Medicine Residency Curriculum" by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant innovations revolving around the featured article and made possible by the immediacy of social media technologies. Six online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and YouTube, which featured 3 preselected questions. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,222 unique page views from 325 cities in 32 countries on the ALiEM Web site, 569,403 Twitter impressions, and 120 views of the video interview with the authors. Five major themes we identified in the discussion included curriculum design, pedagogy, and learning theory; digital curation skills of the 21st-century emergency medicine practitioner; engagement challenges; proposed solutions; and best practice examples. The immediacy of social media technologies provides clinicians the unique opportunity to engage a worldwide audience within a relatively short time frame. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Emergency ultrasound usage among recent emergency medicine residency graduates of a convenience sample of 14 residencies.

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Dean, Anthony J; Breyer, Michael J; Ku, Bon S; Mills, Angela M; Pines, Jesse M

2010-02-01

Emergency Medicine (EM) residency graduates are trained to perform Emergency Medicine bedside ultrasound (EMBU). However, the degree to which they use this skill in their practice after graduation is unknown. We sought to test the amount and type of usage of EMBU among recent residency graduates, and how usage and barriers vary among various types of EM practice settings. Graduates from 14 EM residency programs in 2003-2005 were surveyed on their current practice setting and use of EMBU. There were 252 (73%) graduates who completed the survey. Of the 73% of respondents reporting access to EMBU, 98% had used it within the past 3 months. Access to EMBU was higher in academic (97%) vs. community teaching (79%) vs. community non-teaching settings (62%) (p < 0.001), and in Emergency Departments (EDs) where yearly census exceeded 60,000 visits (87% vs. 65%, p < 0.001). Physicians in academic settings reported "high use" of EMBU more frequently than those in community settings for most modalities. FAST (focused assessment by sonography in trauma) was the most common high-use application and the most useful in practice. The greatest impediment to EMBU use was "not enough time" (61%). Ultrasound usage among recent EM residency graduates is significantly higher in teaching than in community settings and in high-volume EDs. Its use is more widespread than in previous reports in all types of practice. There is a wide range of utilization of ultrasound in the various applications in emergency practice, with the evaluation of trauma being the most common. Copyright (c) 2010 Elsevier Inc. All rights reserved.

The Priority of Intersectionality in Academic Medicine.

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Eckstrand, Kristen L; Eliason, Jennifer; St Cloud, Tiffani; Potter, Jennifer

2016-07-01

Recent societal events highlight inequities experienced by underrepresented and marginalized communities. These inequities are the impetus for ongoing efforts in academic medicine to create inclusive educational and patient care environments for diverse stakeholders. Frequently, approaches focus on singular populations or broad macroscopic concepts and do not always elucidate the complexities that arise at the intersection between multiple identities and life experiences. Intersectionality acknowledges multidimensional aspects of identity inclusive of historical, structural, and cultural factors. Understanding how multiple identity experiences impact different individuals, from patients to trainees to providers, is critical for improving health care education and delivery. Building on existing work within academic medicine, this Commentary outlines six key recommendations to advance intersectionality in academic medicine: embrace personal and collective loci of responsibility; examine and rectify unbalanced power dynamics; celebrate visibility and intersectional innovation; engage all stakeholders in the process of change; select and analyze meaningful metrics; and sustain the commitment to achieving health equity over time. Members of the academic medical community committed to advancing health equity can use these recommendations to promote and maintain meaningful changes that recognize and respond to the multidimensional voices and expressed needs of all individuals engaged in providing and receiving health care.

State of emergency medicine in Azerbaijan

OpenAIRE

Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

2008-01-01

Background There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the ?specialty? model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. Aims The Emergency Medicine De...

Moral imperatives for academic medicine.

Science.gov (United States)

Thompson, J N

1997-12-01

As the health care system becomes dominated by managed care, academic medicine must do more than simply learn how to continue to offer the same level of care with ever-tightening resources and in new practice environments. Three moral imperatives must guide how medicine is practiced and taught: (1) patients' health and well-being must always be foremost, centered in quality of care and respect for life; (2) the emotional and spiritual needs of patients must be considered, not just the physical needs; (3) academic medicine must instill in its trainees discipline, passion, and skills to meet their obligation to be lifelong learners. These imperatives make it more important than ever for medical educators to tackle two crucial questions: What kind of person makes the best possible physician? And what constitutes the best possible training for that person? Taking these questions seriously in the new era of health care may mean that medical educators need to rethink the teaching of medicine. One example of how this might be done is the Curriculum for 2002 Committee recently formed at the Wake Forest University School of Medicine. It is becoming clear that medical educators can do a better and more comprehensive job of helping future physicians uncover and strengthen their own morality and, in the face of managed care's pressures, renew their loyalty to medicine as a service rather than a business. Morally sensitized physicians can better deal with the hard issues of medicine, such as euthanasia and abortion, and can help their students examine these issues. Most important, they can show their students that physicians are members of a moral community dedicated to something other than its own self-interest.

Measuring faculty retention and success in academic medicine.

Science.gov (United States)

Ries, Andrew; Wingard, Deborah; Gamst, Anthony; Larsen, Catherine; Farrell, Elizabeth; Reznik, Vivian

2012-08-01

To develop and demonstrate the usefulness of quantitative methods for assessing retention and academic success of junior faculty in academic medicine. The authors created matched sets of participants and nonparticipants in a junior faculty development program based on hire date and academic series for newly hired assistant professors at the University of California, San Diego (UCSD), School of Medicine between 1988 and 2005. They used Kaplan-Meier and Cox proportional hazards survival analyses to characterize the influence of covariates, including gender, ethnicity, and program participation, on retention. They also developed a new method for quantifying academic success based on several measures including (1) leadership and professional activities, (2) honors and awards, (3) research grants, (4) teaching and mentoring/advising activities, and (5) publications. The authors then used these measures to compare matched pairs of participating and nonparticipating faculty who were subsequently promoted and remained at UCSD. Compared with matched nonparticipants, the retention of junior faculty who participated in the faculty development program was significantly higher. Among those who were promoted and remained at UCSD, the academic success of faculty development participants was consistently greater than that of matched nonparticipants. This difference reached statistical significance for leadership and professional activities. Using better quantitative methods for evaluating retention and academic success will improve understanding and research in these areas. In this study, use of such methods indicated that organized junior faculty development programs have positive effects on faculty retention and may facilitate success in academic medicine.

Does Stereotype Threat Affect Women in Academic Medicine?

OpenAIRE

Burgess, Diana Jill; Joseph, Anne; van Ryn, Michelle; Carnes, Molly

2012-01-01

Multiple complex factors contribute to the slow pace of women’s advancement into leadership positions in academic medicine. In this article, the authors propose that stereotype threat--under which individuals who are members of a group characterized by negative stereotypes in a particular domain perform below their actual abilities in that domain when group membership is emphasized--may play an important role in the underrepresentation of women in leadership positions in academic medicine. Re...

Distributed academic leadership in emergent research organisations

NARCIS (Netherlands)

Kokkeler, Bernardus J.M.

2014-01-01

The thesis “distributed academic leadership in emergent research organizations" that Ben Kokkeler on October 29th 2014 successfully defended at the University of Twente, shows that a specific type of academic leadership developes, deep in the heart of the university, in emerging research institutes.

Education scholarship in emergency medicine part 1: innovating and improving teaching and learning.

Science.gov (United States)

Sherbino, Jonathan; Van Melle, Elaine; Bandiera, Glen; McEwen, Jill; Leblanc, Constance; Bhanji, Farhan; Frank, Jason R; Regehr, Glenn; Snell, Linda

2014-05-01

As emergency medicine (EM) education evolves, a more advanced understanding of education scholarship is required. This article is the first in a series of three articles that reports the recommendations of the 2013 education scholarship consensus conference of the Academic Section of the Canadian Association of Emergency Physicians. Adopting the Canadian Association for Medical Education's definition, education scholarship (including both research and innovation) is defined. A rationale for why education scholarship should be a priority for EM is discussed.

Public health, academic medicine, and the alcohol industry's corporate social responsibility activities.

Science.gov (United States)

Babor, Thomas F; Robaina, Katherine

2013-02-01

We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry's economic interests.

Global Emergency Medicine: A review of the literature from 2017.

Science.gov (United States)

Becker, Torben K; Trehan, Indi; Hayward, Alison Schroth; Hexom, Braden J; Kivlehan, Sean M; Lunney, Kevin M; Modi, Payal; Osei-Ampofo, Maxwell; Pousson, Amelia; Cho, Daniel K; Levine, Adam C

2018-05-23

The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. Another two reviewers searched the gray literature, yielding an additional 11 articles. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 848 articles met our inclusion criteria and underwent full review. 63% were categorized as emergency care in resource-limited settings, 23% as disaster and humanitarian response, and 14% as emergency medicine development. 21 articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed a Cohen's Kappa of 0.344. In 2017, the total number of articles identified by our search continued to increase. Studies and reviews with a focus on infectious diseases, pediatrics, and trauma represented the majority of top-scoring articles. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The Behavioral and Social Sciences: Contributions and Opportunities in Academic Medicine.

Science.gov (United States)

Smith, Patrick O; Grigsby, R Kevin

2017-06-01

The Association of American Medical Colleges plays a leading role in supporting the expansion and evolution of academic medicine and medical science in North America, which are undergoing high-velocity change. Behavioral and social science concepts have great practical value when applied to the leadership practices and administrative structures that guide and support the rapid evolution of academic medicine and medical sciences. The authors are two behavioral and social science professionals who serve as academic administrators in academic medical centers. They outline their career development and describe the many ways activities have been shaped by their work with the Association of American Medical Colleges. Behavioral and social science professionals are encouraged to become change agents in the ongoing transformation of academic medicine.

Executive Summary from the 2017 Emergency Medicine Resident Wellness Consensus Summit.

Science.gov (United States)

Battaglioli, Nicole; Ankel, Felix; Doty, Christopher I; Chung, Arlene; Lin, Michelle

2018-03-01

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. The RWCS was held on May 15, 2017, as a pre-day event prior to the 2017 EEM conference in Las Vegas, Nevada. Seven months before the RWCS event, pre-work began in the ALiEM Wellness Think Tank, which was launched in October 2016. The Wellness Think Tank is a virtual community of practice involving EM residents from the U.S. and Canada, hosted on the Slack digital-messaging platform. A working group was formed for each of the four predetermined themes: wellness curriculum development; educator toolkit resources for specific wellness topics; programmatic innovations; and wellness-targeted technologies. Pre-work for RWCS included 142 residents from 100 different training programs in the Wellness Think Tank. Participants in the actual RWCS event included 44 EM residents, five EM attendings who participated as facilitators, and three EM attendings who acted as participants. The four working groups ultimately reached a consensus on their specific objectives to improve resident wellness on both the individual and program level. The Resident Wellness Consensus Summit was a unique and novel consensus meeting, involving residents as the primary stakeholders. The summit demonstrated that it is possible to galvanize a large group of stakeholders in a relatively short time by creating robust trust, communication, and online learning networks to create resources that support resident wellness.

Academic retainer medicine: an innovative business model for cross-subsidizing primary care.

Science.gov (United States)

Lucier, David J; Frisch, Nicholas B; Cohen, Brian J; Wagner, Michael; Salem, Deeb; Fairchild, David G

2010-06-01

Retainer-medicine primary care practices, commonly referred to as "luxury" or "concierge" practices, provide enhanced services to patients beyond those available in traditional practices for a yearly retainer fee. Adoption of retainer practices has been largely absent in academic health centers (AHCs). Reasons for this trend stem primarily from ethical concerns, such as the potential for patient abandonment when physicians downsize from larger, traditional practices to smaller, retainer-medicine practices.In 2004, the Department of Medicine at Tufts Medical Center developed an academic retainer-medicine primary care practice within the Division of General Medicine that not only generates financial support for the division but also incorporates a clinical and business model that is aligned with the mission and ethics of an academic institution.In contrast to private retainer-medicine practices, this unique business model addresses several of the ethical issues associated with traditional retainer practices-it does not restrict net access to care and it neutralizes concerns about patient abandonment. Addressing the growing primary care shortage, the model also presents the opportunity for a retainer practice to cross-subsidize the expansion of general medicine in an academic medical setting. The authors elucidate the benefits, as well as the inherent challenges, of embedding an academic retainer-medicine practice within an AHC.

Residents values in a rational decision-making model: an interest in academics in emergency medicine.

Science.gov (United States)

Burkhardt, John Christian; Smith-Coggins, Rebecca; Santen, Sally

2016-10-01

Academic physicians train the next generation of doctors. It is important to understand the factors that lead residents to choose an academic career to continue to effectively recruit residents who will join the national medical faculty. A decision-making theory-driven, large scale assessment of this process has not been previously undertaken. To examine the factors that predict an Emergency resident's interest in pursuing an academic career at the conclusion of training. This study employs the ABEM Longitudinal Survey (n = 365). A logistic regression model was estimated using an interest in an academic career in residency as the dependent variable. Independent variables include gender, under-represented minority status, survey cohort, number of dependent children, possession of an advanced degree, ongoing research, publications, and the appeal of science, independence, and clinical work in choosing EM. Logistic regression resulted in a statistically significant model (p < 0.001). Residents who chose EM due to the appeal of science, had peer-reviewed publications and ongoing research were more likely to be interested in an academic career at the end of residency (p < 0.05). An increased number of children (p < 0.05) was negatively associated with an interest in academics. Individual resident career interests, research productivity, and lifestyle can help predict an interest in pursuing an academic career. Recruitment and enrichment of residents who have similar values and behaviors should be considered in programs interested in generating more graduates who enter an academic career.

Emergency medicine and general practice

OpenAIRE

Abela, Gunther

2005-01-01

Emergency Medicine and Immediate Medical Care are relatively new specialties. In Malta, there is quite a considerable area of overlap between these specialties and general practice. Indeed, the family physician is confronted with some sort of medical emergency quite regularly. The brief of this article is to go through recent developments in Emergency Medicine as applied to General Practice. The areas considered are Basic Life Support, Head Injury, Asthma, Anaphylaxis, Community Acquired Pneu...

Regenerative Medicine as an Emergent Cluster in Tampere Region

Directory of Open Access Journals (Sweden)

Tuomo Heinonen

2015-01-01

Full Text Available Clusters are important for regional economies and emergent clusters are in a key position, as a means of adding more diversification to the current economic activity by involving new technologies and industries. Science-based industries may be the most promising in this regard since they are encouraged to develop and enhance the economic imaginaries of territories under the umbrella of radical innovations or in the name of broadening the current economic model based on mostly traditional industries. Regenerative medicine (RM could be an example of these so-called emergent clusters. Regenerative medicine is highly dependent on academic research, which means that local territories must fund the research in this field and, hence, they expect some returns as well. As territories do not typically have existing industries specifically in RM, these industries must emerge or expand from existing ones. Regenerative medicine involves a wide spectrum of different technologies and industries that are likely to form a cluster and benefit from it if successfully developed. The first aim of this paper is to show how some obstacles eventually impede the proper development of these emergent clusters. The second aim is to shed light on how innovations emerge in the cluster and what are the main implications for the territory. In this study, existing literature is used in order to describe the technology market and commercial aspects of the RM sector. Empirically this study is based on the emergent RM cluster in the region of Tampere in Finland. Analysis of 24 conducted interviews helps to contextualize the emergence of the RM cluster in Tampere, where academia is both the booster and the driver of the emergent RM cluster. Commercialization of research in the RM field is one of the goals at the university, even though there are no commercial outcomes yet available. This study contributes to the understanding of emergent cluster development in science

Women in Academic Medicine Leadership: Has Anything Changed in 25 Years?

Science.gov (United States)

Rochon, Paula A; Davidoff, Frank; Levinson, Wendy

2016-08-01

Over the past 25 years, the number of women graduating from medical schools in the United States and Canada has increased dramatically to the point where roughly equal numbers of men and women are graduating each year. Despite this growth, women continue to face challenges in moving into academic leadership positions. In this Commentary, the authors share lessons learned from their own careers relevant to women's careers in academic medicine, including aspects of leadership, recruitment, editorship, promotion, and work-life balance. They provide brief synopses of current literature on the personal and social forces that affect women's participation in academic leadership roles. They are persuaded that a deeper understanding of these realities can help create an environment in academic medicine that is generally more supportive of women's participation, and that specifically encourages women in medicine to take on academic leadership positions.

Hierarchy as a barrier to advancement for women in academic medicine.

Science.gov (United States)

Conrad, Peter; Carr, Phyllis; Knight, Sharon; Renfrew, Megan R; Dunn, Mary B; Pololi, Linda

2010-04-01

Research on barriers to professional advancement for women in academic medicine has not adequately considered the role of environmental factors and how the structure of organizations affects professional advancement and work experiences. This article examines the impact of the hierarchy, including both the organization's hierarchical structure and professionals' perceptions of this structure, in medical school organization on faculty members' experience and advancement in academic medicine. As part of an inductive qualitative study of faculty in five disparate U.S. medical schools, we interviewed 96 medical faculty at different career stages and in diverse specialties, using in-depth semistructured interviews, about their perceptions about and experiences in academic medicine. Data were coded and analysis was conducted in the grounded theory tradition. Our respondents saw the hierarchy of chairs, based on the indeterminate tenure of department chairs, as a central characteristic of the structure of academic medicine. Many faculty saw this hierarchy as affecting inclusion, reducing transparency in decision making, and impeding advancement. Indeterminate chair terms lessen turnover and may create a bottleneck for advancement. Both men and women faculty perceived this hierarchy, but women saw it as more consequential. The hierarchical structure of academic medicine has a significant impact on faculty work experiences, including advancement, especially for women. We suggest that medical schools consider alternative models of leadership and managerial styles, including fixed terms for chairs with a greater emphasis on inclusion. This is a structural reform that could increase opportunities for advancement especially for women in academic medicine.

Gender stereotypes: an explanation to the underrepresentation of women in emergency medicine.

Science.gov (United States)

Pelaccia, Thierry; Delplanq, Hervé; Triby, Emmanuel; Bartier, Jean-Claude; Leman, Cécile; Hadef, Hysham; Pottecher, Thierry; Dupeyron, Jean-Pierre

2010-07-01

Women are underrepresented in emergency medicine (EM) residency programs in comparison with many other specialties. The reasons for this are unclear. One hypothesis is that negative gender stereotypes about EM careers might exist among female medical students. In the field of education, negative gender stereotypes are known to lead to career avoidance, because they tend to decrease self-efficacy perception. The aims of this study were to assess the prevalence of negative gender stereotypes about EM practice among medical students and to measure the effects of these stereotypes on females' self-efficacy perception toward EM learning. A survey was conducted of the 255 third-year medical students from three medical schools who attended a mandatory EM academic program in France. They completed an anonymous questionnaire exploring their gender stereotypes about EM practice and their self-efficacy perception toward EM learning. Gender stereotypes are common among medical students, especially in women. Self-efficacy perception is negatively correlated to female students' belief that EM careers are better suited for men (p stereotypes among female medical students may lead to EM career avoidance, because of the decrease in their self-efficacy perception toward EM learning. 2010 by the Society for Academic Emergency Medicine

Professionalism, responsibility, and service in academic medicine.

Science.gov (United States)

Souba, W W

1996-01-01

Academic medical centers have responded to health care reform initiatives by launching a series of strategic plans designed to maintain patient flow and reduce hospital expenditures. Thought is also being given to processes by which the faculty can individually and collectively adjust to these changes and maintain morale at a time when reductions in the labor force and pay cuts are virtually certain. Physicians are concerned because managed care threatens their autonomy and jeopardizes the traditional ways in which they have carried out their multiple missions. Some doctors believe that it will become increasingly difficult to obtain genuine satisfaction from their job. The strategies that academic medical centers have begun to use to address the numerous challenges posed by a system of health care based on managed competition are reviewed. Potential mechanisms by which academic departments can continue to find fulfillment in an environment that threatens their traditional missions and values are discussed. A study of the social and historical origins of medicine in the United States reveals that the introduction of corporate medicine in the United States was destined to happen. Strategies implemented by academic medical centers in response to managed care include building an integrated delivery network, the acquisition of primary care practices, increasing cost-effectiveness, and creating physician-hospital organizations. Emphasis must be placed on integrating traditional core values (excellence, leadership, and innovation) with newer values such as patient focus, accountability, and diversity. A shift from rugged individualism to entrepreneurial teamwork is crucial. These reforms, although frightening at the onset, can serve to reaffirm our commitment to academic medicine and preserve our mission. The evolving managed care environment offers unique opportunities for academic medical centers to shape and positively impact health care delivery in the twenty

The future of emergency medicine.

Science.gov (United States)

Schneider, Sandra M; Gardner, Angela F; Weiss, Larry D; Wood, Joseph P; Ybarra, Michael; Beck, Dennis M; Stauffer, Arlen R; Wilkerson, Dean; Brabson, Thomas; Jennings, Anthony; Mitchell, Mark; McGrath, Roland B; Christopher, Theodore A; King, Brent; Muelleman, Robert L; Wagner, Mary J; Char, Douglas M; McGee, Douglas L; Pilgrim, Randy L; Moskovitz, Joshua B; Zinkel, Andrew R; Byers, Michelle; Briggs, William T; Hobgood, Cherri D; Kupas, Douglas F; Krueger, Jennifer; Stratford, Cary J; Jouriles, Nicholas J

2010-08-01

The specialty of emergency medicine (EM) continues to experience a significant workforce shortage in the face of increasing demand for emergency care. In July 2009, representatives of the leading EM organizations met in Dallas for the Future of Emergency Medicine Summit. Attendees at the Future of Emergency Medicine Summit agreed on the following: 1) Emergency medical care is an essential community service that should be available to all; 2) An insufficient emergency physician workforce also represents a potential threat to patient safety; 3) Accreditation Council for Graduate Medical Education/American Osteopathic Association (AOA)-accredited EM residency training and American Board of Medical Specialties/AOA EM board certification is the recognized standard for physician providers currently entering a career in emergency care; 4) Physician supply shortages in all fields contribute to-and will continue to contribute to-a situation in which providers with other levels of training may be a necessary part of the workforce for the foreseeable future; 5) A maldistribution of EM residency-trained physicians persists, with few pursuing practice in small hospital or rural settings; 6) Assuring that the public receives high quality emergency care while continuing to produce highly skilled EM specialists through EM training programs is the challenge for EM's future; 7) It is important that all providers of emergency care receive continuing postgraduate education. Copyright 2010. Published by Elsevier Inc.

Public Health, Academic Medicine, and the Alcohol Industry’s Corporate Social Responsibility Activities

Science.gov (United States)

Robaina, Katherine

2013-01-01

We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry’s economic interests. PMID:23237151

Executive Summary from the 2017 Emergency Medicine Resident Wellness Consensus Summit

Directory of Open Access Journals (Sweden)

Felix Ankel

2018-02-01

Full Text Available 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. Seven months before the RWCS event, pre-work began in the ALiEM Wellness Think Tank, which was launched in October 2016. The Wellness Think Tank is a virtual community of practice involving EM residents from the U.S. and Canada, hosted on the Slack digital-messaging platform. A working group was formed for each of the four predetermined themes: wellness curriculum development; educator toolkit resources for specific wellness topics; programmatic innovations; and wellness-targeted technologies. Results: Pre-work for RWCS included 142 residents from 100 different training programs in the Wellness Think Tank. Participants in the actual RWCS event included 44 EM residents, five EM attendings who participated as facilitators, and three EM attendings who acted as participants. The four working groups ultimately reached a consensus on their specific objectives to improve resident wellness on both the individual and program level. Conclusion: The Resident Wellness Consensus Summit was a unique and novel consensus meeting, involving residents as the primary stakeholders. The summit demonstrated that it is possible to galvanize a large group of stakeholders in a relatively short time by creating robust trust, communication, and online learning networks to create resources that support resident wellness.

Collaboration in academic medicine: reflections on gender and advancement.

Science.gov (United States)

Carr, Phyllis L; Pololi, Linda; Knight, Sharon; Conrad, Peter

2009-10-01

Collaboration in academic medicine is encouraged, yet no one has studied the environment in which faculty collaborate. The authors investigated how faculty experienced collaboration and the institutional atmosphere for collaboration. In 2007, as part of a qualitative study of faculty in five disparate U.S. medical schools, the authors interviewed 96 medical faculty at different career stages and in diverse specialties, with an oversampling of women, minorities, and generalists, regarding their perceptions and experiences of collaboration in academic medicine. Data analysis was inductive and driven by the grounded theory tradition. Female faculty expressed enthusiasm about the potential and process of collaboration; male faculty were more likely to focus on outcomes. Senior faculty experienced a more collaborative environment than early career faculty, who faced numerous barriers to collaboration: the hierarchy of medical academe, advancement criteria, and the lack of infrastructure supportive of collaboration. Research faculty appreciated shared ideas, knowledge, resources, and the increased productivity that could result from collaboration, but they were acutely aware that advancement requires an independent body of work, which was a major deterrent to collaboration among early career faculty. Academic medicine faculty have differing views on the impact and benefits of collaboration. Early career faculty face concerning obstacles to collaboration. Female faculty seemed more appreciative of the process of collaboration, which may be of importance for transitioning to a more collaborative academic environment. A reevaluation of effective benchmarks for promotion of faculty is warranted to address the often exclusive reliance on individualistic achievement.

Emergency medicine program targets "brain drain" in Ethiopia ...

International Development Research Centre (IDRC) Digital Library (Canada)

2016-04-29

Apr 29, 2016 ... ... (TAAAC-EM) project, access to emergency medicine is increasing for Ethiopians. With IDRC support, the TAAAC-EM postgraduate emergency medicine training program ... From hospitals to herbalists: Rx herbal medicines.

Resident involvement in civilian tactical emergency medicine.

Science.gov (United States)

Ramirez, Mario Luis; Slovis, Corey M

2010-07-01

Tactical emergency medicine services (TEMS) has emerged as a specialized niche within the field of emergency medicine. With increasing demand for physician participation in civilian tactical teams, there will be efforts by residents to become involved at earlier points in their clinical training. This article discusses resident involvement with a civilian TEMS unit and provides five maxims for emergency physicians to better understand the difference between working in the emergency department or with emergency medical services vs. in a TEMS environment. Differences between TEMS and other trauma life support models, institutional and political barriers likely to be encountered by the resident, the value of preventive medicine and the role of the physician in long-term tactical operations, opportunities for subspecialty growth, and the role of operational security are all discussed in detail. Tactical emergency medicine is a specialty that utilizes the full array of the emergency physician's skill set. It is also a field that is ripe for continued expansion, but the resident looking to become involved with a team should be aware of the requirements necessary to do so and the obstacles likely to be encountered along the way. Copyright 2010 Elsevier Inc. All rights reserved.

Women in academic medicine: perceived obstacles to advancement.

Science.gov (United States)

Bennett, N M; Nickerson, K G

1992-01-01

To investigate perceived obstacles to the advancement of women in academic medicine, we sent a questionnaire assessing perceptions of the fairness and supportiveness of the academic environment to the 229 female teaching and research faculty of the School of Physicians & Surgeons at Columbia University. The overall response rate was 85%. Forty-six percent believed that they had not had the same professional opportunities as their male colleagues, 52% believed that salaries were not equivalent for men and women in similar positions, and 50% believed that promotions were awarded in a biased manner. Thirty percent reported that sexist behavior was common and that sexual harassment occurred in the workplace. Eighty-one percent experienced conflicts between their professional and personal lives and most believed that the institution failed to adequately address the needs of women with children. This survey indicates that there are significant perceived obstacles to the advancement of women in academic medicine that must be addressed.

Are mothers’ and fathers’ parenting characteristics associated with emerging adults’ academic engagement?

Science.gov (United States)

Waterman, Emily A.; Lefkowitz, Eva S.

2017-01-01

Although parenting is clearly linked to academic engagement in adolescence, less is known about links between parenting and academic engagement in emerging adulthood. A diverse sample of college students (N = 633; 53.1% female, 45.7% White/European American, 28.3% Asian American/Hawaiian/Pacific Islander, 26.4% Hispanic/Latino American, 21.6% Black/African American, and 2.8% Native American/American Indian) answered surveys about mothers’ and fathers’ parenting style, parent-offspring relationship quality, academic attitudes, academic behaviors, and academic performance. Emerging adults with more permissive mothers viewed grades as less important than emerging adults with less permissive mothers. Mothers’ authoritarian parenting, mothers’ permissive parenting, and relationship quality with father were differentially related to academic engagement depending on emerging adults’ gender. Both mothers’ and fathers’ parenting characteristics may impact the academic engagement of emerging adults via past parenting behaviors and current quality of the parent-offspring relationship, despite decreased physical proximity of emerging adults and their parents. PMID:28529398

Are mothers' and fathers' parenting characteristics associated with emerging adults' academic engagement?

Science.gov (United States)

Waterman, Emily A; Lefkowitz, Eva S

2017-06-01

Although parenting is clearly linked to academic engagement in adolescence, less is known about links between parenting and academic engagement in emerging adulthood. A diverse sample of college students ( N = 633; 53.1% female, 45.7% White/European American, 28.3% Asian American/Hawaiian/Pacific Islander, 26.4% Hispanic/Latino American, 21.6% Black/African American, and 2.8% Native American/American Indian) answered surveys about mothers' and fathers' parenting style, parent-offspring relationship quality, academic attitudes, academic behaviors, and academic performance. Emerging adults with more permissive mothers viewed grades as less important than emerging adults with less permissive mothers. Mothers' authoritarian parenting, mothers' permissive parenting, and relationship quality with father were differentially related to academic engagement depending on emerging adults' gender. Both mothers' and fathers' parenting characteristics may impact the academic engagement of emerging adults via past parenting behaviors and current quality of the parent-offspring relationship, despite decreased physical proximity of emerging adults and their parents.

Race-Conscious Professionalism and African American Representation in Academic Medicine.

Science.gov (United States)

Powers, Brian W; White, Augustus A; Oriol, Nancy E; Jain, Sachin H

2016-07-01

African Americans remain substantially less likely than other physicians to hold academic appointments. The roots of these disparities stem from different extrinsic and intrinsic forces that guide career development. Efforts to ameliorate African American underrepresentation in academic medicine have traditionally focused on modifying structural and extrinsic barriers through undergraduate and graduate outreach, diversity and inclusion initiatives at medical schools, and faculty development programs. Although essential, these initiatives fail to confront the unique intrinsic forces that shape career development. America's ignoble history of violence, racism, and exclusion exposes African American physicians to distinct personal pressures and motivations that shape professional development and career goals. This article explores these intrinsic pressures with a focus on their historical roots; reviews evidence of their effect on physician development; and considers the implications of these trends for improving African American representation in academic medicine. The paradigm of "race-conscious professionalism" is used to understand the dual obligation encountered by many minority physicians not only to pursue excellence in their field but also to leverage their professional stature to improve the well-being of their communities. Intrinsic motivations introduced by race-conscious professionalism complicate efforts to increase the representation of minorities in academic medicine. For many African American physicians, a desire to have their work focused on the community will be at odds with traditional paths to professional advancement. Specific policy options are discussed that would leverage race-conscious professionalism as a draw to a career in academic medicine, rather than a force that diverts commitment elsewhere.

An Analysis of the Top-cited Articles in Emergency Medicine Education Literature.

Science.gov (United States)

Munzer, Brendan W; Love, Jeffery; Shipman, Barbara L; Byrne, Brendan; Cico, Stephen J; Furlong, Robert; Khandelwal, Sorabh; Santen, Sally A

2017-01-01

Dissemination of educational research is critical to improving medical education, promotion of faculty and ultimately patient care. The objective of this study was to identify the top 25 cited education articles in the emergency medicine (EM) literature and the top 25 cited EM education articles in all journals, as well as report on the characteristics of the articles. Two searches were conducted in the Web of Science in June 2016 using a list of education-related search terms. We searched 19 EM journals for education articles as well as all other literature for EM education-related articles. Articles identified were reviewed for citation count, article type, journal, authors, and publication year. With regards to EM journals, the greatest number of articles were classified as articles/reviews, followed by research articles on topics such as deliberate practice (cited 266 times) and cognitive errors (cited 201 times). In contrast in the non-EM journals, research articles were predominant. Both searches found several simulation and ultrasound articles to be included. The most common EM journal was Academic Emergency Medicine (n = 18), and Academic Medicine was the most common non-EM journal (n=5). A reasonable number of articles included external funding sources (6 EM articles and 13 non-EM articles.). This study identified the most frequently cited medical education articles in the field of EM education, published in EM journals as well as all other journals indexed in Web of Science. The results identify impactful articles to medical education, providing a resource to educators while identifying trends that may be used to guide EM educational research and publishing efforts.

Executive summary of the CAEP 2014 Academic Symposium: How to make research succeed in your department.

Science.gov (United States)

Stiell, Ian G; Artz, Jennifer D; Perry, Jeffrey; Vaillancourt, Christian; Calder, Lisa

2015-05-01

The vision of the recently created Canadian Association of Emergency Physicians (CAEP) Academic Section is to promote high-quality emergency patient care by conducting world-leading education and research in emergency medicine. The Academic Section plans to achieve this goal by enhancing academic emergency medicine primarily at Canadian medical schools and teaching hospitals. It seeks to foster and develop education, research, and academic leadership amongst Canadian emergency physicians, residents, and students. In this light, the Academic Section began in 2013 to hold the annual Academic Symposia to highlight best practices and recommendations for the three core domains of governance and leadership, education scholarship, and research. Each year, members of three panels are asked to review the literature, survey and interview experts, achieve consensus, and present their recommendations at the Symposium (2013, Education Scholarship; 2014, Research; and 2015, Governance and Funding). Research is essential to medical advancement. As a relatively young specialty, emergency medicine is rapidly evolving to adapt to new diagnostic tools, the challenges of crowding in emergency departments, and the growing needs of emergency patients. There is significant variability in the infrastructure, support, and productivity of emergency medicine research programs across Canada. All Canadians benefit from an investigation of the means to improve research infrastructure, training programs, and funding opportunities. Such an analysis is essential to identify areas for improvement, which will support the expansion of emergency medicine research. To this end, physician-scientist leaders were gathered from across Canada to develop pragmatic recommendations on the improvement of emergency medicine research through a comprehensive analysis of current best practices, systematic literature reviews, stakeholder surveys, and expert interviews.

Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.

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Saleh, Fareed; Breslin, Kristen; Mullan, Paul C; Tillett, Zachary; Chamberlain, James M

2017-10-31

The aim of this study was to create a multivariable model of standardized relative value units per hour by adjusting for nonprovider factors that influence efficiency. We obtained productivity data based on billing records measured in emergency relative value units for (1) both evaluation and management of visits and (2) procedures for 16 pediatric emergency medicine providers with more than 750 hours worked per year. Eligible shifts were in an urban, academic pediatric emergency department (ED) with 2 sites: a tertiary care main campus and a satellite community site. We used multivariable linear regression to adjust for the impact of shift and pediatric ED characteristics on individual-provider efficiency and then removed variables from the model with minimal effect on productivity. There were 2998 eligible shifts for the 16 providers during a 3-year period. The resulting model included 4 variables when looking at both ED sites combined. These variables include the following: (1) number of procedures billed by provider, (2) season of the year, (3) shift start time, and (4) day of week. Results were improved when we separately modeled each ED location. A 3-variable model using procedures billed by provider, shift start time, and season explained 23% of the variation in provider efficiency at the academic ED site. A 3-variable model using procedures billed by provider, patient arrivals per hour, and shift start time explained 45% of the variation in provider efficiency at the satellite ED site. Several nonprovider factors affect provider efficiency. These factors should be considered when designing productivity-based incentives.

When an event sparks behavior change: an introduction to the sentinel event method of dynamic model building and its application to emergency medicine.

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Boudreaux, Edwin D; Bock, Beth; O'Hea, Erin

2012-03-01

Experiencing a negative consequence related to one's health behavior, like a medical problem leading to an emergency department (ED) visit, can promote behavior change, giving rise to the popular concept of the "teachable moment." However, the mechanisms of action underlying this process of change have received scant attention. In particular, most existing health behavior theories are limited in explaining why such events can inspire short-term change in some and long-term change in others. Expanding on recommendations published in the 2009 Academic Emergency Medicine consensus conference on public health in emergency medicine (EM), we propose a new method for developing conceptual models that explain how negative events, like medical emergencies, influence behavior change, called the Sentinel Event Method. The method itself is atheoretical; instead, it defines steps to guide investigations that seek to relate specific consequences or events to specific health behaviors. This method can be used to adapt existing health behavior theories to study the event-behavior change relationship or to guide formulation of completely new conceptual models. This paper presents the tenets underlying the Sentinel Event Method, describes the steps comprising the process, and illustrates its application to EM through an example of a cardiac-related ED visit and tobacco use. © 2012 by the Society for Academic Emergency Medicine.

[Adverse drug reaction reporting in emergency medicine].

Science.gov (United States)

Milojevic, Kolia; Chassagnol, Isabelle; Brion, Nathalie; Cléro, Joël; Degrèze, Nathalie; Lambert, Yves

2004-01-01

A regional survey was performed between June and September 2002, to evaluate knowledge and attitudes of emergency physicians regarding adverse drug reaction (ADR) reporting in a French district. 100 questionnaires completed by physicians working in emergency departments and/or mobile intensive care units were analysed. The frequency of ADRs encountered by emergency practitioners was estimated at > or = 0.73 per year and per physician. The ADR notification rate in emergency medicine was estimated at advertising ADR reporting procedures could help to improve the notification rate in emergency medicine.

Episodes of care: is emergency medicine ready?

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Wiler, Jennifer L; Beck, Dennis; Asplin, Brent R; Granovsky, Michael; Moorhead, John; Pilgrim, Randy; Schuur, Jeremiah D

2012-05-01

Optimizing resource use, eliminating waste, aligning provider incentives, reducing overall costs, and coordinating the delivery of quality care while improving outcomes have been major themes of health care reform initiatives. Recent legislation contains several provisions designed to move away from the current fee-for-service payment mechanism toward a model that reimburses providers for caring for a population of patients over time while shifting more financial risk to providers. In this article, we review current approaches to episode of care development and reimbursement. We describe the challenges of incorporating emergency medicine into the episode of care approach and the uncertain influence this delivery model will have on emergency medicine care, including quality outcomes. We discuss the limitations of the episode of care payment model for emergency services and advocate retention of the current fee-for-service payment model, as well as identify research gaps that, if addressed, could be used to inform future policy decisions of emergency medicine health policy leaders. We then describe a meaningful role for emergency medicine in an episode of care setting. Copyright © 2011. Published by Mosby, Inc.

The Changing Fiscal Environment for Academic Veterinary Medicine.

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Zimmel, Dana N; Lloyd, James W

2015-01-01

The fiscal environment for academic veterinary medicine has changed substantially over the past 50 years. Understanding the flux of state and federal government support and the implications for student debt, academic programs, and scholarly work is critical for planning for the future. The recent precipitous decline in public funding highlights the urgent need to develop and maintain an economically sustainable model that can adapt to the changing landscape and serve societal needs.

Perceptions and Development of Political Leadership Skills of Women in Academic Medicine: A Study of Selected Women Alumnae of the Hedwig Van Ameringen Executive Leadership in Academic Medicine (ELAM) Program

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Evers, Cynthia D.

2014-01-01

Despite women having much to offer in the field of academic medicine, women may not be sufficiently attuned to developing their political leadership skills, which are crucial for successful leadership (Ferris, Frink, & Galang, 1993; Ferris & Perrewe, 2010). The study's purpose was to examine how 14 women in academic medicine perceived…

Development of geriatric competencies for emergency medicine residents using an expert consensus process.

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Hogan, Teresita M; Losman, Eve D; Carpenter, Christopher R; Sauvigne, Karen; Irmiter, Cheryl; Emanuel, Linda; Leipzig, Rosanne M

2010-03-01

The emergency department (ED) visit rate for older patients exceeds that of all age groups other than infants. The aging population will increase elder ED patient utilization to 35% to 60% of all visits. Older patients can have complex clinical presentations and be resource-intensive. Evidence indicates that emergency physicians fail to provide consistent high-quality care for elder ED patients, resulting in poor clinical outcomes. The objective was to develop a consensus document, "Geriatric Competencies for Emergency Medicine Residents," by identified experts. This is a minimum set of behaviorally based performance standards that all residents should be able to demonstrate by completion of their residency training. This consensus-based process utilized an inductive, qualitative, multiphase method to determine the minimum geriatric competencies needed by emergency medicine (EM) residents. Assessments of face validity and reliability were used throughout the project. In Phase I, participants (n=363) identified 12 domains and 300 potential competencies. In Phase II, an expert panel (n=24) clustered the Phase I responses, resulting in eight domains and 72 competencies. In Phase III, the expert panel reduced the competencies to 26. In Phase IV, analysis of face validity and reliability yielded a 100% consensus for eight domains and 26 competencies. The domains identified were atypical presentation of disease; trauma, including falls; cognitive and behavioral disorders; emergent intervention modifications; medication management; transitions of care; pain management and palliative care; and effect of comorbid conditions. The Geriatric Competencies for EM Residents is a consensus document that can form the basis for EM residency curricula and assessment to meet the demands of our aging population. Copyright (c) 2010 by the Society for Academic Emergency Medicine.

Emergency medicine as a specialty in Asia.

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Pek, Jen Heng; Lim, Swee Han; Ho, Hiu Fai; Ramakrishnan, T V; Jamaluddin, Sabariah Faizah; Mesa-Gaerlan, Faith Joan C; Tiru, Mohan; Hwang, Sung Oh; Choi, Wai-Mau; Kanchanasut, Somchai; Khruekarnchana, Pairoj; Avsarogullari, Levent; Shimazu, Takeshi; Hori, Shingo

2016-04-01

We aim to examine the similarities and differences in areas of EM development, workload, workforce, and capabilities and support in the Asia region. Emerging challenges faced by our EM community are also discussed. The National Societies for Emergency Medicine of Hong Kong, India, Japan, Malaysia, Philippines, Singapore, South Korea, Taiwan, Thailand and Turkey participated in the joint Japanese Association of Acute Medicine (JAAM) and Asian Conference of Emergency Medicine (ACEM) Special Symposium held in October 2013 at Tokyo, Japan. The findings are reviewed in this paper. Emergency medicine (EM) has over the years evolved into a distinct and recognized medical discipline requiring a unique set of cognitive, administrative and technical skills for managing all types of patients with acute illness or injury. EM has contributed to healthcare by providing effective, safe, efficient and cost-effective patient care. Integrated systems have developed to allow continuity of emergency care from the community into emergency departments. Structured training curriculum for undergraduates, and specialty training programs for postgraduates are in place to equip trainees with the knowledge and skills required for the unique practice of EM. The practice of EM still varies among the Asian countries. However, as a region, we strive to continue in our efforts to develop the specialty and improve the delivery of EM.

State of emergency medicine in Azerbaijan.

Science.gov (United States)

Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

2008-04-01

There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the "specialty" model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. The Emergency Medicine Development Initiative (EMDI) of the International Medical Corps (IMC) was designed to improve the quality of emergency care in four pilot regional centers in Azerbaijan. The objective of this study was to assess the baseline emergency medical capacity of these four centers. EMDI staff conducted a four-part baseline survey in April 2006 to assess emergency care in Ganja (the second largest city in Azerbaijan), Kurdamir, Shamkir and Yevlakh. Data collection involved interviews with relevant personnel and a retrospective records review in each city. Pre-hospital: The number of ambulance teams per 10,000 inhabitants is below the number required by local regulations. On average, 45% of 27 medications and 37% of 17 pieces of critical equipment were available. Of the emergency procedures, 21% could be performed in the pre-hospital setting. In-hospital: Admission rates were near 100% for the admissions department-an area that is supposed to function as an emergency department would. On average 57% of 40 medications and 42% of 22 pieces of critical equipment were available. Of the emergency procedures, 62% could be performed in the in-hospital setting. The emergency medical system surveyed in Azerbaijan is inefficiently organized, under-financed, poorly equipped and lacks adequately trained staff. Reforms need to be directed towards achieving international standards, while adapting new models for service delivery into the existing framework and improving system capacity as highlighted by this baseline

Emergency medicine: an operations management view.

Science.gov (United States)

Soremekun, Olan A; Terwiesch, Christian; Pines, Jesse M

2011-12-01

Operations management (OM) is the science of understanding and improving business processes. For the emergency department (ED), OM principles can be used to reduce and alleviate the effects of crowding. A fundamental principle of OM is the waiting time formula, which has clear implications in the ED given that waiting time is fundamental to patient-centered emergency care. The waiting time formula consists of the activity time (how long it takes to complete a process), the utilization rate (the proportion of time a particular resource such a staff is working), and two measures of variation: the variation in patient interarrival times and the variation in patient processing times. Understanding the waiting time formula is important because it presents the fundamental parameters that can be managed to reduce waiting times and length of stay. An additional useful OM principle that is applicable to the ED is the efficient frontier. The efficient frontier compares the performance of EDs with respect to two dimensions: responsiveness (i.e., 1/wait time) and utilization rates. Some EDs may be "on the frontier," maximizing their responsiveness at their given utilization rates. However, most EDs likely have opportunities to move toward the frontier. Increasing capacity is a movement along the frontier and to truly move toward the frontier (i.e., improving responsiveness at a fixed capacity), we articulate three possible options: eliminating waste, reducing variability, or increasing flexibility. When conceptualizing ED crowding interventions, these are the major strategies to consider. © 2011 by the Society for Academic Emergency Medicine.

Development of a novel sports medicine rotation for emergency medicine residents

Directory of Open Access Journals (Sweden)

Waterbrook AL

2016-04-01

Full Text Available Anna L Waterbrook,1 T Gail Pritchard,2 Allison D Lane,1 Lisa R Stoneking,1 Bryna Koch,2 Robert McAtee,1 Kristi H Grall,1 Alice A Min,1 Jessica Prior,1 Isaac Farrell,1 Holly G McNulty,1 Uwe Stolz1 1Department of Emergency Medicine, 2Office of Medical Student Education, The University of Arizona, Tucson, AZ, USA Abstract: Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC and University Campus (UC. The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the

A Review of Tenure for Black, Latino, and Native American Faculty in Academic Medicine.

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Fisher, Zedeena E; Rodríguez, José E; Campbell, Kendall M

2017-01-01

Tenure policies in US medical schools have been under scrutiny for decades while black/African American, Latino, and Native American faculty continue to be underrepresented in medicine. As medical institutions seek to improve diversity, tenure continues to be a major retention tool. We undertook a systematic review of the literature to investigate the role that tenure plays in the recruitment, retention, and advancement of underrepresented minorities in medicine (URMM) faculty in academic medicine. We searched PubMed, Google Scholar, Web of Knowledge, the Cumulative Index of Nursing and Allied Health Literature, and the Education Resources Information Center for articles relating to URMM faculty and tenure. Articles published in the last 20 years, in English, that discussed recruitment or retention of women, URMM faculty, and tenure in academic medicine, and were of high quality based on data were included in the study. Narrative reviews, opinion, editorials, and letters to the editor were excluded. Of the 1038 articles we reviewed, 23 met the criteria for inclusion. Tenure was associated with leadership, higher salaries, and comfort in the work environment. URMM faculty comprised the lowest percentage of tenured faculty in academic medicine, with the highest percentage pertaining to white men. More research needs to be done to determine whether tenure status can improve the number of URMM faculty in academic medicine. Tenure may provide URMM faculty the benefits that they need to progress in their careers and remain in academic medicine.

Development of a novel sports medicine rotation for emergency medicine residents.

Science.gov (United States)

Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe

2016-01-01

Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational

The distribution of the h-index among academic emergency physicians in the United States.

Science.gov (United States)

DeLuca, Lawrence A; St John, Alex; Stolz, Uwe; Matheson, Lincoln; Simpson, Allan; Denninghoff, Kurt R

2013-10-01

Hirsch's h-index (h) attempts to measure the combined academic impact and productivity of a scientist by counting the number of publications by an author, ranked in descending order by number of citations, until the paper number equals the number of citations. This approach provides a natural number or index of the number of publications and the number of citations per publication. H was first described in physics and was demonstrated to be highly predictive of continued academic activity, including recognized measures of scientific excellence such as membership in the National Academy of Sciences and being a Nobel laureate. Citation rates, research environments, and years of experience all affect h, making any comparisons appropriate only for scientists working in the same field for a similar time period. The authors are unaware of any report describing the distribution of h among academic emergency physicians (AEPs). The objective was to describe the distribution of h for AEPs and to determine whether Hirsch's demonstration of the h-index as a predictor of continued scholarly activity among physicists would also apply to AEPs. Academic EPs were identified from lists provided on allopathic U.S. emergency medicine (EM) residency program websites. "Harzing's Publish or Perish," a free program available on the Web that queries Google Scholar, was used to calculate h for each AEP. Agreement between raters was analyzed on a subset of 100 EPs. An analysis of the 20 EPs with the top h-indices was performed to characterize the entire body of their scholarly work, and their h-indices were calculated at 12 and 24 years into their careers. A total of 4,744 AEPs from 136 programs were evaluated. Nine programs did not publicly list the faculty at their institutions and were excluded. A linear weighted kappa was used to measure rater concordance, with agreement of 98.3% and κ = 0.92 (95% confidence interval [CI] = 0.861 to 0.957). The majority of AEPs had h-indices of zero or

Inadequate progress for women in academic medicine: findings from the National Faculty Study.

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Carr, Phyllis L; Gunn, Christine M; Kaplan, Samantha A; Raj, Anita; Freund, Karen M

2015-03-01

Women have entered academic medicine in significant numbers for 4 decades and now comprise 20% of full-time faculty. Despite this, women have not reached senior positions in parity with men. We sought to explore the gender climate in academic medicine as perceived by representatives to the Association of American Medical Colleges (AAMC) Group on Women in Medicine and Science (GWIMS) and Group on Diversity and Inclusion (GDI). We conducted a qualitative analysis of semistructured telephone interviews with GWIMS and GDI representatives and other senior leaders at 24 randomly selected medical schools of the 1995 National Faculty Study. All were in the continental United States, balanced for public/private status and AAMC geographic region. Interviews were audiotaped, transcribed, and organized into content areas before an inductive thematic analysis was conducted. Themes that were expressed by multiple informants were studied for patterns of association. Five themes were identified: (1) a perceived wide spectrum in gender climate; (2) lack of parity in rank and leadership by gender; (3) lack of retention of women in academic medicine (the "leaky pipeline"); (4) lack of gender equity in compensation; and (5) a disproportionate burden of family responsibilities and work-life balance on women's career progression. Key informants described improvements in the climate of academic medicine for women as modest. Medical schools were noted to vary by department in the gender experience of women, often with no institutional oversight. Our findings speak to the need for systematic review by medical schools and by accrediting organizations to achieve gender equity in academic medicine.

Dilemma of an indigent country: Is academic medicine a good investment?

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Kardas, Przemyslaw

2004-10-01

Academic medicine is a discipline which requires much financial expenditure and the profit is not always immediate. Therefore, an idea has been raised in some circles to limit the expenditures on it. The experience of Poland points out, however, that such a limitation will not bring benefit in the long run--just the opposite, it can bring about both social and economic loss. Even the countries that are not wealthy should invest in academic medicine, as this is a necessary condition for their harmonious growth.

The polity of academic medicine: evidence-based democracy.

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Willing, Steven J; Gunderman, Richard B; Cochran, Philip L; Saxton, Todd

2005-04-01

The authors consider the empirical data examining relationships between democratic governance and organizational success. There is overwhelming evidence that democratically run organizations excel in key parameters of success, such as business valuation, productivity, responsiveness, innovation, decision making, and worker morale and satisfaction. A review of physician surveys shows that discontent with academic administration is a major contributor to faculty turnover. Other data indicate that the basic concepts justifying autocratic governance of a department are deeply flawed and that autocratic governance is counterproductive. The authors conclude that the democratic governance of academic departments is the only model that is scientifically valid and would greatly enhance all missions of academic medicine in the 21st century.

Women in Academic Medicine: Measuring Stereotype Threat Among Junior Faculty.

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Fassiotto, Magali; Hamel, Elizabeth Otto; Ku, Manwai; Correll, Shelley; Grewal, Daisy; Lavori, Philip; Periyakoil, V J; Reiss, Allan; Sandborg, Christy; Walton, Gregory; Winkleby, Marilyn; Valantine, Hannah

2016-03-01

Gender stereotypes in science impede supportive environments for women. Research suggests that women's perceptions of these environments are influenced by stereotype threat (ST): anxiety faced in situations where one may be evaluated using negative stereotypes. This study developed and tested ST metrics for first time use with junior faculty in academic medicine. Under a 2012 National Institutes of Health Pathfinder Award, Stanford School of Medicine's Office of Diversity and Leadership, working with experienced clinicians, social scientists, and epidemiologists, developed and administered ST measures to a representative group of junior faculty. 174 School of Medicine junior faculty were recruited (62% women, 38% men; 75% assistant professors, 25% instructors; 50% white, 40% Asian, 10% underrepresented minority). Women reported greater susceptibility to ST than did men across all items including ST vulnerability (p gender identification (p women reported lower beliefs in advancement (p = 0.021); however, they had similar career interest and identification, felt just as connected to colleagues, and were equally likely to pursue careers outside academia (all p > 0.42). Innovative ST metrics can provide a more complete picture of academic medical center environments. While junior women faculty are susceptible to ST, they may not yet experience all of its consequences in their early careers. As such, ST metrics offer a tool for evaluating institutional initiatives to increase supportive environments for women in academic medicine.

Meaningful Academic Work as Praxis in Emergence

Directory of Open Access Journals (Sweden)

Keijo Räsänen

2008-01-01

Full Text Available The managerial form of university governance has changed the conditions of academic work in many countries. While some academics consider this a welcome development, others experience it as a threat to their autonomy and to the meaningfulness of their work. This essay suggests a stance in response to the current conditions that should serve especially the latter group of academics. The claim is that by approaching academic work as a potential praxis in emergence, it is possible to appreciate local, autonomous activity in renewing academic work. Even if such efforts remain difficult, dispersed in space, discontinuous in time, and incomplete, they may provide a sense of direction and keep up hope. The conception of praxis is a way of articulating the mission of such efforts; simultaneously, it is also a way of defining an epistemic object for research on academic work.

Multigenerational challenges in academic medicine: UCDavis's responses.

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Howell, Lydia Pleotis; Servis, Gregg; Bonham, Ann

2005-06-01

Academic medicine is a unique work environment, one of the few where members of four different generations regularly interact and where multigenerational teams are key to fulfilling its missions, particularly education. This can lead to increased creativity, but also to intergenerational conflict, since each generation has different values and expectations. The authors describe multigenerational challenges confronted at the University of California, Davis, School of Medicine, and that school's responses to them. These challenges include issues related to work hours, workload, compensation, evaluation for advancement, recruitment and retention, and attendance at required meetings. Awareness of the different generational qualities and values allowed the school of medicine to identify the multigenerational origin of many of these ongoing issues and challenges and to plan appropriate solutions within the Office of Academic Affairs. These include policy changes related to work-life balance, utilizing multiple faculty tracks with different roles, allowing part-time faculty appointments, creating a variety of faculty development programs geared toward different generational needs (which utilize flexible modules, menus of options, and alternative technologies for presentation), defining appropriate reward and incentives through compensations plans, and creating peer-reviewed awards. The authors conclude that these efforts mitigate conflict, promote diversity, and allow multigenerational teams to function more effectively and creatively in education, research, and clinical care. Ongoing evaluation will further refine this approach.

"Having the right chemistry": a qualitative study of mentoring in academic medicine.

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Jackson, Vicki A; Palepu, Anita; Szalacha, Laura; Caswell, Cheryl; Carr, Phyllis L; Inui, Thomas

2003-03-01

To develop a deeper understanding of mentoring by exploring lived experiences of academic medicine faculty members. Mentoring relationships are key to developing productive careers in academic medicine, but such alliances hold a certain "mystery." Using qualitative techniques, between November 1999 and March 2000, the authors conducted individual telephone interviews of 16 faculty members about their experiences with mentoring. Interviews were taped and transcribed and authors identified major themes through multiple readings. A consensus taxonomy for classifying content evolved from comparisons of coding by four reviewers. Themes expressed by participants were studied for patterns of connection and grouped into broader categories. Almost 98% of participants identified lack of mentoring as the first (42%) or second (56%) most important factor hindering career progress in academic medicine. Finding a suitable mentor requires effort and persistence. Effective mentoring necessitates a certain chemistry for an appropriate interpersonal match. Prized mentors have "clout," knowledge, and interest in the mentees, and provide both professional and personal support. In cross-gender mentoring, maintaining clear boundaries is essential for an effective relationship. Same-gender or same-race matches between mentor and mentee were not felt to be essential. Having a mentor is critical to having a successful career in academic medicine. Mentees need to be diligent in seeking out these relationships and institutions need to encourage and value the work of mentors. Participants without formalized mentoring relationships should look to peers and colleagues for assistance in navigating the academic system.

Ethics curriculum for emergency medicine graduate medical education.

Science.gov (United States)

Marco, Catherine A; Lu, Dave W; Stettner, Edward; Sokolove, Peter E; Ufberg, Jacob W; Noeller, Thomas P

2011-05-01

Ethics education is an essential component of graduate medical education in emergency medicine. A sound understanding of principles of bioethics and a rational approach to ethical decision-making are imperative. This article addresses ethics curriculum content, educational approaches, educational resources, and resident feedback and evaluation. Ethics curriculum content should include elements suggested by the Liaison Committee on Medical Education, Accreditation Council for Graduate Medical Education, and the Model of the Clinical Practice of Emergency Medicine. Essential ethics content includes ethical principles, the physician-patient relationship, patient autonomy, clinical issues, end-of-life decisions, justice, education in emergency medicine, research ethics, and professionalism. The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution. Copyright © 2011 Elsevier Inc. All rights reserved.

Inadequate Progress for Women in Academic Medicine: Findings from the National Faculty Study

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Gunn, Christine M.; Kaplan, Samantha A.; Raj, Anita; Freund, Karen M.

2015-01-01

Abstract Background: Women have entered academic medicine in significant numbers for 4 decades and now comprise 20% of full-time faculty. Despite this, women have not reached senior positions in parity with men. We sought to explore the gender climate in academic medicine as perceived by representatives to the Association of American Medical Colleges (AAMC) Group on Women in Medicine and Science (GWIMS) and Group on Diversity and Inclusion (GDI). Methods: We conducted a qualitative analysis of semistructured telephone interviews with GWIMS and GDI representatives and other senior leaders at 24 randomly selected medical schools of the 1995 National Faculty Study. All were in the continental United States, balanced for public/private status and AAMC geographic region. Interviews were audiotaped, transcribed, and organized into content areas before an inductive thematic analysis was conducted. Themes that were expressed by multiple informants were studied for patterns of association. Results: Five themes were identified: (1) a perceived wide spectrum in gender climate; (2) lack of parity in rank and leadership by gender; (3) lack of retention of women in academic medicine (the “leaky pipeline”); (4) lack of gender equity in compensation; and (5) a disproportionate burden of family responsibilities and work-life balance on women's career progression. Conclusions: Key informants described improvements in the climate of academic medicine for women as modest. Medical schools were noted to vary by department in the gender experience of women, often with no institutional oversight. Our findings speak to the need for systematic review by medical schools and by accrediting organizations to achieve gender equity in academic medicine. PMID:25658907

[Spanish doctoral theses in emergency medicine (1978-2013)].

Science.gov (United States)

Fernández-Guerrero, Inés María

2015-01-01

To quantitatively analyze the production of Spanish doctoral theses in emergency medicine. Quantitative synthesis of productivity indicators for 214 doctoral theses in emergency medicine found in the database (TESEO) for Spanish universities from 1978 to 2013. We processed the data in 3 ways as follows: compilation of descriptive statistics, regression analysis (correlation coefficients of determination), and modeling of linear trend (time-series analysis). Most of the thesis supervisors (84.1%) only oversaw a single project. No major supervisor of 10 or more theses was identified. Analysis of cosupervision indicated there were 1.6 supervisors per thesis. The theses were defended in 67 departments (both general and specialist departments) because no emergency medicine departments had been established. The most productive universities were 2 large ones (Universitat de Barcelona and Universidad Complutense de Madrid) and 3 medium-sized ones (Universidad de Granada, Universitat Autónoma de Barcelona, and Universidad de La Laguna). Productivity over time analyzed as the trend for 2-year periods in the time-series was expressed as a polynomial function with a correlation coefficient of determination of R2 = 0.80. Spanish doctoral research in emergency medicine has grown markedly. Work has been done in various university departments in different disciplines and specialties. The findings confirm that emergency medicine is a disciplinary field.

Training in Emergency Obstetrics: A Needs Assessment of U.S. Emergency Medicine Program Directors

Directory of Open Access Journals (Sweden)

Daniel W. Robinson

2017-12-01

Full Text Available Introduction Obstetrical emergencies are a high-risk yet infrequent occurrence in the emergency department. While U.S. emergency medicine (EM residency graduates are required to perform 10 low-risk normal spontaneous vaginal deliveries, little is known about how residencies prepare residents to manage obstetrical emergencies. We sought to profile the current obstetrical training curricula through a survey of U.S. training programs. Methods We sent a web-based survey covering the four most common obstetrical emergencies (pre-eclampsia/eclampsia, postpartum hemorrhage (PPH, shoulder dystocia, and breech presentation through email invitations to all program directors (PD of U.S. EM residency programs. The survey focused on curricular details as well as the comfort level of the PDs in the preparation of their graduating residents to treat obstetrical emergencies and normal vaginal deliveries. Results Our survey had a 55% return rate (n=105/191. Of the residencies responding, 75% were in the academic setting, 20.2% community, 65% urban, and 29.8% suburban, and the obstetrical curricula were 2–4 weeks long occurring in post-graduate year one. The most common teaching method was didactics (84.1–98.1%, followed by oral cases for pre-eclampsia (48% and PPH (37.2%, and homemade simulation for shoulder dystocia (37.5% and breech delivery (33.3%. The PDs’ comfort about residency graduate skills was highest for normal spontaneous vaginal delivery, pre-eclampsia, and PPH. PDs were not as comfortable about their graduates’ skill in handling shoulder dystocia or breech delivery. Conclusion Our survey found that PDs are less comfortable in their graduates’ ability to perform non-routine emergency obstetrical procedures.

Emergency Medicine for medical students world wide!

DEFF Research Database (Denmark)

Perinpam, Larshan; Thi Huynh, Anh-Nhi

2015-01-01

A guest blog from Larshan Perinpam (President of ISAEM) and Anh-Nhi Thi Huynh (Vice president of external affairs, ISAEM) - http://blogs.bmj.com/emj/2015/04/17/emergency-medicine-for-medical-students-world-wide/......A guest blog from Larshan Perinpam (President of ISAEM) and Anh-Nhi Thi Huynh (Vice president of external affairs, ISAEM) - http://blogs.bmj.com/emj/2015/04/17/emergency-medicine-for-medical-students-world-wide/...

Work shifts in Emergency Medicine

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Roberto Recupero

2007-06-01

Full Text Available Emergency Medicine is known as a high stress specialty. The adverse effect of constantly rotating shifts is the single most important reason given for premature attrition from the field. In this work problems tied with night shift work will be taken into account and some solutions to reduce the impact of night work on the emergency physicians will be proposed.

[Emergency medicine and vulnerable populations].

Science.gov (United States)

Guillemaud, André-Michel

2012-01-01

In emergency medicine, assessing a situation of precarity is sometimes extremely complex. Home visits often provide useful information which can lead to the putting in place of a system of support. Medical marginalisation results from a combination of multiple difficulties, notably financial. This article is the testimony of a doctor working in a structure providing emergency medical care in the home.

Setting the agenda in emergency medicine in the southern African region: Conference assumptions and recommendations, Emergency Medicine Conference 2014: Gaborone, Botswana

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Lloyd D. Christopher

2014-09-01

Full Text Available The first international emergency medicine (EM conference in Botswana was held on 15th and 16th May 2014 at the Gaborone International Convention Centre. The support from key stakeholders positioned the conference, from its conception, to deliver expert guidance on emergency medicine relevance, education and systems implementation. The conference theme was aptly: “Setting the Agenda in Emergency Medicine in the Southern African Region.” Over 300 local, regional and international delegates convened to participate in this landmark event. Country representation included Botswana, South Africa, Zambia, Namibia, Zimbabwe, Swaziland, Lesotho, Nigeria and the United States of America. Conference assumptions intersected emergency care, African burden of injury and illness and the role of the state; the public protection ethic of emergency care, and the developmental, economic and health interest in promoting EM. The recommendations addressed emergency care relevance; health systems research as an imperative for emergency systems development in southern Africa; community agency as a requisite for emergency care resilience; emergency care workers as pivotal to the emergency medical system, and support of EM system implementation. The conference recommendations – by way of setting an agenda, augur well for emergency care development and implementation in the southern African region and are likely to prove useful to the southern African countries seeking to address health service quality, EM advocacy support and implementation guidance. Emergency medicine is the only discipline with ‘universality’ and ‘responsivity’ at the point of need. This implies the widespread potential for facilitation of access to health care: a public health goal nuanced by the African development agenda.

Self reported involvement in emergency medicine among GPs in Norway.

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Hjortdahl, Magnus; Zakariassen, Erik; Halvorsen, Peder A

2018-04-10

To examine general practitioners' (GPs') perception of their role in emergency medicine and participation in emergency services including ambulance call outs, and the characteristics of the GPs and casualty clinics associated with the GPs' involvement in emergency medicine. Cross-sectional online survey. General practice. General practitioners in Norway (n = 1002). Proportion of GPs perceiving that they have a large role in emergency medicine, regularly being on call, and the proportion of ambulance callouts with GP participation. Forty six percent of the GPs indicated that they play a large role in emergency medicine, 63 percent of the GPs were regularly on call, and 28 percent responded that they usually took part in ambulance call outs. Multivariable logistic regression analyses indicated that these outcomes were strongly associated with participation in multidisciplinary training. Furthermore, the main outcomes were associated with traits commonly seen at smaller casualty clinics such as those with an absence of nursing personnel and extra physicians, and based on the distance to the hospital. Our findings suggest that GPs play an important role in emergency medicine. Multidisciplinary team training may be important for their continued involvement in prehospital emergencies. Key Points   Health authorities and other stakeholders have raised concerns about general practitioner's (GPs) participation in emergency medicine, but few have studied opinions and perceptions among the GPs themselves.   • Norwegian GPs report playing a large role in emergency medicine, regularly being on call, and taking part in selected ambulance call outs.   • A higher proportion of GPs who took part in team training perceived themselves as playing a large role in emergency medicine, regularly being on call, and taking part in ambulance call outs.   • These outcomes were also associated with attributes commonly seen at smaller casualty clinics.

Emergency medicine journal impact factor and change compared to other medical and surgical specialties.

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Reynolds, Joshua C; Menegazzi, James J; Yealy, Donald M

2012-11-01

A journal impact factor represents the mean number of citations per article published. Designed as one tool to measure the relative importance of a journal, impact factors are often incorporated into academic evaluation of investigators. The authors sought to determine how impact factors of emergency medicine (EM) journals compare to journals from other medical and surgical specialties and if any change has taken place over time. The 2010 impact factors and 5-year impact factors for each journal indexed by the Thomson Reuters ISI Web of Knowledge Journal Citation Reports (JCR) were collected, and EM, medical, and surgical specialties were evaluated. The maximum, median, and interquartile range (IQR) of the current impact factor and 5-year impact factor in each journal category were determined, and specialties were ranked according to the summary statistics. The "top three" impact factor journals for each specialty were analyzed, and growth trends from 2001 through 2010 were examined with random effects linear regression. Data from 2,287 journals in 31 specialties were examined. There were 23 EM journals with a current maximum impact factor of 4.177, median of 1.269, and IQR of 0.400 to 2.176. Of 23 EM journals, 57% had a 5-year impact factor available, with a maximum of 4.531, median of 1.325, and IQR of 0.741 to 2.435. The top three EM journals had a mean standard deviation (±SD) impact factor of 3.801 (±0.621) and median of 4.142 and a mean (±SD) 5-year impact factor of 3.788 (±1.091) and median of 4.297, with a growth trend of 0.211 (95% confidence interval [CI] = 0.177 to 0.245; p journals ranked no higher than 24th among 31 specialties. Emergency medicine journals rank low in impact factor summary statistics and growth trends among 31 medical and surgical specialties. © 2012 by the Society for Academic Emergency Medicine.

Emergency medicine and internal medicine trainees’ smartphone use in clinical settings in the United States

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Sonja E. Raaum

2015-10-01

Full Text Available Purpose: Smartphone technology offers a multitude of applications (apps that provide a wide range of functions for healthcare professionals. Medical trainees are early adopters of this technology, but how they use smartphones in clinical care remains unclear. Our objective was to further characterize smartphone use by medical trainees at two United States academic institutions, as well as their prior training in the clinical use of smartphones. Methods: In 2014, we surveyed 347 internal medicine and emergency medicine resident physicians at the University of Utah and Brigham and Women’s Hospital about their smartphone use and prior training experiences. Scores (0%–100% were calculated to assess the frequency of their use of general features (email, text and patient-specific apps, and the results were compared according to resident level and program using the Mann-Whitney U-test. Results: A total of 184 residents responded (response rate, 53.0%. The average score for using general features, 14.4/20 (72.2% was significantly higher than the average score for using patient-specific features and apps, 14.1/44 (33.0%, P<0.001. The average scores for the use of general features, were significantly higher for year 3–4 residents, 15.0/20 (75.1% than year 1–2 residents, 14.1/20 (70.5%, P=0.035, and for internal medicine residents, 14.9/20 (74.6% in comparison to emergency medicine residents, 12.9/20 (64.3%, P= 0.001. The average score reflecting the use of patient-specific apps was significantly higher for year 3–4 residents, 16.1/44 (36.5% than for year 1–2 residents, 13.7/44 (31.1%; P=0.044. Only 21.7% of respondents had received prior training in clinical smartphone use. Conclusion: Residents used smartphones for general features more frequently than for patient-specific features, but patient-specific use increased with training. Few residents have received prior training in the clinical use of smartphones.

Learning behaviour and preferences of family medicine residents under a flexible academic curriculum.

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Sy, Alice; Wong, Eric; Boisvert, Leslie

2014-11-01

To determine family medicine residents' learning behaviour and preferences outside of clinical settings in order to help guide the development of an effective academic program that can maximize their learning. Retrospective descriptive analysis of academic learning logs submitted by residents as part of their academic training requirements between 2008 and 2011. London, Ont. All family medicine residents at Western University who had completed their academic program requirements (N = 72) by submitting 300 or more credits (1 credit = 1 hour). Amount of time spent on various learning modalities, location where the learning took place, resources used for self-study, and the objective of the learning activity. A total of 72 residents completed their academic requirements during the study period and logged a total of 25 068 hours of academic learning. Residents chose to spend most of their academic time engaging in self-study (44%), attending staff physicians' teaching sessions (20%),and participating in conferences, courses, or workshops (12%) and in postgraduate medical education sessions (12%). Textbooks (26%), medical journals (20%), and point-of-care resources (12%) were the 3 most common resources used for self-study. The hospital (32%), residents' homes (32%),and family medicine clinics (14%) were the most frequently cited locations where academic learning occurred. While all physicians used a variety of educational activities, most residents (67%) chose self-study as their primary method of learning. The topic for academic learning appeared to have some influence on the learning modalities used by residents. Residents used a variety of learning modalities and chose self-study over other more traditional modalities (eg, lectures) for most of their academic learning. A successful academic program must take into account residents' various learning preferences and habits while providing guidance and training in the use of more effective learning methods and

Mentoring in academic medicine: a systematic review.

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Sambunjak, Dario; Straus, Sharon E; Marusić, Ana

2006-09-06

Mentoring, as a partnership in personal and professional growth and development, is central to academic medicine, but it is challenged by increased clinical, administrative, research, and other educational demands on medical faculty. Therefore, evidence for the value of mentoring needs to be evaluated. To systematically review the evidence about the prevalence of mentorship and its relationship to career development. MEDLINE, Current Contents, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, PsycINFO, and Scopus databases from the earliest available date to May 2006. We identified all studies evaluating the effect of mentoring on career choices and academic advancement among medical students and physicians. Minimum inclusion criteria were a description of the study population and availability of extractable data. No restrictions were placed on study methods or language. The literature search identified 3640 citations. Review of abstracts led to retrieval of 142 full-text articles for assessment; 42 articles describing 39 studies were selected for review. Of these, 34 (87%) were cross-sectional self-report surveys with small sample size and response rates ranging from 5% to 99%. One case-control study nested in a survey used a comparison group that had not received mentoring, and 1 cohort study had a small sample size and a large loss to follow-up. Less than 50% of medical students and in some fields less than 20% of faculty members had a mentor. Women perceived that they had more difficulty finding mentors than their colleagues who are men. Mentorship was reported to have an important influence on personal development, career guidance, career choice, and research productivity, including publication and grant success. Mentoring is perceived as an important part of academic medicine, but the evidence to support this perception is not strong. Practical recommendations on mentoring in

Promoting interventional radiology in clinical practice of emergency medicine

International Nuclear Information System (INIS)

Zhou Bing; Yuan Jianhua

2009-01-01

Interventional radiology has lot of advantages in dealing with various emergencies. The technique is minimally-invasive, highly-effective and immediately-efficient, moreover, it integrates the diagnosis with the therapy perfectly. Besides, the interventional techniques applied in emergency medicine include not only the vascular interventions,such as embolization, embolectomy, etc, but also the nonvascular interventions, such as tracheal s tent implantation, percutaneous vertebroplasty and so forth. However, importance has not been attached to the clinical use of interventional therapy in emergency medicine so far. It is imperative for us to promote the acceptance of interventional therapy in emergency medicine as well as to popularize the technique in clinical practice. (authors)

Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

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Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

2009-02-01

The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

An Emergency Medicine Research Priority Setting Partnership to establish the top 10 research priorities in emergency medicine.

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Smith, Jason; Keating, Liza; Flowerdew, Lynsey; O'Brien, Rachel; McIntyre, Sam; Morley, Richard; Carley, Simon

2017-07-01

Defining research priorities in a specialty as broad as emergency medicine is a significant challenge. In order to fund and complete the most important research projects, it is imperative that we identify topics that are important to all clinicians, society and to our patients. We have undertaken a priority setting partnership to establish the most important questions facing emergency medicine. The top 10 questions reached through a consensus process are discussed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Bioethics and Emergency Medicine: problems and perspectives

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Maurizio Mori

2005-10-01

Full Text Available Before examining the specific problems of emergency medicine, the article identifies the cardinal points for orientation in bioethics, in the conviction that the knowledge of the basic aspects of the subject allow the reader to make more conscious and suitable choices. The questions of moral relativism and the consequences of the biomedical revolution are addressed in detail in order to support the argument for a new ethical base for healthcare in general and for emergency medicine.

A Qualitative Study of Work-Life Choices in Academic Internal Medicine

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Isaac, Carol; Byars-Winston, Angela; McSorley, Rebecca; Schultz, Alexandra; Kaatz, Anna; Carnes, Mary L.

2014-01-01

The high attrition rate of female physicians pursuing an academic medicine research career has not been examined in the context of career development theory. We explored how internal medicine residents and faculty experience their work within the context of their broader life domain in order to identify strategies for facilitating career…

Conference attendance does not correlate with emergency medicine residency in-training examination scores.

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Gene Hern, H; Wills, Charlotte; Alter, Harrison; Bowman, Steven H; Katz, Eric; Shayne, Philip; Vahidnia, Farnaz

2009-12-01

The residency review committee for emergency medicine (EM) requires residents to have greater than 70% attendance of educational conferences during residency training, but it is unknown whether attendance improves clinical competence or scores on the American Board of Emergency Medicine (ABEM) in-training examination (ITE). This study examined the relationship between conference attendance and ITE scores. The hypothesis was that greater attendance would correlate to a higher examination score. This was a multi-center retrospective cohort study using conference attendance data and examination results from residents in four large county EM residency training programs. Longitudinal multi-level models, adjusting for training site, U.S. Medical Licensing Examination (USMLE) Step 1 score, and sex were used to explore the relationship between conference attendance and in-training examination scores according to year of training. Each year of training was studied, as well as the overall effect of mean attendance as it related to examination score. Four training sites reported data on 405 residents during 2002 to 2008; 386 residents had sufficient data to analyze. In the multi-level longitudinal models, attendance at conference was not a significant predictor of in-training percentile score (coefficient = 0.005, 95% confidence interval [CI] = -0.053 to 0.063, p = 0.87). Score on the USMLE Step 1 examination was a strong predictor of ITE score (coefficient = 0.186, 95% CI = 0.155 to 0.217; p ITE scores. Conference attendance may represent an important part of EM residency training but perhaps not of ITE performance. (c) 2009 by the Society for Academic Emergency Medicine.

Building emergency medicine in Ethiopia | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

2014-09-05

Sep 5, 2014 ... Ethiopia faces a critical gap in emergency medical care. ... Dr Biruk Germa, Senior Emergency Medicine Resident at Addis Ababa University, also ... The issue Inaccessibility to veterinary services in Ethiopia's livestock sector.

Academic career in medicine: requirements and conditions for successful advancement in Switzerland.

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Buddeberg-Fischer, Barbara; Stamm, Martina; Buddeberg, Claus

2009-04-29

Within the framework of a prospective cohort study of Swiss medical school graduates a sample of young physicians aspiring to an academic career were surveyed on their career support and barriers experienced up to their sixth year of postgraduate training. Thirty-one junior academics took part in semi-structured telephone interviews in 2007. The interview guideline focused on career paths to date, career support and barriers experienced, and recommendations for junior and senior academics. The qualitatively assessed data were evaluated according to Mayring's content analysis. Furthermore, quantitatively gained data from the total cohort sample on person- and career-related characteristics were analyzed in regard to differences between the junior academics and cohort doctors who aspire to another career in medicine. Junior academics differ in terms of instrumentality as a person-related factor, and in terms of intrinsic career motivation and mentoring as career-related factors from cohort doctors who follow other career paths in medicine; they also show higher scores in the Career-Success Scale. Four types of career path could be identified in junior academics: (1) focus on basic sciences, (2) strong focus on research (PhD programs) followed by clinical training, (3) one to two years in research followed by clinical training, (4) clinical training and research in parallel. The interview material revealed the following categories of career-supporting experience: making oneself out as a proactive junior physician, research resources provided by superior staff, and social network; statements concerning career barriers encompassed interference between clinical training and research activities, insufficient research coaching, and personality related barriers. Recommendations for junior academics focused on mentoring and professional networking, for senior academics on interest in human resource development and being role models. The conditions for an academic career in

A model for emergency medicine education in post-conflict Liberia

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Braden Hexom

2012-12-01

This article describes a unique paradigm for addressing the deficit in human capacity for emergency health care in the Republic of Liberia. This system was designed and supported by a consortium of academic medical centres in the United States working in conjunction with a local non-governmental organisation, Health Education and Relief Through Teaching (HEARTT. Since 2007, the consortium has delivered virtually uninterrupted emergency medical care and medical education at the largest teaching hospital in Liberia. The Liberian programme objectives included supervising and directing emergency medical care, providing a model for curriculum development, building capacity for medical education, and improving systems-based EM practice. The collaboration of multiple academic institutions in bringing emergency medical services and academic EM teaching to a post-conflict setting remains a unique model for introducing the development of acute care in a developing country.

Rationale and Design of the Women and Inclusion in Academic Medicine Study.

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Hill, Emorcia V; Wake, Michael; Carapinha, René; Normand, Sharon-Lise; Wolf, Robert E; Norris, Keith; Reede, Joan Y

2016-04-21

Women of color (WOC) (African American, Hispanic, Native American/Alaskan Native, and Asian American) faculty remain disproportionately underrepresented among medical school faculty and especially at senior ranks compared with White female faculty. The barriers or facilitators to the career advancement of WOC are poorly understood. The Women and Inclusion in Academic Medicine (WIAM) study was developed to characterize individual, institutional and sociocultural factors that influence the entry, progression and persistence, and advancement of women faculty in academic medical careers with a focus on WOC. Using a purposive sample of 13 academic medical institutions, we collected qualitative interview data from 21 WOC junior faculty and quantitative data from 3,127 (38.9% of 8,053 eligible women) respondents via an online survey. To gather institutional data, we used an online survey and conducted 23 key administrative informant interviews from the 13 institutions. Grounded theory methodology will be used to analyze qualitative data. Multivariable analysis including hierarchical linear modeling will be used to investigate outcomes, such as the inclusiveness of organizational gender climate and women faculty's intent to stay. We describe the design, methods, rationale and limitations of one of the largest and most comprehensive studies of women faculty in academic medicine with a focus on WOC. This study will enhance our understanding of challenges that face women, and, especially WOC, faculty in academic medicine and will provide solutions at both the individual and institutional levels.

Student mistreatment in medical school and planning a career in academic medicine.

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Haviland, Mark G; Yamagata, Hisashi; Werner, Leonard S; Zhang, Kehua; Dial, Thomas H; Sonne, Janet L

2011-01-01

Student mistreatment in medical school is a persistent problem with both known and unexplored consequences [corrected]. The purpose of this study was to determine whether a perception of having been mistreated in medical school had an association with planning a full-time career in academic medicine. Using Association of American Medical Colleges' 2000-2004 Medical School Graduation Questionnaire data, we evaluated the relationship between students' mistreatment experience and their career choice, academic versus nonacademic setting. Meta-analysis and regression were used to evaluate this relationship. At medical schools where relatively high percentages of graduating seniors were planning academic careers, students reporting mistreatment experiences were less likely at graduation to be planning careers in academic medicine. A perception of having been mistreated in medical school is related to students' career choices, a finding that may be useful to medical school administrators/faculty and students as mistreatment is addressed in program planning, counseling, and faculty recruitment.

Osteopathic Emergency Medicine Programs Infrequently Publish in High-Impact Emergency Medicine Journals

OpenAIRE

Baskin, Sean M; Lin, Christina; Carlson, Jestin N

2014-01-01

Introduction: Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. Methods: We performed a retrospective literature re...

New ways of understanding and accomplishing leadership in academic medicine.

Science.gov (United States)

Souba, Wiley W

2004-04-01

Understanding leadership as being about a person in charge is not wrong, but it is no longer adequate. The challenges and problems confronting medicine today are so complex and unpredictable that it is practically impossible for one person to accomplish the work of leadership alone. More leadership requires more shared work, but as hospitals and medical centers begin to break down departmental barriers, people have to learn to work with individuals and groups who may have different work ethics, dissimilar styles of solving problems, or even contrasting values. Successful academic medical centers will make use of a broader repertoire of leadership strategies--besides developing leaders, they will develop leadership as a property of the system, as an organizational capacity. While leader development involves enhancing human (individual) capital, the emphasis in leadership development is on social capital and building more productive relationships that enhance networking, collaboration, and resource exchange. Leadership is created in and emerges from the relational space that connects people--accordingly, leadership development involves building high-quality connections between people. To make leadership happen more effectively, academic medical centers will have to identify and study the ingredients that catalyze and enhance human connectivity, augment social capital and activate leadership. Leadership is a uniquely human activity--studying it and how it works is core to the learning organization.

Women's health and women's leadership in academic medicine: hitting the same glass ceiling?

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Carnes, Molly; Morrissey, Claudia; Geller, Stacie E

2008-11-01

The term "glass ceiling" refers to women's lack of advancement into leadership positions despite no visible barriers. The term has been applied to academic medicine for over a decade but has not previously been applied to the advancement of women's health. This paper discusses (1) the historical linking of the advances in women's health with women's leadership in academic medicine, (2) the slow progress of women into leadership in academic medicine, and (3) indicators that the advancement of women's health has stalled. We make the case that deeply embedded unconscious gender-based biases and assumptions underpin the stalled advancement of women on both fronts. We conclude with recommendations to promote progress beyond the apparent glass ceiling that is preventing further advancement of women's health and women leaders. We emphasize the need to move beyond "fixing the women" to a systemic, institutional approach that acknowledges and addresses the impact of unconscious, gender-linked biases that devalue and marginalize women and issues associated with women, such as their health.

Academic general internal medicine: a mission for the future.

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Armstrong, Katrina; Keating, Nancy L; Landry, Michael; Crotty, Bradley H; Phillips, Russell S; Selker, Harry P

2013-06-01

After five decades of growth that has included advances in medical education and health care delivery, value cohesion, and integration of diversity, we propose an overarching mission for academic general internal medicine to lead excellence, change, and innovation in clinical care, education, and research. General internal medicine aims to achieve health care delivery that is comprehensive, technologically advanced and individualized; instills trust within a culture of respect; is efficient in the use of time, people, and resources; is organized and financed to achieve optimal health outcomes; maximizes equity; and continually learns and adapts. This mission of health care transformation has implications for the clinical, educational, and research activities of divisions of general internal medicine over the next several decades.

History and Guideline of Emergency Medicine Residency Discipline in Shahid Beheshti University of Medical Sciences, Iran; Review of 2014

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Majid Shojaee

2014-09-01

Full Text Available Introduction: Since many years ago several problems have been felt in emergency departments (ED of hospitals. In fact, none of physicians in the hospital have accepted the direct responsibility of patients’ management in the EDs and emergency wards of University centers have been managed by residents of various disciplines. Thus, the first line of therapy does not have guardian and several consultants with various specialists have been performed regarding patient’s management. The necessity of physician training was noticed for the first time in 1950 and after 24 years in 1974, the academic emergency medicine was established in United States of America (USA in response to people expectations for overnight accessibility to specialized and quality medical cares. It was performed with foundation of the first period of resident’s training in emergency medicine discipline at University of Cincinnati, Ohio. At beginning, specialists of different fields such as internal medicine, surgery, anesthesia, orthopedics, and neurosurgery initiated the training of emergency medicine residents together which could be responsible to most of referees. Finally, with formal accepting the specialty board in 1978, this field has been officially identified as the 23th discipline in USA. Today the EDs of most hospitals in European and American countries has been managing by emergency medicine specialists which leads to improve the quality of education and treatment, significantly. Also in Iran the request of establishing this major has been presented in the secretariat of the council for graduate medical education for the first time in 1996. This request was approved and principles of its initiating recognized officially by the ministry of health. But, considering to lack of an appropriate infrastructure, it postponed until 2000 that again this discipline was missioned for initiating to the council for graduate medical education by the minister and its outcome was

Training for Leadership Roles in Academic Medicine: Opportunities for Psychologists in the AAMC LEAD Program.

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LaPaglia, Donna; Thompson, Britta; Hafler, Janet; Chauvin, Sheila

2017-06-01

Psychologists' roles within academic medicine have expanded well beyond research and scholarship. They are active as providers of patient care, medical education, and clinical supervision. Although the number of psychologists in academic health centers continues to grow, they represent a small portion of total medical school faculties. However, with the movement toward collaborative care models, emphasis on interprofessional teams, and increased emphasis on psychological science topics in medical curricula, psychologists are well-positioned to make further contributions. Another path through which psychologists can further increase their contributions and value within academic health centers is to aspire to leadership roles. This article describes the first author's reflections on her experiences in a two-year, cohort-based, educational leadership development certificate program in academic medicine. The cohort was comprised largely of physicians and basic scientists, and a small number of non-physician participants of which the first author was the only clinical psychologist. The insights gained from this experience provide recommendations for psychologists interested in leadership opportunities in academic medicine.

An Integrated Framework for Gender Equity in Academic Medicine.

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Westring, Alyssa; McDonald, Jennifer M; Carr, Phyllis; Grisso, Jeane Ann

2016-08-01

In 2008, the National Institutes of Health funded 14 R01 grants to study causal factors that promote and support women's biomedical careers. The Research Partnership on Women in Biomedical Careers, a multi-institutional collaboration of the investigators, is one product of this initiative.A comprehensive framework is needed to address change at many levels-department, institution, academic community, and beyond-and enable gender equity in the development of successful biomedical careers. The authors suggest four distinct but interrelated aspects of culture conducive to gender equity: equal access to resources and opportunities, minimizing unconscious gender bias, enhancing work-life balance, and leadership engagement. They review the collection of eight articles in this issue, which each address one or more of the four dimensions of culture. The articles suggest that improving mentor-mentee fit, coaching grant reviewers on unconscious bias, and providing equal compensation and adequate resources for career development will contribute positively to gender equity in academic medicine.Academic medicine must adopt an integrated perspective on culture for women and acknowledge the multiple facets essential to gender equity. To effect change, culture must be addressed both within and beyond academic health centers (AHCs). Leaders within AHCs must examine their institutions' processes, resources, and assessment for fairness and transparency; mobilize personnel and financial resources to implement evidence-based initiatives; and assign accountability for providing transparent progress assessments. Beyond AHCs, organizations must examine their operations and implement change to ensure parity of funding, research, and leadership opportunities as well as transparency of assessment and accreditation.

Striving for Gender Equity in Academic Medicine Careers: A Call to Action.

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Bates, Carol; Gordon, Lynn; Travis, Elizabeth; Chatterjee, Archana; Chaudron, Linda; Fivush, Barbara; Gulati, Martha; Jagsi, Reshma; Sharma, Poonam; Gillis, Marin; Ganetzky, Rebecca; Grover, Amelia; Lautenberger, Diana; Moses, Ashleigh

2016-08-01

Women represent approximately half of students entering medical schools and more than half of those entering PhD programs. When advancing through the academic and professional fields, however, women continually face barriers that men do not. In this Commentary, the authors offer ideas for coordinating the efforts of organizations, academic institutions, and leaders throughout the scientific and medical professions to reduce barriers that result in inequities and, instead, strive for gender parity. Specific areas of focus outlined by the authors include facilitating women's access to formal and informal professional networks, acknowledging and addressing the gender pay gap as well as the lack of research funding awarded to women in the field, and updating workplace policies that have not evolved to accommodate women's lifestyles. As academic institutions seek access to top talent and the means to develop those individuals capable of generating the change medicine and science needs, the authors urge leaders and change agents within academic medicine to address the systemic barriers to gender equity that impede us from achieving the mission to improve the health of all.

An eMERGE Clinical Center at Partners Personalized Medicine

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Jordan W. Smoller

2016-01-01

Full Text Available The integration of electronic medical records (EMRs and genomic research has become a major component of efforts to advance personalized and precision medicine. The Electronic Medical Records and Genomics (eMERGE network, initiated in 2007, is an NIH-funded consortium devoted to genomic discovery and implementation research by leveraging biorepositories linked to EMRs. In its most recent phase, eMERGE III, the network is focused on facilitating implementation of genomic medicine by detecting and disclosing rare pathogenic variants in clinically relevant genes. Partners Personalized Medicine (PPM is a center dedicated to translating personalized medicine into clinical practice within Partners HealthCare. One component of the PPM is the Partners Healthcare Biobank, a biorepository comprising broadly consented DNA samples linked to the Partners longitudinal EMR. In 2015, PPM joined the eMERGE Phase III network. Here we describe the elements of the eMERGE clinical center at PPM, including plans for genomic discovery using EMR phenotypes, evaluation of rare variant penetrance and pleiotropy, and a novel randomized trial of the impact of returning genetic results to patients and clinicians.

Developing and implementing core competencies for integrative medicine fellowships.

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Ring, Melinda; Brodsky, Marc; Low Dog, Tieraona; Sierpina, Victor; Bailey, Michelle; Locke, Amy; Kogan, Mikhail; Rindfleisch, James A; Saper, Robert

2014-03-01

The Consortium of Academic Health Centers for Integrative Medicine defines integrative medicine as "the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health and healing." Over the past three decades, the U.S. public increasingly has sought integrative medicine approaches. In an effort to train medical professionals to adequately counsel patients on the safe and appropriate use of these approaches, medical schools and residencies have developed curricula on integrative medicine for their trainees. In addition, integrative medicine clinical fellowships for postresidency physicians have emerged to provide training for practitioners interested in gaining greater expertise in this emerging field. Currently, 13 clinical fellowships in integrative medicine exist in the United States, and they are predominantly connected to academic medical centers or teaching affiliate hospitals. In 2010, the Consortium of Academic Health Centers for Integrative Medicine, represented by 56 member academic health care institutions with a shared commitment to advance the principles and practices of integrative medicine, convened a two-year task force to draft integrative medicine fellowship core competencies. These competencies would guide fellowship curriculum development and ensure that graduates possessed a common body of knowledge, skills, and attitudes. In this article, the authors discuss the competencies and the task force's process to develop them, as well as associated teaching and assessment methods, faculty development, potential barriers, and future directions.

Part-time careers in academic internal medicine: a report from the association of specialty professors part-time careers task force on behalf of the alliance for academic internal medicine.

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Linzer, Mark; Warde, Carole; Alexander, R Wayne; Demarco, Deborah M; Haupt, Allison; Hicks, Leroi; Kutner, Jean; Mangione, Carol M; Mechaber, Hilit; Rentz, Meridith; Riley, Joanne; Schuster, Barbara; Solomon, Glen D; Volberding, Paul; Ibrahim, Tod

2009-10-01

To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhance workforce flexibility, and provide high-quality research, patient care, and education in a cost-effective manner. The task force provided a series of detailed steps for operationalizing part-time practice; to do so, key issues were addressed, such as fixed costs, malpractice insurance, space, cross-coverage, mentoring, career development, productivity targets, and flexible scheduling. Recommendations included (1) increasing respect for work-family balance, (2) allowing flexible time as well as part-time employment, (3) directly addressing negative perceptions about part-time faculty, (4) developing policies to allow flexibility in academic advancement, (5) considering part-time faculty as candidates for leadership positions, (6) encouraging granting agencies, including the National Institutes of Health and Veterans Administration, to consider part-time faculty as eligible for research career development awards, and (7) supporting future research in "best practices" for incorporating part-time faculty into academic departments of medicine.

Academic career in medicine – requirements and conditions for successful advancement in Switzerland

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Stamm Martina

2009-04-01

Full Text Available Abstract Background Within the framework of a prospective cohort study of Swiss medical school graduates a sample of young physicians aspiring to an academic career were surveyed on their career support and barriers experienced up to their sixth year of postgraduate training. Methods Thirty-one junior academics took part in semi-structured telephone interviews in 2007. The interview guideline focused on career paths to date, career support and barriers experienced, and recommendations for junior and senior academics. The qualitatively assessed data were evaluated according to Mayring's content analysis. Furthermore, quantitatively gained data from the total cohort sample on person- and career-related characteristics were analyzed in regard to differences between the junior academics and cohort doctors who aspire to another career in medicine. Results Junior academics differ in terms of instrumentality as a person-related factor, and in terms of intrinsic career motivation and mentoring as career-related factors from cohort doctors who follow other career paths in medicine; they also show higher scores in the Career-Success Scale. Four types of career path could be identified in junior academics: (1 focus on basic sciences, (2 strong focus on research (PhD programs followed by clinical training, (3 one to two years in research followed by clinical training, (4 clinical training and research in parallel. The interview material revealed the following categories of career-supporting experience: making oneself out as a proactive junior physician, research resources provided by superior staff, and social network; statements concerning career barriers encompassed interference between clinical training and research activities, insufficient research coaching, and personality related barriers. Recommendations for junior academics focused on mentoring and professional networking, for senior academics on interest in human resource development and being role

Mentorship in an academic department of family medicine.

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Riley, Margaret; Skye, Eric; Reed, Barbara D

2014-01-01

Lack of quality mentorship has been identified as an impediment to a successful academic career. This study serves as a needs assessment to understand baseline mentoring among faculty in an academic department of family medicine and the existing relationships between mentorship, job satisfaction, and academic productivity before the department begins a structured mentorship program. All faculty received an anonymous online survey inquiring about their current mentorship and their perception of the importance of mentorship, in addition to measures of job satisfaction and academic productivity. Of 62 faculty members completing the survey (83% of faculty), almost all indicated it is very or somewhat important to have a mentor (97%, n=60), although only 45% (n=28) reported having a current mentor. Junior faculty were less likely than senior faculty to be satisfied with their mentorship, particularly if they did not have a current mentor. Job satisfaction was high and was not associated with having a mentor. Faculty members with mentors were more likely to have presented a talk or poster nationally, to have taken on a new educational or leadership role, and to have had a greater volume of academic activities overall. Although faculty believe mentorship is important, less than half have a current mentor. Junior faculty are disproportionately dissatisfied by lack of mentorship. Mentorship was associated with some elements of academic productivity but not with job satisfaction. Further study of the impact of a more structured mentorship program is needed.

Increasing women's leadership in academic medicine: report of the AAMC Project Implementation Committee.

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Bickel, Janet; Wara, Diane; Atkinson, Barbara F; Cohen, Lawrence S; Dunn, Michael; Hostler, Sharon; Johnson, Timothy R B; Morahan, Page; Rubenstein, Arthur H; Sheldon, George F; Stokes, Emma

2002-10-01

The AAMC's Increasing Women's Leadership Project Implementation Committee examined four years of data on the advancement of women in academic medicine. With women comprising only 14% of tenured faculty and 12% of full professors, the committee concludes that the progress achieved is inadequate. Because academic medicine needs all the leaders it can develop to address accelerating institutional and societal needs, the waste of most women's potential is of growing importance. Only institutions able to recruit and retain women will be likely to maintain the best housestaff and faculty. The long-term success of academic health centers is thus inextricably linked to the development of women leaders. The committee therefore recommends that medical schools, teaching hospitals, and academic societies (1) emphasize faculty diversity in departmental reviews, evaluating department chairs on their development of women faculty; (2) target women's professional development needs within the context of helping all faculty maximize their faculty appointments, including helping men become more effective mentors of women; (3) assess which institutional practices tend to favor men's over women's professional development, such as defining "academic success" as largely an independent act and rewarding unrestricted availability to work (i.e., neglect of personal life); (4) enhance the effectiveness of search committees to attract women candidates, including assessment of group process and of how candidates' qualifications are defined and evaluated; and (5) financially support institutional Women in Medicine programs and the AAMC Women Liaison Officer and regularly monitor the representation of women at senior ranks.

Women's Health and Women's Leadership in Academic Medicine: Hitting the Same Glass Ceiling?

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Morrissey, Claudia; Geller, Stacie E.

2008-01-01

Abstract The term “glass ceiling” refers to women's lack of advancement into leadership positions despite no visible barriers. The term has been applied to academic medicine for over a decade but has not previously been applied to the advancement of women's health. This paper discusses (1) the historical linking of the advances in women's health with women's leadership in academic medicine, (2) the slow progress of women into leadership in academic medicine, and (3) indicators that the advancement of women's health has stalled. We make the case that deeply embedded unconscious gender-based biases and assumptions underpin the stalled advancement of women on both fronts. We conclude with recommendations to promote progress beyond the apparent glass ceiling that is preventing further advancement of women's health and women leaders. We emphasize the need to move beyond “fixing the women” to a systemic, institutional approach that acknowledges and addresses the impact of unconscious, gender-linked biases that devalue and marginalize women and issues associated with women, such as their health. PMID:18954235

Part-time careers in academic internal medicine: A report from the association of specialty professors part-time careers task force on behalf of the alliance for academic internal medicine

OpenAIRE

Linzer, M; Warde, C; Alexander, RW; DeMarco, DM; Haupt, A; Hicks, L; Kutner, J; Mangione, CM; Mechaber, H; Rentz, M; Riley, J; Schuster, B; Solomon, GD; Volberding, P; Ibrahim, T

2009-01-01

To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhan...

Why Do Emergency Medicine Residents Experience Burn Out? A qualitative study

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Atefe Kamaloo

2017-06-01

Full Text Available Objective: Emergency medicine residents are a high–risk group for burnout syndrome. This was a qualitative study with content analysis on emergency medical residents with 2 aims: evaluating the incidence of occupational burnout syndrome and identifying the points of view and attitudes of emergency medical residents about factors related to occupational burnout syndrome.Method: For this study, 2 sessions of focus group discussions were set up at Imam Khomeini hospital affiliated to Tehran University of Medical Sciences. Each session took 90 minutes, and 20 emergency medicine residents in their first or second year of emergency medicine residency participated in the sessions. Data were coded   by MAXQDA10 software.Results: Data were categorized in 4 themes as follow: (1 the characteristics of emergency medicine; (2 ambiguity in residents’ duties; (3 educational planning; and (4 careers.Data on the proposed solutions by residents were analyzed and coded in 3 groups including (1 changes in personal life; (2 arrangement in shifts; and  (3 educational issues.Conclusion: According to findings of this qualitative study, most of emergency medicine residents have experienced exhaustion sometime during the course of their residency. Psychological supports may help the residents to cope with their career difficulties and probable burn out.

The Medical Academic Advancement Program at the University of Virginia School of Medicine.

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Fang, W L; Woode, M K; Carey, R M; Apprey, M; Schuyler, J M; Atkins-Brady, T L

1999-04-01

Since 1984 the University of Virginia School of Medicine has conducted the Medical Academic Advancement Program for minority and disadvantaged students interested in careers in medicine. The program is a six-week residential program for approximately 130 undergraduate and post-baccalaureate students per year. It emphasizes academic course work--biology, chemistry, physics, and essay writing--to prepare the participants for the Medical College Admission Test. Non-graded activities, such as a clinical medicine lecture series, clinical experiences, and a special lecture series, and special workshops are also offered. The participants take two simulated MCAT exams. Between 1984 and 1998, 1,497 students have participated in the program, with complete follow-up information available for 690 (46%). Of the 1,487 participants, 80 (5%) have graduated from the University of Virginia School of Medicine and 174 (12%) from other medical schools; 44 (3%) are attending the medical school now, and 237 (16%) are at other medical schools; 44 (3%) have graduated from other health professions schools, and 54 (3%) are attending such schools. The retention rate for participants at the University of Virginia School of Medicine is 91% (that is, all but seven of the 80 who matriculated have been retained past the first year). The Medical Academic Advancement Program has been successful in increasing the number of underrepresented minority students matriculating into and continuing in medical education. Such programs warrant continued support and encouragement.

Mentor Networks in Academic Medicine: Moving Beyond a Dyadic Conception of Mentoring for Junior Faculty Researchers

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DeCastro, Rochelle; Sambuco, Dana; Ubel, Peter A.; Stewart, Abigail; Jagsi, Reshma

2013-01-01

Purpose Career development award programs often require formal establishment of mentoring relationships. The authors sought to gain a nuanced understanding of mentoring from the perspective of a diverse national sample of faculty clinician-researchers who were all members of formal mentoring relationships. Method Between February 2010 and August 2011, the authors conducted semi-structured, in-depth telephone interviews with 100 former recipients of National Institutes of Health mentored career development awards and 28 of their mentors. Purposive sampling ensured a diverse range of viewpoints. Multiple analysts thematically coded verbatim transcripts using qualitative data analysis software. Results Three relevant themes emerged: (1) the numerous roles and behaviors associated with mentoring in academic medicine, (2) the improbability of finding a single person who can fulfill the diverse mentoring needs of another individual, and (3) the importance and composition of mentor networks. Many respondents described the need to cultivate more than one mentor. Several participants discussed the utilization of peer mentors, citing benefits such as pooled resources and mutual learning. Female participants generally acknowledged the importance of having at least one female mentor. Some observed that their portfolio of mentors needed to evolve in order to remain effective. Conclusions Those who seek to promote the careers of faculty in academic medicine should focus upon developing mentoring networks, rather than hierarchical mentoring dyads. The members of each faculty member's mentoring team or network should reflect the protégé's individual needs and preferences, with special attention towards ensuring diversity in terms of area of expertise, academic rank, and gender. PMID:23425990

Workplace violence in emergency medicine

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A. Chatterjee*

2013-12-01

Conclusion: Violence against ED health care workers is a real problem with significant implications to the victims, patients, and departments/institutions. ED WPV needs to be addressed urgently by stakeholders through continued research on effective interventions specific to Emergency Medicine. Coordination, cooperation, and active commitment to the development of such interventions are critical.

A review of existing and emerging digital technologies to combat the global trade in fake medicines.

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Mackey, Tim K; Nayyar, Gaurvika

2017-05-01

The globalization of the pharmaceutical supply chain has introduced new challenges, chief among them, fighting the international criminal trade in fake medicines. As the manufacture, supply, and distribution of drugs becomes more complex, so does the need for innovative technology-based solutions to protect patients globally. Areas covered: We conducted a multidisciplinary review of the science/health, information technology, computer science, and general academic literature with the aim of identifying cutting-edge existing and emerging 'digital' solutions to combat fake medicines. Our review identified five distinct categories of technology including mobile, radio frequency identification, advanced computational methods, online verification, and blockchain technology. Expert opinion: Digital fake medicine solutions are unifying platforms that integrate different types of anti-counterfeiting technologies as complementary solutions, improve information sharing and data collection, and are designed to overcome existing barriers of adoption and implementation. Investment in this next generation technology is essential to ensure the future security and integrity of the global drug supply chain.

New Academic Partnerships in Global Health: Innovations at Mount Sinai School of Medicine

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Landrigan, Philip J.; Ripp, Jonathan; Murphy, Ramon J. C.; Claudio, Luz; Jao, Jennifer; Hexom, Braden; Bloom, Harrison G.; Shirazian, Taraneh; Elahi, Ebby; Koplan, Jeffrey P.

2011-01-01

Global health has become an increasingly important focus of education, research, and clinical service in North American universities and academic health centers. Today there are at least 49 academically based global health programs in the United States and Canada, as compared with only one in 1999. A new academic society, the Consortium of Universities for Global Health, was established in 2008 and has grown significantly. This sharp expansion reflects convergence of 3 factors: (1) rapidly growing student and faculty interest in global health; (2) growing realization–powerfully catalyzed by the acquired immune deficiency syndrome epidemic, the emergence of other new infections, climate change, and globalization–that health problems are interconnected, cross national borders, and are global in nature; and (3) rapid expansion in resources for global health. This article examines the evolution of the concept of global health and describes the driving forces that have accelerated interest in the field. It traces the development of global health programs in academic health centers in the United States. It presents a blueprint for a new school-wide global health program at Mount Sinai School of Medicine. The mission of that program, Mount Sinai Global Health, is to enhance global health as an academic field of study within the Mount Sinai community and to improve the health of people around the world. Mount Sinai Global Health is uniting and building synergies among strong, existing global health programs within Mount Sinai; it is training the next generation of physicians and health scientists to be leaders in global health; it is making novel discoveries that translate into blueprints for improving health worldwide; and it builds on Mount Sinai’s long and proud tradition of providing medical and surgical care in places where need is great and resources few. PMID:21598272

Systematic Analysis of Theses in the Field of Emergency Medicine in Turkey

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Erdem CEVIK

2015-03-01

Full Text Available SUMMARY: Objectives: The aim of this study is to systematically evaluate the theses in the field of emergency medicine in Turkey and to determine whether they were published as a scientific paper. Methods: This is a retrospective observational study. Theses in the field of emergency medicine between 1998 and 2013 were browsed from the internet database of National Thesis Center (Council of Higher Education. Study type, both if it was in the field of emergency, or if it was published and the journal's scope of published studies were assessed and recorded in the study chart. Results: 579 theses were included in the study. 27.1% of them were published and 14.9% of them were published in SCI/SCI-E journals. Advisors of theses were emergency medicine specialists in 67.6% of theses and 493 (85.1% of them were in the field of emergency medicine. 77.4% of theses were observational and 20.9% were experimental study. Most of the experimental studies (72.7%, n=88 were animal studies. Conclusions: It was concluded that very few theses in the field of emergency medicine were published in journals that were indexed in SCI/SCI-E. Key words: Emergency medicine, systematic analysis, theses

Job Satisfaction Among Academic Family Physicians.

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Agana, Denny Fe; Porter, Maribeth; Hatch, Robert; Rubin, Daniel; Carek, Peter

2017-09-01

Family physicians report some of the highest rates of burnout among their physician peers. Over the past few years, this rate has increased and work-life balance has decreased. In academic medicine, many report lack of career satisfaction and have considered leaving academia. Our aim was to explore the factors that contribute to job satisfaction and burnout in faculty members in a family medicine department. Six academic family medicine clinics were invited to participate in this qualitative study. Focus groups were conducted to allow for free-flowing, rich dialogue between the moderator and the physician participants. Transcripts were analyzed in a systematic manner by independent investigators trained in grounded theory. The constant comparison method was used to code and synthesize the qualitative data. Six main themes emerged: time (62%), benefits (9%), resources (8%), undervalue (8%), physician well-being (7%), and practice demand (6%). Within the main theme of time, four subthemes emerged: administrative tasks/emails (61%), teaching (17%), electronic medical records (EMR) requirements (13%), and patient care (9%). Academic family physicians believe that a main contributor to job satisfaction is time. They desire more resources, like staff, to assist with increasing work demands. Overall, they enjoy the academic primary care environment. Future directions would include identifying the specific time restraints that prevent them from completing tasks, the type of staff that would assist with the work demands, and the life stressors the physicians are experiencing.

A Transformative Approach to Academic Medicine: The Partnership Between the University of Arizona and Banner Health.

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Cairns, Charles B; Bollinger, Kathy; Garcia, Joe G N

2017-01-01

The University of Arizona Health Network (UAHN) was a modestly successful health care delivery organization with a vibrant academic portfolio and stable finances. By 2013, however, market forces, health care financing changes, and the burden of technology and informatics upgrades led to a compromised financial position at UAHN, a situation experienced by many academic medical centers. Concurrently, Banner Health had been interested in forming an academic partnership to enhance innovation, including the incorporation of new approaches into health care delivery, and to recruit high-quality providers to the organization. In 2015, the University of Arizona (UA) and Banner Health entered into a unique partnership known as Banner - University Medicine. The objective was to create a statewide system that provides reliable, compassionate, high-quality health care across all of its providers and facilities and to make a 30-year commitment to UA's College of Medicine in Tucson and the College of Medicine in Phoenix to support the State of Arizona's position as a first-tier research and training destination with world-class physicians. The goal of the Banner - University Medicine partnership is to create a nationally leading organization that transforms health care by delivering better care, enhanced service, and lower costs through new approaches focused on wellness. Key elements of this partnership are highlighted in this Commentary, including the unique governance structure of the Academic Management Council, the creation of the Academic Enhancement Fund to support the UA Colleges of Medicine in Tucson and Phoenix, and novel approaches to medical education, research, innovation, and care.

The historical development of academic journals in occupational medicine, 1901-2009.

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Smith, Derek R

2009-01-01

Academic journals in a specialist field provide an interesting historical record of its development and progression over time. This article describes the evolution of some major international journals of occupational medicine, including some historical background on their editorial board. As North America, the United Kingdom, and Northern Europe are known to have the highest contribution to scientific production, it was considered appropriate to investigate the main occupational medicine periodicals in these regions. Given the remarkable improvements in Japanese occupational health following the Second World War, it was also considered worthwhile to investigate the two English-language journals of occupational medicine from this country.

Revitalization of academic medicine in Macedonia--an urgent need.

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Donev, Donco M

2004-12-01

This paper presents the current status of the academic medicine of the Skopje University Faculty of Medicine and the necessity of the medical education reform, initiated in 2001 by the decision of the Ss. Cyril and Methodius University Rectorate Administration to introduce the credit system in the university education in the Republic of Macedonia. This essay describes and reviews the actual conditions and priority problems and needs; proposes activities that should be undertaken to solve and overcome the existing problems and provide further development of teaching and research at the Faculty. Structural reorganization and overall mobilization of the human resources of the Faculty towards achieving the desired goals is needed.

An assessment of the faculty development needs of junior clinical faculty in emergency medicine.

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Farley, Heather; Casaletto, Jennifer; Ankel, Felix; Young, Kelly D; Hockberger, Robert

2008-07-01

Academic physicians must be able to access the resources necessary to support their ongoing professional development and meet requirements for continued academic advancement. The authors sought to determine the self-perceived career development needs of junior clinical faculty in emergency medicine (EM) and the availability of educational resources to meet those needs. An educational "needs assessment" survey was distributed to 954 American College of Emergency Physicians (ACEP) members listed in the ACEP database as being faculty at EM residency programs in the United States and having graduated from an EM residency within the past 7 years. Respondents were asked to rank the importance of 22 areas of faculty development to their own professional growth and then to indicate whether educational resources in each area were available to them. Respondents were also asked to note the educational formats they prefer. A search for currently available resources in each topic area was undertaken and compared to the survey results. A total of 240 responses were received. Self-perceived career development needs were identified in the following areas: bedside teaching, lecture development, business skills, managerial skills, educational research, mentorship and career counseling, interpersonal skills, leadership skills, scholarly writing skills, physician wellness, and knowledge of the faculty development process. While a review of currently available educational resources revealed lectures, conferences, and online materials pertinent to most of these topics, a relative lack of resources in the areas of mentorship and physician wellness was identified. Junior clinical faculty in EM perceive a lack of educational resources in a number of areas of faculty development. The academic community of EM should strive to improve awareness of and access to currently existing resources and to develop additional resources to address the area of physician wellness. The lack of mentorship in

Promotion of women physicians in academic medicine. Glass ceiling or sticky floor?

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Tesch, B J; Wood, H M; Helwig, A L; Nattinger, A B

1995-04-05

To assess possible explanations for the finding that the percentage of women medical school faculty members holding associate or full professor rank remains well below the percentage of men. Cross-sectional survey of physician faculty of US medical schools using the Association of American Medical Colleges (AAMC) database. Surveyed were 153 women and 263 men first appointed between 1979 and 1981, matched for institutions of original faculty appointment. Academic rank achieved, career preparation, academic resources at first appointment, familial responsibilities, and academic productivity. After a mean of 11 years on a medical school faculty, 59% of women compared with 83% of men had achieved associate or full professor rank, and 5% of women compared with 23% of men had achieved full professor rank. Women and men reported similar preparation for an academic career, but women began their careers with fewer academic resources. The number of children was not associated with rank achieved. Women worked about 10% fewer hours per week and had authored fewer publications. After adjustment for productivity factors, women remained less likely to be associate or full professors (adjusted odds ratio [OR] = 0.37; 95% confidence interval [CI], 0.21 to 0.66) or to achieve full professor rank (adjusted OR = 0.27; 95% CI, 0.12 to 0.63). Based on the AAMC database, 50% of both women and men originally appointed as faculty members between 1979 and 1981 had left academic medicine by 1991. Women physician medical school faculty are promoted more slowly than men. Gender differences in rank achieved are not explained by productivity or by differential attrition from academic medicine.

Psychiatry and emergency medicine: medical student and physician attitudes toward homeless persons.

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Morrison, Ann; Roman, Brenda; Borges, Nicole

2012-05-01

The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden curriculum" in medical education, in which values are communicated from teacher to student outside of the formal instruction. A group of 79 students on Psychiatry and 66 on Emergency Medicine clerkships were surveyed at the beginning and end of their rotation regarding their attitudes toward homeless persons by use of the Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI). The HPATHI was also administered to 31 Psychiatry residents and faculty and 41 Emergency Medicine residents and faculty one time during the course of this study. For Psychiatry clerks, t-tests showed significant differences pre- and post-clerkship experiences on 2 of the 23 items on the HPATHI. No statistically significant differences were noted for the Emergency Medicine students. An analysis of variance revealed statistically significant differences on 7 out of the 23 survey questions for residents and faculty in Psychiatry, as compared with those in Emergency Medicine. Results suggest that medical students showed small differences in their attitudes toward homeless people following clerkships in Psychiatry but not in Emergency Medicine. Regarding resident and faculty results, significant differences between specialties were noted, with Psychiatry residents and faculty exhibiting more favorable attitudes toward homeless persons than residents and faculty in Emergency Medicine. Given that medical student competencies should be addressing the broader social issues of homelessness, medical schools need to first understand the attitudes of medical students to such issues, and then develop curricula to overcome inaccurate or stigmatizing beliefs.

Can emergency medicine research benefit from adaptive design clinical trials?

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Flight, Laura; Julious, Steven A; Goodacre, Steve

2017-04-01

Adaptive design clinical trials use preplanned interim analyses to determine whether studies should be stopped or modified before recruitment is complete. Emergency medicine trials are well suited to these designs as many have a short time to primary outcome relative to the length of recruitment. We hypothesised that the majority of published emergency medicine trials have the potential to use a simple adaptive trial design. We reviewed clinical trials published in three emergency medicine journals between January 2003 and December 2013. We determined the proportion that used an adaptive design as well as the proportion that could have used a simple adaptive design based on the time to primary outcome and length of recruitment. Only 19 of 188 trials included in the review were considered to have used an adaptive trial design. A total of 154/165 trials that were fixed in design had the potential to use an adaptive design. Currently, there seems to be limited uptake in the use of adaptive trial designs in emergency medicine despite their potential benefits to save time and resources. Failing to take advantage of adaptive designs could be costly to patients and research. It is recommended that where practical and logistical considerations allow, adaptive designs should be used for all emergency medicine clinical trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Work-life balance in academic medicine: narratives of physician-researchers and their mentors.

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Strong, Erin A; De Castro, Rochelle; Sambuco, Dana; Stewart, Abigail; Ubel, Peter A; Griffith, Kent A; Jagsi, Reshma

2013-12-01

Leaders in academic medicine are often selected from the ranks of physician-researchers, whose demanding careers involve multiple professional commitments that must also be balanced with demands at home. To gain a more nuanced understanding of work-life balance issues from the perspective of a large and diverse group of faculty clinician-researchers and their mentors. A qualitative study with semi-structured, in-depth interviews conducted from 2010 to 2011, using inductive analysis and purposive sampling. One hundred former recipients of U.S. National Institutes of Health (NIH) K08 or K23 career development awards and 28 of their mentors. Three researchers with graduate training in qualitative methods conducted the interviews and thematically coded verbatim transcripts. Five themes emerged related to work-life balance: (1) the challenge and importance of work-life balance for contemporary physician-researchers, (2) how gender roles and spousal dynamics make these issues more challenging for women, (3) the role of mentoring in this area, (4) the impact of institutional policies and practices intended to improve work-life balance, and (5) perceptions of stereotype and stigma associated with utilization of these programs. In academic medicine, in contrast to other fields in which a lack of affordable childcare may be the principal challenge, barriers to work-life balance appear to be deeply rooted within professional culture. A combination of mentorship, interventions that target institutional and professional culture, and efforts to destigmatize reliance on flexibility (with regard to timing and location of work) are most likely to promote the satisfaction and success of the new generation of clinician-researchers who desire work-life balance.

Abstract to publication ratio for papers presented at scientific meetings: how does emergency medicine compare?

Science.gov (United States)

Walby, A; Kelly, A M; Georgakas, C

2001-12-01

The aims of the present study were to determine the publication rate of abstracts presented by Australasian emergency physicians at major emergency medicine meetings and to identify the site of publication of papers. All free paper abstracts presented (oral and poster) by Australasian emergency physicians and trainees at five Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings between 1995 and 1998 were identified retrospectively from conference programmes. In order to determine whether or not the abstract had been published, the PubMed database (http://www4.ncbi.nlm.nih.gov/PubMed/) was searched using the presenter's name and key words from the abstract. In addition, a hand search of the non-abstracted journal Emergency Medicine was conducted. Of the 207 free paper abstracts identified, 73 (35%) had been published as full articles. Papers were published in a variety of journals; however, Emergency Medicine accounted for almost half the published papers. The mean time between presentation and publication was 12.6 months (median 11 months). The abstract to publication rate for papers presented by Australasian emergency physicians and trainees at Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings is 35%, which is lower than that reported by some other established specialities, but comparable to rates reported for US-based national and international emergency medicine meetings. Future research should look at barriers to the publication of findings and ways to assist the publication process.

Cost-effectiveness Analysis Appraisal and Application: An Emergency Medicine Perspective.

Science.gov (United States)

April, Michael D; Murray, Brian P

2017-06-01

Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policymakers have any formal training in CEA methodology. This paper provides an introduction to the interpretation and use of CEA with a focus on application to emergency medicine problems and settings. It applies a previously published CEA to the hypothetical case of a patient presenting to the ED with chest pain who requires risk stratification. This paper uses a widely cited checklist to appraise the CEA. This checklist serves as a vehicle for presenting basic CEA terminology and concepts. General topics of focus include measurement of costs and outcomes, incremental analysis, and sensitivity analysis. Integrated throughout the paper are recommendations for good CEA practice with emphasis on the guidelines published by the U.S. Panel on Cost-Effectiveness in Health and Medicine. Unique challenges for emergency medicine CEAs discussed include the projection of long-term outcomes from emergent interventions, costing ED services, and applying study results to diverse patient populations across various ED settings. The discussion also includes an overview of the limitations inherent in applying CEA results to clinical practice to include the lack of incorporation of noncost considerations in CEA (e.g., ethics). After reading this article, emergency medicine leaders and researchers will have an enhanced understanding of the basics of CEA critical appraisal and application. The paper concludes with an overview of economic evaluation resources for readers interested in conducting ED-based economic evaluation

Nuclear medicine in emergency

International Nuclear Information System (INIS)

Mansi, L.; Rambaldi, P.F.; Cuccurullo, V.; Varetto, T.

2005-01-01

The role of a procedure depends not only on its own capabilities but also on a cost/effective comparison with alternative technique giving similar information. Starting from the definition of emergency as a sudden unexpected occurrence demanding immediate action, the role of nuclear medicine (NM) is difficult to identify if it is not possible to respond 24h a day, 365 days a year, to clinical demands. To justify a 24 h NM service it is necessary to reaffirm the role in diagnosis of pulmonary embolism in the spiral CT era, to spread knowledge of the capabilities of nuclear cardiology in reliability diagnosis myocardial infraction (better defining admission and discharge to/from the emergency department), to increase the number of indications. Radionuclide technique could be used as first line, alternative, complementary procedures in a diagnostic tree taking into account not only the diagnosis but also the connections with prognosis and therapy in evaluating cerebral pathologies, acute inflammation/infection, transplants, bleeding, trauma, skeletal, hepatobiliary, renal and endocrine emergencies, acute scrotal pain

Systematic Analysis of Theses in the Field of Emergency Medicine in Turkey.

Science.gov (United States)

Cevik, Erdem; Karakus Yilmaz, Banu; Acar, Yahya Ayhan; Dokur, Mehmet

2015-03-01

The aim of this study is to systematically evaluate the theses in the field of emergency medicine in Turkey and to determine whether they were published as a scientific paper. This is a retrospective observational study. Theses in the field of emergency medicine between 1998 and 2013 were browsed from the internet database of National Thesis Center (Council of Higher Education). Study type, both if it was in the field of emergency, or if it was published and the journal's scope of published studies were assessed and recorded in the study chart. 579 theses were included in the study. 27.1% of them were published and 14.9% of them were published in SCI/SCI-E journals. Advisors of theses were emergency medicine specialists in 67.6% of theses and 493 (85.1%) of them were in the field of emergency medicine. 77.4% of theses were observational and 20.9% were experimental study. Most of the experimental studies (72.7%, n=88) were animal studies. It was concluded that very few theses in the field of emergency medicine were published in journals that were indexed in SCI/SCI-E.

Publication rate of abstracts presented at the emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012.

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Kalkan, Asim; Kose, Ozkan; Bilir, Ozlem; Ersunan, Gokhan; Ozel, Deniz; Guler, Ferhat

2015-09-01

The purpose of this study was to assess the publication rate of the abstracts presented at the 6th Mediterranean Emergency Medicine Congress, 2011 and the 7th European Congress on Emergency Medicine, 2012. All abstracts, both posters and oral presentations, from the international emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012 were identified. To establish whether these abstracts were subsequently published in peer-reviewed medical journals, the names of all the authors and the title of the abstracts were searched for in the databases of Clinical Key/Elsevier, EBSCO Discovery Service, MD Consult, Science Direct, Scopus, EMBASE, Medscape, Google Scholar and local ULAKBIM. The year of publication, consistency of author names and titles, the type of study, the journals in which papers were published and countries from which reports were submitted were all recorded. A total of 1721 abstracts were examined; 626 from 2011 (307 oral presentations and 319 posters) and 1095 from 2012 (154 oral presentations and 941 posters). Of all abstracts in 2011, 172 (27.5%) and of all abstracts in 2012, 265 (24.2%) were subsequently published as full-text reports in peer-reviewed journals. Of the 172 papers published in 2011, 152 (88.4%) were accepted by Science Citation Index (SCI) and/or SCI Expanded (SCI-E) journals and 155 (58.5%) of 265 papers were accepted by SCI and/or SCI-E journals in 2012 (p=0.0001). The publication rate of abstracts submitted to international emergency medicine congresses held by EUSEM over those 2 years was low compared with that of abstracts presented in other emergency medicine congresses. Presenters should be encouraged to send their studies to peer-reviewed journals. During the selection process by the scientific panel, constructive critics should be notified to the presenters instead of simply accepting or rejecting the studies that submitted to the congress, which may increase the

The development of academic family medicine in central and eastern Europe since 1990.

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Krztoń-Królewiecka, Anna; Švab, Igor; Oleszczyk, Marek; Seifert, Bohumil; Smithson, W Henry; Windak, Adam

2013-03-19

Since the early 1990s former communist countries have been reforming their health care systems, emphasizing the key role of primary care and recognizing family medicine as a specialty and an academic discipline. This study assesses the level of academic development of the discipline characterised by education and research in central and eastern European (CEE) countries. A key informants study, using a questionnaire developed on the basis of a systematic literature review and panel discussions, conducted in 11 central and eastern European countries and Russia. Family medicine in CEE countries is now formally recognized as a medical specialty and successfully introduced into medical training at undergraduate and postgraduate levels. Almost all universities have FM/GP departments, but only a few of them are led by general practitioners. The specialist training programmes in all countries except Russia fulfil the recommendations of the European Parliament. Structured support for research in FM/GP is not always available. However specific scientific organisations function in almost all countries except Russia. Scientific conferences are regularly organised in all the countries, but peer-reviewed journals are published in only half of them. Family medicine has a relatively strong position in medical education in central and eastern Europe, but research in family practice is less developed. Although the position of the discipline at the universities is not very strong, most of the CEE countries can serve as an example of successful academic development for countries southern Europe, where family medicine is still not fully recognised.

Commentary: health care payment reform and academic medicine: threat or opportunity?

Science.gov (United States)

Shomaker, T Samuel

2010-05-01

Discussion of the flaws of the current fee-for-service health care reimbursement model has become commonplace. Health care costs cannot be reduced without moving away from a system that rewards providers for providing more services regardless of need, effectiveness, or quality. What alternatives are likely under health care reform, and how will they impact the challenged finances of academic medical centers? Bundled payment methodologies, in which all providers rendering services to a patient during an episode of care split a global fee, are gaining popularity. Also under discussion are concepts like the advanced medical home, which would establish primary care practices as a regular source of care for patients, and the accountable care organization, under which providers supply all the health care services needed by a patient population for a defined time period in exchange for a share of the savings resulting from enhanced coordination of care and better patient outcomes or a per-member-per-month payment. The move away from fee-for-service reimbursement will create financial challenges for academic medicine because of the threat to clinical revenue. Yet academic health centers, because they are in many cases integrated health care organizations, may be aptly positioned to benefit from models that emphasize coordinated care. The author also has included a series of recommendations for how academic medicine can prepare for the implementation of new payment models to help ease the transition away from fee-for-service reimbursement.

[Ambulance in emergency medicine].

Science.gov (United States)

Aksoy, Fikret; Ergun, Alper

2002-07-01

The ambulance service is very important in emergency medicine. The aim of this study was to investigate the new governing statuate of private ambulance service and to propose some new ideas. We examinated the new governing statuate of private ambulance service, rules of patient transporte between the hospitals and reports written by SSK Goztepe Educational Hospital ambulance drivers. We concluded that SSK Goztepe Educational Hospital ambulance drivers have a iot of problems especially at the rules of patient transport between the hospitals and there are some defiencies at the new governing statuate of private ambulance service. We concluded that it is necesssary to manage all the ambulance services in one center; all the private ambulance services have to have a specialist and all these must be determinated by the special rules. Key words: Regulation ofprivate ambulance, emergency head maintanence, ambulance services

Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond.

Science.gov (United States)

Rosenman, Elizabeth D; Branzetti, Jeremy B; Fernandez, Rosemarie

2016-07-01

Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature.

Ludwig Edelstein (1902-1965): a German historian of medicine in North American exile and the emergence of the modern Hippocratic Oath.

Science.gov (United States)

Pow, Stephen; Stahnisch, Frank W

2016-11-01

Already emerging as an original thinker in the field of classical philology and history of medicine, German scholar Ludwig Edelstein became one of many scholars who lost his academic position when the National Socialists came to power in early 1933. This paper details his life before and after his difficult transition from Europe to North America, while reviewing the lasting significance of his translation and commentary on the Hippocratic Oath. © The Author(s) 2015.

Women faculty: an analysis of their experiences in academic medicine and their coping strategies.

Science.gov (United States)

Pololi, Linda H; Jones, Sandra J

2010-10-01

Women represent a persistently low proportion of faculty in senior and leadership roles in medical schools, despite an adequate pipeline. This article highlights women's concerns in the context of the academic medical culture in which they work, and considers the ways in which they cope with and resist marginalizing situations. To explore the experiences of faculty in academic medicine, a multidisciplinary faculty research team conducted 96 open-ended interviews with faculty representing a broad set of disciplines at 4 different career stages (early career, leaders, plateaued, and left academic medicine) in 5 medical schools. Coded data from interview transcripts indicated situations in which women were marginalized. Experiences of marginality were examined through a systematic secondary analysis of a subset of 17 representative cases using qualitative analysis. Women had a sense of "not belonging" in the organization, perceiving themselves as cultural outsiders and feeling isolated and invisible. They described barriers to advancement, including bias and gender role expectations. Faculty from underrepresented minority groups and PhDs perceived a double disadvantage. Four strategies were identified that helped women cope with and resist professional barriers: self-silencing, creating microenvironments, balancing life and work, and simultaneously holding dual identities--being successful in the organization while trying to change the culture. Although the sample size was small, this analysis found that many women faculty perceive themselves as outsiders within academic medicine. Because of their marginalization, minority and non-minority women are more able to see the bias and exclusion that may operate in academic medical centers as well as other problematic dimensions of the culture. As cultural outsiders, women may be better able to advance change to improve academic medical culture. A next step is to leverage women's awareness to develop a broader vision of what

Increasing emergency medicine residents' confidence in disaster management: use of an emergency department simulator and an expedited curriculum.

Science.gov (United States)

Franc, Jeffrey Michael; Nichols, Darren; Dong, Sandy L

2012-02-01

Disaster Medicine is an increasingly important part of medicine. Emergency Medicine residency programs have very high curriculum commitments, and adding Disaster Medicine training to this busy schedule can be difficult. Development of a short Disaster Medicine curriculum that is effective and enjoyable for the participants may be a valuable addition to Emergency Medicine residency training. A simulation-based curriculum was developed. The curriculum included four group exercises in which the participants developed a disaster plan for a simulated hospital. This was followed by a disaster simulation using the Disastermed.Ca Emergency Disaster Simulator computer software Version 3.5.2 (Disastermed.Ca, Edmonton, Alberta, Canada) and the disaster plan developed by the participants. Progress was assessed by a pre- and post-test, resident evaluations, faculty evaluation of Command and Control, and markers obtained from the Disastermed.Ca software. Twenty-five residents agreed to partake in the training curriculum. Seventeen completed the simulation. There was no statistically significant difference in pre- and post-test scores. Residents indicated that they felt the curriculum had been useful, and judged it to be preferable to a didactic curriculum. In addition, the residents' confidence in their ability to manage a disaster increased on both a personal and and a departmental level. A simulation-based model of Disaster Medicine training, requiring approximately eight hours of classroom time, was judged by Emergency Medicine residents to be a valuable component of their medical training, and increased their confidence in personal and departmental disaster management capabilities.

Changing the culture of academic medicine to eliminate the gender leadership gap: 50/50 by 2020.

Science.gov (United States)

Valantine, Hannah; Sandborg, Christy I

2013-10-01

Central to the daily struggles that successful working women face is the misalignment of the current work culture and the values of the workforce. In addition to contributing to work-life integration conflicts, this disconnect perpetuates the gender leadership gap. The dearth of women at the highest ranks of academic medicine not only sends a clear message to women that they must choose between career advancement and their personal life but also represents a loss of talent for academic health centers as they fail to recruit and retain the best and the brightest. To close the gender leadership gap and to meet the needs of the next generation of physicians, scientists, and educators, the authors argue that the culture of academic medicine must change to one in which flexibility and work-life integration are core parts of the definition of success. Faculty must see flexibility policies, such as tenure clock extensions and parental leaves, as career advancing rather than career limiting. To achieve these goals, the authors describe the Stanford University School of Medicine Academic Biomedical Career Customization (ABCC) model. This framework includes individualized career plans, which span a faculty member's career, with options to flex up or down in research, patient care, administration, and teaching, and mentoring discussions, which ensure that faculty take full advantage of the existing policies designed to make career customization possible. The authors argue that with vision, determination, and focus, the academic medicine community can eliminate the gender leadership gap to achieve 50/50 by 2020.

State of emergency medicine in Rwanda 2015: an innovative trainee and trainer model.

Science.gov (United States)

Mbanjumucyo, Gabin; DeVos, Elizabeth; Pulfrey, Simon; Epino, Henry M

2015-01-01

The 1994 Rwandan war and genocide left more than 1 million people dead; millions displaced; and the country's economic, social, and health infrastructure destroyed. Despite remaining one of the poorest countries in the world, Rwanda has made remarkable gains in health, social, and economic development over the last 20 years, but modern emergency care has been slow to progress. Rwanda has recently established the Human Resources for Health program to rapidly build capacity in multiple sectors of its healthcare delivery system, including emergency medicine. This project involves multiple medical and surgical residencies, nursing programs, allied health professional trainings, and hospital administrative support. A real strength of the program is that trainers work with international faculty at Rwanda's referral hospital, but also as emergency medicine specialty trainers when returning to their respective district hospitals. Rwanda's first emergency medicine trainees are playing a unique and important role in the implementation of emergency care systems and education in the country's district hospitals. While there has been early vital progress in building emergency medicine's foundations in Rwanda, there remains much work to be done. This will be accomplished with careful planning and strong commitment from the country's healthcare and emergency medicine leaders.

A Model Curriculum for an Emergency Medical Services (EMS Rotation for Emergency Medicine Residents

Directory of Open Access Journals (Sweden)

Michael Mancera

2018-01-01

Full Text Available Audience: This EMS curriculum is designed for Emergency Medicine residents at all levels of training. Introduction: Emergency Medicine (EM physicians have routine interaction with Emergency Medical Services (EMS in their clinical practice. Additionally, the American College of Graduate Medical Education (ACGME mandates that all Emergency Medicine resident physicians receive specific training in the area of EMS.1 Historically, EMS training for EM residents has been conducted in the absence of a standardized didactic curriculum. Despite advancements in the area of prehospital training, there remains wide inconsistency in EMS training experiences among EM residency training programs.2 To our knowledge a standardized and reproducible EMS curriculum for EM residents does not exist. Objectives: The aim of this curriculum is to provide a robust learning experience for EM residents around prehospital care and EMS that fulfills the ACGME requirements and which can be easily replicated and implemented in a variety of EM residency training programs. Method: The educational strategies used in this curriculum include didactics, asynchronous learning through online modules and a focused reading list, experiential learning through ride-alongs, structured small group discussion, supervised medical command shifts, and mentored practice in organizing and delivering didactics to EMS providers.

A novel online didactic curriculum helps improve knowledge acquisition among non-emergency medicine rotating residents.

Science.gov (United States)

Branzetti, Jeremy B; Aldeen, Amer Z; Foster, Andrew W; Courtney, D Mark

2011-01-01

Rotating residents represent a significant proportion of housestaff in academic emergency departments (EDs), yet they rarely receive targeted didactic education during their emergency medicine (EM) rotations. The goals of this study were: 1) to determine the effectiveness of an online didactic curriculum in improving EM knowledge among rotating residents and 2) to assess rotating resident satisfaction with this curriculum. The authors created an online lecture series of six EM subject areas targeted to rotating residents called the Northwestern University Rotating Resident Curriculum (NURRC). All rotating residents at the study site were eligible, written consent was obtained, and the study was approved by the institutional review board. Consenting participants were pretested with a 42-question multiple-choice examination and then randomized to two groups: one with access to the NURRC during the first 2 weeks of the rotation (experimental) and one without (control). Halfway through the rotation, all participants were post-tested with a different multiple-choice examination, and the controls were then granted NURRC access. The primary outcome was the difference between pretest and posttest scores (score delta). The t-test was used to compare mean scores, and a linear regression model was used to determine the association of NURRC access on score delta after adjustment for pretest type and resident type. A postintervention survey was administered at the end of the rotation to assess satisfaction with the NURRC and collect suggestions for improvement. Fifty-four rotating residents were enrolled: 29 in the experimental group and 25 in the control group. There was no significant difference in pretest scores between the two groups. Mean score delta was 17.3% in the experimental group and 1.6% in the control group, an absolute difference of 15.7% (95% confidence interval [CI]=10% to 22%). After adjustment for resident type and pretest type, the only variable positively

Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond

Science.gov (United States)

Rosenman, Elizabeth D.; Branzetti, Jeremy B.; Fernandez, Rosemarie

2016-01-01

Background Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. Objective This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. Methods We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Results Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Conclusions Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature. PMID:27413434

Reluctance to Retire: A Qualitative Study on Work Identity, Intergenerational Conflict, and Retirement in Academic Medicine.

Science.gov (United States)

Silver, Michelle Pannor; Williams, Sarah A

2018-03-19

Some professions foster expectations that individuals cultivate their work identity above all other aspects of life. This can be problematic when individuals are confronted with the expectation that they will readily terminate this identity in later-career stages as institutions seek to cycle in new generations. This study examines the relationship between work identity and retirement by examining multiple generations of academic physicians. This study used a multimethod qualitative design that included document analysis, participant observation, focus groups, and in-depth interviews with academic physicians from one of the oldest departments of medicine in North America. This study illustrates how participants were predisposed and then groomed through institutional efforts to embrace a career trajectory that emphasized work above all else and fostered negative sensibilities about retirement. Participants across multiple generations described a lack of work-life balance and a prioritization of their careers above nonwork commitments. Assertions that less experienced physicians were not as dedicated to medicine and implicit assumptions that later-career physicians should retire emerged as key concerns. Strong work identity and tensions between different generations may confound concerns about retirement in ways that complicate institutional succession planning and that demonstrate how traditional understandings of retirement are out of date. Findings support the need to creatively reconsider the ways we examine relations between work identity, age, and retirement in ways that account for the recent extensions in the working lives of professionals.

[Glass ceiling for women in academic medicine in France].

Science.gov (United States)

Rosso, C; Leger, A; Steichen, O

2018-06-03

To determine whether career development in academic medicine is more difficult for women than for men, and, if any, the nature and level of barriers to this progression. Extraction of full-time medical staff in a Parisian hospital group, through the SIGAPS platform; an online questionnaire survey of career choices and barriers experienced by full-time male and female physicians. The study population comprises 181 hospital practitioners and 141 academic physicians (49 associate professors and 92 full professors). Women represent 49% of the medical staff but 15% of full professors. This underrepresentation of women is more important among intensivists/anesthesiologists than technique-based specialists (such as radiologists, biologists…). There is no difference in scientific output, marital status and parenthood between women and men. On the other hand, there is a difference in attitudes highlighted by the EVAR risk-taking scale as well as in the burden of familial involvement and the prejudices felt by women during the academic selection process. The glass ceiling exists in one of the largest French hospital group. Career development principles promote merit, but should decrease the benefit of "masculine" attitudes in the competition for academic positions. Academic selection criteria should evolve to limit the disadvantage of women related to deeper familial involvement and less competitive strategies and risk-taking attitudes. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Resident experience of abuse and harassment in emergency medicine: ten years later.

Science.gov (United States)

Li, Siu Fai; Grant, Kelly; Bhoj, Tanuja; Lent, Gretchen; Garrick, Jocelyn Freeman; Greenwald, Peter; Haber, Marc; Singh, Malini; Prodany, Karla; Sanchez, Leon; Dickman, Eitan; Spencer, James; Perera, Tom; Cowan, Ethan

2010-02-01

In 1995, a Society for Academic Emergency Medicine in-service survey reported high rates of verbal and physical abuse experienced by Emergency Medicine (EM) residents. We sought to determine the prevalence of abuse and harassment 10 years later to bring attention to these issues and determine if there has been a change in the prevalence of abuse over this time period. To determine the prevalence of abuse and harassment in a sample of EM residencies. We conducted a cross-section survey of EM residents from 10 residencies. EM residents were asked about their experience with verbal abuse, verbal threats, physical threats, physical attacks, sexual harassment, and racial harassment; and by whom. The primary outcome of the study was the prevalence of abuse and harassment as reported by EM residents. There were 196 of 380 residents (52%) who completed the survey. The prevalence of any type of abuse experienced was 91%; 86% of residents experienced verbal abuse, 65% verbal threats, 50% physical threats, 26% physical attacks, 23% sexual harassment, and 26% racial harassment. Women were more likely than men to encounter sexual harassment (37% [38/102] vs. 8% [7/92]; p harassment was not limited to minorities (23% [16/60] for Caucasians vs. 26% [29/126] for non-Caucasians; p = 0.59). Senior residents were more likely to have encountered verbal and physical abuse. Only 12% of residents formally reported the abuse they experienced. Abuse and harassment during EM residency continues to be commonplace and is underreported. Copyright (c) 2010 Elsevier Inc. All rights reserved.

[Occupational aspects of emergency medicine practice in Catalonia: the OPENCAT opinion survey].

Science.gov (United States)

Jacob, Javier; Gené, Emili; Alonso, Gilberto; Rimbau, Pere; Zorrilla, José; Casarramona, Francesc; Netto, Cristina; Sánchez, Pere; Hernández, Ricard; Escalada, Xavier; Miró, Òscar

2017-01-01

To gather information on the contracting and training of members of the Catalan Society of Emergency Medicine (SoCMUE) who work in emergency medicine and services in Catalonia. To survey their opinions on certain aspects of resource availability and working conditions. Cross-sectional descriptive study based on a survey sent to SoCMUE members. We studied the opinions of 5 types of respondent: hospital physicians, out-of-hospital physicians, hospital nurses, out-of-hospital nurses, and emergency medical technicians. Responses were grouped to compare the opinions of physicians and nurses and workers in hospital and prehospital settings. We received 616 responses from 1273 members (48.4% response rate). More physicians than nurses come from outside Catalonia and have contracts specifically linked to emergency care; in addition, physicians have done less postgraduate training in emergency medicine. More hospital staff than prehospital staff have permanent contracts linked to the department where they work. More hospital physicians are specialized in internal medicine than in family and community medicine. The opinion that emergency services are inadequately staffed was widespread. Most respondents believed that patient transport is good or adequate. However, respondents working in prehospital services expressed a lower opinion of transport. Great difficulty in combining work with family (life achieving work-life balance) was expressed by 13.5% overall, and more often by hospital staff. Some type of aggression was experienced by 88.2%; 60% reported the event to superiors. Nurses reported aggression more often than physicians. A police report was filed by 10.1%. Emergency medicine working conditions can be improved in Catalonia according to members of SoCMUE. Relations between groups of professionals are not optimum in some aspects.

Understanding Emergency Care Delivery Through Computer Simulation Modeling.

Science.gov (United States)

Laker, Lauren F; Torabi, Elham; France, Daniel J; Froehle, Craig M; Goldlust, Eric J; Hoot, Nathan R; Kasaie, Parastu; Lyons, Michael S; Barg-Walkow, Laura H; Ward, Michael J; Wears, Robert L

2018-02-01

In 2017, Academic Emergency Medicine convened a consensus conference entitled, "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes." This article, a product of the breakout session on "understanding complex interactions through systems modeling," explores the role that computer simulation modeling can and should play in research and development of emergency care delivery systems. This article discusses areas central to the use of computer simulation modeling in emergency care research. The four central approaches to computer simulation modeling are described (Monte Carlo simulation, system dynamics modeling, discrete-event simulation, and agent-based simulation), along with problems amenable to their use and relevant examples to emergency care. Also discussed is an introduction to available software modeling platforms and how to explore their use for research, along with a research agenda for computer simulation modeling. Through this article, our goal is to enhance adoption of computer simulation, a set of methods that hold great promise in addressing emergency care organization and design challenges. © 2017 by the Society for Academic Emergency Medicine.

The state of emergency medicine in the United Republic of Tanzania

Directory of Open Access Journals (Sweden)

B.A. Nicks

2012-09-01

Currently at most hospitals, emergency patients are cared for in Emergency Centres (ECs staffed with rotating personnel who are neither trained nor equipped to provide complete resuscitative care, but dedicated emergency care training projects are emerging. The first Emergency Medicine residency in the country was initiated in 2010 and will produce its first graduates in 2013. In 2011, a dedicated Emergency Nursing curriculum was introduced, and the Emergency Medical Association of Tanzania (EMAT, the first Emergency Medicine professional society in the country, was formed and ratified by the Ministry of Health. EMAT has been given a mandate to develop feasible initiatives for the dissemination of emergency care training to district and sub-district facilities. However, significant gaps exist in the capacity for emergency medical care including deficits in human resources, essential equipment and infrastructure – concurrent issues that EMAT must address within its development strategy.

The Role of Emotional Intelligence in Mediating the Relationship between Emerging Adulthood and Academic Achievement

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Noor, Farukh; Hanafi, Zahyah

2017-01-01

Purpose: Academic achievement of students can be fostered and improved if they learn to apply emotional intelligence in their emerging adulthood. The core objective of this research is to test the relationship between emerging adulthood and academic achievement by taking emotional intelligence as a mediator. Methodology: The sample comprises 90…

Factors that influence medical student selection of an emergency medicine residency program: implications for training programs.

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Love, Jeffrey N; Howell, John M; Hegarty, Cullen B; McLaughlin, Steven A; Coates, Wendy C; Hopson, Laura R; Hern, Gene H; Rosen, Carlo L; Fisher, Jonathan; Santen, Sally A

2012-04-01

An understanding of student decision-making when selecting an emergency medicine (EM) training program is essential for program directors as they enter interview season. To build upon preexisting knowledge, a survey was created to identify and prioritize the factors influencing candidate decision-making of U.S. medical graduates. This was a cross-sectional, multi-institutional study that anonymously surveyed U.S. allopathic applicants to EM training programs. It took place in the 3-week period between the 2011 National Residency Matching Program (NRMP) rank list submission deadline and the announcement of match results. Of 1,525 invitations to participate, 870 candidates (57%) completed the survey. Overall, 96% of respondents stated that both geographic location and individual program characteristics were important to decision-making, with approximately equal numbers favoring location when compared to those who favored program characteristics. The most important factors in this regard were preference for a particular geographic location (74.9%, 95% confidence interval [CI] = 72% to 78%) and to be close to spouse, significant other, or family (59.7%, 95% CI = 56% to 63%). Factors pertaining to geographic location tend to be out of the control of the program leadership. The most important program factors include the interview experience (48.9%, 95% CI = 46% to 52%), personal experience with the residents (48.5%, 95% CI = 45% to 52%), and academic reputation (44.9%, 95% CI = 42% to 48%). Unlike location, individual program factors are often either directly or somewhat under the control of the program leadership. Several other factors were ranked as the most important factor a disproportionate number of times, including a rotation in that emergency department (ED), orientation (academic vs. community), and duration of training (3-year vs. 4-year programs). For a subset of applicants, these factors had particular importance in overall decision-making. The vast majority

Refining the Enrolment Process in Emergency Medicine Research.

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Sahan, Kate M; Channon, Keith M; Choudhury, Robin P; Kharbanda, Rajesh K; Lee, Regent; Sheehan, Mark

2016-04-01

Research in the emergency setting involving patients with acute clinical conditions is needed if there are to be advances in diagnosis and treatment. But research in these areas poses ethical and practical challenges. One of these is the general inability to obtain informed consent due to the patient's lack of mental capacity and insufficient time to contact legal representatives. Regulatory frameworks which allow this research to proceed with a consent 'waiver', provided patients lack mental capacity, miss important ethical subtleties. One of these is the varying nature of mental capacity among emergency medicine patients. Not only is their capacity variable and often unclear, but some patients are also likely to be able to engage with the researcher and the context to varying degrees. In this paper we describe the key elements of a novel enrolment process for emergency medicine research that refines the consent waiver and fully engages with the ethical rationale for consent and, in this context, its waiver. The process is verbal but independently documented during the 'emergent' stages of the research. It provides appropriate engagement with the patient, is context-sensitive and better addresses ethical subtleties. In line with regulation, full written consent for on-going participation in the research is obtained once the emergency is passed.

Establishing an Integrative Medicine Program Within an Academic Health Center: Essential Considerations.

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Eisenberg, David M; Kaptchuk, Ted J; Post, Diana E; Hrbek, Andrea L; O'Connor, Bonnie B; Osypiuk, Kamila; Wayne, Peter M; Buring, Julie E; Levy, Donald B

2016-09-01

Integrative medicine (IM) refers to the combination of conventional and "complementary" medical services (e.g., chiropractic, acupuncture, massage, mindfulness training). More than half of all medical schools in the United States and Canada have programs in IM, and more than 30 academic health centers currently deliver multidisciplinary IM care. What remains unclear, however, is the ideal delivery model (or models) whereby individuals can responsibly access IM care safely, effectively, and reproducibly in a coordinated and cost-effective way.Current models of IM across existing clinical centers vary tremendously in their organizational settings, principal clinical focus, and services provided; practitioner team composition and training; incorporation of research activities and educational programs; and administrative organization (e.g., reporting structure, use of medical records, scope of clinical practice) and financial strategies (i.e., specific business plans and models for sustainability).In this article, the authors address these important strategic issues by sharing lessons learned from the design and implementation of an IM facility within an academic teaching hospital, the Brigham and Women's Hospital at Harvard Medical School; and review alternative options based on information about IM centers across the United States.The authors conclude that there is currently no consensus as to how integrative care models should be optimally organized, implemented, replicated, assessed, and funded. The time may be right for prospective research in "best practices" across emerging models of IM care nationally in an effort to standardize, refine, and replicate them in preparation for rigorous cost-effectiveness evaluations.

The academic trend of Oriental Medicine during the Japanese colonial period as observed through the publication of medical books

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KIM Nam-il

2006-06-01

Full Text Available This thesis examines the academical trend of Oriental Medicine in the Japanese colonial period observed through medical books published during the Japanese colonial period.This is a period in which Western Medicine was introduced,and due to the lean-to-one-side policy by the Japanese, Western Medicine became the mainstream medical science while Oriental Medicine was pushed to the outskirts.Even after all this,the academic activity was flourishing during this period compared to any other periods. This article is divided into various chapters each with its own theme in order to understand the academic trend of Oriental Medicine during the Japanese colonial period.Focusing on the publication of medical books, this article is divided and observed according to various themes such as the study of Dong-Eui-Bo-Gam(東醫寶鑑,the study of Bang-Yak-Hap- Pyeun(方藥合編,the study of Sang-Han-Ron(傷寒論,the study of Sa-sang (四象constitutional medicine,the study of Eui-Hak-Ip-Mun (醫學入門,the study about Bu-Yang-Ron(扶陽論,On-Bo-Ron(溫補論,and pediatrics, compromise between Western and Oriental Medicine,the study of experience medicine,the study of acupuncture and moxibustion,and etc.

Shared Decision-making in the Emergency Department: Respecting Patient Autonomy When Seconds Count.

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Hess, Erik P; Grudzen, Corita R; Thomson, Richard; Raja, Ali S; Carpenter, Christopher R

2015-07-01

Shared decision-making (SDM), a collaborative process in which patients and providers make health care decisions together, taking into account the best scientific evidence available, as well as the patient's values and preferences, is being increasingly advocated as the optimal approach to decision-making for many health care decisions. The rapidly paced and often chaotic environment of the emergency department (ED), however, is a unique clinical setting that offers many practical and contextual challenges. Despite these challenges, in a recent survey emergency physicians reported there to be more than one reasonable management option for over 50% of their patients and that they take an SDM approach in 58% of such patients. SDM has also been selected as the topic on which to develop a future research agenda at the 2016 Academic Emergency Medicine consensus conference, "Shared Decision-making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda" (http://www.saem.org/annual-meeting/education/2016-aem-consensus-conference). In this paper the authors describe the conceptual model of SDM as originally conceived by Charles and Gafni and highlight aspects of the model relevant to the practice of emergency medicine. In addition, through the use of vignettes from the authors' clinical practices, the applicability of SDM to contemporary EM practice is illustrated and the ethical and pragmatic implications of taking an SDM approach are explored. It is hoped that this document will be read in advance of the 2016 Academic Emergency Medicine consensus conference, to facilitate group discussions at the conference. © 2015 by the Society for Academic Emergency Medicine.

Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons

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Morrison, Ann; Roman, Brenda; Borges, Nicole

2012-01-01

Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

Eliminating Gender-Based Bias in Academic Medicine: More Than Naming the "Elephant in the Room".

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Morgan, Anna U; Chaiyachati, Krisda H; Weissman, Gary E; Liao, Joshua M

2018-06-01

Gender-based discrimination and bias are widespread in professional settings, including academic medicine. Overt manifestations such as sexual harassment have long been identified but attention is only more recently turning towards subtler forms of bias, including inequity in promotion and compensation. Barriers to progress vary across institutions and include lack of awareness, inadequate training, poor informational transparency, and challenging power dynamics. We propose five solutions that the academic medical community can adopt to not only name, but also address, gender-based bias as the proverbial elephant in the room: definitively identify the systemic nature of the problem, prompt those with influence and power to advance a culture of equity, broadly incorporate evidence-based explicit anti-sexist training, increase transparency of information related to professional development and compensation, and use robust research methods to study the drivers and potential solutions of gender inequity within academic medicine. While implementing these proposals is no small task, doing so is an important step in helping the academic medical community become more just.

Admission Scores as a Predictor of Academic Success in the Fiji School of Medicine

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Ezeala, Christian C.; Swami, Niraj S.; Lal, Nilesh; Hussain, Shagufta

2012-01-01

Secondary education in Fiji ends with the Form 7 examination. Predictive validity for academic success of Form 7 scores which form the basis for admission into the Bachelor of Medicine Bachelor of Surgery programme of the Fiji School of Medicine was examined via a cohort of 129 students. Success rates for year 1 in 2008, 2009, and 2010 were 90.7…

Social media; resolving tunnel vision in practicing medicine.

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Kordmahaleh, Fatemeh Hosseini; Rouhipour, Alaleh; Mirbaha, Sahar; Baratloo, Alireza

2018-01-01

With the emergence of social media, physicians who use social media, including emergency medicine physicians, have shared their experiences with their colleagues instead of working alone and keeping their experiences to themselves. This study aimed to evaluate the rate and type of use of electronic online sources and social media, in order to improve learning and education among emergency medicine residents. This was a cross-sectional study carried out from September 2015 until August 2016 on emergency medicine residents of two main medical universities of Tehran, Iran. A questionnaire was prepared by reviewing the existing studies and asking emergency medicine professors inside and outside Iran for opinions. Census sampling method was applied and all emergency medicine residents were included. The gathered data were analyzed using statistical tests of chi square, Independent-samples t-test and Pearson's correlation coefficient via SPSS version 21. Seventy three residents with the mean age of 34.2±5.2 years participated in this study (60.3% female). Smart phone is the most important tool they use for connecting to the Internet. About 30% use the Internet for about 1-2 hours a day. In half of these participants less than 25% of this time is spent on something related to their academic field of study. The correlation of sex (p=0.034) and age (p=0.049) with extent of using social media related to the academic field of study were significant. Other analytical analyses were not statistically significant (p>0.05). In summary, the findings of current study showed that despite sufficient access to proper technology, use of social media and online sources by high majority of the studied EM residents regarding improvement of their learning and educational level is very limited.

Child abuse training and knowledge: a national survey of emergency medicine, family medicine, and pediatric residents and program directors.

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Starling, Suzanne P; Heisler, Kurt W; Paulson, James F; Youmans, Eren

2009-04-01

The objective of this study was to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. Surveys were administered to program directors and third-year residents at 67 residency programs. The resident survey included a 24-item quiz to assess knowledge regarding the medical management of physical and sexual child abuse. Sites were solicited from members of a network of child abuse physicians practicing at institutions with residency programs. Analyzable surveys were received from 53 program directors and 462 residents. Compared with emergency medicine and family medicine programs, pediatric programs were significantly larger and more likely to have a medical provider specializing in child abuse pediatrics, have faculty primarily responsible for child abuse training, use a written curriculum for child abuse training, and offer an elective rotation in child abuse. Exposure to child abuse training and abused patients was highest for pediatric residents and lowest for family medicine residents. Comfort with managing child abuse cases was lowest among family medicine residents. On the knowledge quiz, pediatric residents significantly outperformed emergency medicine and family medicine residents. Residents with high knowledge scores were significantly more likely to come from larger programs and programs that had a center, provider, or interdisciplinary team that specialized in child abuse pediatrics; had a physician on faculty responsible for child abuse training; used a written curriculum for child abuse training; and had a required rotation in child abuse pediatrics. By analyzing the relationship between program characteristics and residents' child abuse knowledge, we found that pediatric programs provide far more training and resources for child abuse education than emergency medicine and family medicine programs. As leaders, pediatricians must

[The department of interdisciplinary emergency medicine: organization, structure and process optimization].

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Bernhard, Michael; Pietsch, Christian; Gries, André

2009-06-01

The essential tasks of a department of interdisciplinary emergency medicine are the initial triage and assessment of vital function as well as the subsequent organization und initiation of emergency treatment. A previously defined set of diagnostic and therapeutic measures is carried out before the patient is allocated to an in-hospital clinical service and is admitted to a ward. Moreover, diagnosis and treatment for outpatients are performed. "Time" is a critical factor to be considered for all organizational and structural aspects of a department of interdisciplinary emergency medicine.

Plagiarism, Intertextuality and Emergent Authorship in University Students' Academic Writing

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Celia Helen Thompson

2009-08-01

Full Text Available Issues of plagiarism, intertextuality and authorial presence in academic writing are fundamental to the teaching and learning activities of all university lecturers and their students. Knowing how to assist students, particularly those who speak English as an additional language (EAL, to develop a sense of text/knowledge ownership and authorial presence in the creation of discipline-based scholarly texts can be especially challenging. Clarifying what is encompassed by the notion of ‘common knowledge’ is also central to this process. The aim of this paper is to explore the political and intertextual nature of text/knowledge construction and emergent student authorship through the analysis of interviews and written assignments from two EAL students, together with interview data from lecturers from relevant disciplinary fields. Drawing on the work of Bakhtin, Kristeva and Penrose and Geisler, I conclude by suggesting that it is by engaging with, rather than fearing, intertextual connections, that we can create a dialogic pedagogy for academic writing that will enable students to articulate an authoritative authorial identity of their own. The importance of lecturer intervention during the drafting stages of text production is also emphasised. Keywords: plagiarism; intertextuality; emergent authorship; academic writing

A Survey of Graduates of Combined Emergency Medicine-Pediatrics Residency Programs: An Update.

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Strobel, Ashley M; Chasm, Rose M; Woolridge, Dale P

2016-10-01

In 1998, emergency medicine-pediatrics (EM-PEDS) graduates were no longer eligible for the pediatric emergency medicine (PEM) sub-board certification examination. There is a paucity of guidance regarding the various training options for medical students who are interested in PEM. We sought to to determine attitudes and personal satisfaction of graduates from EM-PEDS combined training programs. We surveyed 71 graduates from three EM-PEDS residences in the United States. All respondents consider their combined training to be an asset when seeking a job, 92% find it to be an asset to their career, and 88% think it provided added flexibility to job searches. The most commonly reported shortcoming was their ineligibility for the PEM sub-board certification. The lack of this designation was perceived to be a detriment to securing academic positions in dedicated children's hospitals. When surveyed regarding which training offers the better skill set for the practice of PEM, 90% (44/49) stated combined EM-PEDS training. When asked which training track gives them the better professional advancement in PEM, 52% (23/44) chose combined EM-PEDS residency, 27% (12/44) chose a pediatrics residency followed by a PEM fellowship, and 25% (11/44) chose an EM residency then a PEM fellowship. No EM-PEDS respondents considered PEM fellowship training after the completion of the dual training program. EM-PEDS graduates found combined training to be an asset in their career. They felt that it provided flexibility in job searches, and that it was ideal training for the skill set required for the practice of PEM. EM-PEDS graduates' practices varied, including mixed settings, free-standing children's hospitals, and community emergency departments. Copyright © 2016 Elsevier Inc. All rights reserved.

An index to characterize female career promotion in academic medicine.

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Brüggmann, Dörthe; Groneberg, David A

2017-01-01

Imbalances in female career promotion are a key factor of gender disparities at the workplace. They may lead to stress and stress-related diseases including burnout, depression or cardiovascular diseases. Since this problem cannot be generalized and varies between different fields, new approaches are needed to assess and describe the magnitude of the problem in single fields of work. To construct a new index, operating figures of female and male medical students were collected for Germany in a period over 15 years and their progression throughout their studies towards specialization and academic chair positions. By the use of different female to male ratios (f:m), we constructed an index that describes the extend by which women can ascent in their academic career by using the field of academic medicine as an example. A medical student f:m ratio of 1.54 (52,366 female vs. 34,010 male) was found for Germany in 2013. In 1998, this f:m ratio was 0.999. In the same year (2013), the OB/GYN hospital specialists' f:m ratio was 1.566 (3347 female vs. 2137 male physicians) and 0.577 (516 female vs 894 male physicians) for ENT hospital specialists, respectively. The f:m ratios concerning chairs of OB/GYN and ENT were 0.105 and 0.1, respectively. Then an index was generated that incorporated these operating figures with the student f:m ratio as denominator and the chair f:m ratio as numerator while the hospital specialist f:m ratio served as a corrector in the numerator in order to adjust to the attraction of a given field to female physicians. As a result, the index was 0.044 for OB/GYN and 0.113 for ENT instead of ideally ~1 in a completely gender harmonized situation. In summary, a new index to describe female career advancement was established for academic medicine. By the use of this index, different academic and medical fields can now be compared to each other and future benchmarks could be proposed. Also, country differences may be examined using the proposed index and

Burnout and Associated Factors among Iranian Emergency Medicine Practitioners

OpenAIRE

JALILI, Mohammad; SADEGHIPOUR ROODSARI, Gholamreza; BASSIR NIA, Anahita

2013-01-01

Abstract Background Emergency physicians are at risk of burnout, which can affect their mental health, as well as patient care. We assessed burnout level among Iranian emergency physicians and investigated demographic, work-related factors and stressors associated with higher burnout. Methods In a cross-sectional study, we surveyed all 188 emergency medicine residents and practitioners in Iran. We measured burnout using 22-item Maslach Burnout Inventory assessing emotional exhaustion, deperso...

Implementing standardized, inter-unit communication in an international setting: handoff of patients from emergency medicine to internal medicine.

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Balhara, Kamna S; Peterson, Susan M; Elabd, Mohamed Moheb; Regan, Linda; Anton, Xavier; Al-Natour, Basil Ali; Hsieh, Yu-Hsiang; Scheulen, James; Stewart de Ramirez, Sarah A

2018-04-01

Standardized handoffs may reduce communication errors, but research on handoff in community and international settings is lacking. Our study at a community hospital in the United Arab Emirates characterizes existing handoff practices for admitted patients from emergency medicine (EM) to internal medicine (IM), develops a standardized handoff tool, and assesses its impact on communication and physician perceptions. EM physicians completed a survey regarding handoff practices and expectations. Trained observers utilized a checklist based on the Systems Engineering Initiative for Patient Safety model to observe 40 handoffs. EM and IM physicians collaboratively developed a written tool encouraging bedside handoff of admitted patients. After the intervention, surveys of EM physicians and 40 observations were subsequently repeated. 77.5% of initial observed handoffs occurred face-to-face, with 42.5% at bedside, and in four different languages. Most survey respondents considered face-to-face handoff ideal. Respondents noted 9-13 patients suffering harm due to handoff in the prior month. After handoff tool implementation, 97.5% of observed handoffs occurred face-to-face (versus 77.5%, p = 0.014), with 82.5% at bedside (versus 42.5%, p face-to-face and bedside handoff, positively impacted workflow, and increased perceptions of safety by EM physicians in an international, non-academic setting. Our three-step approach can be applied towards developing standardized, context-specific inter-specialty handoff in a variety of settings.

A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine.

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Sambunjak, Dario; Straus, Sharon E; Marusic, Ana

2010-01-01

Mentorship is perceived to play a significant role in the career development and productivity of academic clinicians, but little is known about the characteristics of mentorship. This knowledge would be useful for those developing mentorship programs. To complete a systematic review of the qualitative literature to explore and summarize the development, perceptions and experiences of the mentoring relationship in academic medicine. Medline, PsycINFO, ERIC, Scopus and Current Contents databases from the earliest available date to December 2008. We included studies that used qualitative research methodology to explore the meaning and characteristics of mentoring in academic medicine. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. No restrictions were placed on the language of articles. A total of 8,487 citations were identified, 114 full text articles were assessed, and 9 articles were selected for review. All studies were conducted in North America, and most focused on the initiation and cultivation phases of the mentoring relationship. Mentoring was described as a complex relationship based on mutual interests, both professional and personal. Mentees should take an active role in the formation and development of mentoring relationships. Good mentors should be sincere in their dealings with mentees, be able to listen actively and understand mentees' needs, and have a well-established position within the academic community. Some of the mentoring functions aim at the mentees' academic growth and others at personal growth. Barriers to mentoring and dysfunctional mentoring can be related to personal factors, relational difficulties and structural/institutional barriers. Successful mentoring requires commitment and interpersonal skills of the mentor and mentee, but also a facilitating environment at academic medicine's institutions.

76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety...

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2011-11-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety Foundation AGENCY: Agency for... notification of voluntary relinquishment from Emergency Medicine Patient Safety Foundation of its status as a...

Incorporating teledermatology into emergency medicine.

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Muir, Jim; Xu, Cathy; Paul, Sanjoy; Staib, Andrew; McNeill, Iain; Singh, Philip; Davidson, Samantha; Soyer, H Peter; Sinnott, Michael

2011-10-01

The aim of the present study was to investigate the feasibility of using a store-and-forward Skin Emergency Telemedicine Service (SETS) to provide rapid specialist diagnostic and management advice for dermatological cases in an ED. This pilot study was conducted at the Princess Alexandra Hospital between August 2008 and August 2009. Study subjects were consenting patients over 18 years of age who presented with a dermatological condition to the ED. The ED doctor sent the patient's history, examination findings and the digital images of the skin conditions to a secure email address, which automatically forwarded this to the teledermatologist. The teledermatologist reviewed the cases and sent advice on diagnosis and management to the referring ED doctor via email and/or telephone. Face-to-face follow-up consultations with the patients were conducted within 2 weeks. The diagnostic and management concordance between ED doctors, teledermatologists and reviewing dermatologists were analysed. A total of 60 patients participated in the present study. SETS provided a rapid response with 56 (93%) of ED consultations receiving a dermatology opinion within 2 h. Face-to-face follow up occurred in 50 patients (83%). Statistical analysis showed significant levels of agreement between tele-diagnosis and ED diagnosis of 71.2% (Kappa 0.42) and tele-diagnosis and final clinical diagnosis of 98% (Kappa: 0.93). The clinical management concordance was 96% in complete agreement and 4% in relative agreement between the teledermatologists and reviewing dermatologists, based on chart review. The present study has shown that SETS can provide rapid and accurate diagnostic and treatment advice from a specialist for dermatological presentations to the ED. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

How alternative payment models in emergency medicine can benefit physicians, payers, and patients.

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Harish, Nir J; Miller, Harold D; Pines, Jesse M; Zane, Richard D; Wiler, Jennifer L

2017-06-01

While there has been considerable effort devoted to developing alternative payment models (APMs) for primary care physicians and for episodes of care beginning with inpatient admissions, there has been relatively little attention by payers to developing APMs for specialty ambulatory care, and no efforts to develop APMs that explicitly focus on emergency care. In order to ensure that emergency care is appropriately integrated and valued in future payment models, emergency physicians (EPs) must engage with the stakeholders within the broader health care system. In this article, we describe a framework for the development of APMs for emergency medicine and present four examples of APMs that may be applicable in emergency medicine. A better understanding of how APMs can work in emergency medicine will help EPs develop new APMs that improve the cost and quality of care, and leverage the value that emergency care brings to the system. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality of registration for clinical trials published in emergency medicine journals.

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Jones, Christopher W; Platts-Mills, Timothy F

2012-10-01

In 2005, the International Committee of Medical Journal Editors established clinical trial registration as a requirement for articles submitted to member journals, with the goal of improving the transparency of clinical research. The objective of this study is to characterize the registration of clinical trials published in emergency medicine journals. Randomized trials involving human subjects and published between June 1, 2008, and May 31, 2011 in the 5 emergency medicine journals with the highest impact factors were included. We assessed the clarity of registered primary outcomes, timing of registration relative to patient enrollment, and consistency between registered and published outcomes. Of the 123 trials included, registry entries were identified for 57 (46%). Of the 57 registered studies, 45 (79%) were registered after the initiation of subject enrollment, 9 (16%) had registered outcomes that were unclear, and 26 (46%) had discrepancies between registered and published outcomes. Only 5 studies were registered before patient enrollment with a clear primary outcome that was consistent with the published primary outcome. Annals of Emergency Medicine was the only journal in which the majority of trials were registered. Current compliance with clinical trial registration guidelines is poor among trials published in emergency medicine journals. Copyright © 2012. Published by Mosby, Inc.

Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Obstetric and Gynecologic Emergencies Small Group Module

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Jillian McGrath

2017-09-01

Full Text Available Audience: This curriculum, created and implemented at The Ohio State University Wexner Medical Center, was primarily designed to educate our emergency medicine (EM residents (PGY1-3 and emergency medicine/internal medicine (EM/IM residents (PGY1-5 on core obstetrics and gynecology topics in EM. Additional audience members include medical students and faculty physicians. Introduction: In 2013, there were over 1 million emergency department visits in the United States which resulted in primary obstetric or gynecologic diagnoses.1 EM Residents must be proficient in the differential diagnosis and management of the wide variety of obstetric and gynecologic emergencies. To do this, we developed a flipped classroom curricular model, which consists of self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this type of curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for EM residents.4-6 The Ohio State University Wexner Medical Center EM residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 Our didactic curriculum is delivered over the course of 18 months; however, it could easily be adapted to other academic calendar cycles. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of obstetric and gynecologic emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident

Just allocation and team loyalty: a new virtue ethic for emergency medicine

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Girod, J; Beckman, A

2005-01-01

When traditional virtue ethics is applied to clinical medicine, it often claims as its goal the good of the individual patient, and focuses on the dyadic relationship between one physician and one patient. An alternative model of virtue ethics, more appropriate to the practice of emergency medicine, will be outlined by this paper. This alternative model is based on the assumption that the appropriate goal of the practice of emergency medicine is a team approach to the medical wellbeing of individual patients, constrained by the wellbeing of the patient population served by a particular emergency department. By defining boundaries and using the key virtues of justice and team loyalty, this model fits emergency practice well and gives care givers the conceptual clarity to apply this model to various conflicts both within the department and with those outside the department. PMID:16199595

Chart Smart: A Need for Documentation and Billing Education Among Emergency Medicine Residents?

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Brian Dawson, MD

2010-05-01

Full Text Available Objective: The healthcare chart is becoming ever more complex, serving clinicians, patients, third party payers, regulators, and even medicolegal parties. The purpose of this study was to identify our emergency medicine (EM resident and attending physicians’ current knowledge and attitudes about billing and documentation practices. We hypothesized that resident and attending physicians would identify billing and documentation as an area in which residents need further education.Methods: We gave a 15-question Likert survey to resident and attending physicians regarding charting practices, knowledge of billing and documentation, and opinions regarding need for further education.Results: We achieved a 100% response rate, with 47% (16/34 of resident physicians disagreeing or strongly disagreeing that they have adequate training in billing and documentation, while 91% (31/34 of residents and 95% (21/22 of attending physicians identified this skill as important to a resident’s future practice. Eighty-two percent (28/34 of resident physicians and 100% of attending physicians recommended further education for residents.Conclusion: Residents in this academic EM department identified a need for further education in billing and documentation practices. [West J Emerg Med. 2010;11(2: 116-119.

Academic profile of students who transferred to Zagreb School of Medicine from other medical schools in Croatia.

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Dusek, Davorka; Dolovcak, Svjetlana; Kljaković-Gaspić, Marko

2004-02-01

To assess the academic performance of students who transferred to the Zagreb School of Medicine from other three medical schools in Croatia. Academic performance of medical students who moved from Rijeka, Osijek, or Split University Medical Schools to the Zagreb University School of Medicine at the second or third year was compared with academic performance of students enrolled at the Zagreb University School of Medicine. Using the Zagreb Medical School's registry, we made a list of 57 transfer students to Zagreb Medical School in the 1985-1994 period. Control group was formed of students enrolled at the Zagreb School of Medicine in the same period, whose names followed in alphabetical order after the names of transfer students. Students' performance was analyzed according to their grade average before transfer, grade average in the first year after transfer, total grade average after transfer, overall grade average, and duration of studies. We also analyzed the proportion of students in each group who did not pass the admission test at the Zagreb School of Medicine in the year before the enrollment in Zagreb, Osijek, Rijeka, and Split Medical Schools. Nineteen transfer students, transferred between 1985 and 1988, and their controls were excluded from the analysis because of incomplete data. Transfer students had significantly lower grade average before transfer (3.2-/+0.6 vs 3.5-/+0.7, p=0.03, Student t-test), lower grade average in the first year after transfer (3.2-/+0.6 vs 3.5-/+0.7, p=0.03), lower total grade average after transfer (3.6-/+0.5 vs 4.0-/+0.6, pZagreb School of Medicine in the year before the final enrollment than their controls (15/38 vs 4/38, p=0.009, chi-square test). Transfer students had poorer academic performance than students who passed the admission test and were enrolled at the Zagreb School of Medicine from the first year of studies.

Tradition meets innovation: transforming academic medical culture at the University of Pennsylvania's Perelman School of Medicine.

Science.gov (United States)

Pati, Susmita; Reum, Josef; Conant, Emily; Tuton, Lucy Wolf; Scott, Patricia; Abbuhl, Stephanie; Grisso, Jeane Ann

2013-04-01

Traditional performance expectations and career advancement paths for academic physicians persist despite dramatic transformations in the academic workflow, workload, and workforce over the past 20 years. Although the academic physician's triple role as clinician, researcher, and educator has been lauded as the ideal by academic health centers, current standards of excellence for promotion and tenure are based on outdated models. These models fail to reward collaboration and center around rigid career advancement plans that do little to accommodate the changing needs of individuals and organizations. The authors describe an innovative, comprehensive, multipronged initiative at the Perelman School of Medicine at the University of Pennsylvania to initiate change in the culture of academic medicine and improve academic productivity, job satisfaction, and overall quality of life for junior faculty. As a key part of this intervention, task forces from each of the 13 participating departments/divisions met five times between September 2010 and January 2011 to produce recommendations for institutional change. The authors discuss how this initiative, using principles adopted from business transformation, generated themes and techniques that can potentially guide workforce environment innovation in academic health centers across the United States. Recommendations include embracing a promotion/tenure/evaluation system that supports and rewards tailored individual academic career plans; ensuring leadership, decision-making roles, and recognition for junior faculty; deepening administrative and team supports for junior faculty; and solidifying and rewarding mentorship for junior faculty. By doing so, academic health centers can ensure the retention and commitment of faculty throughout all stages of their careers.

FOAMSearch.net: A custom search engine for emergency medicine and critical care.

Science.gov (United States)

Raine, Todd; Thoma, Brent; Chan, Teresa M; Lin, Michelle

2015-08-01

The number of online resources read by and pertinent to clinicians has increased dramatically. However, most healthcare professionals still use mainstream search engines as their primary port of entry to the resources on the Internet. These search engines use algorithms that do not make it easy to find clinician-oriented resources. FOAMSearch, a custom search engine (CSE), was developed to find relevant, high-quality online resources for emergency medicine and critical care (EMCC) clinicians. Using Google™ algorithms, it searches a vetted list of >300 blogs, podcasts, wikis, knowledge translation tools, clinical decision support tools and medical journals. Utilisation has increased progressively to >3000 users/month since its launch in 2011. Further study of the role of CSEs to find medical resources is needed, and it might be possible to develop similar CSEs for other areas of medicine. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Why do women choose or reject careers in academic medicine? A narrative review of empirical evidence.

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Edmunds, Laurel D; Ovseiko, Pavel V; Shepperd, Sasha; Greenhalgh, Trisha; Frith, Peggy; Roberts, Nia W; Pololi, Linda H; Buchan, Alastair M

2016-12-10

Women are under-represented in academic medicine. We reviewed the empirical evidence focusing on the reasons for women's choice or rejection of careers in academic medicine. Using a systematic search, we identified 52 studies published between 1985, and 2015. More than half had methodological limitations and most were from North America. Eight main themes were explored in these studies. There was consistent evidence for four of these themes: women are interested in teaching more than in research; participation in research can encourage women into academic medicine; women lack adequate mentors and role models; and women experience gender discrimination and bias. The evidence was conflicting on four themes: women are less interested in research than men; women lose commitment to research as their education and training progress; women are deterred from academic careers by financial considerations; and women are deterred by concerns about work-life balance. Inconsistency of findings across studies suggests significant opportunities to overcome barriers by providing a more enabling environment. We identified substantial gaps in the scientific literature that could form the focus of future research, including shifting the focus from individuals' career choices to the societal and organisational contexts and cultures within which those choices are made; extending the evidence base to include a wider range of countries and settings; and testing the efficacy of interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Of Sophists and Spin-Doctors: Industry-Sponsored Ghostwriting and the Crisis of Academic Medicine

OpenAIRE

McHenry, Leemon

2010-01-01

Ghostwriting for medical journals has become a major, but largely invisible, factor contributing to the problem of credibility in academic medicine. In this paper I argue that the pharmaceutical marketing objectives and use of medical communication firms in the production of ghostwritten articles constitute a new form of sophistry. After identifying three distinct types of medical ghostwriting, I survey the known cases of ghostwriting in the literature and explain the harm done to academic me...

Emergency department operations and management education in emergency medicine training

Institute of Scientific and Technical Information of China (English)

Bret A Nicks; Darrell Nelson

2012-01-01

BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs.METHODS:Residency program directors at all US-based Emergency Medicine Residency programs were anonymously surveyed via a web-based instrument.Participants indicated their levels of residency education dedicated to documentation,billing/coding,core measure/quality indicator compliance,and operations management.Data were analyzed using descriptive statistics for the ordinal data/Likert scales.RESULTS:One hundred and six(106)program directors completed the study instrument of one hundred and fifty-six(156)programs(70%).Of these,82.6%indicated emergency department(ED)operations and management education within the training curriculum.Dedicated documentation training was noted in all but 1 program(99%).Program educational offerings also included billing/coding(83%),core measure/quality indicators(78%)and operations management training(71%).In all areas,the most common means of educating came through didactic sessions and direct attending feedback or 69%-94%and 72%-98%respectively.Residency leadership was most confident with resident understanding of quality documentation(80%)and less so with core measures(72%),billing/coding/RVUs(58%),and operations management tools(23%).CONCLUSIONS:While most EM residency programs integrate basic operational education related to documentation and billing/coding,a smaller number provide focused education on the dayto-day management and operations of the ED.Residency leadership perceives graduating resident understanding of operational management tools to be limited.All respondents value further resident curriculum development of ED operations and management.

The economic role of the Emergency Department in the health care continuum: applying Michael Porter's five forces model to Emergency Medicine.

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Pines, Jesse M

2006-05-01

Emergency Medicine plays a vital role in the health care continuum in the United States. Michael Porters' five forces model of industry analysis provides an insight into the economics of emergency care by showing how the forces of supplier power, buyer power, threat of substitution, barriers to entry, and internal rivalry affect Emergency Medicine. Illustrating these relationships provides a view into the complexities of the emergency care industry and offers opportunities for Emergency Departments, groups of physicians, and the individual emergency physician to maximize the relationship with other market players.

Academic Training: Physics technologies in medicine

CERN Multimedia

Françoise benz

2005-01-01

24, 25, 26, 27 January 2004-2005 ACADEMIC TRAINING PROGRAMME LECTURE SERIES from 11.00 to 12.00 hrs - Main Auditorium, bldg. 500 Physics technologies in medicine M. GILARDI / Univ. of Milano, I. - U. AMALDI / Univ. of Milano Bicocca and TERA Foundation - M. SCHOLZ / GSI, Darmstadt, D. - O. JÄKEL / Deutsches Krebsforschungszentrum, Heidelberg, D Monday 24 January The frontiers of medical imaging M. GILARDI / Univ. of Milano, I. Tuesday 25 January From the discovery of X-rays to CT/PET diagnostics and conformal radiation therapy U. AMALDI / Univ. of Milano Bicocca and TERA Foundation Wednesday 26 January The increased biological effectiveness of heavy charged particle radiation: from cell culture experiments to biophysics modelling M. SCHOLZ / GSI, Darmstadt, D. Thursday 27 January Medical Physics aspects of radiotherapy with ions O. JÄKEL / Deutsches Krebsforschungszentrum, Heidelberg, D The lectures are open to all those interested, without application. The abstract of the lectures...

Academic Training: Physics technologies in medicine

CERN Multimedia

Françoise Benz

2005-01-01

24, 25, 26, 27 January 2004-2005 ACADEMIC TRAINING PROGRAMME LECTURE SERIES from 11.00 to 12.00 hrs - Main Auditorium, bldg. 500 Physics technologies in medicine M. GILARDI / Univ. of Milano, I. - U. AMALDI / Univ. of Milano Bicocca and TERA Foundation - M. SCHOLZ / GSI, Darmstadt, D. - O. JÄKEL / Deutsches Krebsforschungszentrum, Heidelberg, D Monday 24 January The frontiers of medical imaging M. GILARDI / Univ. of Milano, I. The lecture will deal with the evolution of diagnostic imaging techniques, focussing on tomographic methods (x rays Computerized Tomography, CT, Magnetic Resonance Imaging. MRI, Positron Emission Tomography, PET). The physical parameters characterizing the performance of current generation scanners and their potential future improvement will be discussed. The clinical diagnostic value of multi modal imaging and the relevance of image fusion to image guided radiotherapy will be also presented. Tuesday 25 January From the discovery of X-rays to CT/PET diagnostics and co...

Emergency medicine resident education in palliative care: a needs assessment.

Science.gov (United States)

Lamba, Sangeeta; Pound, Amy; Rella, Joseph G; Compton, Scott

2012-05-01

Hospice and Palliative Medicine is a newly designated subspecialty of Emergency Medicine (EM). As yet, no well defined palliative care (PC) models for education or training exist. A needs assessment is the first step towards developing a curriculum. To characterize emergency physicians' (EP) perceived educational and formal training needs for PC related skills. All EM residents and faculty of one academic facility were asked to complete an anonymous needs-assessment survey. Participants were asked to rank statements related to attitudes about PC and rate their formal training and knowledge in 10 aspects of PC using a 5-point Likert-scale. EPs also ranked 4 learning modalities in order of preference and 12 PC educational topics in order of perceived importance in an EM curriculum. Ninety-three percent (42/45) of eligible participants completed the survey (28 residents, 14 faculty). Respondents agreed/strongly agreed that PC skills are an important competence for EM (88%, 37/42) and that they would "like to have more training/education in PC" (79%, 33/42). Respondents also disagreed/strongly disagreed with the statement that "PC consult is called when no more can be done for the patient" (90%, 38/42). Important PC topics identified were pain management, discussing code status, and management of dyspnea and other symptoms in terminal illness. Bedside teaching was listed as the preferred learning modality. EM residents reported minimal training in pain management (46%, 13/28), managing hospice patients (54%, 15/28), withdrawal/withholding life support (54%, 15/28), and managing the imminently dying (43%, 12/28). There was no consistent, significant improvement reported in any domain as training and experience progressed from PGY (postgraduate year) 1 to PGY 4 to attending physician. EPs view PC skills as important for EM practice and report that they are not yet adequately educated and trained in providing PC. Domains of particular interest and targeted areas for PC

Highlights in emergency medicine medical education research: 2008.

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Farrell, Susan E; Coates, Wendy C; Khun, Gloria J; Fisher, Jonathan; Shayne, Philip; Lin, Michelle

2009-12-01

The purpose of this article is to highlight medical education research studies published in 2008 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine. Through a PubMed search of the English language literature in 2008, 30 medical education research studies were independently identified as hypothesis-testing investigations and measurements of educational interventions. Six reviewers independently rated and scored all articles based on eight anchors, four of which related to methodologic criteria. Articles were ranked according to their total rating score. A ranking agreement among the reviewers of 83% was established a priori as a minimum for highlighting articles in this review. Five medical education research studies met the a priori criteria for inclusion and are reviewed and summarized here. Four of these employed experimental or quasi-experimental methodology. Although technology was not a component of the structured literature search employed to identify the candidate articles for this review, 14 of the articles identified, including four of the five highlighted articles, employed or studied technology as a focus of the educational research. Overall, 36% of the reviewed studies were supported by funding; three of the highlighted articles were funded studies. This review highlights quality medical education research studies published in 2008, with outcomes of relevance to teaching and education in emergency medicine. It focuses on research methodology, notes current trends in the use of technology for learning in emergency medicine, and suggests future avenues for continued rigorous study in education.

Full text publication rates of studies presented at an international emergency medicine scientific meeting.

Science.gov (United States)

Chan, Jannet W M; Graham, Colin A

2011-09-01

The publication rate of full text papers following an abstract presentation at a medical conference is variable, and few studies have examined the situation with respect to international emergency medicine conferences. This retrospective study aimed to identify the publication rate of abstracts presented at the 2006 International Conference on Emergency Medicine (ICEM) held in Halifax, Canada. The full text publication rate was 33.2%, similar to previous emergency medicine meetings. English language barriers may play a role in the low publication rate seen.

A research agenda for gender and substance use disorders in the emergency department.

Science.gov (United States)

Choo, Esther K; Beauchamp, Gillian; Beaudoin, Francesca L; Bernstein, Edward; Bernstein, Judith; Bernstein, Steven L; Broderick, Kerryann B; Cannon, Robert D; D'Onofrio, Gail; Greenberg, Marna R; Hawk, Kathryn; Hayes, Rashelle B; Jacquet, Gabrielle A; Lippmann, Melanie J; Rhodes, Karin V; Watts, Susan H; Boudreaux, Edwin D

2014-12-01

For many years, gender differences have been recognized as important factors in the etiology, pathophysiology, comorbidities, and treatment needs and outcomes associated with the use of alcohol, drugs, and tobacco. However, little is known about how these gender-specific differences affect ED utilization; responses to ED-based interventions; needs for substance use treatment and barriers to accessing care among patients in the ED; or outcomes after an alcohol-, drug-, or tobacco-related visit. As part of the 2014 Academic Emergency Medicine consensus conference on "Gender-Specific Research in Emergency Care: Investigate, Understand and Translate How Gender Affects Patient Outcomes," a breakout group convened to generate a research agenda on priority questions related to substance use disorders. © 2014 by the Society for Academic Emergency Medicine.

Disposition of Patients Before and After Establishment of Emergency Medicine Specialists

Directory of Open Access Journals (Sweden)

Payman Asadi

2014-09-01

Full Text Available Introduction: Emergency department (ED as the fundamental part of hospital has a specific importance due to admitting the most various and sensitive group of patients. The aim of the ED is presenting services with highest quality in the least time. To reach this goal establishment of an emergency medicine specialist who performs assessment, resuscitation, stabilization, detection, and maintenance of emergency patients is noteworthy. The aim of this study was evaluating the effect of establishing the emergency medicine specialists on the performance of ED in Poursina Hospital, Rasht, Iran.  Methods: In this cross-sectional study files of all patients hospitalized in the ED of Poursina, Rasht, Iran, through 2005-2012 were evaluated. Variables such as age, gender, cause of refer and number of hospitalization, number of discharging from department, percentage of bed occupation and daily bed occupation, time of hospitalization, number of discharging under six hours, number of transportation to other wards or hospitals, and the rate of bed circulation in the ED were assessed, too. Data was gathered through hospital information system and analyzed using SPSS 20. Results: Through 2005 to 2012 number of admitted patients in the ED has increased so that the most admitted number was related to 2012 (p=0.0001. The present of discharged patients under six hours and the rate of direct discharging before the presence of emergency medicine specialists have increased from 15.5% and 58.9% to 23.4% and 61.2% in after their presence, respectively(p=0.001. Transporting to other wards and hospitals were also decreased from 41.1% to 38.8% (p=0.0001. The occupied beds percentage after presenting of emergency medicine specialists has noticeably decreased compared to the past, while bed turnover rate increased. In other words, the bed turnover mean has increased from 354.5±108.4 during 2005-2008 to 637.7±30.8 through 2009-2012 (p=0.002. Also, during 2005-2008 the

Commentary: Missing the elephant in my office: recommendations for part-time careers in academic medicine.

Science.gov (United States)

Helitzer, Deborah

2009-10-01

Several recent articles in this journal, including the article by Linzer and colleagues in this issue, discuss and promote the concept of part-time careers in academic medicine as a solution to the need to achieve a work-life balance and to address the changing demographics of academic medicine. The article by Linzer and colleagues presents the consensus of a task force that attempted to address practical considerations for part-time work in academic internal medicine. Missing from these discussions, however, are a consensus on the definition of part-time work, consideration of how such strategies would be available to single parents, how time or resources will be allocated to part-time faculty to participate in professional associations, develop professional networks, and maintain currency in their field, and how part-time work can allow for the development of expertise in research and scholarly activity. Most important, the discussions about the part-time solution do not address the root cause of dissatisfaction and attrition: the ever-increasing and unsustainable workload of full-time faculty. The realization that an academic full-time career requires a commitment of 80 hours per week begs the question of whether part-time faculty would agree to work 40 hours a week for part-time pay. The historical underpinnings of the current situation, the implications of part-time solutions for the academy, and the consequences of choosing part-time work as the primary solution are discussed. Alternative strategies for addressing some of the problems facing full-time faculty are proposed.

Development of pediatric emergency medicine at Addis Ababa University/Tikuranbessa Specialized Hospital, Ethiopia.

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Tefera, Muluwork; Bacha, Tigist; Butteris, Sabrina; Teshome, Getachew; Ross, Joshua; Hagen, Scott; Svenson, Jim; Busse, Heidi; Tefera, Girma

2014-07-01

In the world emergencies occur everywhere, and each day they consume ressources regardless of whether there are systems capable of achieving good outcomes. Low-income countries suffer the most highest rates of every category of injury--from traffic and the highest rates of acute complications of communicable diseases including tuberculosis, malaria and HIV. To describe the development of pediatrics emergency medicine at Tikur Anbesa Specialized Hospital A twinning partnership model was used in developing a pediatric emergency medicine training program helps in development of pediatrics emergency system. Strengthening the capacity of Addis Ababa University (AAU), Tikur Anbessa Hospital (TASH) to provide pediatric emergency medical services through improved organization of the pediatrics emergency department and strengthening of continuing education opportunities for faculty and staff capacity building by this improving quality of care in pediatrics patients in the country. The Addis Ababa University, University of Wiscosin and People to People partners intend to continue working together to strengthening and developing effetive systems to deliver quality pediatrics emergency medicine care troughout all regions of Ethiopia.

Perceptions of Unprofessional Social Media Behavior Among Emergency Medicine Physicians.

Science.gov (United States)

Soares, William; Shenvi, Christina; Waller, Nikki; Johnson, Reuben; Hodgson, Carol S

2017-02-01

Use of social media (SM) by physicians has exposed issues of privacy and professionalism. While guidelines have been created for SM use, details regarding specific SM behaviors that could lead to disciplinary action presently do not exist. To compare State Medical Board (SMB) directors' perceptions of investigation for specific SM behaviors with those of emergency medicine (EM) physicians. A multicenter anonymous survey was administered to physicians at 3 academic EM residency programs. Surveys consisted of case vignettes, asking, "If the SMB were informed of the content, how likely would they be to initiate an investigation, possibly leading to disciplinary action?" (1, very unlikely, to 4, very likely). Results were compared to published probabilities using exact binomial testing. Of 205 eligible physicians, 119 (58%) completed the survey. Compared to SMB directors, EM physicians indicated similar probabilities of investigation for themes involving identifying patient images, inappropriate communication, and discriminatory speech. Participants indicated lower probabilities of investigation for themes including derogatory speech (32%, 95% confidence interval [CI] 24-41 versus 46%, P  social identity, compared to SMB directors, particularly for images of alcohol and derogatory speech.

Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies

Directory of Open Access Journals (Sweden)

Waterbrook AL

2018-05-01

Full Text Available Anna L Waterbrook,1 Karen C Spear Ellinwood,2 T Gail Pritchard,3 Karen Bertels,1 Ariel C Johnson,4 Alice Min,1 Lisa R Stoneking1 1Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA; 2Department of Obstetrics and Gynecology, The University of Arizona College of Medicine, Tucson, AZ, USA; 3Department of Pediatrics, The University of Arizona College of Medicine, Tucson, AZ, USA; 4College of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management are challenging for a supervising emergency medicine (EM physician to evaluate in real-time on shift while also managing a busy emergency department (ED. This study examines residents’ perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills.Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones.Results: Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2. Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received

Gender differences in neurological emergencies part II: a consensus summary and research agenda on traumatic brain injury.

Science.gov (United States)

Wright, David W; Espinoza, Tamara R; Merck, Lisa H; Ratcliff, Jonathan J; Backster, Anika; Stein, Donald G

2014-12-01

Traumatic brain injury (TBI) is a major cause of death and disability worldwide. There is strong evidence that gender and sex play an important role across the spectrum of TBI, from pathophysiology to clinical care. In May 2014, Academic Emergency Medicine held a consensus conference "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." A TBI working group was formed to explore what was known about the influence of sex and gender on TBI and to identify gaps for future research. The findings resulted in four major recommendations to guide the TBI research agenda. © 2014 by the Society for Academic Emergency Medicine.

Technology-enhanced simulation in emergency medicine: a systematic review and meta-analysis.

Science.gov (United States)

Ilgen, Jonathan S; Sherbino, Jonathan; Cook, David A

2013-02-01

with other instruction. Future research should investigate the features that lead to effective simulation-based instructional design. © 2013 by the Society for Academic Emergency Medicine.

Video-Based Learning vs Traditional Lecture for Instructing Emergency Medicine Residents in Disaster Medicine Principles of Mass Triage, Decontamination, and Personal Protective Equipment.

Science.gov (United States)

Curtis, Henry A; Trang, Karen; Chason, Kevin W; Biddinger, Paul D

2018-02-01

Introduction Great demands have been placed on disaster medicine educators. There is a need to develop innovative methods to educate Emergency Physicians in the ever-expanding body of disaster medicine knowledge. The authors sought to demonstrate that video-based learning (VBL) could be a promising alternative to traditional learning methods for teaching disaster medicine core competencies. Hypothesis/Problem The objective was to compare VBL to traditional lecture (TL) for instructing Emergency Medicine residents in the American College of Emergency Physicians (ACEP; Irving, Texas USA) disaster medicine core competencies of patient triage and decontamination. A randomized, controlled pilot study compared two methods of instruction for mass triage, decontamination, and personal protective equipment (PPE). Emergency Medicine resident learning was measured with a knowledge quiz, a Likert scale measuring comfort, and a practical exercise. An independent samples t-test compared the scoring of the VBL with the TL group. Twenty-six residents were randomized to VBL (n=13) or TL (n=13). Knowledge score improvement following video (14.9%) versus lecture (14.1%) did not differ significantly between the groups (P=.74). Comfort score improvement also did not differ (P=.64) between video (18.3%) and lecture groups (15.8%). In the practical skills assessment, the VBL group outperformed the TL group overall (70.4% vs 55.5%; Plearning vs traditional lecture for instructing emergency medicine residents in disaster medicine principles of mass triage, decontamination, and personal protective equipment. Prehosp Disaster Med. 2018;33(1):7-12.

From Test Scores to Language Use: Emergent Bilinguals Using English to Accomplish Academic Tasks

Science.gov (United States)

Rodriguez-Mojica, Claudia

2018-01-01

Prominent discourses about emergent bilinguals' academic abilities tend to focus on performance as measured by test scores and perpetuate the message that emergent bilinguals trail far behind their peers. When we remove the constraints of formal testing situations, what can emergent bilinguals do in English as they engage in naturally occurring…

Factors enhancing career satisfaction among female emergency physicians.

Science.gov (United States)

Clem, Kathleen J; Promes, Susan B; Glickman, Seth W; Shah, Anand; Finkel, Michelle A; Pietrobon, Ricardo; Cairns, Charles B

2008-06-01

Attrition rates in emergency medicine have been reported as high as 25% in 10 years. The number of women entering emergency medicine has been increasing, as has the number of female medical school graduates. No studies have identified factors that increase female emergency physician career satisfaction. We assess career satisfaction in women emergency physicians in the American College of Emergency Physicians (ACEP) and identify factors associated with career satisfaction. The survey questionnaire was developed by querying 3 groups: (1) ACEP women in the American Association of Women Emergency Physicians, the (2) Society for Academic Emergency Medicine Mentoring Women Interest Group, and (3) nonaffiliated female emergency physicians. Their responses were categorized into 6 main areas: schedule, relationships with colleagues, administrative support and mentoring, patient/work-related issues, career advancement opportunities, and financial. The study cohort for the survey included all female members of ACEP with a known e-mail address. All contact with survey recipients was exclusively through the e-mail that contained a uniform resource locator link to the survey itself. Two thousand five hundred two ACEP female members were sent the uniform resource locator link. The Web survey was accessed a total of 1,851 times, with a total of 1,380 surveys completed, an overall response rate of 56%. Most women were satisfied with their career as an emergency physician, 492 (35.5%) very satisfied, 610 (44.0%) satisfied, 154 (11.1%) neutral, 99 (7.1%) not satisfied, and 31 (2.3%) very unsatisfied. Significant factors for career satisfaction included amount of recognition at work, career advancement, schedule flexibility, and the fairness of financial compensation. Workplace factors associated with high satisfaction included academic practice setting and sex-equal opportunity for advancement and sex-equal financial compensation. Most of the ACEP female physicians surveyed were

Exploring Scholarship and the Emergency Medicine Educator: A Workforce Study.

Science.gov (United States)

Jordan, Jaime; Coates, Wendy C; Clarke, Samuel; Runde, Daniel P; Fowlkes, Emilie; Kurth, Jacqueline; Yarris, Lalena M

2017-01-01

Recent literature calls for initiatives to improve the quality of education studies and support faculty in approaching educational problems in a scholarly manner. Understanding the emergency medicine (EM) educator workforce is a crucial precursor to developing policies to support educators and promote education scholarship in EM. This study aims to illuminate the current workforce model for the academic EM educator. Program leadership at EM training programs completed an online survey consisting of multiple choice, completion, and free-response type items. We calculated and reported descriptive statistics. 112 programs participated. Mean number of core faculty/program: 16.02 ± 7.83 [14.53-17.5]. Mean number of faculty full-time equivalents (FTEs)/program dedicated to education is 6.92 ± 4.92 [5.87-7.98], including (mean FTE): Vice chair for education (0.25); director of medical education (0.13); education fellowship director (0.2); residency program director (0.83); associate residency director (0.94); assistant residency director (1.1); medical student clerkship director (0.8); assistant/associate clerkship director (0.28); simulation fellowship director (0.11); simulation director (0.42); director of faculty development (0.13). Mean number of FTEs/program for education administrative support is 2.34 ± 1.1 [2.13-2.61]. Determination of clinical hours varied; 38.75% of programs had personnel with education research expertise. Education faculty represent about 43% of the core faculty workforce. Many programs do not have the full spectrum of education leadership roles and educational faculty divide their time among multiple important academic roles. Clinical requirements vary. Many departments lack personnel with expertise in education research. This information may inform interventions to promote education scholarship.

Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

Science.gov (United States)

Plint, Amy C; Stang, Antonia S; Calder, Lisa A

2015-01-01

Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for

Research evaluation and competition for academic positions in occupational medicine.

Science.gov (United States)

Franco, Giuliano

2013-01-01

Citation analysis is widely used to evaluate the performance of individual researchers, journals, and universities. Its outcome plays a crucial role in the decision-making process of ranking applicants for an academic position. A number of indicators, including the h-index reflecting both scientific productivity and its relevance in medical fields, are available through the Web of Knowledge( sm ) and Scopus®. In the field of occupational medicine, the adoption of the h-index in assessing the value of core journals shows some advantages compared with traditional bibliometrics and may encourage researchers to submit their papers. Although evaluation of the overall individual performance for academic positions should assess several aspects, scientific performance is usually based on citation analysis indicators. Younger researchers should be aware of the new approach based on transparent threshold rules for career promotion and need to understand the new evaluation systems based on metrics.

Core Content for Wilderness Medicine Training: Development of a Wilderness Medicine Track Within an Emergency Medicine Residency.

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Schrading, Walter A; Battaglioli, Nicole; Drew, Jonathan; McClure, Sarah Frances

2018-03-01

Wilderness medicine training has become increasingly popular among medical professionals with numerous educational opportunities nationwide. Curricula for fellowship programs and for medical student education have previously been developed and published, but a specific curriculum for wilderness medicine education during emergency medicine (EM) residency has not. The objective of this study is to create a longitudinal wilderness medicine curriculum that can be incorporated into an EM residency program. Interest-specific tracks are becoming increasingly common in EM training. We chose this model to develop our curriculum specific to wilderness medicine. Outlined in the article is a 3-year longitudinal course of study that includes a core didactic curriculum and a plan for graduated level of responsibility. The core content is specifically related to the required EM core content for residency training with additions specific to wilderness medicine for the residents who pursue the track. The wilderness medicine curriculum would give residencies a framework that can be used to foster learning for residents interested in wilderness medicine. It would enhance the coverage of wilderness and environmental core content education for all EM residents in the program. It would provide wilderness-specific education and experience for interested residents, allowing them to align their residency program requirements through a focused area of study and enhancing their curriculum vitae at graduation. Finally, given the popularity of wilderness medicine, the presence of a wilderness medicine track may improve recruitment for the residency program. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ?

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Hobgood, Cherri; Weiner, Bryan; Tamayo-Sarver, Joshua H

2006-04-01

To determine if the three types of emergency medicine providers--physicians, nurses, and out-of-hospital providers (emergency medical technicians [EMTs])--differ in their identification, disclosure, and reporting of medical error. A convenience sample of providers in an academic emergency department evaluated ten case vignettes that represented two error types (medication and cognitive) and three severity levels. For each vignette, providers were asked the following: 1) Is this an error? 2) Would you tell the patient? 3) Would you report this to a hospital committee? To assess differences in identification, disclosure, and reporting by provider type, error type, and error severity, the authors constructed three-way tables with the nonparametric Somers' D clustered on participant. To assess the contribution of disclosure instruction and environmental variables, fixed-effects regression stratified by provider type was used. Of the 116 providers who were eligible, 103 (40 physicians, 26 nurses, and 35 EMTs) had complete data. Physicians were more likely to classify an event as an error (78%) than nurses (71%; p = 0.04) or EMTs (68%; p error to the patient (59%) than physicians (71%; p = 0.04). Physicians were the least likely to report the error (54%) compared with nurses (68%; p = 0.02) or EMTs (78%; p error types, identification, disclosure, and reporting increased with increasing severity. Improving patient safety hinges on the ability of health care providers to accurately identify, disclose, and report medical errors. Interventions must account for differences in error identification, disclosure, and reporting by provider type.

Variation in Emergency Department vs Internal Medicine Excess Charges in the United States.

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Xu, Tim; Park, Angela; Bai, Ge; Joo, Sarah; Hutfless, Susan M; Mehta, Ambar; Anderson, Gerard F; Makary, Martin A

2017-08-01

Uninsured and insured but out-of-network emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. To examine the variation in excess charges for services provided by emergency medicine and internal medicine physicians. Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013. Data analysis was conducted from January 1 to July 31, 2016. Markup ratios for ED and internal medicine professional services, defined as the charges submitted by the hospital divided by the Medicare allowable amount. Our analysis included 12 337 emergency medicine physicians from 2707 hospitals and 57 607 internal medicine physicians from 3669 hospitals in all 50 states. Services provided by emergency medicine physicians had an overall markup ratio of 4.4 (340% excess charges), which was greater than the markup ratio of 2.1 (110% excess charges) for all services performed by internal medicine physicians. Markup ratios for all ED services ranged by hospital from 1.0 to 12.6 (median, 4.2; interquartile range [IQR], 3.3-5.8); markup ratios for all internal medicine services ranged by hospital from 1.0 to 14.1 (median, 2.0; IQR, 1.7-2.5). The median markup ratio by hospital for ED evaluation and management procedure codes varied between 4.0 and 5.0. Among the most common ED services, laceration repair had the highest median markup ratio (7.0); emergency medicine physician review of a head computed tomographic scan had the greatest interhospital variation (range, 1.6-27.7). Across hospitals, markups in the ED were often substantially higher than those in the internal medicine department for the same services. Higher ED markup ratios were associated with hospital for-profit ownership (median, 5.7; IQR, 4.0-7.1), a greater percentage of uninsured patients seen

Curriculum Design and Implementation of the Emergency Medicine Chief Resident Incubator.

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Gisondi, Michael A; Chou, Adaira; Joshi, Nikita; Sheehy, Margaret K; Zaver, Fareen; Chan, Teresa M; Riddell, Jeffrey; Sifford, Derek P; Lin, Michelle

2018-02-24

Background Chief residents receive minimal formal training in preparation for their administrative responsibilities. There is a lack of professional development programs specifically designed for chief residents. Objective In 2015, Academic Life in Emergency Medicine designed and implemented an annual, year-long, training program and virtual community of practice for chief residents in emergency medicine (EM). This study describes the curriculum design process and reports measures of learner engagement during the first two cycles of the curriculum. Methods Kern's Six-Step Approach for curriculum development informed key decisions in the design and implementation of the Chief Resident Incubator. The resultant curriculum was created using constructivist social learning theory, with specific objectives that emphasized the needs for a virtual community of practice, longitudinal content delivery, mentorship for participants, and the facilitation of multicenter digital scholarship. The 12-month curriculum included 11 key administrative or professional development domains, delivered using a combination of digital communications platforms. Primary outcomes measures included markers of learner engagement with the online curriculum, recognized as modified Kirkpatrick Level One outcomes for digital learning. Results An average of 206 chief residents annually enrolled in the first two years of the curriculum, with an overall participation by 33% (75/227) of the allopathic EM residency programs in the United States (U.S.). There was a high level of learner engagement, with an average 13,414 messages posted per year. There were also 42 small group teaching sessions held online, which included 39 faculty and 149 chief residents. The monthly e-newsletter had a 50.7% open rate. Digital scholarship totaled 23 online publications in two years, with 67 chief resident co-authors and 21 faculty co-authors. Conclusions The Chief Resident Incubator is a virtual community of practice that

Auckland regional emergency medicine trainee mentoring uptake survey.

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Nicholls, Gordon Michael Mike; Lawrey, Emma; Jones, Peter

2017-10-01

The primary objective of this study is to quantify how many Auckland region emergency medicine (EM) trainees would like a formal mentoring programme. The secondary objectives were to quantify how many Auckland region EM trainees would like to participate in a formal mentoring programme; to determine trainees' current understanding of mentoring; how trainees prefer mentors to be allocated; why trainees may want a mentor; what mentees perceive would be good qualities in a mentor; and trainees' prior experience with mentoring. Online survey of EM trainees in the Auckland region in June 2015. Of 61 potential respondents, 40 (65.6%) respondents replied to the survey. Of the 40, 38 (95%; 95% confidence interval (CI) 82.6-99.5) respondents indicated they would like some form of mentoring system, and of the 38, 25 (65.8%; 95% CI 49.8-78.9) preferred this to be formal. Of the 38, 19 (50%; 95% CI 34.9-65.2) currently wanted assistance obtaining a mentor. Of the 40, 30 (75%; 95% CI 59.6-86.0) are not currently in any form of mentoring relationship. Respondents believed that mentors would be most beneficial in critical incidents, career development and with work/life balance. The attributes participants considered most important in a mentor were respecting confidentiality, being honest and the ability to provide constructive feedback. Many EM trainees in Auckland want a formal mentoring system and would like a mentor. Appropriate mentor-mentee matching through a formalised voluntary system, with adequate mentor training, may enable the Auckland region to develop a suitable mentoring programme for EM trainees. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Interprofessional education of medical students and paramedics in emergency medicine.

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Hallikainen, J; Väisänen, O; Rosenberg, P H; Silfvast, T; Niemi-Murola, L

2007-03-01

Emergency medicine is team work from the field to the hospital and therefore it is also important for physicians to understand the work of paramedics, and vice versa. Interprofessional emergency medicine education for medical and paramedic students in Helsinki was started in 2001. It consisted of a 15 European credit transfer system (ECTS) credits programme combining 22 students in 2001. In 2005, the number of students had increased to 25. The programme consisted of three parts: acute illness in childhood and adults (AI), advanced life support (ALS) and trauma life support (TLS). In this paper, we describe the concept of interprofessional education of medical students and paramedics in emergency medicine. After finishing the programmes in 2001 and in 2005, the students' opinions regarding the education were collected using a standardized questionnaire. There were good ratings for the courses in AI (2001 vs. 2005, whole group; 4.3 +/- 0.7 vs. 4.2 +/- 0.4, P = 0.44) ALS (4.7 +/- 0.5 vs. 4.4 +/- 0.5, P = 0.06) and TLS (3.9 +/- 0.7 vs. 4.4 +/- 0.5, P = 0.01) in both years. Most of the medical students considered that this kind of co-education should be arranged for all medical students (2001 vs. 2005; 4.8 +/- 0.6 vs. 4.4 +/- 0.5, P = 0.02) and should be obligatory (3.5 +/- 1.5 vs. 3.1 +/- 1.3, P = 0.35). Co-education was well received and determined by the students as an effective way of improving their knowledge of emergency medicine and medical skills. The programme was rated as very useful and it should be included in the educational curriculum of both student groups.

Global emergency medicine journal club: a social media discussion about the Age-Adjusted D-Dimer Cutoff Levels To Rule Out Pulmonary Embolism trial.

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Rezaie, Salim R; Swaminathan, Anand; Chan, Teresa; Shaikh, Sam; Lin, Michelle

2015-05-01

Annals of Emergency Medicine collaborated with an educational Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Journal of the American Medical Association publication on the Age-Adjusted D-Dimer Cutoff Levels to Rule Out Pulmonary Embolism (ADJUST-PE) trial by Righini et al. The objective is to describe a 14-day (August 25 to September 7, 2014) worldwide academic dialogue among clinicians in regard to 4 preselected questions about the age-adjusted D-dimer cutoff to detect pulmonary embolism. Five online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and Google Hangout. Comments across the social media platforms were curated for this report, as framed by the 4 preselected questions, and engagement was tracked through various Web analytic tools. Blog and Twitter comments, as well as video expert commentary involving the ADJUST-PE trial, are summarized. The dialogue resulted in 1,169 page views from 391 cities in 52 countries on the ALiEM Web site, 502,485 Twitter impressions, and 159 views of the video interview with experts. A postdiscussion summary on the Journal Jam podcast resulted in 3,962 downloads in its first week of publication during September 16 to 23, 2014. Common themes that arose in the multimodal discussions included the heterogeneity of practices, D-dimer assays, provider knowledge about these assays, and prevalence rates in different areas of the world. This educational approach using social media technologies demonstrates a free, asynchronous means to engage a worldwide audience in scholarly discourse. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Current and emerging applications of 3D printing in medicine.

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Liaw, Chya-Yan; Guvendiren, Murat

2017-06-07

Three-dimensional (3D) printing enables the production of anatomically matched and patient-specific devices and constructs with high tunability and complexity. It also allows on-demand fabrication with high productivity in a cost-effective manner. As a result, 3D printing has become a leading manufacturing technique in healthcare and medicine for a wide range of applications including dentistry, tissue engineering and regenerative medicine, engineered tissue models, medical devices, anatomical models and drug formulation. Today, 3D printing is widely adopted by the healthcare industry and academia. It provides commercially available medical products and a platform for emerging research areas including tissue and organ printing. In this review, our goal is to discuss the current and emerging applications of 3D printing in medicine. A brief summary on additive manufacturing technologies and available printable materials is also given. The technological and regulatory barriers that are slowing down the full implementation of 3D printing in the medical field are also discussed.

Forensic Emergency Medicine - Six-Year Experience of 13823 Cases in a University Emergency Department

OpenAIRE

DEMİRCAN, Ahmet; KELEŞ, Ayfer; GÜRBÜZ, Neslihan; BİLDİK, Fikret

2008-01-01

Aims: Clinical forensic medicine deals with cases involving both the legal and medical aspects of patient care, such as motor vehicle trauma or poisoning. In this study, we aimed to draw attention to the forensic issues by retrospective investigation of 13823 emergency cases and to share our experiences on this topic. Materials and Methods: This retrospective study was conducted in a university Emergency Department (ED) in Ankara, Turkey. The data were collected from official hospital polic...

The German emergency and disaster medicine and management system—history and present

Directory of Open Access Journals (Sweden)

Norman Hecker

2018-04-01

Full Text Available As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the “Golden Standard” of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach. Keywords: Emergency medical systems, Disaster medicine, Public health, Germany

Important historical efforts at emergency department categorization in the United States and implications for regionalization.

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Mehrotra, Abhishek; Sklar, David P; Tayal, Vivek S; Kocher, Keith E; Handel, Daniel A; Myles Riner, R

2010-12-01

This article is drawn from a report created for the American College of Emergency Physicians (ACEP) Emergency Department (ED) Categorization Task Force and also reflects the proceedings of a breakout session, "Beyond ED Categorization-Matching Networks to Patient Needs," at the 2010 Academic Emergency Medicine consensus conference, "Beyond Regionalization: Integrated Networks of Emergency Care." The authors describe a brief history of the significant national and state efforts at categorization and suggest reasons why many of these efforts failed to persevere or gain wider implementation. The history of efforts to categorize hospital (and ED) emergency services demonstrates recognition of the potential benefits of categorization, but reflects repeated failures to implement full categorization systems or limited excursions into categorization through licensing of EDs or designation of receiving and referral facilities. An understanding of the history of hospital and ED categorization could better inform current efforts to develop categorization schemes and processes. 2010 by the Society for Academic Emergency Medicine.

Emergency Medicine Curriculum: Complications of Pregnancy Small Group Module

Directory of Open Access Journals (Sweden)

Linda L Herman

2017-07-01

Full Text Available Audience: This curriculum, created and implemented at Kaweah Delta HCD emergency medicine program, was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction: Obstetrical (OB emergencies pose a unique challenge to the EM physician. Given the relative rarity of these presentations within the Emergency Department (ED, it is important that residents are educated in a comprehensive manner to ensure understanding and retention.1 The exact prevalence of emergency department (ED visits that are associated with complications of pregnancy is unknown, but they are likely a sizeable portion of the patient population of the ED. Also, many hospitals in rural areas have closed their labor and delivery units due to higher operating costs and lack of available medical personnel.2 New models of high-quality teaching that ensure retention of clinically rare, but critical presentations are required. There is a body of research that suggests a small-group discussion model rather than traditional lecture-based content may improve learner engagement and retention. This model encourages active learning, which requires simultaneous instructor and learner engagement.3, 4, 5, 6, 7 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine.3 The small group discussion classroom is facilitated by content experts with personal experience in the topic at hand. Objectives: We aim to teach the presentation and management of pregnancy complications through interactive teaching during small group discussions concerning patient cases. This curriculum utilizes resources chosen by education faculty, study questions, actual experience, and small group discussions in place of a traditional lecture-based format. In doing so, a goal of the curriculum is to

Academic Feedback in Veterinary Medicine: A comparison of School Leaver and Graduate Entry cohorts

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Hughes, Kirsty Jean; McCune, Velda; Rhind, Susan

2013-01-01

This study analysed the expectations and experiences of students on a five-year undergraduate ("n"?=?91) and four-year graduate entry ("n"?=?47) veterinary medicine degree programme relating to academic feedback. Qualitative and quantitative methodologies were used to explore new students' expectations and prior experiences of…

Narratives of Participants in National Career Development Programs for Women in Academic Medicine: Identifying the Opportunities for Strategic Investment.

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Helitzer, Deborah L; Newbill, Sharon L; Cardinali, Gina; Morahan, Page S; Chang, Shine; Magrane, Diane

2016-04-01

Academic medicine has initiated changes in policy, practice, and programs over the past several decades to address persistent gender disparity and other issues pertinent to its sociocultural context. Three career development programs were implemented to prepare women faculty to succeed in academic medicine: two sponsored by the Association of American Medical Colleges, which began a professional development program for early career women faculty in 1988. By 1995, it had evolved into two programs one for early career women and another for mid-career women. By 2012, more than 4000 women faculty from medical schools across the U.S and Canada had participated in these intensive 3-day programs. The third national program, the Hedwig van Ameringen Executive Leadership in Academic Medicine(®) (ELAM) program for women, was developed in 1995 at the Drexel University College of Medicine. Narratives from telephone interviews representing reflections on 78 career development seminars between 1988 and 2010 describe the dynamic relationships between individual, institutional, and sociocultural influences on participants' career advancement. The narratives illuminate the pathway from participating in a career development program to self-defined success in academic medicine in revealing a host of influences that promoted and/or hindered program attendance and participants' ability to benefit after the program in both individual and institutional systems. The context for understanding the importance of these career development programs to women's advancement is nestled in the sociocultural environment, which includes both the gender-related influences and the current status of institutional practices that support women faculty. The findings contribute to the growing evidence that career development programs, concurrent with strategic, intentional support of institutional leaders, are necessary to achieve gender equity and diversity inclusion.

The role of emergency medicine clerkship e-Portfolio to monitor the learning experience of students in different settings: a prospective cohort study.

Science.gov (United States)

Cevik, Arif Alper; Shaban, Sami; El Zubeir, Margret; Abu-Zidan, Fikri M

2018-04-12

Although emergency departments provide acute care learning opportunities for medical students, student exposure to recommended curriculum presentations and procedures are limited. In this perspective, clinical environments providing learning opportunities for students should be monitored as part of an ongoing quality improvement process. This study aims to analyze student exposures and their involvement levels in two different hospitals (Tawam and Al Ain) so as to improve the teaching and learning activities. This is a prospective study on all 76 final year medical students' electronic logbooks (e-Portfolio) of the academic year 2016/2017. Students recorded 5087 chief complaints and 3721 procedures. The average patient and procedure exposure in a shift per student in Al Ain Hospital compared with Tawam Hospital were 7.2 vs 6.4 and 5.8 vs 4.3, respectively. The highest full involvement with presentations was seen in the pediatric unit (67.1%, P portfolio has proven to be a very useful tool in defining the learning activities of final year medical students during their emergency medicine clerkship and in comparing activities in two different clinical settings. Data collected and analyzed using this e-Portfolio has the potential to help medical educators and curriculum designers improve emergency medicine teaching and learning activities.

Effect of Educational Debt on Emergency Medicine Residents: A Qualitative Study Using Individual Interviews.

Science.gov (United States)

Young, Timothy P; Brown, Madison M; Reibling, Ellen T; Ghassemzadeh, Sassan; Gordon, Dawn M; Phan, Tammy H; Thomas, Tamara L; Brown, Lance

2016-10-01

In 2001, less than 20% of emergency medicine residents had more than $150,000 of educational debt. Our emergency medicine residents anecdotally reported much larger debt loads. Surveys have reported that debt affects career and life choices. Qualitative approaches are well suited to explore how and why such complex phenomena occur. We aim to gain a better understanding of how our emergency medicine residents experience debt. We conducted individual semistructured interviews with emergency medicine residents. We collected self-reported data related to educational debt and asked open-ended questions about debt influence on career choices, personal life, future plans, and financial decisions. We undertook a structured thematic analysis using a qualitative approach based in the grounded theory method. Median educational debt was $212,000. Six themes emerged from our analysis: (1) debt influenced career and life decisions by altering priorities; (2) residents experienced debt as a persistent source of background stress and felt powerless to change it; (3) residents made use of various techniques to negotiate debt in order to focus on day-to-day work; (4) personal debt philosophy, based on individual values and obtained from family, shaped how debt affected each individual; (5) debt had a normative effect and was acculturated in residency; and (6) residents reported a wide range of financial knowledge, but recognized its importance to career success. Our emergency medicine residents' debt experience is complex and involves multiple dimensions. Given our current understanding, simple solutions are unlikely to be effective in adequately addressing this issue. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

THE ROLE OF THE N.V. SKLIFOSOVSKY RESEARCH INSTITUTE FOR EMERGENCY MEDICINE IN THE CREATION OF DISASTER MEDICINE IN THE COUNTRY

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M. S. Khubutiya

2016-01-01

Full Text Available The occurrence  of large-scale emergencies with great  human  losses  and the  absence of a unified authority  of the country health  system which would manage  its medical and sanitary consequences required  the  creation  of special  units to provide emergency  health  services (EHS in mass injuries. The disaster  medicine  became  attractive for the N.V. Sklifosovsky Research  Institute  for Emergency Medicine in the 70s of the last century. Originally, the Department for Disaster Medicine was established at the  Institute  in 1987. At the  Department, the  extensive  work was performed  to shorten  a time gap between the delivery of medical care and the beginning  of a disaster  as much as possible. It was based  on a created  concept  for organization of medical  assistance and evacuation,  methods of its expertise and the  development of technical  means  for phased  medical  and evacuatiol  support of victims. The organizational and medical-diagnostic specificity of EHS in emergencies and its delivery were analyzed  in order to reduce  the severity of consequences. The health  care experience in emergencies has been  enriched  by the staff of the Institute  (who were not employees  of the Department  actively involved in the management of mass injuries and poisonings via air ambulance at the accident site and in the treatment of victims admitted to the Institute  from sites of emergencies. Consequently, the N.V. Sklifosovsky Research Institute  for Emergency Medicine developed and offered the  scientific and organizational basis  for EHS in emergencies which made  a significant  practical contribution to the creation  of public services for disaster  medicine in the country.

A survey of the knowledge, use, and adoption of emerging technologies by academics in an Open Distance Learning environment

Directory of Open Access Journals (Sweden)

B Chimbo

2014-07-01

Full Text Available The realisation of the advantages offered by e-learning accompanied by the use of various emerging information technologies has resulted in a noticeable shift by academia towards e-learning. An analysis of the use, knowledge and adoption of emerging technologies by academics in an Open Distance Learning (ODL environment at the University of South Africa (UNISA was undertaken in this study. The aim of the study was to evaluate the use, knowledge and adoption of emerging e-learning technologies by the academics from the selected schools. The academics in the Schools of Arts, Computing and Science were purposively selected in order to draw on views of academics from different teaching and educational backgrounds. Questionnaires were distributed both electronically and manually. The results showed that academics in all the Schools were competent at the use of information technology tools and applications such as emailing, word-processing, Internet, myUnisa (UNISA’s online teaching platform, and Microsoft PowerPoint and Excel. An evaluation of the awareness of different emerging technological tools showed that most academics were aware of Open Access Technologies, Social Networking Sites, Blogs, Video Games and Microblogging Platforms. While the level of awareness was high for these technologies, the use by the academics was low. At least 62.3% of the academics indicated willingness to migrate to online teaching completely and also indicated the need for further training on new technologies. A comparison of the different schools showed no statistically significant difference in the use, knowledge and willingness to adopt technology amongst the academics.

The development of the specialism of emergency medicine: media and cultural influences.

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Timmons, Stephen; Nairn, Stuart

2015-01-01

In this article we analyse, via a critical review of the literature, the development of a relatively new medical specialism in the United Kingdom, that of emergency medicine. Despite the high media profile of emergency care, it is a low-status specialism within UK medicine. The creation of a specialist College in 2008 means that, symbolically, recognition as a full specialism has now been achieved. In this article, we will show, using a sociology of professions approach, how emergency medicine defined itself as a specialism, and sought to carve out a distinctive jurisdiction. While, in the context of the UK National Health Service, the state was clearly an important factor in the development of this profession, we wish to develop the analysis further than is usual in the sociology of professions. We will analyse the wider cultural context for the development of this specialism, which has benefited from its high profile in the media, through both fictional and documentary sources. © The Author(s) 2014.

Customizing anaphylaxis guidelines for emergency medicine.

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Nowak, Richard; Farrar, Judith Rosen; Brenner, Barry E; Lewis, Lawrence; Silverman, Robert A; Emerman, Charles; Hays, Daniel P; Russell, W Scott; Schmitz, Natalie; Miller, Judi; Singer, Ethan; Camargo, Carlos A; Wood, Joseph

2013-08-01

Most episodes of anaphylaxis are managed in emergency medical settings, where the cardinal signs and symptoms often differ from those observed in the allergy clinic. Data suggest that low recognition of anaphylaxis in the emergency setting may relate to inaccurate coding and lack of a standard, practical definition. Develop a simple, consistent definition of anaphylaxis for emergency medicine providers, supported by clinically relevant consensus statements. Definitions of anaphylaxis and criteria for diagnosis from current anaphylaxis guidelines were reviewed with regard to their utilization in emergency medical settings. The agreed-upon working definition is: Anaphylaxis is a serious reaction causing a combination of characteristic findings, and which is rapid in onset and may cause death. It is usually due to an allergic reaction but can be non-allergic. The definition is supported by Consensus Statements, each with referenced discussion. For a positive outcome, quick diagnosis and treatment of anaphylaxis are critical. However, even in the emergency setting, the patient may not present with life-threatening symptoms. Because mild initial symptoms can quickly progress to a severe, even fatal, reaction, the first-line treatment for any anaphylaxis episode--regardless of severity--is intramuscular injection of epinephrine into the anterolateral thigh; delaying its administration increases the potential for morbidity and mortality. When a reaction appears as "possible anaphylaxis," it is generally better to err on the side of caution and administer epinephrine. We believe that this working definition and the supporting Consensus Statements are a first step to better management of anaphylaxis in the emergency medical setting. Copyright © 2013 Elsevier Inc. All rights reserved.

Designing a clinical dashboard to fill information gaps in the emergency department.

Science.gov (United States)

Swartz, Jordan L; Cimino, James J; Fred, Matthew R; Green, Robert A; Vawdrey, David K

2014-01-01

Data fragmentation within electronic health records causes gaps in the information readily available to clinicians. We investigated the information needs of emergency medicine clinicians in order to design an electronic dashboard to fill information gaps in the emergency department. An online survey was distributed to all emergency medicine physicians at a large, urban academic medical center. The survey response rate was 48% (52/109). The clinical information items reported to be most helpful while caring for patients in the emergency department were vital signs, electrocardiogram (ECG) reports, previous discharge summaries, and previous lab results. Brief structured interviews were also conducted with 18 clinicians during their shifts in the emergency department. From the interviews, three themes emerged: 1) difficulty accessing vital signs, 2) difficulty accessing point-of-care tests, and 3) difficulty comparing the current ECG with the previous ECG. An emergency medicine clinical dashboard was developed to address these difficulties.

Pediatric emergency medicine asynchronous e-learning: a multicenter randomized controlled Solomon four-group study.

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Chang, Todd P; Pham, Phung K; Sobolewski, Brad; Doughty, Cara B; Jamal, Nazreen; Kwan, Karen Y; Little, Kim; Brenkert, Timothy E; Mathison, David J

2014-08-01

Asynchronous e-learning allows for targeted teaching, particularly advantageous when bedside and didactic education is insufficient. An asynchronous e-learning curriculum has not been studied across multiple centers in the context of a clinical rotation. We hypothesize that an asynchronous e-learning curriculum during the pediatric emergency medicine (EM) rotation improves medical knowledge among residents and students across multiple participating centers. Trainees on pediatric EM rotations at four large pediatric centers from 2012 to 2013 were randomized in a Solomon four-group design. The experimental arms received an asynchronous e-learning curriculum consisting of nine Web-based, interactive, peer-reviewed Flash/HTML5 modules. Postrotation testing and in-training examination (ITE) scores quantified improvements in knowledge. A 2 × 2 analysis of covariance (ANCOVA) tested interaction and main effects, and Pearson's correlation tested associations between module usage, scores, and ITE scores. A total of 256 of 458 participants completed all study elements; 104 had access to asynchronous e-learning modules, and 152 were controls who used the current education standards. No pretest sensitization was found (p = 0.75). Use of asynchronous e-learning modules was associated with an improvement in posttest scores (p effect (partial η(2) = 0.19). Posttest scores correlated with ITE scores (r(2) = 0.14, p e-learning is an effective educational tool to improve knowledge in a clinical rotation. Web-based asynchronous e-learning is a promising modality to standardize education among multiple institutions with common curricula, particularly in clinical rotations where scheduling difficulties, seasonality, and variable experiences limit in-hospital learning. © 2014 by the Society for Academic Emergency Medicine.

Does Homeland Security Constitute an Emerging Academic Discipline?

Science.gov (United States)

2013-03-01

the Only Means of Survival in This Age of Complexity,” July 10, 2011, http://www.telegraph.co.uk/ finance /comment/8628701/Co-operation-is-the-only...The same can be said for virtually every area and industry (e.g., finance , law, government, manufacturing, etc.). The following represents the...with the discipline—just as alchemy eventually became chemistry and medicine. Regardless, what society is witnessing currently is the emergence of an

Barriers towards the publication of academic drug trials. Follow-up of trials approved by the Danish Medicines Agency

DEFF Research Database (Denmark)

Berendt, Louise; Petersen, Lene Grejs; Bach, Karin Friis

2017-01-01

OBJECTIVE: To characterize and quantify barriers towards the publication of academic drug trials. STUDY DESIGN: We identified academic drug trials approved during a 3-year period (2004-2007) by the Danish Medicines Agency. We conducted a survey among the trial sponsors to describe the rates...... of initiation, completion, and publication, and the reasons for the failure to reach each of these milestones. Information on size and methodological characteristics of the trials was extracted from the EudraCT database, a prospective register of all approved clinical drug trials submitted to European medicines...... agencies since 2004. RESULTS: A total of 181 academic drug trials were eligible for inclusion, 139 of which participated in our survey (response rate: 77%). Follow-up time ranged from 5.1 to 7.9 years. Most trials were randomized controlled trials (73%, 95% CI 65-81%). Initiation and completion rates were...

Medical Journalism and Emergency Medicine

Directory of Open Access Journals (Sweden)

Saeed Safari

2015-07-01

Full Text Available Nowadays, many researches in the field of medicine are conducting all around the world and medical journalism is a way to share the results. In fact, dissemination of the related manuscripts can prevent the repetitive research or may even lead to conducting a better survey. Therefore high quality medical journals are considered as up-to-date resources for further investigations. Medical journals are propagating their papers in various media including television programs, newspapers, internet websites and different social media. So they can influence the government policy makers, health-care professionals and even public. Moreover, most researchers hear about medical discoveries for the first time through medical journals and their related social media. So as well a high quality journal can help to improve medical science, a journal of poor quality can be damaging and distorting. Indeed, popular journals have the power of inventing a “communication storm” to draw attention to a certain topic. Thus they have to respect the accepted international principles to prevent spreading inaccurate and misleading data. This paper aims to review the previous and current situation of medical journalism by focus on field of emergency medicine.

Investigation on legal problems encountered by emergency medicine physicians in Turkey.

Directory of Open Access Journals (Sweden)

Afsin Emre Kayipmaz

Full Text Available Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians' legal-administrative problems and reveal their level of understanding on forensic cases.An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. p<0.05 was considered statistically significant.294 physicians participated in the questionnaire. According to the questionnaire, 170 of the physicians were reported to the patient communication units due to medical malpractice. Mean number of compliant reports was 3.20±3.5. 29 of the physicians received administrative penalties. 42 of the physicians were judged in the court for medical malpractice. 1 physician was fined 5000 Turkish Liras as a result of these judgments.We found that the number of complaint reports is negatively correlated with duration of service in emergency medicine and age. There was a significant difference between number of complaint reports and career (p<0.05. The physicians' level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and

Diagnostic ultrasound use in physiotherapy, emergency medicine, and anaesthesiology

Energy Technology Data Exchange (ETDEWEB)

McKiernan, Sharmaine [School of Health Sciences, University of Newcastle, Callagham, NSW 2308 (Australia)], E-mail: sharmaine.mckiernan@newcastle.edu.au; Chiarelli, Pauline; Warren-Forward, Helen [School of Health Sciences, University of Newcastle, Callagham, NSW 2308 (Australia)

2010-05-15

Background: Diagnostic ultrasound is traditionally and extensively used within the radiology department. However in recent years its use has expanded outside this traditional area into health professions such as physiotherapy, emergency medicine and anaesthesiology. Purpose: The radiology community needs to be aware of the expansion of use of diagnostic ultrasound. This article starts this exploration in the health professions mentioned, however it is acknowledged that diagnostic ultrasound use goes beyond what is covered in this article. As diagnostic ultrasound is a user dependant modality and the outcome of an examination is largely influenced by the skill and experience of the operator, the radiology community should take a guiding role in its use, training and protocol development for health professionals. Method: This article explores the literature on the use of diagnostic ultrasound within physiotherapy, emergency medicine and anaesthesiology. Literature was searched for on the databases Medline, Cinahl and Embase. Results: Diagnostic ultrasound is being used in health professions such as physiotherapy, where it is being used to provide biofeedback to patients on contraction of abdominal and pelvic floor muscles; emergency medicine, for the investigation of free fluid within the abdomen of a trauma patient and anaesthesiology, for the placement of catheters and nerve blocks. Conclusion: As members of the radiology community are considered experts in the field, they need to take the lead to guide and mentor the other health professionals who are now using the modality. To be able to achieve this they must have an understanding of what these professions are using the modality for.

Diagnostic ultrasound use in physiotherapy, emergency medicine, and anaesthesiology

International Nuclear Information System (INIS)

McKiernan, Sharmaine; Chiarelli, Pauline; Warren-Forward, Helen

2010-01-01

Background: Diagnostic ultrasound is traditionally and extensively used within the radiology department. However in recent years its use has expanded outside this traditional area into health professions such as physiotherapy, emergency medicine and anaesthesiology. Purpose: The radiology community needs to be aware of the expansion of use of diagnostic ultrasound. This article starts this exploration in the health professions mentioned, however it is acknowledged that diagnostic ultrasound use goes beyond what is covered in this article. As diagnostic ultrasound is a user dependant modality and the outcome of an examination is largely influenced by the skill and experience of the operator, the radiology community should take a guiding role in its use, training and protocol development for health professionals. Method: This article explores the literature on the use of diagnostic ultrasound within physiotherapy, emergency medicine and anaesthesiology. Literature was searched for on the databases Medline, Cinahl and Embase. Results: Diagnostic ultrasound is being used in health professions such as physiotherapy, where it is being used to provide biofeedback to patients on contraction of abdominal and pelvic floor muscles; emergency medicine, for the investigation of free fluid within the abdomen of a trauma patient and anaesthesiology, for the placement of catheters and nerve blocks. Conclusion: As members of the radiology community are considered experts in the field, they need to take the lead to guide and mentor the other health professionals who are now using the modality. To be able to achieve this they must have an understanding of what these professions are using the modality for.

A top-five list for emergency medicine: a pilot project to improve the value of emergency care.

Science.gov (United States)

Schuur, Jeremiah D; Carney, Dylan P; Lyn, Everett T; Raja, Ali S; Michael, John A; Ross, Nicholas G; Venkatesh, Arjun K

2014-04-01

IMPORTANCE The mean cost of medical care in the United States is growing at an unsustainable rate; from 2003 through 2011, the cost for an emergency department (ED) visit rose 240%, from $560 to $1354. The diagnostic tests, treatments, and hospitalizations that emergency clinicians order result in significant costs. OBJECTIVE To create a "top-five" list of tests, treatments, and disposition decisions that are of little value, are amenable to standardization, and are actionable by emergency medicine clinicians. DESIGN, SETTING, AND PARTICIPANTS Modified Delphi consensus process and survey of 283 emergency medicine clinicians (physicians, physician assistants, and nurse practitioners) from 6 EDs. INTERVENTION We assembled a technical expert panel (TEP) and conducted a modified Delphi process to identify a top-five list using a 4-step process. In phase 1, we generated a list of low-value clinical decisions from TEP brainstorming and e-mail solicitation of clinicians. In phase 2, the TEP ranked items on contribution to cost, benefit to patients, and actionability by clinicians. In phase 3, we surveyed all ordering clinicians from the 6 EDs regarding distinct aspects of each item. In phase 4, the TEP voted for a final top-five list based on survey results and discussion. MAIN OUTCOMES AND MEASURES A top-five list for emergency medicine. The TEP ranked items on contribution to cost, benefit to patients, and actionability by clinicians. The survey asked clinicians to score items on the potential benefit or harm to patients and the provider actionability of each item. Voting and surveys used 5-point Likert scales. A Pearson interdomain correlation was used. RESULTS Phase 1 identified 64 low-value items. Phase 2 narrowed this list to 7 laboratory tests, 3 medications, 4 imaging studies, and 3 disposition decisions included in the phase 3 survey (71.0% response rate). All 17 items showed a significant positive correlation between benefit and actionability (r, 0.19-0.37 [P�

Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

Directory of Open Access Journals (Sweden)

Stoneking LR

2016-08-01

Full Text Available LR Stoneking,1 AL Waterbrook,1 J Garst Orozco,2 D Johnston,1 A Bellafiore,1 C Davies,3 T Nuño,1 J Fatás-Cabeza,4 O Beita,5 V Ng,1 KH Grall,6 W Adamas-Rappaport7 1Department of Emergency Medicine, University of Arizona, Tucson, AZ, 2Department of Emergency Medicine, Sinai Health System, Chicago, IL, 3Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, 4Department of Spanish and Portuguese, University of Arizona, Tucson, AZ, 5Department of Family and Community Medicine, University of Arizona, Tucson, AZ, 6Department of Emergency Medicine, Regions Hospital, St Paul, MN, 7Department of Surgery, University of Arizona, Tucson, AZ, USA Background: After emergency department (ED discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit.Objectives: To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency.Methods: Our ED has two Emergency Medicine Residency Programs, University Campus (UC and South Campus (SC. SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions.Results: Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study

Reducing Implicit Gender Leadership Bias in Academic Medicine With an Educational Intervention.

Science.gov (United States)

Girod, Sabine; Fassiotto, Magali; Grewal, Daisy; Ku, Manwai Candy; Sriram, Natarajan; Nosek, Brian A; Valantine, Hannah

2016-08-01

One challenge academic health centers face is to advance female faculty to leadership positions and retain them there in numbers equal to men, especially given the equal representation of women and men among graduates of medicine and biological sciences over the last 10 years. The purpose of this study is to investigate the explicit and implicit biases favoring men as leaders, among both men and women faculty, and to assess whether these attitudes change following an educational intervention. The authors used a standardized, 20-minute educational intervention to educate faculty about implicit biases and strategies for overcoming them. Next, they assessed the effect of this intervention. From March 2012 through April 2013, 281 faculty members participated in the intervention across 13 of 18 clinical departments. The study assessed faculty members' perceptions of bias as well as their explicit and implicit attitudes toward gender and leadership. Results indicated that the intervention significantly changed all faculty members' perceptions of bias (P leadership of all participants regardless of age or gender (P = .008). These results suggest that providing education on bias and strategies for reducing it can serve as an important step toward reducing gender bias in academic medicine and, ultimately, promoting institutional change, specifically the promoting of women to higher ranks.

Time-Driven Activity-Based Costing in Emergency Medicine.

Science.gov (United States)

Yun, Brian J; Prabhakar, Anand M; Warsh, Jonathan; Kaplan, Robert; Brennan, John; Dempsey, Kyle E; Raja, Ali S

2016-06-01

Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine which interventions might improve value for their patients. Although ongoing research may determine which outcomes are meaningful, an accurate costing system is also needed. This article reviews current costing mechanisms in the ED and their pitfalls. It then describes how time-driven activity-based costing may be superior to these current costing systems. Time-driven activity-based costing, in addition to being a more accurate costing system, can be used for process improvements in the ED. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Investigation on legal problems encountered by emergency medicine physicians in Turkey.

Science.gov (United States)

Kayipmaz, Afsin Emre; Kavalci, Cemil; Gulalp, Betul; Kocalar, Ummu Gulsum; Giray, Tufan Akin; Yesilagac, Hasan; Ozel, Betul Akbuga; Celikel, Elif; Karagun, Ozlem

2015-01-01

Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians' legal-administrative problems and reveal their level of understanding on forensic cases. An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. pmedicine and age. There was a significant difference between number of complaint reports and career (p<0.05). The physicians' level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and periodical reviews might be beneficial.

Faculty self-reported experience with racial and ethnic discrimination in academic medicine.

Science.gov (United States)

Peterson, Neeraja B; Friedman, Robert H; Ash, Arlene S; Franco, Shakira; Carr, Phyllis L

2004-03-01

Despite the need to recruit and retain minority faculty in academic medicine, little is known about the experiences of minority faculty, in particular their self-reported experience of racial and ethnic discrimination at their institutions. To determine the frequency of self-reported experience of racial/ethnic discrimination among faculty of U.S. medical schools, as well as associations with outcomes, such as career satisfaction, academic rank, and number of peer-reviewed publications. A 177-item self-administered mailed survey of U.S. medical school faculty. Twenty-four randomly selected medical schools in the contiguous United States. A random sample of 1,979 full-time faculty, stratified by medical school, specialty, graduation cohort, and gender. Frequency of self-reported experiences of racial/ethnic bias and discrimination. The response rate was 60%. Of 1,833 faculty eligible, 82% were non-Hispanic white, 10% underrepresented minority (URM), and 8% non-underrepresented minority (NURM). URM and NURM faculty were substantially more likely than majority faculty to perceive racial/ethnic bias in their academic environment (odds ratio [OR], 5.4; P discrimination by a superior or colleague. Faculty with such reported experiences had lower career satisfaction scores than other faculty (P discrimination achieved academic productivity similar to that of other faculty.

The academic value of rehabilitation medicine meetings.

Science.gov (United States)

Sivan, Manoj; Smith, Matthew; Bavikatte, Ganesh; Bradley, Lloyd

2010-01-01

Twice-yearly meetings of The British Society of Rehabilitation Medicine (BSRM) take place at which posters and free papers are generated, as abstracts, to present novel research findings, audits and case reports. The aim of this study was to evaluate the academic value of these meetings, by determining the subsequent rate of publication in peer-reviewed journals of abstracts presented. This was compared to the publication rate of other European medical specialist society meetings. The authors used MEDLINE, PubMed and Google Scholar search engines to look for publication of abstracts presented at BSRM meetings within peer-reviewed journals over a 7-year period (2000-2006). The abstracts were categorised into sub-groups (original study, audit, review, case report and service description) to determine which type was more likely to be published. The above databases were used also to extract studies on publication rate of other medical specialties in Europe. In 7 years, a total of 251 abstracts (of which 152 are original studies) have been presented as free papers or posters in a total of 13 meetings. The publication rate for the described study categories were: total 34%, original study 52%, review 50%, case report 5%, audit 0% and service description 0%. Publication rates from other specialist meetings in Europe range from 10% to 70%. The average publication rate for an abstract submitted to a BSRM meeting is 34% for any abstract and 52% for an original study suggesting that the meeting is generating abstracts of comparable academic interest to other specialist societies.

Women chairs in academic medicine: engendering strategic intuition.

Science.gov (United States)

Isaac, Carol; Griffin, Lindsay

2015-01-01

Because stereotypically masculine behaviors are required for effective leadership, examining female chairs' leadership in academic medicine can provide insight into the complex ways in which gender impacts on their leadership practices. The paper aims to discuss this issue. The author interviewed three female clinical chairs and compared the findings to interviews with 28 of their faculty. Grounded theory analysis of the subsequent text gathered comprehensive, systematic, and in-depth information about this case of interest at a US top-tier academic medical center. Four of five themes from the faculty were consistent with the chair's narrative with modifications: Prior Environment (Motivated by Excellence), Tough, Direct, Transparent (Developing Trust), Communal Actions (Creating Diversity of Opinion), and Building Power through Consensus (an "Artful Exercise") with an additional theme, the Significance (and Insignificance) of a Female Chair. While faculty members were acutely aware of the chair's gender, the chairs paradoxically vacillated between gender being a "non-issue" and noting that male chairs "don't do laundry." All three female chairs in this study independently and explicitly stated that gender was not a barrier, yet intuitively used successful strategies derived from the research literature. This study suggests that while their gender was highlighted by faculty, these women dismissed gender as a "non-issue." The duality of gender for these three female leaders was both minimized and subtly affirmed.

The Market for Academic Knowledge: Its Historical Emergence and Inherent Tensions

Science.gov (United States)

Weik, Elke

2014-01-01

This paper contributes to the discussion about the marketisation of universities by providing a historical perspective. Going back to the time when the market for academic knowledge emerged, I argue that it was created through incorporating a number of inherent tensions that have been, and still are, shaping its development. I show how these…

Survey of emergency medicine resident debt status and financial planning preparedness.

Science.gov (United States)

Glaspy, Jeffrey N; Ma, O John; Steele, Mark T; Hall, Jacqueline

2005-01-01

Most resident physicians accrue significant financial debt throughout their medical and graduate medical education. The objective of this study was to analyze emergency medicine resident debt status, financial planning actions, and educational experiences for financial planning and debt management. A 22-item questionnaire was sent to all 123 Accreditation Council on Graduate Medical Education-accredited emergency medicine residency programs in July 2001. Two follow-up mailings were made to increase the response rate. The survey addressed four areas of resident debt and financial planning: 1) accrued debt, 2) moonlighting activity, 3) financial planning/debt management education, and 4) financial planning actions. Descriptive statistics were used to analyze the data. Survey responses were obtained from 67.4% (1,707/2,532) of emergency medicine residents in 89 of 123 (72.4%) residency programs. Nearly one half (768/1,707) of respondents have accrued more than 100,000 dollars of debt. Fifty-eight percent (990/1,707) of all residents reported that moonlighting would be necessary to meet their financial needs, and more than 33% (640/1,707) presently moonlight to supplement their income. Nearly one half (832/1,707) of residents actively invested money, of which online trading was the most common method (23.3%). Most residents reported that they received no debt management education during residency (82.1%) or medical school (63.7%). Furthermore, 79.1% (1,351/1,707) of residents reported that they received no financial planning lectures during residency, although 84.2% (1,438/1,707) reported that debt management and financial planning education should be available during residency. Most emergency medicine residency programs do not provide their residents with financial planning education. Most residents have accrued significant debt and believe that more financial planning and debt management education is needed during residency.

Difficult airway equipment in departments of emergency medicine in Ireland: results of a national survey.

LENUS (Irish Health Repository)

Walsh, K

2012-02-03

BACKGROUND AND OBJECTIVE: Adverse effects associated with difficult airway management can be catastrophic and include death, brain injury and myocardial injury. Closed-malpractice claims have shown prolonged and persistent attempts at endotracheal intubation to be the most common situation leading to disastrous respiratory events. To date, there has been no evaluation of the types of difficult airway equipment currently available in Irish departments of emergency medicine. The objective of this survey was to identify the difficult airway equipment available in Irish departments of emergency medicine. METHODS: Departments of emergency medicine in the Republic of Ireland with at least one dedicated Emergency Medicine consultant were surveyed via telephone. RESULTS: All of the departments contacted held at least one alternative device on site for both ventilation and intubation. The most common alternative ventilation device was the laryngeal mask airway (89%). The most common alternative intubating device was the surgical airway device (100%). CONCLUSIONS: Irish departments of emergency medicine compare well with those in the UK and USA, when surveyed concerning difficult airway equipment. However, we believe that this situation could be further improved by training inexperienced healthcare providers in the use of the laryngeal mask airway and intubating laryngeal mask airway, by placing greater emphasis on the ready availability of capnography and by the increased use of portable difficult airway storage units.

Advances in point-of-care ultrasound in pediatric emergency medicine.

Science.gov (United States)

Gallagher, Rachel A; Levy, Jason A

2014-06-01

Point-of-care ultrasound (POCUS) has become an integral part of emergency medicine practice. Research evaluating POCUS in the care of pediatric patients has improved the understanding of its potential role in clinical care. Recent work has investigated the ability of pediatric emergency medicine (PEM) physicians to perform a wide array of diagnostic and procedural applications in POCUS ultrasound. Studies have demonstrated that PEM providers are able to identify an array of diseases, including intussusception, pyloric stenosis and appendicitis. Novel applications of ultrasound, such as a cardiac evaluation in the acutely ill patient or identification of skull fractures in the assessment of a patient with head injury, have shown excellent promise in recent studies. These novel applications have the potential to reshape pediatric diagnostic algorithms. Key applications in PEM have been investigated in the recent publications. Further exploration of the ability to integrate ultrasound into routine practice will require larger-scale studies and continued growth of education in the field. The use of ultrasound in clinical practice has the potential to improve safety and efficiency of care in the pediatric emergency department.

Acceptability of the flipped classroom approach for in-house teaching in emergency medicine.

Science.gov (United States)

Tan, Eunicia; Brainard, Andrew; Larkin, Gregory L

2015-10-01

To evaluate the relative acceptability of the flipped classroom approach compared with traditional didactics for in-house teaching in emergency medicine. Our department changed its learning model from a 'standard' lecture-based model to a 'flipped classroom' model. The 'flipped classroom' included provided pre-session learning objectives and resources before each 2 h weekly session. In-session activities emphasised active learning strategies and knowledge application. Feedback was sought from all medical staff regarding the acceptability of the new approach using an online anonymous cross-sectional qualitative survey. Feedback was received from 49/57 (86%) medical staff. Ninety-eight per cent (48/49) of respondents preferred the flipped classroom over the traditional approach. Aspects of the flipped classroom learners liked most included case-based discussion, interaction with peers, application of knowledge, self-directed learning and small-group learning. Barriers to pre-session learning include work commitments, 'life', perceived lack of time, family commitments, exam preparation and high volume of learning materials. Reported motivational factors promoting pre-session learning include formal assessment, participation requirements, more time, less material, more clinical relevance and/or more interesting material. Case studies and 'hands-on' activities were perceived to be the most useful in-session activities. The flipped classroom shows promise as an acceptable approach to in-house emergency medicine teaching. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Pioneering small-group learning in Tanzanian emergency medicine: Investigating acceptability for physician learners

Directory of Open Access Journals (Sweden)

A G Lim

2017-03-01

Full Text Available Background. Emergency medicine (EM is a relatively new, but growing medical specialty in sub-Saharan Africa. African EM training programmes have used small-group learning (SGL modalities in their curricula. However, there is little knowledge of whether SGL modalities are perceived to be effective in these African EM training programmes. Objectives. To investigate the acceptability of SGL for physicians’ training in an academic Tanzanian emergency department using a novel EM curriculum. Methods. Using responses to a written questionnaire, we explored the perceived effectiveness of SGL compared with traditional didactic lectures among 38 emergency department physician learners in Dar es Salaam, Tanzania. Perceptions of SGL were identified from qualitative responses, and regression analyses were used to determine strength of association between quantitative outcomes. Results. Reported benefits of SGL included team building, simulation training, enhancement of procedural skills, and the opportunity to discuss opinions on clinical management. SGL scored more favourably with regard to improving clinical practice, enjoyment of learning, and building peer-to-peer relations. Lectures scored more favourably at improving medical knowledge. Preference towards SGL over lectures for overall training increased with years of clinical experience (95% confidence interval (CI 0.16 - 0.62, p=0.002, Spearman’s rho 0.51, and the perception that SGL reinforces learner-teacher relationships correlated with seniority within residency training (95% CI 0.14 - 0.86, p=0.007, Spearman’s rho 0.47. Conclusion. Techniques of SGL were perceived as effective at improving clinical practice in the emergency department setting. These modalities may be more favourably accepted by more experienced physician learners – therefore, new EM teaching programmes in Africa should consider these factors when targeting educational strategies for their respective regions and learner

Experiencing the culture of academic medicine: gender matters, a national study.

Science.gov (United States)

Pololi, Linda H; Civian, Janet T; Brennan, Robert T; Dottolo, Andrea L; Krupat, Edward

2013-02-01

Energized and productive faculty are critical to academic medicine, yet studies indicate a lack of advancement and senior roles for women. Using measures of key aspects of the culture of academic medicine, this study sought to identify similarity and dissimilarity between perceptions of the culture by male and female faculty. The C - Change Faculty Survey was used to collect data on perceptions of organizational culture. A stratified random sample of 4,578 full-time faculty at 26 nationally representative US medical colleges (response rate 52 %). 1,271 (53 %) of respondents were female. Factor analysis assisted in the creation of scales assessing dimensions of the culture, which served as the key outcomes. Regression analysis identified gender differences while controlling for other demographic characteristics. Compared with men, female faculty reported a lower sense of belonging and relationships within the workplace (T = -3.30, p men to perceive their institution as family-friendly (T = -4.06, p men did not differ significantly on levels of engagement, leadership aspirations, feelings of ethical/moral distress, perception of institutional commitment to faculty advancement, or perception of institutional change efforts to improve support for faculty. Faculty men and women are equally engaged in their work and share similar leadership aspirations. However, medical schools have failed to create and sustain an environment where women feel fully accepted and supported to succeed; how can we ensure that medical schools are fully using the talent pool of a third of its faculty?

A Cultural Hybridization Perspective: Emerging Academic Subculture among International Students from East Asia in U.S.

Science.gov (United States)

Li, Jian

2016-01-01

This research examines the emerging academic subculture of international students from East Asia in U.S. academics from the cultural hybridization perspective. In a knowledge-based economy, international education plays a pivotal role in the global educational environment. Advocacy of international student mobility is essential; international…

Changing the Culture of Academic Medicine to Eliminate the Gender Leadership Gap: 50/50 by 2020

OpenAIRE

Valantine, Hannah; Sandborg, Christy I.

2013-01-01

Central to the daily struggles that successful working women face is the misalignment of the current work culture and the values of the workforce. In addition to contributing to work-life integration conflicts, this disconnect also perpetuates the gender leadership gap. The dearth of women at the highest ranks of academic medicine not only sends a clear message to women that they must choose between career advancement and their personal life but also represents a loss of talent for academic h...

Hurdles in clinical implementation of academic advanced therapy medicinal products: A national evaluation.

Science.gov (United States)

de Wilde, Sofieke; Veltrop-Duits, Louise; Hoozemans-Strik, Merel; Ras, Thirza; Blom-Veenman, Janine; Guchelaar, Henk-Jan; Zandvliet, Maarten; Meij, Pauline

2016-06-01

Since the implementation of the European Union (EU) regulation for advanced therapy medicinal products (ATMPs) in 2009, only six ATMPs achieved marketing authorization approval in the EU. Recognizing the major developments in the ATMP field, starting mostly in academic institutions, we investigated which hurdles were experienced in the whole pathway of ATMP development towards clinical care. Quality interviews were executed with different stakeholders in The Netherlands involved in the ATMP development field, e.g. academic research groups, national authorities and patient organizations. Based on the hurdles mentioned in the interviews, questionnaires were subsequently sent to the academic principal investigators (PIs) and ATMP good manufacturing practice (GMP) facility managers to quantify these hurdles. Besides the familiar regulatory routes of marketing authorization (MA) and hospital exemption (HE), a part of the academic PIs perceived that ATMPs should become available by the Tissues and Cells Directive or did not anticipate on the next development steps towards implementation of their ATMP towards regular clinical care. The main hurdles identified were: inadequate financial support, rapidly evolving field, study-related problems, lacking regulatory knowledge, lack of collaborations and responsibility issues. Creating an academic environment stimulating and planning ATMP development and licensing as well as investing in expanding the relevant regulatory knowledge in academic institutions seems a prerequisite to develop ATMPs from bench to patient. Copyright © 2016 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

Disaster Education: A Survey Study to Analyze Disaster Medicine Training in Emergency Medicine Residency Programs in the United States.

Science.gov (United States)

Sarin, Ritu R; Cattamanchi, Srihari; Alqahtani, Abdulrahman; Aljohani, Majed; Keim, Mark; Ciottone, Gregory R

2017-08-01

The increase in natural and man-made disasters occurring worldwide places Emergency Medicine (EM) physicians at the forefront of responding to these crises. Despite the growing interest in Disaster Medicine, it is unclear if resident training has been able to include these educational goals. Hypothesis This study surveys EM residencies in the United States to assess the level of education in Disaster Medicine, to identify competencies least and most addressed, and to highlight effective educational models already in place. The authors distributed an online survey of multiple-choice and free-response questions to EM residency Program Directors in the United States between February 7 and September 24, 2014. Questions assessed residency background and details on specific Disaster Medicine competencies addressed during training. Out of 183 programs, 75 (41%) responded to the survey and completed all required questions. Almost all programs reported having some level of Disaster Medicine training in their residency. The most common Disaster Medicine educational competencies taught were patient triage and decontamination. The least commonly taught competencies were volunteer management, working with response teams, and special needs populations. The most commonly identified methods to teach Disaster Medicine were drills and lectures/seminars. There are a variety of educational tools used to teach Disaster Medicine in EM residencies today, with a larger focus on the use of lectures and hospital drills. There is no indication of a uniform educational approach across all residencies. The results of this survey demonstrate an opportunity for the creation of a standardized model for resident education in Disaster Medicine. Sarin RR , Cattamanchi S , Alqahtani A , Aljohani M , Keim M , Ciottone GR . Disaster education: a survey study to analyze disaster medicine training in emergency medicine residency programs in the United States. Prehosp Disaster Med. 2017;32(4):368-373.

Radiologic procedures, policies and protocols for pediatric emergency medicine

International Nuclear Information System (INIS)

Woodward, George A.

2008-01-01

Protocol development between radiology and pediatric emergency medicine requires a multidisciplinary approach to manage straightforward as well as complex and time-sensitive needs for emergency department patients. Imaging evaluation requires coordination of radiologic technologists, radiologists, transporters, nurses and coordinators, among others, and might require accelerated routines or occur at sub-optimal times. Standardized protocol development enables providers to design a best practice in all of these situations and should be predicated on evidence, mission, and service expectations. As in any new process, constructive feedback channels are imperative for evaluation and modification. (orig.)

Burnout and Associated Factors among Iranian Emergency Medicine Practitioners.

Science.gov (United States)

Jalili, Mohammad; Sadeghipour Roodsari, Gholamreza; Bassir Nia, Anahita

2013-09-01

Emergency physicians are at risk of burnout, which can affect their mental health, as well as patient care. We assessed burnout level among Iranian emergency physicians and investigated demographic, work-related factors and stressors associated with higher burnout. In a cross-sectional study, we surveyed all 188 emergency medicine residents and practitioners in Iran. We measured burnout using 22-item Maslach Burnout Inventory assessing emotional exhaustion, depersonalization and personal accomplishment, also demographic factors, work related factors and sources of stress in emergency department using anonymous self-administered questionnaire. Descriptive analysis, univariate analysis to evaluate association with higher score of burnout, and multivariate logistic regression analysis to predict high burnout in 3 subscales was performed. Totally, 165 questionnaires were filled (response rate: 88%; mean age: 33.6 years, 91% male). Mean burnout scores were 22.94 for emotional exhaustion (95% CI=20.78-25.01; moderate), 9.3 for depersonalization (95% CI=8.24-10.36; moderate to high), and 31.47 for personal accomplishment (95% CI=29.87-33.07; moderate to high). Frequent reported sources of stress were shortage of equipment, problem with work physical environment, and relationship with other services. All 19 sources of stress were associated with higher score of emotional exhaustion and depersonalization; while twelve out of 19 were significantly associated with lower level of personal accomplishment. In logistic regression model, the significant predictors for high emotional exhaustion were work overload, feeling of insecurity for future career and difficulties to balance professional and private life. Burnout is high among Iranian emergency medicine practitioners and some interventions can be proposed to reduce stress.

Human factors and safety in emergency medicine

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Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.

1994-01-01

A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.

Faculty perceptions of gender discrimination and sexual harassment in academic medicine.

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Carr, P L; Ash, A S; Friedman, R H; Szalacha, L; Barnett, R C; Palepu, A; Moskowitz, M M

2000-06-06

Gender-based discrimination and sexual harassment are common in medical practice and may be even more prevalent in academic medicine. To examine the prevalence of gender-based discrimination and sexual harassment among medical school faculty and the associations of gender-based discrimination with number of publications, career satisfaction, and perceptions of career advancement. A self-administered mailed questionnaire of U.S. medical school faculty that covered a broad range of topics relating to academic life. 24 randomly selected medical schools in the contiguous United States. A random sample of 3332 full-time faculty, stratified by specialty, graduation cohort, and sex. Prevalence of self-reported experiences of discrimination and harassment, number of peer-reviewed publications, career satisfaction, and perception of career advancement. Female faculty were more than 2.5 times more likely than male faculty to perceive gender-based discrimination in the academic environment (P productivity but lower career satisfaction scores than did other women (Padvancement (72% compared with 47%). Publications, career satisfaction, and professional confidence were not affected by sexual harassment, and self-assessed career advancement was only marginally lower for female faculty who had experienced sexual harassment (P = 0.06). Despite substantial increases in the number of female faculty, reports of gender-based discrimination and sexual harassment remain common.

[Family medicine as a medical specialty and an academic discipline in the medical students' assessment].

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Krztoń-Królewiecka, Anna; Jarczewska, Dorota Łucja; Windak, Adam

2015-01-01

Family medicine has been recognized as the key element of a good health care system. Despite the significance of the family physician's role the number of medical students choosing to train in family medicine has been declining in recent years. The aim of this study was to describe opinions about family medicine and family medicine teaching among medical students. A cross sectional study with an anonymous questionnaire was carried out. The study population was all sixth-year students in Faculty Medicine of Jagiellonian University Medical College, who completed family medicine course in winter semester of academic year 2012/2013. 111 students filled in the questionnaire. The response rate was 84.1%. Less than one third of respondents (30.6%) considered family medicine as a future career choice. Almost all students recognized responsibility of the family doctor for the health of community. 52% of respondents agreed that the family doctor is competent to provide most of the health care an individual may require. Experience from family medicine course was according to the students the most important factor influencing their opinions. Medical students appreciate the social role of family doctors. Family medicine teachers should not only pass on knowledge, but they also should encourage medical students to family medicine as a future career choice.

The Association between Preschool Children's Social Functioning and Their Emergent Academic Skills

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Arnold, David H.; Kupersmidt, Janis B.; Voegler-Lee, Mary Ellen; Marshall, Nastassja A.

2012-01-01

This study examined the relationship between social functioning and emergent academic development in a sample of 467 preschool children (M=55.9 months old, SD=3.8). Teachers reported on children's aggression, attention problems, and prosocial skills. Preliteracy, language, and early mathematics skills were assessed with standardized tests. Better…

Mid-Career Faculty Development in Academic Medicine: How Does It Impact Faculty and Institutional Vitality?

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Campion, MaryAnn W.; Bhasin, Robina M.; Beaudette, Donald J.; Shann, Mary H.; Benjamin, Emelia J.

2016-01-01

Purpose: Faculty vitality is integral to the advancement of higher education. Strengthening vitality is particularly important for midcareer faculty, who represent the largest and most dissatisfied segment. The demands of academic medicine appear to be another factor that may put faculty at risk of attrition. To address these issues, we initiated…

The role of emergency physicians in the institutionalization of emergency medicine.

Science.gov (United States)

van Schothorst, Jannine; van den Brand, Crispijn L; Gaakeer, Menno I; Wallenburg, Iris

2017-08-01

Emergency medicine is a fast-growing medical profession. Nevertheless, the clinical activities emergency physicians (EPs) carry out and the responsibilities they have differ considerably between hospitals. This article addresses the question how the role of EPs is shaped and institutionalized in the everyday context of acute care in hospitals. A cross-case ethnographic study was conducted, comprising observations, document analysis, and in-depth interviews in three emergency departments in the Netherlands. Drawing on the theoretical concept of institutional work, we show that managers, already established medical specialties, and EPs all conduct institutional work to enhance private interests, which both restricts and enlarges EPs' work domain. These actions are strategic and intentional, as well as unintentional and part of EPs' everyday work in acute care delivery. It is in this very process that tasks and responsibilities are redistributed and the role of the EP is shaped. In contemporary literature it is often argued that the role and status of EPs should be enhanced by strengthening regulation and improving training programs. This article shows that attention should also be paid to the more subtle everyday processes of role development.

Impact of a Dedicated Emergency Medicine Teaching Resident Rotation at a Large Urban Academic Center.

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Ahn, James; Golden, Andrew; Bryant, Alyssa; Babcock, Christine

2016-03-01

In the face of declining bedside teaching and increasing emergency department (ED) crowding, balancing education and patient care is a challenge. Dedicated shifts by teaching residents (TRs) in the ED represent an educational intervention to mitigate these difficulties. We aimed to measure the perceived learning and departmental impact created by having TR. TRs were present in the ED from 12 pm-10 pm daily, and their primary roles were to provide the following: assist in teaching procedures, give brief "chalk talks," instruct junior trainees on interesting cases, and answer clinical questions in an evidence-based manner. This observational study included a survey of fourth-year medical students (MSs), residents and faculty at an academic ED. Surveys measured the perceived effect of the TR on teaching, patient flow, ease of procedures, and clinical care. Survey response rates for medical students, residents, and faculty are 56%, 77%, and 75%, respectively. MSs perceived improved procedure performance with TR presence and the majority agreed that the TR was a valuable educational experience. Residents perceived increased patient flow, procedure performance, and MS learning with TR presence. The majority agreed that the TR improved patient care. Faculty agreed that the TR increased resident and MS learning, as well as improved patient care and procedure performance. The presence of a TR increased MS and resident learning, improved patient care and procedure performance as perceived by MSs, residents and faculty. A dedicated TR program can provide a valuable resource in achieving a balance of clinical education and high quality healthcare.

Impact of a Dedicated Emergency Medicine Teaching Resident Rotation at a Large Urban Academic Center

Directory of Open Access Journals (Sweden)

James Ahn, MD

2016-03-01

Full Text Available Introduction: In the face of declining bedside teaching and increasing emergency department (ED crowding, balancing education and patient care is a challenge. Dedicated shifts by teaching residents (TRs in the ED represent an educational intervention to mitigate these difficulties. We aimed to measure the perceived learning and departmental impact created by having TR. Methods: TRs were present in the ED from 12pm-10pm daily, and their primary roles were to provide the following: assist in teaching procedures, give brief “chalk talks,” instruct junior trainees on interesting cases, and answer clinical questions in an evidence-based manner. This observational study included a survey of fourth-year medical students (MSs, residents and faculty at an academic ED. Surveys measured the perceived effect of the TR on teaching, patient flow, ease of procedures, and clinical care. Results: Survey response rates for medical students, residents, and faculty are 56%, 77%, and 75%, respectively. MSs perceived improved procedure performance with TR presence and the majority agreed that the TR was a valuable educational experience. Residents perceived increased patient flow, procedure performance, and MS learning with TR presence. The majority agreed that the TR improved patient care. Faculty agreed that the TR increased resident and MS learning, as well as improved patient care and procedure performance. Conclusion: The presence of a TR increased MS and resident learning, improved patient care and procedure performance as perceived by MSs, residents and faculty. A dedicated TR program can provide a valuable resource in achieving a balance of clinical education and high quality healthcare.

Research Productivity of Sports Medicine Fellowship Faculty

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Cvetanovich, Gregory L.; Saltzman, Bryan M.; Chalmers, Peter N.; Frank, Rachel M.; Cole, Brian J.; Bach, Bernard R.

2016-01-01

Background: Research productivity is considered an important factor in academic advancement in sports medicine. No study to date has evaluated academic productivity and correlates of academic rank for sports medicine fellowship faculty. Purpose: To describe the academic productivity of American Orthopaedic Society for Sports Medicine (AOSSM) fellowship program faculty and to determine the association between academic productivity, fellowship characteristics, and academic rank. Study Design: D...

Geographic mobility advances careers: study of the Executive Leadership in Academic Medicine (ELAM) program for women.

Science.gov (United States)

McLean, Marsha R; Morahan, Page S; Dannels, Sharon A; McDade, Sharon A

2013-11-01

To explore whether geographic mobility is associated with career advancement of women in U.S. medical schools who are entering mid- to executive-level positions. Using an existing dataset of 351 participants in academic medicine who attended the Executive Leadership in Academic Medicine (ELAM) Program for Women (1996-2005) (adjusted to 345 participants in some analyses because data on initial faculty rank were missing), the authors conducted a quantitative study in 2009 to determine whether geographic mobility was associated with administrative promotion for those who relocated geographically (from employer while attending ELAM to employer at last job of record). Twenty-four percent of women (83/345) relocated geographically (movers) after attending ELAM. Moving had a positive association with career advancement (P = .001); odds for promotion were 168% higher for movers than for stayers [odds ratio Exp(β) = 2.684]. Movers attained higher administrative positions (P = .003), and more movers (60%) were promoted at the most recent job compared with stayers (40%) (P = .0001). Few movers changed city size; 70% already resided in large or urban cities where most medical schools are located. Age was not a barrier to mobility. Career advancement was not related to research reputation (National Institutes of Health grant award ranking) of participants' schools (either at time of attending ELAM or post-ELAM). Similar to findings outside academic medicine, 24% of women classified as geographic "movers" among midcareer faculty in medical schools attained career advantages. Psychosocial and socioeconomic factors underlying women's relocation decisions require additional study.

Women chairs in academic medicine: engendering strategic intuition

Science.gov (United States)

Isaac, Carol; Griffin, Lindsay

2017-01-01

Purpose Because stereotypically masculine behaviors are required for effective leadership, examining female chairs’ leadership in academic medicine can provide insight into the complex ways in which gender impacts on their leadership practices. The paper aims to discuss this issue. Design/methodology/approach The author interviewed three female clinical chairs and compared the findings to interviews with 28 of their faculty. Grounded theory analysis of the subsequent text gathered comprehensive, systematic, and in-depth information about this case of interest at a US top-tier academic medical center. Findings Four of five themes from the faculty were consistent with the chair’s narrative with modifications: Prior Environment (Motivated by Excellence), Tough, Direct, Transparent (Developing Trust), Communal Actions (Creating Diversity of Opinion), and Building Power through Consensus (an “Artful Exercise”) with an additional theme, the Significance (and Insignificance) of a Female Chair. While faculty members were acutely aware of the chair’s gender, the chairs paradoxically vacillated between gender being a “non-issue” and noting that male chairs “don’t do laundry.” All three female chairs in this study independently and explicitly stated that gender was not a barrier, yet intuitively used successful strategies derived from the research literature. Originality/value This study suggests that while their gender was highlighted by faculty, these women dismissed gender as a “non-issue.” The duality of gender for these three female leaders was both minimized and subtly affirmed. PMID:26045192

The relationship between faculty performance assessment and results on the in-training examination for residents in an emergency medicine training program.

Science.gov (United States)

Ryan, James G; Barlas, David; Pollack, Simcha

2013-12-01

Medical knowledge (MK) in residents is commonly assessed by the in-training examination (ITE) and faculty evaluations of resident performance. We assessed the reliability of clinical evaluations of residents by faculty and the relationship between faculty assessments of resident performance and ITE scores. We conducted a cross-sectional, observational study at an academic emergency department with a postgraduate year (PGY)-1 to PGY-3 emergency medicine residency program, comparing summative, quarterly, faculty evaluation data for MK and overall clinical competency (OC) with annual ITE scores, accounting for PGY level. We also assessed the reliability of faculty evaluations using a random effects, intraclass correlation analysis. We analyzed data for 59 emergency medicine residents during a 6-year period. Faculty evaluations of MK and OC were highly reliable (κ  =  0.99) and remained reliable after stratification by year of training (mean κ  =  0.68-0.84). Assessments of resident performance (MK and OC) and the ITE increased with PGY level. The MK and OC results had high correlations with PGY level, and ITE scores correlated moderately with PGY. The OC and MK results had a moderate correlation with ITE score. When residents were grouped by PGY level, there was no significant correlation between MK as assessed by the faculty and the ITE score. Resident clinical performance and ITE scores both increase with resident PGY level, but ITE scores do not predict resident clinical performance compared with peers at their PGY level.

Predictors of job satisfaction among academic family medicine faculty: Findings from a faculty work-life and leadership survey.

Science.gov (United States)

Krueger, Paul; White, David; Meaney, Christopher; Kwong, Jeffrey; Antao, Viola; Kim, Florence

2017-03-01

To identify predictors of job satisfaction among academic family medicine faculty members. A comprehensive Web-based survey of all faculty members in an academic department of family medicine. Bivariate and multivariable analyses (logistic regression) were used to identify variables associated with job satisfaction. The Department of Family and Community Medicine at the University of Toronto in Ontario and its 15 affiliated community teaching hospitals and community-based teaching practices. All 1029 faculty members in the Department of Family and Community Medicine were invited to complete the survey. Faculty members' demographic and practice information; teaching, clinical, administration, and research activities; leadership roles; training needs and preferences; mentorship experiences; health status; stress levels; burnout levels; and job satisfaction. Faculty members' perceptions about supports provided, recognition, communication, retention, workload, teamwork, respect, resource distribution, remuneration, and infrastructure support. Faculty members' job satisfaction, which was the main outcome variable, was obtained from the question, "Overall, how satisfied are you with your job?" Of the 1029 faculty members, 687 (66.8%) responded to the survey. Bivariate analyses revealed 26 predictors as being statistically significantly associated with job satisfaction, including faculty members' ratings of their local department and main practice setting, their ratings of leadership and mentorship experiences, health status variables, and demographic variables. The multivariable analyses identified the following 5 predictors of job satisfaction: the Maslach Burnout Inventory subscales of emotional exhaustion and personal accomplishment; being born in Canada; the overall quality of mentorship that was received being rated as very good or excellent; and teamwork being rated as very good or excellent. The findings from this study show that job satisfaction among academic

Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Genitourinary Emergencies Small Group Module

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Andrew King

2017-07-01

Full Text Available Audience: This curriculum, created and implemented at The Ohio State University Wexner Medical Center, was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students. Introduction: In 2013, there were over 6 million Emergency Department visits in the United States which resulted in a primary diagnosis of the genitourinary system. This represents 5.2% of all Emergency Department visits.1 Residents must be proficient in the differential diagnosis and management of the wide variety of genitourinary emergencies. This flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.4-6 The Ohio State University Wexner Medical Center EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. Our curriculum utilizes an 18-month curricular cycle to cover the defined emergency medicine content. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of genitourinary emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real

Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Psychiatric Emergencies Small Group Module

Directory of Open Access Journals (Sweden)

Andrew King

2017-07-01

Full Text Available Audience: This curriculum created and implemented at The Ohio State University Wexner Medical Center was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction: In 2007, there were 12 million adult Emergency Department visits for mental health and substance abuse complaints. This represents 12.5% of all adult emergency department visits.1 Residents must be proficient in the differential diagnosis and management of the wide variety of psychiatric emergencies. The flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.4-6 The Ohio State University EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. Our curriculum utilizes an 18-month curricular cycle to cover the defined emergency medicine content. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of psychiatric emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group

A Formalized Three-Year Emergency Medicine Residency Ultrasound Education Curriculum

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Andrew King

2016-09-01

Full Text Available Audience and type of curriculum: The Ohio State University Wexner Medical Center Emergency Medicine Residency Program Ultrasound Education Curriculum is a three-year curriculum for PGY-1 to PGY-3 learners. Introduction/Background: Each year of the three-year The Ohio State University Wexner Medical Center Emergency Medicine Ultrasound Curriculum focuses on different aspects of emergency ultrasonography, thereby promoting progressive understanding and utilization of point-of-care ultrasound in medical decision-making during residency training. Ultrasound is an invaluable bedside tool for emergency physicians; this skill must be mastered by resident learners during residency training, and ultrasound competency is a required ACGME milestone.1 The American College of Emergency Physicians (ACEP currently recommends that 11 applications of emergency ultrasound be part of the core skills of an emergency physician.2 This curriculum acknowledges the standards developed by ACEP and the ACGME. Objectives: Learners will 1 know the indications for each the 11 ACEP point-of-care ultrasound (POCUS applications; 2 perform each of the 11 ACEP POCUS applications; 3 integrate POCUS into medical decision-making. Methods: The educational strategies used in this curriculum include: independent, self-directed learning (textbook and literature reading, brief didactic sessions describing indications and technique for each examination, hands-on ultrasound scanning under the direct supervision of ultrasound faculty with real-time feedback, and quality assurance review of ultrasound images. Residents are expected to perform a minimum of 150 ultrasound examinations with associated quality assurance during the course of their residency training. The time requirements, reading material, and ultrasound techniques taught vary depending on the year of training. Length of curriculum: The entirety of the curriculum is three years; however, each year of residency training has

Leadership values in academic medicine.

Science.gov (United States)

Souba, Wiley W; Day, David V

2006-01-01

To gain a deeper understanding of the guiding core values that deans of academic medical centers (AMCs) considered most essential for their leadership and the major leadership challenges that confront them. In 2003-04, semistructured interviews of 18 deans at U.S. colleges of medicine or AMCs were organized around four dimensions: background, leadership challenges, organizational effectiveness, and systems enablers/restrainers for leadership. A values Q-sort was used to determine how widely core values were shared among deans and how the complex challenges they faced did or did not align with these values. Fourteen of the 18 (78%) deans identified financial difficulties as their most pressing leadership challenge, followed by weak institutional alignment (61%), staffing problems (33%), and poor morale (28%). Open, candid communication was reported as the most effective means of addressing these complex problems. Enacting espoused shared values and having a positive attitude were identified as the most important enablers of systemic leadership, whereas micromanagement and difficult people were the major restraints. Q-sort results on 38 positive leadership values indicated that participants considered integrity most essential. Integrity was positively correlated with humanistic values and negatively correlated with results. Vision, another highly espoused value, correlated strongly with performance-oriented values but correlated negatively with humanistic values. A dynamic tension exists in AMCs between humanistic values and performance-based core values. The ability to manage that tension (i.e., when to prioritize one set of values over the other) is inherent in a dean's work.

Systematic Molecular Phenotyping: A Path Towards Precision Emergency Medicine?

Science.gov (United States)

Limkakeng, Alexander T.; Monte, Andrew; Kabrhel, Christopher; Puskarich, Michael; Heitsch, Laura; Tsalik, Ephraim L.; Shapiro, Nathan I.

2016-01-01

Precision medicine is an emerging approach to disease treatment and prevention that considers variability in patient genes, environment, and lifestyle. However, little has been written about how such research impacts emergency care. Recent advances in analytical techniques have made it possible to characterize patients in a more comprehensive and sophisticated fashion at the molecular level, promising highly individualized diagnosis and treatment. Among these techniques are various systematic molecular phenotyping analyses (e.g., genomics, transcriptomics, proteomics, and metabolomics). Although a number of emergency physicians use such techniques in their research, widespread discussion of these approaches has been lacking in the emergency care literature and many emergency physicians may be unfamiliar with them. In this article, we briefly review the underpinnings of such studies, note how they already impact acute care, discuss areas in which they might soon be applied, and identify challenges in translation to the emergency department. While such techniques hold much promise, it is unclear whether the obstacles to translating their findings to the emergency department will be overcome in the near future. Such obstacles include validation, cost, turnaround time, user interface, decision support, standardization, and adoption by end users. PMID:27288269

Dispatches from the front: emergency medicine teachers' perceptions of competency-based education.

Science.gov (United States)

Bandiera, Glen; Lendrum, David

2011-05-01

Controversy exists regarding the applicability of competency-based education during clinical rotations in emergency medicine (EM). Little has been written about the perceptions of front-line teachers regarding one such competency-based education paradigm, the CanMEDS framework. We undertook to determine 1) what perceptions exist among front-line teachers at two academic health science emergency departments (EDs) regarding the use of the CanMEDS roles to frame what residents should learn on ED rotations and 2) how those same teachers envision practically incorporating the CanMEDS roles into feedback provided to residents. Teachers at two sites volunteered for a semistructured focus group study. Focus groups were moderated by an experienced qualitative researcher, and verbatim transcriptions were coded by two independent reviewers. The codes were merged into final themes. The final focus group was used to further explore issues raised and test assumptions made in the preceding groups. In five focus groups involving 21 participants, the Medical Expert and Professional roles were seen as most relevant to an EM rotation, whereas the Health Advocate, Manager, Scholar, and Collaborator roles were least relevant. On further exploration, however, faculty identified highly relevant components of each role that they could envision teaching in an ED. Participants also felt that the framework helped highlight the breadth of physician competencies and provided structure for teaching and feedback. EM faculty find the CanMEDS framework helpful for structuring teaching and learning and that many elements of the roles, when defined, are feasible to integrate into a clinical rotation.

Psychological impact on house staff of an initial versus subsequent emergency medicine rotation.

Science.gov (United States)

Alagappan, K; Grlic, N; Steinberg, M; Pollack, S

2001-01-01

The objective of this study was to assess the psychological impact of a 4-week emergency medicine (EM) rotation on residents undergoing their first EM experience. These findings were compared to the psychological impact the rotation had on residents with prior EM experience. Data were obtained from a post hoc analysis of a previous study. Prerotation and postrotation psychological distress levels were assessed over a 4-week EM rotation. Anxiety and depressive symptoms were evaluated by the Brief Symptom Inventory and the Dissociative Experience Scale that together comprise a total of 14 psychometric scales. All scales were given at the beginning and end of the initial EM rotation for the academic year of 1994-1995. All information was coded and confidential. Eighteen junior residents (9/18 EM [50%]) were analyzed as a group and compared to 53 residents (34/51 EM [66%]) with prior exposure to the authors' emergency department. Residents doing their first EM rotation (N = 18) showed improvement in 13 of 14 scales (P = .002). Of the 13 scales that improved, 3 improved significantly: Brief Symptom Inventory = anxiety (P = .002) and Dissociative Experience Scale = absorption (P = .001) and other (P = .001). Residents with prior EM experience (N = 53) displayed worsening in 9 of 13 scales (P = not significant) and no change in 1. Residents undergoing their first EM rotation showed a significant decrease in psychological distress over the 4-week period. Residents with prior EM experience did not show a similar change.

Emergency medicine clerkship curriculum in a high-income developing country: methods for development and application.

Science.gov (United States)

Cevik, Arif Alper; Cakal, Elif Dilek; Abu-Zidan, Fikri M

2018-06-07

The published recommendations for international emergency medicine curricula cover the content, but exclude teaching and learning methods, assessment, and evaluation. We aim to provide an overview on available emergency medicine clerkship curricula and report the development and application experience of our own curriculum. Our curriculum is an outcome-based education, enriched by e-learning and various up-to-date pedagogic principles. Teaching and learning methods, assessment, and evaluation are described. The theory behind our practice in the light of recent literature is discussed aiming to help other colleagues from developing countries to have a clear map for developing and tailoring their own curricula depending on their needs. The details of our emergency medicine clerkship will serve as an example for developing and developed countries having immature undergraduate emergency medicine clerkship curricula. However, these recommendations will differ in various settings depending on available resources. The main concept of curriculum development is to create a curriculum having learning outcomes and content relevant to the local context, and then align the teaching and learning activities, assessments, and evaluations to be in harmony. This may assure favorable educational outcome even in resource limited settings.

Knowledge, Skills and Experience Managing Tracheostomy Emergencies: A Survey of Critical Care Medicine trainees

LENUS (Irish Health Repository)

Nizam, AA

2016-10-01

Since the development of percutaneous tracheostomy, the number of tracheostomy patients on hospital wards has increased. Problems associated with adequate tracheostomy care on the wards are well documented, particularly the management of tracheostomy-related emergencies. A survey was conducted among non-consultant hospital doctors (NCHDs) starting their Critical Care Medicine training rotation in a university affiliated teaching hospital to determine their basic knowledge and skills in dealing with tracheostomy emergencies. Trainees who had received specific tracheostomy training or who had previous experience of dealing with tracheostomy emergencies were more confident in dealing with such emergencies compared to trainees without such training or experience. Only a minority of trainees were aware of local hospital guidelines regarding tracheostomy care. Our results highlight the importance of increased awareness of tracheostomy emergencies and the importance of specific training for Anaesthesia and Critical Care Medicine trainees.

[Biomarkers in emergency medicine and critical care patients: advances and pitfalls for news tools].

Science.gov (United States)

Claessens, Yann-Erick; Mallet-Coste, Thomas; Riqué, Thomas; Macchi, Marc-Alexis; Ray, Patrick; Chenevier-Gobeaux, Camille

2014-01-01

The use of biomarkers has changed approach of diagnosis and treatment procedures in emergency medicine, especially in the field of cardiovascular disorders. Effectiveness of new strategies that integrate biomarkers has precluded development and research in novel tools that may improve safety and efficiency at bedside. This mini-review presents current knowledge on utility of biomarkers in emergency medicine, including data that should be taken into account to avoid misleading utilization. Copyright © 2013. Published by Elsevier Masson SAS.

A national survey of terrorism preparedness training among pediatric, family practice, and emergency medicine programs.

Science.gov (United States)

Martin, Shelly D; Bush, Anneke C; Lynch, Julia A

2006-09-01

Domestic terrorism is a real threat focusing on a need to engage in effective emergency preparedness planning and training. Front-line physicians are an important component of any emergency preparedness plan. Potential victims of an attack include children who have unique physiologic and psychological vulnerabilities in disasters. Front-line providers need to have adequate training to effectively participate in local planning initiatives and to recognize and treat casualties including children. The goal of the survey was to assess the current state of terrorism preparedness training, including child victims, by emergency medicine, family practice, and pediatric residency programs in the United States and to assess methods of training and barriers to establishing effective training. A survey was e-mailed to a comprehensive list of all US pediatric, family practice, and emergency medicine residency programs 3 times between September 2003 and January 2004. The survey measured the perceived risk of terrorist attack, level of training by type of attack, level of training regarding children, method of training, and barriers to training. Overall, 21% of programs responded (46 of 182 pediatric, 75 of 400 family practice, and 29 of 125 emergency medicine programs). Across all of the event types, emergency medicine programs were more likely to report adequate/comprehensive training. However, terrorism preparedness funding, these data suggest that we are failing to provide adequate training to front-line providers who may care for children in a catastrophic domestic terrorist event.

Review of monograph of Doctor of Medicine, Professor Prokopov V.O. «Drinking water of Ukraine: medical-ecologic and sanitary-hygiene aspects» edited by Doctor of Medicine, Academician of NAMS of Ukraine A.M. Serdiuk. – K.: Academic Press «Medicine», 2016.

OpenAIRE

Shevchenko, O. A.

2017-01-01

Review of monograph of Doctor ofMedicine, Professor Prokopov V.O. «Drinking water ofUkraine: medical-ecologic and sanitary-hygiene aspects»edited by Doctor of Medicine, Academician of NAMS ofUkraine A.M. Serdiuk. – K.: Academic Press «Medicine»,2016. – 400 p.

Nanotechnology in reproductive medicine: emerging applications of nanomaterials.

Science.gov (United States)

Barkalina, Natalia; Charalambous, Charis; Jones, Celine; Coward, Kevin

2014-07-01

In the last decade, nanotechnology has been extensively introduced for biomedical applications, including bio-detection, drug delivery and diagnostic imaging, particularly in the field of cancer diagnostics and treatment. However, there is a growing trend towards the expansion of nanobiotechnological tools in a number of non-cancer applications. In this review, we discuss the emerging uses of nanotechnology in reproductive medicine and reproductive biology. For the first time, we summarise the available evidence regarding the use of nanomaterials as experimental tools for the detection and treatment of malignant and benign reproductive conditions. We also present an overview of potential applications for nanomaterials in reproductive biology, discuss the benefits and concerns associated with their use in a highly delicate system of reproductive tissues and gametes, and address the feasibility of this innovative and potentially controversial approach in the clinical setting and for investigative research into the mechanisms underlying reproductive diseases. This unique review paper focuses on the emerging use of nanotechnology in reproductive medicine and reproductive biology, highlighting the role of nanomaterials in the detection and treatment of various reproductive conditions, keeping in mind the benefits and potential concerns associated with nanomaterial use in the delicate system of reproductive tissue and gametes. Copyright © 2014 Elsevier Inc. All rights reserved.

EM Talk: communication skills training for emergency medicine patients with serious illness.

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Grudzen, Corita R; Emlet, Lillian L; Kuntz, Joanne; Shreves, Ashley; Zimny, Erin; Gang, Maureen; Schaulis, Monique; Schmidt, Scott; Isaacs, Eric; Arnold, Robert

2016-06-01

The emergency department visit for a patient with serious illness represents a sentinel event, signalling a change in the illness trajectory. By better understanding patient and family wishes, emergency physicians can reinforce advance care plans and ensure the hospital care provided matches the patient's values. Despite their importance in care at the end of life, emergency physicians have received little training on how to talk to seriously ill patients and their families about goals of care. To expand communication skills training to emergency medicine, we developed a programme to give emergency medicine physicians the ability to empathically deliver serious news and to talk about goals of care. We have built on lessons from prior studies to design an intervention employing the most effective pedagogical techniques, including the use of simulated patients/families, role-playing and small group learning with constructive feedback from master clinicians. Here, we describe our evidence-based communication skills training course EM Talk using simulation, reflective feedback and deliberate practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Profiles of Emergent Literacy Skills among Preschool Children Who Are at Risk for Academic Difficulties

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Cabell, Sonia Q.; Justice, Laura M.; Konold, Timothy R.; McGinty, Anita S.

2011-01-01

The purpose of this study was to explore patterns of within-group variability in the emergent literacy skills of preschoolers who are at risk for academic difficulties. We used the person-centered approach of cluster analysis to identify profiles of emergent literacy skills, taking into account both oral language and code-related skills.…

Perceptions of Academic Fieldwork Coordinators Regarding the Value of Fieldwork in Emerging Areas of Practice

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Victoria G. Wilburn

2016-10-01

Full Text Available This study investigated the perceptions of academic fieldwork coordinators (AFWCs regarding emerging areas of practice as fieldwork experiences for entry-level occupational therapy (OT students. Further, this study explored several aspects of fieldwork experiences in emerging areas of practice on student personal and professional development, academic curriculum, partnering community agencies, and the profession at large. A survey designed through Qualtrics®, an electronic survey system, was sent to 163 AFWCs of fully accredited master’s and doctoral entry-level OT programs. Forty-four participants (27% completed the 16-question survey. Significance at p < .05 was found in higher levels of Bloom’s taxonomy student performance when compared to traditional areas of practice. Common perceptions found among the AFWCs related to emerging areas of practice fieldwork experiences included: improved student professional and personal skills, increased connections and collaborations across and in health care disciplines, an enhanced ability to define and understand OT. Continued opportunities for fieldwork in emerging areas of practice are essential as the profession contemplates new markets and avenues in a changing health care environment.

Blog and Podcast Watch: Cutaneous Emergencies

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Andrew Grock

2017-02-01

Full Text Available The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM based on the ongoing Academic Life in Emergency Medicine (ALiEM Approved Instructional Resources (AIR and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of cutaneous emergencies from the AIR series.    The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Directors (CORD annual testing schedule. For each module, relevant content is collected from the top 50 most accessed sites per the Social Media Index published within the previous 12 months and scored by eight board members using five equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM score, accuracy, educational utility, evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIR label. Resources scoring 27-29 receive an “honorable mention” label, if the editorial board agrees that the post is accurate and educationally valuable. A total of 35 blog posts and podcasts were evaluated. None scored ≥30 points necessary for the AIR label, although four honorable mention posts were identified. Key educational pearls from these honorable mention posts are summarized. This Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. This series provides an expertbased, post-publication curation of educational social media content for EM clinicians with this installment focusing on cutaneous emergencies. [West J Emerg Med. 2017;18(2288-292.

Global health and emergency care: a resuscitation research agenda--part 1

NARCIS (Netherlands)

Aufderheide, Tom P.; Nolan, Jerry P.; Jacobs, Ian G.; van Belle, Gerald; Bobrow, Bentley J.; Marshall, John; Finn, Judith; Becker, Lance B.; Bottiger, Bernd; Cameron, Peter; Drajer, Saul; Jung, Julianna J.; Kloeck, Walter; Koster, Rudolph W.; Huei-Ming Ma, Matthew; Shin, Sang Do; Sopko, George; Taira, Breena R.; Timerman, Sergio; Eng Hock Ong, Marcus

2013-01-01

At the 2013 Academic Emergency Medicine global health consensus conference, a breakout session on a resuscitation research agenda was held. Two articles focusing on cardiac arrest and trauma resuscitation are the result of that discussion. This article describes the burden of disease and outcomes,

Characterization of Complementary and Alternative Medicine-Related Consultations in an Academic Drug Information Service.

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Gregory, Philip J; Jalloh, Mohamed A; Abe, Andrew M; Hu, James; Hein, Darren J

2016-12-01

To characterize requests received through an academic drug information consultation service related to complementary and alternative medicines. A retrospective review and descriptive analysis of drug information consultations was conducted. A total of 195 consultations related to complementary and alternative medicine were evaluated. All consultation requests involved questions about dietary supplements. The most common request types were related to safety and tolerability (39%), effectiveness (38%), and therapeutic use (34%). Sixty-eight percent of the requests were from pharmacists. The most frequent consultation requests from pharmacists were questions related to drug interactions (37%), therapeutic use (37%), or stability/compatibility/storage (34%). Nearly 60% of complementary and alternative medicine-related consultation requests were able to be completely addressed using available resources. Among review sources, Natural Medicines Comprehensive Database, Clinical Pharmacology, Micromedex, and Pharmacist's Letter were the most common resources used to address consultations. Utilization of a drug information service may be a viable option for health care professionals to help answer a complementary and alternative medicine-related question. Additionally, pharmacists and other health care professionals may consider acquiring resources identified to consistently answering these questions. © The Author(s) 2015.

Attitude of interns towards implementation and contribution of undergraduate Emergency Medicine training: Experience of an Ethiopian Medical School

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Temesgen Beyene

2017-09-01

Conclusion: An Emergency Medicine rotation during the final year of medical school provides opportunities to learn about undifferentiated medical emergencies and it should be included for other medical schools in the country. Participants suggest that leadership aspects of Emergency Medicine need more emphasis as the curriculum is further developed in the future.

A framework for implementation, education, research and clinical use of ultrasound in emergency departments by the Danish Society for Emergency Medicine

DEFF Research Database (Denmark)

Laursen, Christian B; Nielsen, Klaus; Riishede, Minna

2014-01-01

The first Danish Society for Emergency Medicine (DASEM) recommendations for the use of clinical ultrasound in emergency departments has been made. The recommendations describes what DASEM believes as being current best practice for training, certification, maintenance of acquired competencies...

#Me_Who: Anatomy of Scholastic, Leadership, and Social Isolation of Underrepresented Minority Women in Academic Medicine.

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Albert, Michelle A

2018-05-22

In academic medicine, under-represented minority women physician-scientists (URMWP)* are uncommon, particularly in leadership positions. Data from the American Association of Medical Colleges (AAMC) show that among internal medicine chairs, there are 12 Asian males, 10 African/American (blacks; 9 men), 7 Hispanics (2 females) and 137 whites (21 females). In the top 40 ranked cardiology programs, there are no female cardiology chiefs, whereas there are at least 10, 2, 1 and 24 Asian, black, Hispanic and white males respectively. There are more URMWP than URM males, yet URMWP are less likely to be professors and occupy leadership positions in academia. Specifically, among United States medical school faculty, relative proportions at assistant, associate and full professor levels according to race/ethnicity and gender have remained essentially unchanged over the past 20 years. AAMC information demonstrates that only 11%, 9%, 11% and 24% of Asian, black, Hispanic and white women are full professors compared with 21%, 18%, 19% and 36% of Asian, black, Hispanic and white men. Additionally, while there are representative proportions of women and Asians at the lowest faculty levels, they have not equitably progressed in academic medicine, likely reflecting discrimination and structural/organizational barriers that are also applicable to black and Hispanic females 1 .

Development of a productive research culture in emergency medicine: Report of the outcomes of a research forum.

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Taylor, David McD; Cohen, Donna R; Epstein, Joseph; Freeman, Peter; Gosbell, Andrew D; Judkins, Simon; Mowatt, Elizabeth J M; O'Reilly, Gerard M; Vinen, John

2016-02-01

In recent years, the Australasian College for Emergency Medicine (ACEM) has increasingly focused on the need for high-quality research in emergency medicine (EM). One important initiative was the establishment of the ACEM Foundation, which among other responsibilities, is required to support clinical research through the provision of research funding and other measures. In February 2015, the Foundation held a Research Forum that was attended by the leading EM researchers from Australasia. The Forum aimed to determine how a productive research culture could be developed within the ACEM. Nine key objectives were determined including that research should be a core business of the ACEM and a core activity of the EM workforce, and that EM research should be sustainable and adequately supported. This report describes the background and conduct of the Forum, its recommendations and the way in which they could be implemented. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

The Effect of Emergency Department Overcrowding on Efficiency of Emergency Medicine Residents’ Education

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Anita Sabzghabaei

2014-09-01

Full Text Available Introduction: Creating a calm and stress-free environment affects education significantly. The effects of the emergency department overcrowding (EDO on the training of emergency medicine residents (EMR is a highly debated subject. Therefore, this study aimed to evaluate the effect of EDO on efficiency of EMR’s education. Methods: In this cross-sectional study, the effects of overcrowding on EMR’s education in the resuscitation room and acute care unit. Data collection was done using a questionnaire, which was filled out by the second year EMRs.  The crowding level was calculated based on the national emergency department overcrowding scale (NEDOCS. The relationship between the two studied variables was evaluated using independent sample t-test and SPSS 21 statistical software. Results: 130 questionnaires were filled out during 61 shifts. 47 (77.05% shifts were overcrowded. The attend’s ability to teach was not affected by overcrowding in the resuscitation room (p=0.008. The similar results were seen regarding the attend’s training ability in the acute care unit. Conclusion: It seems that the emergency department overcrowding has no effect on the quality of education to the EMRs.

Grit, anxiety, and stress in emergency physicians.

Science.gov (United States)

Wong, Matthew L; Anderson, Jared; Knorr, Thomas; Joseph, Joshua W; Sanchez, Leon D

2018-02-26

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. Thirty-six emergency medicine resident and attending physicians from an urban academic medical center consented for enrollment. Participants were administered the Duckworth 12-point Grit Scale, the State-Trait Anxiety Inventory (STAI), and the Perceived Stress Scale (PSS), which measure grit, anxiousness, and perceived stress, respectively. These are the gold standard psychological instruments for each of their areas. We analyzed the results with descriptive statistics, Spearman correlations, and linear regression. Nineteen residents and 17 attending physicians completed the surveys during the first quarter of a new academic year. The mean grit score was 3.7 (95% CI 3.5-3.8, SD: 0.56), the mean trait-anxiety score was 32.61 (95% CI 30.15-35.07, SD: 7.26), and the mean PSS score was 12.28 (95% CI 10.58-13.97, SD: 4.99). Only trait-anxiety and perceived stress were significantly correlated (Spearman's rho: 0.70, panxious reported more stress. Levels of grit were not associated with trait-anxiety. These psychological concepts should be studied further as they relate to the function and health of emergency medicine providers. Copyright © 2018. Published by Elsevier Inc.

[Scientific research and academic promotion in occupational medicine: what are the rules of the game?].

Science.gov (United States)

Franco, G

2011-01-01

Recently, the National University Council (CUN) recognized the importance of bibliometric indicators in assessing scientific output and the Ministry of Education, University and Research established that the selection committees' decision must be guided by internationally recognized metrics including the impact factor (IF). To analyse methods and tools of metrics to assess scientific performance in Occupational Medicine by examining some critical aspects for entry-level positions and academic promotion in the Universities. By means of different databases (Web of Knowledge, Scopus, SCImago), the h-index was studied to assess the scientific output in the field of Occupational Medicine. The h-index was used as an index of both output and quality of overall output of researchers, disciplines, journals, and countries. Italian scientific output in the Public, Environmental & Occupational Health subject category (h-index = 62) was lower than almost the total of other medical disciplines and, at an international level, is ranked at 12th place (other disciplines ranked 3rd to 9th). Output was 32% compared to that of the USA (other disciplines ranged from 42% and 61%). However, it should be noted that most scientific papers of Occupational Medicine researchers are published mainly in journals of different disciplines (with a higher IF) rather than in journals of Public, Environmental & Occupational Health (with a lower IF). Assuming that selection committees' decisions will be guided by metrics and will respect the minimum standard proposed by CUN, Occupational Medicine researchers aiming at academic promotion will have good reason to ask themselves not only which journals are most useful but also which journals have the greatest impact. This fact could have profound implications for the future of the discipline.

Leadership Primer for Current and Aspiring Pulmonary, Critical Care, and Sleep Medicine Academic Division Chiefs.

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Nguyen, H Bryant; Thomson, Carey C; Kaminski, Naftali; Schnapp, Lynn M; Madison, J Mark; Glenny, Robb W; Dixon, Anne E

2018-02-27

An academic medical career traditionally revolves around patient care, teaching, and scholarly projects. Thus, when an opportunity for a leadership role arises, such as Division Chief, the new leader is often unprepared with little or no formal leadership training. In this article, academic leaders of the Association of Pulmonary, Critical Care and Sleep Division Directors reviewed several leadership concepts adapted from the business sector and applied years of their experience to aid new division chiefs with their first day on the job. The first 90 days are highlighted to include accomplishing the early wins, performing a division Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, establishing division rapport, redefining the division infrastructure, avoiding conflicts, and managing their relationship with the department chair. The five levels of leadership applicable to academic medicine are discussed: position, permission, production, people, and pinnacle. Finally, emotional intelligence and behavior styles crucial to leadership success are reviewed.

The culture of academic medicine: faculty perceptions of the lack of alignment between individual and institutional values.

Science.gov (United States)

Pololi, Linda; Kern, David E; Carr, Phyllis; Conrad, Peter; Knight, Sharon

2009-12-01

Energized, talented faculty are essential to achieving the missions of academic medical centers (AMCs) in education, research and health care. The alignment of individuals' values with workplace experiences are linked to meaningfulness of work and productivity. To determine faculty values and their alignment with institutional values. A qualitative hypothesis-generating interview study to understand the professional experiences of faculty and organizational approach in five AMCs that were nationally representative in regional and organizational characteristics. Analysis was inductive and data driven. Using stratified, purposeful sampling, we interviewed 96 male and female faculty at different career stages (early career, plateaued, senior faculty and those who had left academic medicine) and diverse specialties (generalists, medical and surgical subspecialists, and research scientists). Dominant themes that emerged from the data. Faculty described values relating to excellence in clinical care, community service (including care for the underserved and disadvantaged), teaching, intellectual rigor/freedom and discovery, all values that mirror the stated missions of AMCs. However, many faculty also described behaviors that led them to conclude that their AMCs, in practice, undervalued excellence in clinical care, and their social and educational missions. Themes were seen across gender, career stage, race and discipline, except that female leaders appeared more likely than male leaders to identify incongruence of individual values and organizational practices. In this study of five diverse medical schools, faculty values were well aligned with stated institutional missions; however, many perceived that institutional behaviors were not always aligned with individual faculty values.

[The importance of teamwork in emergency medicine training].

Science.gov (United States)

Vermeulen, B; Carron, P-N

2007-08-15

The study of dynamics in relation to performing in small groups has increased pedagogic knowledge about teamwork. The successful management of patients with life-threatening pathologies depends highly from a succession of teams with a specific mission as: the call centre 144, Paramedics, the ED, the Operating Theatre and the Intensive care. To enable each team to operate successfully, it is essential to coordinate their qualifications and synergism. This can be efficiently attained by simulating real situations and by following protocols dedicated to teamwork. Emergency Medicine, which is on the brink of acquiring its proper curriculum, must adopt this concept to integrate knowledge and know-how, and the art of being and doing. At this stage, the Emergency Physician will have the competence which will enable him to be a real "team leader".

Full-text publication of abstracts in emergency medicine in Denmark.

Science.gov (United States)

Ravn, Anne Katrine; Petersen, Dan Brun; Folkestad, Lars; Hallas, Peter; Brabrand, Mikkel

2014-05-24

Abstracts presented at medical conferences or scientific meetings should ideally be published as full-text articles in peer-reviewed journals after initial presentation and feedback regardless of the findings. The aim of this survey was to determine the publication rate of papers presented at the Danish Emergency Medicine Conferences in 2009, 2010 and 2011. Abstracts presented at the conferences were identified and authors contacted to obtain publication information. A further search was conducted using relevant databases. Publication rates for the 2009 and 2010 were approximately 30% (25-31.6%). The publication rate for the 2011 conference was 14.5% within 18 months with an additional 9% under review prior to publication. When comparing full-text publication rates from DEMC to previous international studies in EM Danish EM research community has similar publication rates. However, other more established specialties have higher publication levels. Knowledge of reasons for non-publication could lead to efforts to promote publication like funding; the possibility of discussion between authors and editors at conferences; "publication mentors"; and/or research courses provided by the Danish Society of Emergency Medicine.

Creation and implementation of an emergency medicine education and training program in Turkey: an effective educational intervention to address the practitioner gap.

Science.gov (United States)

Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby

2013-07-22

The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. To address this "practitioner gap," the authors developed a four-phase comprehensive emergency medicine education and training program for general practitioners practicing in government hospitals in Turkey. From April 2006 until June 2009, 42 courses were taught by 62 trainers across seven regions in Turkey. A total of 2,262 physicians were trained. The mean course pre-test score for all regions was 42.3 (95% CI 39.8 to 44.7). The mean course post-test score was 70.1 (95% CI 67.2 to 72.9). The difference between the mean scores was 27.8 (95% CI 25.3 to 30.4, P emergency medicine department and an emergency medicine society to implement country-wide training of physicians practicing in public emergency departments can serve as a successful model for capacity-building global emergency medicine endeavors.

Moving global health forward in academic institutions

Directory of Open Access Journals (Sweden)

Didier Wernli

2016-06-01

Full Text Available Global health has attracted growing attention from academic institutions. Its emergence corresponds to the increasing interdependence that characterizes our time and provides a new worldview to address health challenges globally. There is still a large potential to better delineate the limits of the field, drawing on a wide perspective across sciences and geographical areas. As an implementation and integration science, academic global health aims primarily to respond to societal needs through research, education, and practice. From five academic institutions closely engaged with international Geneva, we propose here a definition of global health based on six core principles: 1 cross–border/multilevel approach, 2 inter–/trans–disciplinarity, 3 systems thinking, 4 innovation, 5 sustainability, and 6 human rights/equity. This definition aims to reduce the century–old divide between medicine and public health while extending our perspective to other highly relevant fields. Overall, this article provides an intellectual framework to improve health for all in our contemporary world with implications for academic institutions and science policy.

Evaluation of a point-of-care ultrasound scan list in a resource-limited emergency centre in Addis Ababa Ethiopia

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Maja Stachura

2017-09-01

Discussion: In this urban, low-resource, academic EC in Ethiopia, POCUS provided clinically relevant information for patient management, particularly for polytrauma, undifferentiated shock and undifferentiated dyspnea. Results have subsequently been used to develop a locally relevant emergency department ultrasound curriculum for Ethiopia’s first emergency medicine residency program.

Developing emergency medical dispatch systems in Africa – Recommendations of the African Federation for Emergency Medicine/International Academies of Emergency Dispatch Working Group

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Nee-Kofi Mould-Millman

2015-09-01

To facilitate the development of EMD systems appropriate for the African setting, the African Federation for Emergency Medicine (AFEM and the International Academies of Emergency Dispatch (IAED convened a working group in November 2014 to provide conceptual, technical, and innovative recommendations for contextually appropriate EMD systems for African settings. It is hoped that these recommendations will augment efficiency, effectiveness, and standardisation within and among African EMD systems, thereby improving health outcomes for sufferers of acute illness or injury.

Strategies for coping with stress in emergency medicine: Early education is vital

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Gillian R Schmitz

2012-01-01

Full Text Available Introduction: Physician burnout has received considerable attention in the literature and impacts a large number of emergency medicine physicians, but there is no standardized curriculum for wellness in resident education. A culture change is needed to educate about wellness, adopt a preventative and proactive approach, and focus on resiliency. Discussion: We describe a novel approach to wellness education by focusing on resiliency rather than the unintended endpoint of physician burnout. One barrier to adoption of wellness education has been establishing legitimacy among emergency medicine (EM residents and educators. We discuss a change in the language of wellness education and provide several specific topics to facilitate the incorporation of these topics in resident education. Conclusion: Wellness education and a culture of training that promotes well-being will benefit EM residents. Demonstrating the impact of several factors that positively affect emergency physicians may help to facilitate alert residents to the importance of practicing activities that will result in wellness. A change in culture and focus on resiliency is needed to adequately address and optimize physician self-care.

[Current emergency medicine for neurological disorders in children].

Science.gov (United States)

Osamura, Toshio

2010-01-01

In 2006, the number of pediatric outpatients consulting our hospital during non-practice hours increased by 218.1% of that in 1996. The number of pediatric inpatients during non-practice hours in 2006 increased by 71.3% of that in 1996. In 2006, the number of patients who were admitted with neurological disorders in children during non-practice hours increased to 213.3% of that in 1996. The proportion of these pediatric patients among those who were admitted during non-practice hours was 16.6% in our hospital, suggesting the importance of neurological disorders in pediatric emergency medicine. More than 60% of inpatients with neurological disorders in children were 3 years old or younger. The most common neurological symptoms observed at admission included convulsion (81.6%) and disturbance of consciousness (8.5%). The disorders were mainly febrile seizure (41.4%) and epilepsy (29.0%). Most patients with severe disorders requiring emergency medicine, such as head bruise, acute encephalitis/encephalopathy, purulent meningitis, and head trauma, were admitted during non-practice hours. The prognoses of most neurological disorders in children were favorable. However, patients with sequelae (especially, hypoxic encephalopathy, acute encephalitis/encephalopathy) showed an unfavorable neurological prognosis. Early rehabilitation during admission was useful as a support method for their families. In the future, a comprehensive rehabilitation program for children with acquired brain injury should be established and laws to promote home care must be passed.

Dimensionality of Helicopter Parenting and Relations to Emotional, Decision-Making, and Academic Functioning in Emerging Adults.

Science.gov (United States)

Luebbe, Aaron M; Mancini, Kathryn J; Kiel, Elizabeth J; Spangler, Brooke R; Semlak, Julie L; Fussner, Lauren M

2016-08-24

The current study tests the underlying structure of a multidimensional construct of helicopter parenting (HP), assesses reliability of the construct, replicates past relations of HP to poor emotional functioning, and expands the literature to investigate links of HP to emerging adults' decision-making and academic functioning. A sample of 377 emerging adults (66% female; ages 17-30; 88% European American) were administered several items assessing HP as well as measures of other parenting behaviors, depression, anxiety, decision-making style, grade point average, and academic functioning. Exploratory factor analysis results suggested a four-factor, 23-item measure that encompassed varying levels of parental involvement in the personal and professional lives of their children. A bifactor model was also fit to the data and suggested the presence of a reliable overarching HP factor in addition to three reliable subfactors. The fourth subfactor was not reliable and item variances were subsumed by the general HP factor. HP was found to be distinct from, but correlated in expected ways with, other reports of parenting behavior. HP was also associated with poorer functioning in emotional functioning, decision making, and academic functioning. Parents' information-seeking behaviors, when done in absences of other HP behaviors, were associated with better decision making and academic functioning. © The Author(s) 2016.

The academic quilting bee.

Science.gov (United States)

Mayer, Anita P; Files, Julia A; Ko, Marcia G; Blair, Janis E

2009-03-01

In medicine, the challenges faced by female faculty members who are attempting to achieve academic advancement have been well described. Various strategies have been proposed to increase academic productivity to aid the promotion of women in medicine. We propose an innovative collaboration strategy that encourages completion of an academic writing project. This strategy acknowledges the challenges inherent in achieving work-life balance and utilizes a collaborative work style with a group of peer physicians. The model is designed to encourage the completion and collation of independently prepared sections of an academic paper within a setting that emphasizes social networking and collaboration. This approach has many similarities to the construction of a quilt during a "quilting bee."

Creation and implementation of an emergency medicine education and training program in Turkey: an effective educational intervention to address the practitioner gap

OpenAIRE

Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby

2013-01-01

Background The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. Methods To address this ?practitioner gap,? the authors developed a four-phase comprehensive emergency medicine education and training program for gen...

Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Gastrointestinal Emergencies Small Group Module

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Andrew King

2017-01-01

Full Text Available Audience and type of curriculum: This curriculum created and implemented at The Ohio State University Wexner Medical Center was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction/Background: Gastrointestinal (GI emergencies comprise approximately 12% of emergency department (ED visits.1 Residents must be proficient in the differential diagnosis and management of the wide variety of GI emergencies. The flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.4-6 The Ohio State University EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. This proposed curriculum utilizes an 18-month curricular cycle. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of GI emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. In doing so, a goal of the curriculum is to encourage self

Impact of night shifts on emergency medicine resident resuscitation performance.

Science.gov (United States)

Edgerley, Sarah; McKaigney, Conor; Boyne, Devon; Ginsberg, Darrell; Dagnone, J Damon; Hall, Andrew K

2018-03-12

Emergency medicine (EM) trainees often work nightshifts. We sought to measure how this circadian disruption affects EM resident performance during simulated resuscitations. 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). Primary and secondary exposures of interest were the presence of a nightshift (late-evening shifts ending between midnight and 03h00 or overnight shifts ending after 06h00) the day before or within three days before an OSCE. A random effects linear regression model was used to quantify the association between nightshifts and OSCE scores. From 57 residents, 136 OSCE scores were collected. Working a nightshift the day before an OSCE did not affect male trainee scores but was associated with a significant absolute decrease in mean total scores (-6% [95% CI -12% to 0%]), GAS (-7% [-13% to 0%]), and communication (-9% [-16% to -2%]) scores among women. Working any nightshift within three days before an OSCE lowered absolute mean total scores by 4% [-7% to 0%] and communication scores by 5% [-5% to 0%] irrespective of gender. Our results suggest that shift work may impact EM resident resuscitation performance, particularly in the communication domain. This impact may be more significant in women than men, suggesting a need for further investigation. Copyright © 2018 Elsevier B.V. All rights reserved.

Barriers towards the publication of academic drug trials. Follow-up of trials approved by the Danish Medicines Agency.

Science.gov (United States)

Berendt, Louise; Petersen, Lene Grejs; Bach, Karin Friis; Poulsen, Henrik Enghusen; Dalhoff, Kim

2017-01-01

To characterize and quantify barriers towards the publication of academic drug trials. We identified academic drug trials approved during a 3-year period (2004-2007) by the Danish Medicines Agency. We conducted a survey among the trial sponsors to describe the rates of initiation, completion, and publication, and the reasons for the failure to reach each of these milestones. Information on size and methodological characteristics of the trials was extracted from the EudraCT database, a prospective register of all approved clinical drug trials submitted to European medicines agencies since 2004. A total of 181 academic drug trials were eligible for inclusion, 139 of which participated in our survey (response rate: 77%). Follow-up time ranged from 5.1 to 7.9 years. Most trials were randomized controlled trials (73%, 95% CI 65-81%). Initiation and completion rates were 92% (95% CI: 88-97%) and 93% (95% CI: 89-97%) respectively. The publication rate of completed trials was 73% (95% CI: 62-79%). RCTs were published faster than non-RCTs (quartile time to publication 2.9 vs. 3.1 years, p = 0.0412). Many academic drug trials are left unpublished. Main barriers towards publication were related to the process from completion to publication. Hence, there is much to gain by facilitating the process from analysis to publication. Research institutions and funders should actively influence this process, e.g. by requiring the publication of trial results within a given time after completion.

The British Columbia Emergency Medicine Network: A Paradigm Shift in a Provincial System of Emergency Care.

Science.gov (United States)

Abu-Laban, Riyad B; Drebit, Sharla; Lindstrom, Ronald R; Archibald, Chantel; Eggers, Kim; Ho, Kendall; Khazei, Afshin; Lund, Adam; MacKinnon, Carolyn; Markham, Ray; Marsden, Julian; Martin, Ed; Christenson, Jim

2018-01-04

As generalists, emergency practitioners face challenges in providing state-of-the-art care owing to the broad spectrum of practice and the rapid rate of new knowledge generation. Networks have become increasingly prevalent in health care, and it was in this backdrop, and the resulting opportunity to advance evidence-informed emergency care in the Canadian province of British Columbia (BC), that a new "Emergency Medicine Network" (EM Network) was launched in 2017. The EM Network consists of four programs, each led by a physician with expertise and a track record in the domain: (1) Clinical Resources; (2) Innovation; (3) Continuing Professional Development; and (4) Real-time Support. This paper provides an overview of the EM Network, including its background, purpose, programs, anticipated evolution, and impact on the BC health care system.

How Do Emergency Medicine Residency Programs Structure Their Clinical Competency Committees? A Survey.

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Doty, Christopher I; Roppolo, Lynn P; Asher, Shellie; Seamon, Jason P; Bhat, Rahul; Taft, Stephanie; Graham, Autumn; Willis, James

2015-11-01

and function suggest that there are myriad strategies that residency programs can use to match individual program needs and resources to requirements of the ACGME. Identifying a single protocol for CCC structure and development may prove challenging. © 2015 by the Society for Academic Emergency Medicine.

Assessment of academic/non-academic factors and extracurricular activities influencing performance of medical students of faculty of medicine, Universiti Sultan Zainal Abidin, Malaysia

Directory of Open Access Journals (Sweden)

Mainul Haque

2018-01-01

Full Text Available Background: Physical and mental comfort is known to have a crucial influence on health and performance amongst medical students. Very often, medical students suffer from poor quality of life (QOL related to the work-life balance due to the lack of sleep, nutritional and dietary disorders and low physical activity, resulting in a negative impact on their academic performance. This study aims to determine the potential academic/non-academic factors and extra-curricular activities influencing the performance of medical students in Universiti Sultan Zainal Abidin (UniSZA. Materials and Methods: This was a cross-sectional study conducted on medical students at the Faculty of Medicine, UniSZA, Terengganu, Malaysia. A sample size of 300 respondents were recruited from Year I to V medical students. The questionnaire was adopted, modified and validated from a similar study in Saudi Arabia. Results: Majority of the students enjoy medical education are self-motivated, have a good command of English, non-smokers and have a sufficient sleep. Conclusion: University medical students possess good QOL within the optimum educational environment.

Sexual Assault Training in Emergency Medicine Residencies: A Survey of Program Directors

Directory of Open Access Journals (Sweden)

Margaret K Sande

2013-09-01

Full Text Available Introduction: There is currently no standard forensic medicine training program for emergency medicine residents. In the advent of sexual assault nurse examiner (SANE programs aimed at improving the quality of care for sexual assault victims, it is also unclear how these programs impact emergency medicine (EM resident forensic medicine training. The purpose of this study was togather information on EM residency programs’ training in the care of sexual assault patients and determine what impact SANE programs may have on the experience of EM resident training from the perspective of residency program directors (PDs.Methods: This was a cross-sectional survey. The study cohort was all residency PDs from approved EM residency training programs who completed a closed-response self-administered survey electronically.Results: We sent surveys to 152 PDs, and 71 responded for an overall response rate of 47%. Twenty-two PDs (31% reported that their residency does not require procedural competency for the sexual assault exam, and 29 (41% reported their residents are required only to observe sexual assault exam completion to demonstrate competency. Residency PDs were asked how their programs established resident requirements for sexual assault exams. Thirty-seven PDs (52% did not know how their sexual assault exam requirement was established.Conclusion: More than half of residency PDs did not know how their sexual assault guidelines were established, and few were based upon recommendations from the literature. There is no clear consensus as to how PDs view the effect of SANE programs on resident competency with the sexual assault exam. This study highlights both a need for increased awareness of EM resident sexual assault education nationally and also a possible need for a training curriculum defining guidelines forEM residents performing sexual assault exams. [West J Emerg Med. 2013;14(5:461–466.

Academic medical centers as innovation ecosystems to address population -omics challenges in precision medicine.

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Silva, Patrick J; Schaibley, Valerie M; Ramos, Kenneth S

2018-02-15

While the promise of the Human Genome Project provided significant insights into the structure of the human genome, the complexities of disease at the individual level have made it difficult to utilize -omic information in clinical decision making. Some of the existing constraints have been minimized by technological advancements that have reduced the cost of sequencing to a rate far in excess of Moore's Law (a halving in cost per unit output every 18 months). The reduction in sequencing costs has made it economically feasible to create large data commons capturing the diversity of disease across populations. Until recently, these data have primarily been consumed in clinical research, but now increasingly being considered in clinical decision- making. Such advances are disrupting common diagnostic business models around which academic medical centers (AMCs) and molecular diagnostic companies have collaborated over the last decade. Proprietary biomarkers and patents on proprietary diagnostic content are no longer driving biomarker collaborations between industry and AMCs. Increasingly the scope of the data commons and biorepositories that AMCs can assemble through a nexus of academic and pharma collaborations is driving a virtuous cycle of precision medicine capabilities that make an AMC relevant and highly competitive. A rebalancing of proprietary strategies and open innovation strategies is warranted to enable institutional precision medicine asset portfolios. The scope of the AMC's clinical trial and research collaboration portfolios with industry are increasingly dependent on the currency of data, and less on patents. Intrapeneurial support of internal service offerings, clinical trials and clinical laboratory services for example, will be important new points of emphasis at the academic-industry interface. Streamlining these new models of industry collaboration for AMCs are a new area for technology transfer offices to offer partnerships and to add value

Gender and academic medicine: a good pipeline of women graduates is not advancing.

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Puljak, Livia; Kojundzic, Sanja Lovric; Sapunar, Damir

2008-01-01

Women are underrepresented in the higher levels of appointment in academic medicine, despite the so-called feminization of medicine. A 27-year (1979-2006) retrospective study was conducted regarding the success and advancement of women and men at the University of Split School of Medicine in Croatia. Data were collected from the school's archive, including number of women and men among applicants, enrollees, graduates, teachers, department chairs and the school management: high school grade averages and admission tests scores by applicant gender and gender-based graduation grade averages. The number and gender patterns of all employed and unemployed physicians in the Split-Dalmatia county were also collected. Men represent the minority among applicants, enrollees, and graduates, whereas women were in the minority among faculty, department chairs, and the school management across all 27 years. Graduation grades from high school and medical school showed that women were statistically better students, although the difference was slight. In the same geographic area, women are more often unemployed and less likely to specialize. More women are applying, enrolling and graduating from the University of Split School of Medicine. Women also perform statistically better on entrance exam and have better graduation grades, yet they remain a minority in faculty and leadership positions. A review of county-wise employment statistics revealed that women were more frequently unemployed and less likely to specialize in this study.

The academic health center in complex humanitarian emergencies: lessons learned from the 2010 Haiti earthquake.

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Babcock, Christine; Theodosis, Christian; Bills, Corey; Kim, Jimin; Kinet, Melodie; Turner, Madeleine; Millis, Michael; Olopade, Olufunmilayo; Olopade, Christopher

2012-11-01

On January 12, 2010, a 7.0-magnitude earthquake struck Haiti. The event disrupted infrastructure and was marked by extreme morbidity and mortality. The global response to the disaster was rapid and immense, comprising multiple actors-including academic health centers (AHCs)-that provided assistance in the field and from home. The authors retrospectively examine the multidisciplinary approach that the University of Chicago Medicine (UCM) applied to postearthquake Haiti, which included the application of institutional structure and strategy, systematic deployment of teams tailored to evolving needs, and the actual response and recovery. The university mobilized significant human and material resources for deployment within 48 hours and sustained the effort for over four months. In partnership with international and local nongovernmental organizations as well as other AHCs, the UCM operated one of the largest and more efficient acute field hospitals in the country. The UCM's efforts in postearthquake Haiti provide insight into the role AHCs can play, including their strengths and limitations, in complex disasters. AHCs can provide necessary intellectual and material resources as well as technical expertise, but the cost and speed required for responding to an emergency, and ongoing domestic responsibilities, may limit the response of a large university and hospital system. The authors describe the strong institutional backing, the detailed predeployment planning and logistical support UCM provided, the engagement of faculty and staff who had previous experience in complex humanitarian emergencies, and the help of volunteers fluent in the local language which, together, made UCM's mission in postearthquake Haiti successful.

The imperative for emergency medicine to create its own alternative payment model.

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Medford-Davis, Laura N

2017-06-01

Seven years after the Affordable Care Act legislated Alternative Payment Models, it is time for Emergency Medicine to find its place within this value-based trend by developing its own Alternative Payment Model. Copyright © 2017 Elsevier Inc. All rights reserved.

Results of an academic promotion and career path survey of faculty at the Johns Hopkins University School of Medicine.

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Thomas, Patricia A; Diener-West, Marie; Canto, Marcia I; Martin, Don R; Post, Wendy S; Streiff, Michael B

2004-03-01

Clinician-educator faculty are increasing in numbers in academic medical centers, but their academic advancement is slower than that of research faculty. The authors sought to quantify the magnitude of this difference in career advancement and to explore the characteristics of faculty that might explain the difference. In 1999, a questionnaire was administered to all MD faculty at the rank of instructor and above (259) in the Department of Medicine at the Johns Hopkins University School of Medicine. A total of 180 (69%) faculty returned questionnaires. Of these, 178 identified with one of four career paths: basic researcher (46), clinical researcher (69), academic clinician (38), or teacher-clinician (25). Career path did not differ by age, gender, rank, years on faculty, hours worked per week, family responsibility, or global work satisfaction. After adjusting for age, gender, time at rank, and work satisfaction, the odds of being at a higher rank were 85% less for academic clinicians (odds ratio,.15; 95% confidence interval, 0.06-0.40) and 69% less for teacher-clinicians (odds ratio,.31; 95% confidence interval, 0.11-0.88) than for basic researchers. Clinical researchers did not differ from basic researchers in the likelihood of being at higher rank. Similarly, compared with basic research faculty, the adjusted odds of being more satisfied with progress towards academic promotion were 92% lower for academic clinicians and 87% lower for teacher-clinicians. Clinician-educator faculty were less likely to be at higher rank at this institution than were faculty in research paths. Differences in rank may be explained by lower rank at hire for faculty in these career paths, time available for scholarly activities, or other resources available to support scholarship. Retaining clinician-educators will require further exploration of barriers to promotion inherent to these career paths and methods of modifying these barriers.

On a Work Expected to the Department of Emergency and Critical Care Medicine and the Emergency Unit of the Niigata University Hospital

OpenAIRE

小山, 真; Koyama, Shin

2001-01-01

The author would like to celebrate the start of the Department of emergency and critical care medicine and the Emergency unit of the Niigata University Hospital. The author also wishes to express his opinion, which is mentioned below, on preparing the Department and the Emergency unit for their future activity. 1 . The stuff members of the Department are expected to instruct undergraduate students in the knowledge and technique of Triage and the first aid in emergency exactly. 2 . The Emergen...

Web technology for emergency medicine and secure transmission of electronic patient records.

Science.gov (United States)

Halamka, J D

1998-01-01

The American Heritage dictionary defines the word "web" as "something intricately contrived, especially something that ensnares or entangles." The wealth of medical resources on the World Wide Web is now so extensive, yet disorganized and unmonitored, that such a definition seems fitting. In emergency medicine, for example, a field in which accurate and complete information, including patients' records, is urgently needed, more than 5000 Web pages are available today, whereas fewer than 50 were available in December 1994. Most sites are static Web pages using the Internet to publish textbook material, but new technology is extending the scope of the Internet to include online medical education and secure exchange of clinical information. This article lists some of the best Web sites for use in emergency medicine and then describes a project in which the Web is used for transmission and protection of electronic medical records.

A Simulation-based Approach to Measuring Team Situational Awareness in Emergency Medicine: A Multicenter, Observational Study.

Science.gov (United States)

Rosenman, Elizabeth D; Dixon, Aurora J; Webb, Jessica M; Brolliar, Sarah; Golden, Simon J; Jones, Kerin A; Shah, Sachita; Grand, James A; Kozlowski, Steve W J; Chao, Georgia T; Fernandez, Rosemarie

2018-02-01

teams). All teams completed the assessment scenario and postsimulation measures. TSA agreement ranged from 0.19 to 0.9 and had a mean (±SD) of 0.61 (±0.17). TSA correlated with team clinical performance (p team perception of shared understanding, team leader effectiveness, or team experience. Team situational awareness supports adaptive teams and is critical for high reliability organizations such as healthcare systems. Simulation can provide a platform for research aimed at understanding and measuring TSA. This study provides a feasible method for simulation-based assessment of TSA in interdisciplinary teams that addresses prior measure limitations and is appropriate for use in highly dynamic, uncertain situations commonly encountered in emergency department systems. Future research is needed to understand the development of and interactions between individual-, team-, and system (distributed)-level cognitive processes. © 2017 by the Society for Academic Emergency Medicine.

Development of experts for radiation emergency medicine. An experience at the National Institute of Radiological Sciences

International Nuclear Information System (INIS)

Tatsuzaki, H.; Hachiya, M.

2016-01-01

The National Institute of Radiological Sciences has been conducting many training courses on radiation emergency medicine, both for Japanese and foreigners. Medical professionals working in hospitals and first responders who deal with victims have been main participants of these courses for Japanese. Typically, these courses include table top exercises and/or practical drills, which give unique features to our courses, in addition to lectures. Apart from training courses, some medical professionals came to work as a staff member of NIRS for a long term, such as two years, to learn about radiation emergency medicine. Some foreigners also stayed in NIRS as short to middle term visitors to learn about the fields. Courses for foreigners were organized sometimes in cooperation with international organizations. Participants were mainly from Asian countries, and some courses targeted one country. For example, courses for Korean professionals were organized nine times. The NIRS will continue to contribute to human development in radiation emergency medicine with training courses and other methods of education. (author)

Can You Multitask? Evidence and Limitations of Task Switching and Multitasking in Emergency Medicine.

Science.gov (United States)

Skaugset, L Melissa; Farrell, Susan; Carney, Michele; Wolff, Margaret; Santen, Sally A; Perry, Marcia; Cico, Stephen John

2016-08-01

Emergency physicians work in a fast-paced environment that is characterized by frequent interruptions and the expectation that they will perform multiple tasks efficiently and without error while maintaining oversight of the entire emergency department. However, there is a lack of definition and understanding of the behaviors that constitute effective task switching and multitasking, as well as how to improve these skills. This article reviews the literature on task switching and multitasking in a variety of disciplines-including cognitive science, human factors engineering, business, and medicine-to define and describe the successful performance of task switching and multitasking in emergency medicine. Multitasking, defined as the performance of two tasks simultaneously, is not possible except when behaviors become completely automatic; instead, physicians rapidly switch between small tasks. This task switching causes disruption in the primary task and may contribute to error. A framework is described to enhance the understanding and practice of these behaviors. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Emergency medicine educational resource use in Cape Town: modern or traditional?

Science.gov (United States)

Kleynhans, A C; Oosthuizen, A H; van Hoving, D J

2017-05-01

The integration of online resources and social media into higher education and continued professional development is an increasingly common phenomenon. To describe the usage of various traditional and modern educational resources by members of the divisions of emergency medicine at Stellenbosch University and the University of Cape Town. Members affiliated with the divisions during 2014 were invited to participate in an online survey. Participants were given 8 weeks to complete the questionnaire; with weekly reminders until they responded or the deadline expired. Summary statistics were used to describe the variables. Eighty-seven divisional members completed the survey (69.6% response rate). The resources most preferred were textbooks (n=78, 89.7%), open access educational resources (n=77, 88.5%) and journals (n=76, 87.4%). Emergency medicine trainees (n=31, 92.1%) and respondents ≤30 years (n=17, 94.4%) were more inclined to use social media. International Emergency Medicine and Critical Care blogs are frequently being used by 71% of respondents. YouTube (35%) and podcasts (21%) were the most commonly used multimedia resources. Computers (desktop and laptop) were most frequently used to access educational resources except for social media where smart phones were preferred. The use of modern and electronic resources is relatively common, but traditional educational resources are still preferred. This study illustrates an opportunity for greater integration of online resources and social media in educational activities to enhance multimodal and self-directed learning. Specific training in the use of these resources and how to appraise them may further improve their utility. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Approach to Acute Headache: A Flipped Classroom Module for Emergency Medicine Trainees

Directory of Open Access Journals (Sweden)

Jeff Riddell

2016-07-01

Full Text Available Audience: This module is designed for emergency medicine trainees. Though it focuses on those early in their career (medical students and junior residents, it is applicable to all emergency medicine learners. Introduction: In the United States, headache is the fifth most-common primary complaint of patients presenting to the emergency department and can be the primary symptomatic manifestation of many life-threatening illnesses. The emergency physician plays a unique role in diagnosing and managing these patients. The emergency physician’s two major responsibilities are to relieve headache pain and to ensure that life-threatening causes are diagnosed and treated. Objectives: At the end of this module, the learner will be able to: 1 list the diagnoses critical to the emergency physician that may present with headache; 2 identify key historical and examination findings that help differentiate primary (benign from secondary (serious causes of headache; 3 discuss the indications for diagnostic imaging, lumbar puncture and laboratory testing in patients with headache; 4 recognize life-threatening diagnoses on CT imaging and CSF examination; 5 describe treatment strategies to relieve headache symptoms. Methods: This module includes a complete flipped classroom module. Learners are responsible for viewing a 20-minute video prior to the 30-minute small-group, case-based didactic discussion portion. The learners are assessed with multiple-choice question assessments, for low stakes retrieval practice or spaced practice. This could alternatively be run as a team-based learning session, with the pre- and post-tests used as an individual or group readiness assessment test, and the small group exercises converted to a group application exercise.

[Postdoctoral lecturer thesis in medicine: academic competence or career booster?].

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Sorg, H; Betzler, C; Grieswald, C; Schwab, C G G; Tilkorn, D J; Hauser, J

2016-06-01

The postdoctoral lecturer thesis in medicine represents an essential success factor for the career of a physician; however, there is controversial discussion on whether this reflects academic competence or is more a career booster. In this context we conducted a survey among postdoctoral medical lecturers with the aim to evaluate the significance of this qualification. The online survey was performed using a questionnaire requesting biographical parameters and subjective ratings of topics concerning the postdoctoral lecturer thesis. Overall 628 questionnaires were included in the study. The significance of the postdoctoral qualification was rated high in 68.6 % and was seen to be necessary for professional advancement in 71.0 %. The chances of obtaining a full professorship after achieving a postdoctoral qualification were rated moderate to low (68.1 %); nevertheless, 92.3 % would do it again and 86.5 % would recommend it to colleagues. Accordingly, 78.8 % were against its abolishment. Wishes for reforms included standardized federal regulations, reduced dependency on professors and more transparency. The postdoctoral lecturer qualification in medicine is highly valued and the majority of responders did not want it to be abolished. Although the chances for a full professorship were only rated low, successful graduation seems to be beneficial for the career; however, there is a need for substantial structural and international changes.

Evaluation of Social Media Use by Emergency Medicine Residents and Faculty.

Science.gov (United States)

Pearson, David; Bond, Michael C; Kegg, Jason; Pillow, Tyson; Hopson, Laura; Cooney, Robert; Garg, Manish; Khadpe, Jay; Runyon, Michael; Patterson, Leigh

2015-09-01

Clinicians and residency programs are increasing their use of social media (SM) websites for educational and promotional uses, yet little is known about the use of these sites by residents and faculty. The objective of the study is to assess patterns of SM use for personal and professional purposes among emergency medicine (EM) residents and faculty. In this multi-site study, an 18-question survey was sent by e-mail to the residents and faculty in 14 EM programs and to the Council of Emergency Medicine Residency Directors (CORD) listserv via the online tool SurveyMonkey™. We compiled descriptive statistics, including assessment with the chi-square test or Fisher's exact test. StatsDirect software (v 2.8.0, StatsDirect, Cheshire, UK) was used for all analyses. We received 1,314 responses: 63% of respondents were male, 40% were respondents completed residency more than 10 years ago. Residents used SM markedly more than faculty for social interactions with family and friends (83% vs 65% [psocial media. Awareness of these utilization patterns could benefit future educational endeavors.

Do Emergency Physicians Educate Patients about the Dangers of Drinking and Driving after a Motor Vehicle Collision, and What Are the Barriers or Motivators to Do So?

Science.gov (United States)

Garnett, Meghan; Stewart, Tanya Charyk; Van Aarsen, Kristine; Millard, Wanda; Lim, Rodrick; Miller, Michael R.

2016-01-01

Introduction: Impaired driving is the leading cause of criminal death in Canada and results in numerous emergency department (ED) visits each year. Methods: An online survey was distributed to 94 emergency physicians and emergency medicine residents at an academic tertiary care hospital in Southwestern Ontario. Descriptive statistics were…

Entrepreneurship, Emerging Technologies, Emerging Markets

NARCIS (Netherlands)

Thukral, Inderpreet S.; Von Ehr, James; Walsh, Steven Thomas; Groen, Arend J.; van der Sijde, Peter; Adham, Khairul Akmaliah

2008-01-01

Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies

The current status and reinforcement plan for radiation emergency medicine in Korea

International Nuclear Information System (INIS)

Kim, Hyun Ki; Lee, Youngmin; Lee, Jai Ki

2011-01-01

Korea operating twenty nuclear power plants was ranked 6th in nuclear power generation in the world. The potential risk for radiological emergency also increases along with the growing use of radiation and radioisotopes and a constant expansion of the nuclear industry in neighboring countries, Japan and China. This paper is intended for finding ways to strengthen medical planning and response preparedness from achievements in radiation emergency medicine over the years. 'Integrated Medical Preparedness System' for a radiological disaster is proposed as a practical way to enhance mobilization of existing human and material resources in the health care. It is based on the collaborative response among the related medical institutes : radiation emergency medical institutes around the Korean Institute of Radiological and Medical Sciences, emergency medical centers around the National Emergency Medical Center and other hospitals available. (author)

Clinical audit of emergency unit before and after establishment of the emergency medicine department.

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Amini, Afshin; Dindoost, Payam; Moghimi, Mehrdad; Kariman, Hamid; Shahrami, Ali; Dolatabadi, Ali Arhami; Ali-Mohammadi, Hossein; Alavai-Moghaddam, Mostafa; Derakhshanfar, Hojjat; Hatamabadi, HamidReza; Heidari, Kamran; Alamdari, Shahram; Meibodi, Mohammad Kalantar; Shojaee, Majid; Foroozanfar, Mohammad Mehdi; Hashemi, Behrooz; Sabzeghaba, Anita; Kabir, Ali

2012-02-01

To assess the deficiencies and potential areas through a medical audit of the emergency departments, in six general hospitals affiliated to Shahid Beheshti University of Medical Sciences at Tehran, Iran, after preparing specific wards-based international standards. A checklist was completed for all hospitals which met our eligibility criteria mainly observation and interviews with head nurses and managers of the emergency medicine unit of the hospitals before (2003) and after (2008) the establishment of emergency departments there. Domains studied included staffing, education and continuing professional development (CPD), facility (design), equipment, ancillary services, medical records, manuals and references, research, administration, pre-hospital care, information systems, disaster planning, bench-marking and hospital accreditation. Education and CPD (p = 0.042), design and facility (p = 0.027), equipment (p = 0.028), and disaster (p = 0.026) had significantly improved after the establishment of emergency departments. Nearly all domains showed a positive change though it was non-significant in a few. In terms of observation, better improvement was seen in disaster, security, design, and research. According to the score for each domain compared to what it was in the earlier phase, better improvement was observed in hospital accreditation, information systems, security, disaster planning, and research. Security, disaster planning, research, design and facility had improved in hospitals that wave studied, while equipment, records, ancillary services, administration and bench-marking had the lowest improvement even after the establishment of emergency department, and, hence, needed specific attention.

[Alternative medicine: really an alternative to academic medicine?].

Science.gov (United States)

Happle, R

2000-06-01

Numerous courses on alternative medicine are regularly advertised in Deutsches Arzteblatt, the organ of the German Medical Association. The present German legislation likewise supports this form of medicine, and this explains why Iscador, an extract of the mistletoe, is found in the Rote Liste, a directory of commercially available medical drugs, under the heading "cytostatic and antimetastatic drugs" although such beneficial effect is unproven. To give another example, a German health insurance fund was sentenced to pay for acupuncture as a treatment for hepatic failure. This judgement is characteristic of the present German judicial system and represents a victory of "oracling irrationalism" (Popper). The astonishing popularity of alternative medicine can be explained by a revival of romanticism. An intellectually fair opposite position has been delineated by Karl Popper in the form of critical rationalism. It is important to realize, however, that our decision to adhere to rational thinking is made in the innermost depth of our heart but not on the basis of rational arguing. Rather, the decision in favor of reason has a moral dimension.

Hospitalist and Internal Medicine Leaders' Perspectives of Early Discharge Challenges at Academic Medical Centers.

Science.gov (United States)

Patel, Hemali; Fang, Margaret C; Mourad, Michelle; Green, Adrienne; Wachter, Robert M; Murphy, Ryan D; Harrison, James D

2018-06-01

Improving early discharges may improve patient flow and increase hospital capacity. We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness of early-discharge initiatives. We assembled a list of hospitalist and general internal medicine leaders at 115 US-based academic medical centers. We emailed each institutional representative a 30-item online survey regarding early-discharge initiatives. The survey included questions on discharge prioritization, the prevalence and effectiveness of early-discharge initiatives, and barriers to implementation. We received 61 responses from 115 institutions (53% response rate). Forty-seven (77%) "strongly agreed" or "agreed" that early discharge was a priority. "Discharge by noon" was the most cited goal (n = 23; 38%) followed by "no set time but overall goal for improvement" (n = 13; 21%). The majority of respondents reported early discharge as more important than obtaining translators for non-English-speaking patients and equally important as reducing 30-day readmissions and improving patient satisfaction. The most commonly reported factors delaying discharge were availability of postacute care beds (n = 48; 79%) and patient-related transport complications (n = 44; 72%). The most effective early discharge initiatives reported involved changes to the rounding process, such as preemptive identification and early preparation of discharge paperwork (n = 34; 56%) and communication with patients about anticipated discharge (n = 29; 48%). There is a strong interest in increasing early discharges in an effort to improve hospital throughput and patient flow. © 2017 Society of Hospital Medicine.

Why are a quarter of faculty considering leaving academic medicine? A study of their perceptions of institutional culture and intentions to leave at 26 representative U.S. medical schools.

Science.gov (United States)

Pololi, Linda H; Krupat, Edward; Civian, Janet T; Ash, Arlene S; Brennan, Robert T

2012-07-01

Vital, productive faculty are critical to academic medicine, yet studies indicate high dissatisfaction and attrition. The authors sought to identify key personal and cultural factors associated with intentions to leave one's institution and/or academic medicine. From 2007 through early 2009, the authors surveyed a stratified random sample of 4,578 full-time faculty from 26 representative U.S. medical schools. The survey asked about advancement, engagement, relationships, diversity and equity, leadership, institutional values and practices, and work-life integration. A two-level, multinomial logit model was used to predict leaving intentions. A total of 2,381 faculty responded (52%); 1,994 provided complete data for analysis. Of these, 1,062 (53%) were female and 475 (24%) were underrepresented minorities in medicine. Faculty valued their work, but 273 (14%) had seriously considered leaving their own institution during the prior year and 421 (21%) had considered leaving academic medicine altogether because of dissatisfaction; an additional 109 (5%) cited personal/family issues and 49 (2%) retirement as reasons to leave. Negative perceptions of the culture-unrelatedness, feeling moral distress at work, and lack of engagement-were associated with leaving for dissatisfaction. Other significant predictors were perceptions of values incongruence, low institutional support, and low self-efficacy. Institutional characteristics and personal variables (e.g., gender) were not predictive. Findings suggest that academic medicine does not support relatedness and a moral culture for many faculty. If these issues are not addressed, academic health centers may find themselves with dissatisfied faculty looking to go elsewhere.

Changing the Culture of Academic Medicine: Critical Mass or Critical Actors?

Science.gov (United States)

Helitzer, Deborah L; Newbill, Sharon L; Cardinali, Gina; Morahan, Page S; Chang, Shine; Magrane, Diane

2017-05-01

By 2006, women constituted 34% of academic medical faculty, reaching a critical mass. Theoretically, with critical mass, culture and policy supportive of gender equity should be evident. We explore whether having a critical mass of women transforms institutional culture and organizational change. Career development program participants were interviewed to elucidate their experiences in academic health centers (AHCs). Focus group discussions were held with institutional leaders to explore their perceptions about contemporary challenges related to gender and leadership. Content analysis of both data sources revealed points of convergence. Findings were interpreted using the theory of critical mass. Two nested domains emerged: the individual domain included the rewards and personal satisfaction of meaningful work, personal agency, tensions between cultural expectations of family and academic roles, and women's efforts to work for gender equity. The institutional domain depicted the sociocultural environment of AHCs that shaped women's experience, both personally and professionally, lack of institutional strategies to engage women in organizational initiatives, and the influence of one leader on women's ascent to leadership. The predominant evidence from this research demonstrates that the institutional barriers and sociocultural environment continue to be formidable obstacles confronting women, stalling the transformational effects expected from achieving a critical mass of women faculty. We conclude that the promise of critical mass as a turning point for women should be abandoned in favor of "critical actor" leaders, both women and men, who individually and collectively have the commitment and power to create gender-equitable cultures in AHCs.

Do emergency medicine journals promote trial registration and adherence to reporting guidelines? A survey of "Instructions for Authors".

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Sims, Matthew T; Henning, Nolan M; Wayant, C Cole; Vassar, Matt

2016-11-24

The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of emergency medicine journals. We performed a web-based data abstraction from the "Instructions for Authors" of the 27 Emergency Medicine journals catalogued in the Expanded Science Citation Index of the 2014 Journal Citation Reports and Google Scholar Metrics h5-index to identify whether each journal required, recommended, or made no mention of the following reporting guidelines: EQUATOR Network, ICMJE, ARRIVE, CARE, CONSORT, STARD, TRIPOD, CHEERS, MOOSE, STROBE, COREQ, SRQR, SQUIRE, PRISMA-P, SPIRIT, PRISMA, and QUOROM. We also extracted whether journals required or recommended trial registration. Authors were blinded to one another's ratings until completion of the data validation. Cross-tabulations and descriptive statistics were calculated using IBM SPSS 22. Of the 27 emergency medicine journals, 11 (11/27, 40.7%) did not mention a single guideline within their "Instructions for Authors," while the remaining 16 (16/27, 59.3%) mentioned one or more guidelines. The QUOROM statement and SRQR were not mentioned by any journals whereas the ICMJE guidelines (18/27, 66.7%) and CONSORT statement (15/27, 55.6%) were mentioned most often. Of the 27 emergency medicine journals, 15 (15/27, 55.6%) did not mention trial or review registration, while the remaining 12 (12/27, 44.4%) at least mentioned one of the two. Trial registration through ClinicalTrials.gov was mentioned by seven (7/27, 25.9%) journals while the WHO registry was mentioned by four (4/27, 14.8%). Twelve (12/27, 44.4%) journals mentioned trial registration through any registry platform. The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of

Increased ICU resource needs for an academic emergency general surgery service*.

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Lissauer, Matthew E; Galvagno, Samuel M; Rock, Peter; Narayan, Mayur; Shah, Paulesh; Spencer, Heather; Hong, Caron; Diaz, Jose J

2014-04-01

ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 ± 17.4 d) versus general surgery (8.7 ± 12.9), transplant (7.8 ± 11.6), oral-maxillofacial surgery (5.5 ± 4.2), and neurosurgery (4.47 ± 9.8) (all psurgery patients: acute care emergency surgery 73.4% versus general surgery 64.9%, transplant 63.3%, oral-maxillofacial surgery 58.4%, and neurosurgery 53.1% (all p surgery patients: acute care emergency surgery 10.8% versus general surgery 4.3%, transplant 6.6%, oral-maxillofacial surgery 0%, and neurosurgery 0.5% (all p surgery patients were more likely interhospital transfers for tertiary care services than general surgery or transplant (24.5% vs 15.5% and 8.3% respectively, p surgery (13.7% vs 6.7% and 3.5%, all p surgery and general surgery, whereas transplant had fewer. Emergency general surgery patients have increased ICU needs in terms of length of stay, ventilator usage, and continuous renal replacement therapy usage compared with other services, perhaps due to the higher percentage of transfers and emergent surgery required. These patients represent a distinct population. Understanding their resource needs

Factors influencing career progress for early stage clinician-scientists in emerging Asian academic medical centres: a qualitative study in Singapore

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Yoon, Sungwon; Koh, Woon-Puay; Ong, Marcus E H; Thumboo, Julian

2018-01-01

Objectives To explore the factors that influence career progress for early stage clinician-scientists and to identify ways to mitigate these factors in the context of emerging Asian academic medical centres (AMCs). Design Qualitative interviews and thematic data analysis based on grounded theory. Setting and participants Five focus group interviews comprising 29 early career clinician-scientists who have received their first national-level career development award in Singapore. Results Clinical priorities represented an overarching concern with many reporting the difficulty in delineating responsibilities between clinical care and research. Additionally, there was a prevailing perception of the lack of support for research at the institutional level. Participants tended to identify mentors through their own efforts in a relatively haphazard manner, often owing to the dearth of role models and perceived inadequacy of reward systems for mentoring. Support from mentors was thought to be limited in terms of targeted scientific guidance and long-term commitments to the relationship. Most of the participants expressed concerns about how they could secure the next level of funding with diminishing confidence. Notably, the work-life balance was neither conceptualised as a ‘barrier’ to successful pursuit of research career nor was it translated into the reason for leaving the dual clinical-research career pathway. Conclusions Results revealed specific limitations presented by the research environment in newly emerging Asian AMCs. To retain a vibrant clinician-scientist workforce, additional measures are needed, aiming to improve institutional culture of research, build mentoring networks, adopt effective tools for tracking career progress and provide a clear and viable career progression path for clinician-scientist. Further research might explore the cross-cultural differences in managing work-life balance in academic medicine. PMID:29502093

Factors influencing career progress for early stage clinician-scientists in emerging Asian academic medical centres: a qualitative study in Singapore.

Science.gov (United States)

Yoon, Sungwon; Koh, Woon-Puay; Ong, Marcus E H; Thumboo, Julian

2018-03-03

To explore the factors that influence career progress for early stage clinician-scientists and to identify ways to mitigate these factors in the context of emerging Asian academic medical centres (AMCs). Qualitative interviews and thematic data analysis based on grounded theory. Five focus group interviews comprising 29 early career clinician-scientists who have received their first national-level career development award in Singapore. Clinical priorities represented an overarching concern with many reporting the difficulty in delineating responsibilities between clinical care and research. Additionally, there was a prevailing perception of the lack of support for research at the institutional level. Participants tended to identify mentors through their own efforts in a relatively haphazard manner, often owing to the dearth of role models and perceived inadequacy of reward systems for mentoring. Support from mentors was thought to be limited in terms of targeted scientific guidance and long-term commitments to the relationship. Most of the participants expressed concerns about how they could secure the next level of funding with diminishing confidence. Notably, the work-life balance was neither conceptualised as a 'barrier' to successful pursuit of research career nor was it translated into the reason for leaving the dual clinical-research career pathway. Results revealed specific limitations presented by the research environment in newly emerging Asian AMCs. To retain a vibrant clinician-scientist workforce, additional measures are needed, aiming to improve institutional culture of research, build mentoring networks, adopt effective tools for tracking career progress and provide a clear and viable career progression path for clinician-scientist. Further research might explore the cross-cultural differences in managing work-life balance in academic medicine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All

The Cost and Burden of the Residency Match in Emergency Medicine

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Bush, Jeffrey S

2017-01-01

Full Text Available To obtain a residency match, medical students entering emergency medicine (EM must complete away rotations, submit a number of lengthy applications, and travel to multiple programs to interview. The expenses incurred acquiring this residency position are burdensome, but there is little specialty-specific data estimating it. We sought to quantify the actual cost spent by medical students applying to EM residency programs by surveying students as they attended a residency interview. Researchers created a 16-item survey, which asked about the time and monetary costs associated with the entire EM residency application process. Applicants chosen to interview for an EM residency position at our institution were invited to complete the survey during their interview day. In total, 66 out of a possible 81 residency applicants (an 81% response rate completed our survey. The “average applicant” who interviewed at our residency program for the 2015-16 cycle completed 1.6 away, or “audition,” rotations, each costing an average of $1,065 to complete. This “average applicant” applied to 42.8 programs, and then attended 13.7 interviews. The cost of interviewing at our program averaged $342 and in total, an average of $8,312 would be spent in the pursuit of an EM residency. Due to multiple factors, the costs of securing an EM residency spot can be expensive. By understanding the components that are driving this trend, we hope that the academic EM community can explore avenues to help curtail these costs.

Effect of obesity on academic grades among Saudi female medical students at College of Medicine, King Saud University: Pilot study.

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Suraya, Faryal; Meo, Sultan Ayoub; Almubarak, Zaid; Alqaseem, Yazeed Abdullah

2017-08-01

The aim was to investigate the effect of obesity on academic grades among Saudi female medical students. This cross sectional study was conducted in the Department of Plastic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period November 2014 to June 2015. In all 191 second and third year female medical students with an average age of 21.31 years and body mass indices 15-40 were included. An English language questionnaire was established to obtain the information about age, gender, body mass index, level of study and the academic grades [Grade Point Average-GPA]. Female medical students with BMI 21-25 and 26-30 achieved high GPA while female medical students with higher BMI 31-35 and greater than 36 obtained low GPA. High BMI in female medical students impair the academic performance. The academic institutes must establish extra-curricular physical fitness policies to minimize the obesity and achieve better health and academic outcomes.

Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Head, Eyes, Ears, Nose and Throat Emergencies Small Group Module

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