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3.
MedEdPORTAL ; 20: 11422, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39044803

RESUMEN

Introduction: Human trafficking (HT) is a public health issue that adversely affects patients' well-being. Despite the prevalence of trafficked persons in health care settings, a lack of educational modules exists for use in clinical contexts. We developed a 50-minute train-the-trainer module on HT. Methods: After piloting the workshop for faculty, fellows, and residents (n = 19) at the Society for Academic Emergency Medicine (SAEM) national conference, we implemented it in medical students' curricula during their emergency medicine clerkship at the University of Iowa (n = 162). We evaluated the worskhop by (a) a retrospective pre-post survey of self-reported ability to (1) define HT, (2) recognize high-risk signs, (3) manage situations with trafficked persons, and (4) teach others about HT, and (b) a 3-month follow-up survey to assess longitudinal behavior change. Results: In both contexts, results demonstrated improvement across all learning outcomes (pre-post differences of 1.5, 1.3, 1.9, and 1.7 on a 4-point Likert-type scale for each learning objective above, respectively, at the SAEM conference and 1.2, 1.0, 1.3, and 1.3 at the University of Iowa; p < .001 for all). In the 3-month follow-up, we observed statistically significant changes in self-reported consideration of and teaching about HT during clinical encounters among learners who had previously never done either (p < .001 and p = .006, respectively). Discussion: This train-the-trainer module is a brief and effective clinical tool for bedside teaching about HT, especially among people who have never previously considered HT in a clinical context.


Asunto(s)
Curriculum , Trata de Personas , Humanos , Iowa , Trata de Personas/prevención & control , Encuestas y Cuestionarios , Medicina de Emergencia/educación , Enseñanza , Estudiantes de Medicina/estadística & datos numéricos , Estudios Retrospectivos , Educación de Pregrado en Medicina/métodos
4.
West J Emerg Med ; 25(4): 574-578, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39028243

RESUMEN

Introduction: In this study we aimed to investigate the effects of incorporating Swedish-style fika (coffee) breaks into the didactic schedule of emergency medicine residents on their sleepiness levels during didactic sessions. Fika is a Swedish tradition that involves a deliberate decision to take a break during the workday and usually involves pastries and coffee. We used the Karolinska Sleepiness Scale to assess changes in sleepiness levels before and after the implementation of fika breaks. Methods: The study design involved a randomized crossover trial approach, with data collected from emergency medicine residents over a specific period. This approach was done to minimize confounding and to be statistically efficient. Results: Results revealed the average sleepiness scale was 4.6 and 5.5 on fika and control days, respectively (P = 0.004). Conclusion: Integration of fika breaks positively influenced sleepiness levels, thus potentially enhancing the educational experience during residency didactics.


Asunto(s)
Café , Estudios Cruzados , Medicina de Emergencia , Internado y Residencia , Humanos , Medicina de Emergencia/educación , Suecia , Masculino , Femenino , Adulto , Somnolencia
5.
West J Emerg Med ; 25(4): 565-573, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39028242

RESUMEN

Introduction: Evidence-based medicine (EBM) is a critical skill for physicians, and EBM competency has been shown to increase implementation of best medical practices, reduce medical errors, and increase patient-centered care. Like any skill, EBM must be practiced, receiving iterative feedback to improve learners' comprehension. Having residents document patient interactions in logbooks to allow for residency program review, feedback, and documentation of competency has been previously described as a best practice within emergency medicine (EM) to document practice-based learning (PBL) competency. Quantifying how residents use the information they query, locate, evaluate, and apply while providing direct patient care can measure the efficacy of EBM education and provide insight into more efficient ways of providing medical care. Methods: Practice-based learning logs were surveys created to record resident EBM activity on-shift and were placed into our residency management software program. Residents were required to submit 3-5 surveys of EBM activity performed during a 28-day rotation during which additional information was sought. This study included all PBL logs completed by EM residents from June 1, 2013-May 11, 2020. Using qualitative methodology, a codebook was created to analyze residents' free-text responses to the prompt: "Based on your research, would you have done anything differently?" The codebook was designed to generate a three-digit code conveying the effect of the researched information on the patient about whom the log was written, as well as whether the information would affect future patient care and whether these decisions were based on scientific evidence. Results: A total of 10,574 logs were included for primary analysis. In total, 1,977 (18.7%) logs indicated that the evidence acquired through research would affect future patient care. Of these, 392 (3.7%) explicitly stated that the EBM activity conducted as part of our project led to real-time changes in patient care in the ED and would change future management of patients as well. Conclusion: We present a proof of concept that PBL log activity can lead to integration of evidence-based medicine into real-time patient care. While a convenience sample, our cohort recorded evidence of both lifelong learning and application to patient care.


Asunto(s)
Competencia Clínica , Medicina de Emergencia , Medicina Basada en la Evidencia , Internado y Residencia , Humanos , Medicina de Emergencia/educación , Atención al Paciente/normas , Encuestas y Cuestionarios , Educación de Postgrado en Medicina
6.
West J Emerg Med ; 25(4): 579-583, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39028244

RESUMEN

Background: It is an unfortunate truth that Emergency Medicine (EM) physicians will, at some point, have contact with the medicolegal system. However, most EM residency training programs lack education on the legal system in their curriculum, leaving EM physicians unprepared for litigation. To fill this gap, we designed a high-yield and succinct medical legal workshop highlighting legal issues commonly encountered by EM physicians. We aimed to determine the effectiveness of this curriculum by measuring pre and post knowledge questions. Methods: A two-hour session included a case-based discussion of common misconceptions held by physicians about the legal system, proper steps when interacting with the legal system and review of legal documents. This session was developed with the involvement of our hospital legal counsel and discussed real encounters. The effectiveness of the session was determined using pre- and post-session surveys assessing participant knowledge and comfort approaching the scenarios. Results: A total of 34 EM residents had the opportunity to complete this workshop as a part of their conference curriculum. A total of 26 participants completed the pre-survey and 19 participants completed the post-survey. No participants had previous training in the legal aspects of medicine, including handling a subpoena, serving as a witness, or giving a deposition. The pre-survey demonstrated that there was significant uncertainty surrounding the processes, definitions, and the legal system interaction. Many participants stated they would not know what to do if they received a subpoena (85.71%), were called as a witness in a trial (96.43%) or receive correspondence from a lawyer (96.43%). The post survey revealed an increased knowledge base and confidence following the session. 100% of residents reported knowing what to do after receiving a subpoena, being called as a witness and understanding the process involved in giving a deposition. All residents reported that the session was beneficial and provided crucial information. Conclusion: EM residents have limited baseline understanding of how to approach common legal scenarios. Educational materials available for this curriculum topic are limited. Based on the rapid knowledge increase observed in our residents, we believe our workshop could be adapted for use at other residency programs.


Asunto(s)
Curriculum , Medicina de Emergencia , Internado y Residencia , Medicina de Emergencia/educación , Humanos , Encuestas y Cuestionarios , Educación de Postgrado en Medicina
7.
West J Emerg Med ; 25(4): 557-564, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39028241

RESUMEN

Introduction: Optimizing the performance of emergency department (ED) teams impacts patient care, but the utility of current, team-based performance assessment tools to comprehensively measure this impact is underexplored. In this study we aimed to 1) evaluate ED team performance using current team-based assessment tools during an interprofessional in situ simulation and 2) identify characteristics of effective ED teams. Methods: This mixed-methods study employed case study methodology based on a constructivist paradigm. Sixty-three eligible nurses, technicians, pharmacists, and postgraduate year 2-4 emergency medicine residents at a tertiary academic ED participated in a 10-minute in situ simulation of a critically ill patient. Participants self-rated performance using the Team Performance Observation Tool (TPOT) 2.0 and completed a brief demographic form. Two raters independently reviewed simulation videos and rated performance using the TPOT 2.0, Team Emergency Assessment Measure (TEAM), and Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS). Following simulations, we conducted semi-structured interviews and focus groups with in situ participants. Transcripts were analyzed using thematic analysis. Results: Eighteen team-based simulations took place between January-April 2021. Raters' scores were on the upper end of the tools for the TPOT 2.0 (R1 4.90, SD 0.17; R2 4.53, SD 0.27, IRR [inter-rater reliability] 0.47), TEAM (R1 3.89, SD 0.19; R2 3.58, SD 0.39, IRR 0.73), and Ottawa GRS (R1 6.6, SD 0.56; R2 6.2, SD 0.54, IRR 0.68). We identified six themes from our interview data: team member entrustment; interdependent energy; leadership tone; optimal communication; strategic staffing; and simulation empowering team performance. Conclusion: Current team performance assessment tools insufficiently discriminate among high performing teams in the ED. Emergency department-specific assessments that capture features of entrustability, interdependent energy, and leadership tone may offer a more comprehensive way to assess an individual's contribution to a team's performance.


Asunto(s)
Competencia Clínica , Servicio de Urgencia en Hospital , Grupo de Atención al Paciente , Humanos , Masculino , Relaciones Interprofesionales , Femenino , Medicina de Emergencia/educación , Entrenamiento Simulado , Adulto , Grupos Focales , Simulación de Paciente
8.
West J Emerg Med ; 25(4): 593-601, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39028246

RESUMEN

There is recognition in the field of emergency medicine (EM) that social determinants of health (SDoH) are key drivers of patient care outcomes. Leaders in EM are calling for curricula integrating SDoH assessment and intervention, public health, and multidisciplinary approaches to EM care throughout medical school and residency. This intersection of SDoH and the emergency care system is known as social emergency medicine (SEM). Currently, there are few resources available for EM training programs to integrate this content; as a result, few EM trainees receive adequate education in SEM. To address this gap, we developed a four-part training in SEM tailored to EM residency programs and medical schools. This curriculum, known as RISE-EM (Resident Instruction in Social Emergency Medicine), uses video lectures, case examples, and group discussions to engage trainees and develop competency in providing sound care that is grounded in evidence-based principles of SEM. In the current study, we tested RISE-EM by delivering the video lectures to residents and medical students in two training programs. We administered pre- and post-course knowledge tests and a post-course participant attitudes survey to assess the acceptability and potential efficacy of the program for improving SEM knowledge and attitudes among EM learners. We found it to be both feasible and acceptable to introduce SEM content in residency conferences, with preliminary data showing statistically significant improvement in knowledge of the content and self-efficacy to apply it to their clinical practice. In summary, RISE-EM has been highly valued by EM learners and viewed as a strong supplement to their existing training, and it has been shown to successfully improve SEM knowledge and attitudes.


Asunto(s)
Curriculum , Medicina de Emergencia , Internado y Residencia , Humanos , Medicina de Emergencia/educación , Determinantes Sociales de la Salud , Femenino , Estudios de Cohortes , Masculino , Estudiantes de Medicina , Medicina Social/educación , Competencia Clínica , Encuestas y Cuestionarios
9.
MedEdPORTAL ; 20: 11421, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38984064

RESUMEN

Introduction: Critical care, emergency medicine, and surgical trainees frequently perform surgical and Seldinger-technique tube thoracostomy, thoracentesis, and thoracic ultrasound. However, approaches to teaching these skills are highly heterogeneous. Over 10 years, we have developed a standardized, multidisciplinary curriculum to teach these procedures. Methods: Emergency medicine residents, surgical residents, and critical care fellows, all in the first year of their respective programs, underwent training in surgical and Seldinger chest tube placement and securement, thoracentesis, and thoracic ultrasound. The curriculum included preworkshop instructional videos and 45-minute in-person practice stations (3.5 hours total). Sessions were co-led by faculty from emergency medicine, thoracic surgery, and pulmonary/critical care who performed real-time formative assessment with standardized procedural steps. Postcourse surveys assessed learners' confidence before versus after the workshop in each procedure, learners' evaluations of faculty by station and specialty, and the workshop overall. Results: One hundred twenty-three trainees completed course evaluations, demonstrating stable and positive responses from learners of different backgrounds taught by a multidisciplinary group of instructors, as well as statistically significant improvement in learner confidence in each procedure. Over time, we have made incremental changes to our curriculum based on feedback from instructors and learners. Discussion: We have developed a unique curriculum designed, revised, and taught by a multidisciplinary faculty over many years to teach a unified approach to the performance of common chest procedures to surgical, emergency medicine, and critical care trainees. Our curriculum can be readily adapted to the needs of institutions that desire a standardized, multidisciplinary approach to thoracic procedural education.


Asunto(s)
Cuidados Críticos , Curriculum , Medicina de Emergencia , Internado y Residencia , Humanos , Medicina de Emergencia/educación , Internado y Residencia/métodos , Toracostomía/educación , Competencia Clínica/normas , Educación de Postgrado en Medicina/métodos , Cirugía General/educación , Encuestas y Cuestionarios , Evaluación Educacional/métodos , Tubos Torácicos , Toracocentesis/educación , Cirugía de Cuidados Intensivos
10.
J Grad Med Educ ; 16(3): 323-327, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38882409

RESUMEN

Background In medical education, artificial intelligence techniques such as natural language processing (NLP) are starting to be used to capture and analyze emotions through written text. Objective To explore the application of NLP techniques to understand resident and faculty emotions related to entrustable professional activity (EPA) assessments. Methods Open-ended text data from a survey on emotions toward EPA assessments were analyzed. Respondents were residents and faculty from pediatrics (Peds), general surgery (GS), and emergency medicine (EM), recruited for a larger emotions study in 2023. Participants wrote about their emotions related to receiving/completing EPA assessments. We analyzed the frequency of words rated as positive via a validated sentiment lexicon used in NLP studies. Specifically, we were interested if the count of positive words varied as a function of group membership (faculty, resident), specialty (Peds, GS, EM), gender (man, woman, nonbinary), or visible minority status (yes, no, omit). Results A total of 66 text responses (30 faculty, 36 residents) contained text data useful for sentiment analysis. We analyzed the difference in the count of words categorized as positive across group, specialty, gender, and being a visible minority. Specialty was the only category revealing significant differences via a bootstrapped Poisson regression model with GS responses containing fewer positive words than EM responses. Conclusions By analyzing text data to understand emotions of residents and faculty through an NLP approach, we identified differences in EPA assessment-related emotions of residents versus faculty, and differences across specialties.


Asunto(s)
Competencia Clínica , Emociones , Docentes Médicos , Internado y Residencia , Procesamiento de Lenguaje Natural , Humanos , Femenino , Masculino , Docentes Médicos/psicología , Evaluación Educacional/métodos , Encuestas y Cuestionarios , Educación de Postgrado en Medicina , Cirugía General/educación , Medicina de Emergencia/educación , Pediatría/educación , Educación Basada en Competencias/métodos
11.
BMC Med Educ ; 24(1): 682, 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-38902689

RESUMEN

BACKGROUND: Emergency medicine (EM) trainee comfort level with lumbar puncture (LP) has decreased over time due to changing practice guidelines, particularly amongst pediatric patients. We implemented a "just in time" (JIT) brief educational video based on a previously published LP Performance Scoring Checklist to improve trainee efficiency and competence in LP performance. METHODS: Our pilot quasi-experimental study took place January-June 2022 within a large, academic Midwestern emergency department (ED) with an established 3-year EM residency program. All 9 interns performed a timed diagnostic LP on an infant LP model in January, scored according to the LP Performance Scoring Checklist. In June, interns repeated the timed LP procedure directly after watching a brief educational video based on major checklist steps. The study was deemed exempt by the Institutional Review Board. RESULTS: All interns completed both assessments. At baseline, interns had logged performance of median 2 (IQR 0-5) LPs and spent 12.9 (10.3-14.4) minutes performing the procedure. Post-intervention, interns had logged an additional median 2 (0-5) LPs and completed the procedure faster with an average time of 10.3 (9.7-11.3) minutes (p = 0.004). A median of 5 (4-7) major steps were missed at baseline, compared to 1 (1-2) at time of post-intervention assessment (p = 0.015). CONCLUSION: Development of a brief educational video improved efficiency and competency amongst our intern class in performing an infant LP when viewed Just-In-Time. Similar efforts may improve education and performance of other rare (or decreasing in frequency) procedures within EM training.


Asunto(s)
Competencia Clínica , Medicina de Emergencia , Internado y Residencia , Punción Espinal , Grabación en Video , Punción Espinal/métodos , Humanos , Medicina de Emergencia/educación , Proyectos Piloto , Pediatría/educación , Servicio de Urgencia en Hospital , Lista de Verificación , Masculino , Lactante
12.
Ann Emerg Med ; 84(1): 65-81, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38906628

RESUMEN

The American Board of Emergency Medicine gathers extensive background information on Accreditation Council of Graduate Medical Education-accredited emergency medicine residency and fellowship programs as well as the residents and fellows training in those programs. We present the 2024 annual report on the status of physicians training in ACGME-accredited emergency medicine training programs in the United States.


Asunto(s)
Medicina de Emergencia , Becas , Internado y Residencia , Medicina de Emergencia/educación , Estados Unidos , Humanos , Acreditación , Educación de Postgrado en Medicina
14.
BMC Med ; 22(1): 222, 2024 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-38831293

RESUMEN

BACKGROUND: It is a requirement that medical students are educated in emergencies and feel well prepared for practice as a doctor, yet national surveys show that many students feel underprepared. Virtual reality (VR), combined with 360-degree filming, provides an immersive, realistic, and interactive simulation experience. Unlike conventional in-person simulation, it is scalable with reduced workforce demands. We sought to compare students' engagement and enjoyment of VR simulation to desktop computer-based simulation. METHODS: We conducted a prospective, interventional, evaluation study. The study was carried out on final year medical students undertaking their Pre-Foundation Assistantship (n = 116) at Imperial College School of Medicine (ICSM) in London. We compared objective engagement, subjective engagement, and subjective enjoyment of VR simulation to desktop computer-based simulation using cardiac arrest and life-threatening asthma scenarios. Engagement was measured objectively using students' physiological parameters, including heart rate and eye tracking, and facilitator observations using the validated 'Behavioural Engagement Related to Instruction' (BERI) protocol. Students' subjective engagement and enjoyment levels were measured using a post-session survey. RESULTS: Students' maximum heart rates were significantly higher during VR simulation with a mean difference of 4.2 beats per minute (3.2 to 5.2, p < 0.001), and eye tracking showed they spent a significantly greater mean percentage of time of 6.4% (5.1 to 7.7, p < 0.001) focusing on the scenarios in VR compared to standard desktop. Qualitative data showed students enjoyed and felt engaged with the sessions, which provided a safe space for learning. CONCLUSIONS: Our study shows that students found VR simulations enjoyable and were more engaged compared to standard desktop simulation. This suggests that 360-degree VR simulation experiences provide students with immersive, realistic training, which is scalable, giving them the unique opportunity to manage emergencies and work within emergency teams, which would not typically occur during traditional training.


Asunto(s)
Educación de Pregrado en Medicina , Entrenamiento Simulado , Estudiantes de Medicina , Realidad Virtual , Humanos , Estudios Prospectivos , Masculino , Femenino , Educación de Pregrado en Medicina/métodos , Entrenamiento Simulado/métodos , Adulto Joven , Adulto , Londres , Medicina de Emergencia/educación
15.
CJEM ; 26(6): 377-380, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38856939

RESUMEN

The Canadian Association of Emergency Physicians' (CAEP) Global Emergency Medicine committee presents a four-part series that builds upon the Academic Symposium recommendations from the CAEP 2018 meeting (Collier et al. in CJEM 21(5):600-606, 2019). This series presents best practices and offers practical tools for the development and practice of Global EM. This is the first paper of the series which provides an overview of current Global EM systems and development. The breadth and scope of the field is described, and key definitions are outlined. International efforts, initiatives, and organizations relating to public health and humanitarian response are introduced. Other key aspects of Global EM are explored in papers 2-4 including: developing partnerships, supporting centers of research and practice, and education and training.


RéSUMé: Le Comité mondial de la médecine d'urgence de l'Association canadienne des médecins d'urgence (ACMU) présente une série en quatre parties qui s'appuie sur les recommandations du Symposium universitaire de la réunion de 2018 de l'ACMU [1]. Cette série présente les meilleures pratiques et propose des outils pratiques pour le développement et la pratique de la ME mondiale. Il s'agit du premier article de la série qui donne un aperçu des systèmes et du développement actuels de la ME mondiale. L'étendue et la portée du domaine sont décrites, ainsi que les définitions clés. Les efforts, les initiatives et les organisations internationales en matière de santé publique et d'intervention humanitaire sont présentés. D'autres aspects clés de la GU mondiale sont explorés dans les documents 2 à 4, notamment : le développement de partenariats, le soutien des centres de recherche et de pratique, et l'éducation et la formation.


Asunto(s)
Medicina de Emergencia , Salud Global , Humanos , Medicina de Emergencia/educación , Canadá
16.
Medicine (Baltimore) ; 103(18): e38026, 2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38701308

RESUMEN

As point-of-care ultrasound (POCUS) is increasingly being used in clinical settings, ultrasound education is expanding into student curricula. We aimed to determine the status and awareness of POCUS education in Korean medical schools using a nationwide cross-sectional survey. In October 2021, a survey questionnaire consisting of 20 questions was distributed via e-mail to professors in the emergency medicine (EM) departments of Korean medical schools. The questionnaire encompassed 19 multiple-choice questions covering demographics, current education, perceptions, and barriers, and the final question was an open-ended inquiry seeking suggestions for POCUS education. All EM departments of the 40 medical schools responded, of which only 13 (33%) reported providing POCUS education. The implementation of POCUS education primarily occurred in the third and fourth years, with less than 4 hours of dedicated training time. Five schools offered a hands-on education. Among schools offering ultrasound education, POCUS training for trauma cases is the most common. Eight schools had designated professors responsible for POCUS education and only 2 possessed educational ultrasound devices. Of the respondents, 64% expressed the belief that POCUS education for medical students is necessary, whereas 36%, including those with neutral opinions, did not anticipate its importance. The identified barriers to POCUS education included faculty shortages (83%), infrastructure limitations (76%), training time constraints (74%), and a limited awareness of POCUS (29%). POCUS education in Korean medical schools was limited to a minority of EM departments (33%). To successfully implement POCUS education in medical curricula, it is crucial to clarify learning objectives, enhance faculty recognition, and improve the infrastructure. These findings provide valuable insights for advancing ultrasound training in medical schools to ensure the provision of high-quality POCUS education for future healthcare professionals.


Asunto(s)
Curriculum , Sistemas de Atención de Punto , Facultades de Medicina , Ultrasonografía , Estudios Transversales , Humanos , República de Corea , Ultrasonografía/estadística & datos numéricos , Encuestas y Cuestionarios , Medicina de Emergencia/educación
17.
CJEM ; 26(6): 413-423, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38703266

RESUMEN

INTRODUCTION: Sexual orientation and gender identity (SOGI)-diverse patients are marginalized and poorly cared for in the emergency department, yet well-designed educational interventions to meet this gap are lacking. We developed, implemented, and assessed a novel multi-modal SOGI curriculum on health and cultural humility for emergency medicine physician trainees. METHODS: We conducted a prospective, single-arm evaluation of our educational intervention. A convenience sample of emergency medicine resident physicians (n = 21) participated in the facilitated curriculum including didactic and clinical simulation components. Participants completed a pre- and post-curriculum evaluation that assessed clinical skills, preparedness, attitudinal awareness, and basic knowledge in caring for SOGI-diverse patients. The content of the module was based on a scoping literature review and national needs assessment of Canadian emergency physicians, educators, and trainees along with expert collaborator and input from patient/community partners. The curriculum included a facilitated pre-brief, didactic presentation, clinical simulation modules, and a structured de-brief. Participant clinical skills were evaluated before and after the educational intervention. Our primary outcome was change in clinical preparedness, attitudinal awareness, and basic knowledge in caring for SOGI-diverse patients pre- and post-intervention. RESULTS: Our patient-centered, targeted emergency medicine SOGI health and cultural humility training resulted in a significant improvement in resident self-rated clinical preparedness, attitudes, and knowledge in caring for SOGI-diverse patients. This training was valued by participants. CONCLUSION: We have designed an effective, patient-centered curriculum in health and cultural humility for SOGI-diverse patients in EM. Other programs can consider using this model and developed resources in their jurisdictions to enhance provider capacities to care for this marginalized group.


RéSUMé: INTRODUCTION: L'orientation sexuelle et l'identité de genre (OSIG) - des patients de diverses natures sont marginalisés et mal soignés dans les services d'urgence, mais des interventions éducatives bien conçues pour combler cette lacune font défaut. Nous avons élaboré, mis en œuvre et évalué un nouveau programme multimodal de l'OSIG sur la santé et l'humilité culturelle pour les médecins d'urgence stagiaires. MéTHODES: Nous avons effectué une évaluation prospective de notre intervention éducative à un seul bras. Un échantillon pratique de médecins résidents en médecine d'urgence (n = 21) a participé au programme facilité, y compris les composantes didactiques et de simulation clinique. Les participants ont effectué une évaluation avant et après le programme d'études qui évaluait les compétences cliniques, la préparation, la sensibilisation aux attitudes et les connaissances de base en matière de soins aux patients atteints de diverses OSIG. Le contenu du module était fondé sur une analyse documentaire de portée et une évaluation des besoins nationaux des médecins d'urgence, des éducateurs et des stagiaires canadiens, ainsi que sur un collaborateur expert et les commentaires des patients et des partenaires communautaires. Le programme comprenait un pré-briefing animé, une présentation didactique, des modules de simulation clinique et un débriefing structuré. Les compétences cliniques des participants ont été évaluées avant et après l'intervention éducative. Notre résultat principal était un changement dans la préparation clinique, la sensibilisation aux attitudes et les connaissances de base dans les soins aux patients atteints de diverses OSIG avant et après l'intervention. RéSULTATS: Notre formation sur la santé et l'humilité culturelle axée sur le patient et ciblée en médecine d'urgence SOGI a permis d'améliorer considérablement la préparation clinique, les attitudes et les connaissances auto-évaluées des résidents en matière de soins aux patients SOGI-divers. Cette formation a été appréciée par les participants. CONCLUSIONS: Nous avons conçu un programme efficace et centré sur le patient en matière de santé et d'humilité culturelle pour les patients SOGI-divers en EM. D'autres programmes peuvent envisager d'utiliser ce modèle et d'élaborer des ressources dans leur administration pour améliorer les capacités des fournisseurs de soins à ce groupe marginalisé.


Asunto(s)
Curriculum , Medicina de Emergencia , Internado y Residencia , Humanos , Medicina de Emergencia/educación , Femenino , Masculino , Estudios Prospectivos , Identidad de Género , Canadá , Conducta Sexual , Competencia Clínica , Adulto , Entrenamiento Simulado/métodos
18.
J Emerg Med ; 67(1): e80-e88, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38806349

RESUMEN

BACKGROUND: Emergency physicians and trainees provide the initial care for critically ill patients. In times of emergency department boarding, this care may extend beyond the first few hours. To meet the needs of this population, a standardized novel critical care curriculum targeting third- and fourth-year medical students was developed. OBJECTIVES: We hypothesized that the institution of such a curriculum is feasible and will provide an increased understanding of the underlying critical care principles within this learner population. METHODS: We developed a 2-month-long critical care curriculum (February-April) and carried out the course twice from 2022-2023. Our pilot study deployed this curriculum to medical students interested in critical care through the American Academy of Emergency Medicine/Resident and Student Association. The primary outcome included was the overall composite score comparison of the pre- and post-course evaluations, with a higher score indicating that the student improved their comprehension. Secondary outcomes included the individual factors of the pre- and post-course surveys. RESULTS: Fifty-one trainees completed the pilot course, including 11/51 (21.6%) third-year medical students and 40/51 (78.4%) fourth-year medical students. Overall, 39 had "no experience" in critical care and 12 indicated that they had "previous experience." The students' baseline pre-course from the pooled 2022 and 2023 Introduction to Critical Care in Emergency Medicine (ICCEM) curriculum data was 3 (interquartile range 4-3) and their post-course score was 9 (interquartile range 9-9), p-value 0.015 for the 51/54 students who completed the course. CONCLUSIONS: The novel curriculum was found to be effective during its implementation in third- and fourth-year medical students. As such, it indicated that a critical care fundamentals course improves confidence in these topics for students with and without prior experience. Further work is necessary to understand the generalizability and knowledge retention of the proposed pilot curriculum.


Asunto(s)
Cuidados Críticos , Curriculum , Medicina de Emergencia , Estudiantes de Medicina , Humanos , Curriculum/tendencias , Curriculum/normas , Medicina de Emergencia/educación , Cuidados Críticos/métodos , Proyectos Piloto , Estudiantes de Medicina/estadística & datos numéricos , Femenino , Masculino , Encuestas y Cuestionarios , Adulto , Educación de Pregrado en Medicina/métodos , Educación de Pregrado en Medicina/normas , Evaluación Educacional/métodos
19.
CJEM ; 26(6): 409-412, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38801635

RESUMEN

Mentorship models deviating from traditional staff-student dyads are beginning to emerge, and the CAEP Women in Emergency Medicine (WEM) Committee has implemented a novel, vertical mentorship program in the hopes of increasing mentorship accessibility across Canada for students, residents, and attending physicians. The vertical mentorship consisted of an attending physician, resident, and medical student all practicing or interested in EM. Groups were created based on location or niche preference. Early and post-mentorship surveys were sent to all 60 participants to gauge overall impact on career development, academic promotion, emotional wellbeing, and niche development. Overall, the implementation of an innovative, national, vertical mentorship program was largely beneficial for the personal wellbeing and professional development of participants. Academic institutions are strongly encouraged to implement formal vertical mentorship to increase access to mentorship for trainees at all stages in their career.


RéSUMé: Des modèles de mentorat qui s'écartent des dyades traditionnelles du personnel et des étudiants commencent à émerger, et le Comité des femmes en médecine d'urgence (ME) de l'ACMU a mis en œuvre un nouveau programme de mentorat vertical dans l'espoir d'accroître l'accessibilité du mentorat partout au Canada pour les étudiants. les résidents et les médecins traitants. Le mentorat vertical consistait en un médecin traitant, un résident et un étudiant en médecine, tous pratiquant ou intéressés par la SE. Les groupes ont été créés en fonction de l'emplacement ou de la préférence de niche. Des sondages ont été envoyés aux 60 participants pour évaluer l'impact global sur le développement de carrière, la promotion académique, le bien-être émotionnel et le développement de niche. Dans l'ensemble, la mise en œuvre d'un programme de mentorat novateur, national et vertical a été largement bénéfique pour le bien-être personnel et le perfectionnement professionnel des participants. Les établissements d'enseignement sont fortement encouragés à mettre en œuvre un mentorat vertical formel afin d'accroître l'accès au mentorat pour les stagiaires à toutes les étapes de leur carrière.


Asunto(s)
Medicina de Emergencia , Mentores , Médicos Mujeres , Humanos , Medicina de Emergencia/educación , Canadá , Femenino , Internado y Residencia , Selección de Profesión
20.
CJEM ; 26(7): 460-462, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38801634

RESUMEN

Proficiency in Quality Improvement and Patient Safety (QIPS) methodologies has been identified as a standard of residency training. However, there is no consensus on how to achieve these competencies. We used Kern's model of curricular development to create a QIPS curriculum for the local Emergency Medicine (EM) residency training program. The curriculum was designed following best practice recommendations for QIPS education and took the form of a 10-h educational experience including two in-person live sessions. The curriculum was delivered to a mix of local transition to practice residents and faculty members. Participants reported favorable outcomes and objectively demonstrated QIPS knowledge acquisition. This curriculum serves as a model that could be adapted by other residency training programs seeking to implement their own QIPS curricula.


RéSUMé: La maîtrise des méthodologies d'amélioration de la qualité et de la sécurité des patients (QIPS) a été identifiée comme une norme de formation en résidence. Cependant, il n'y a pas de consensus sur la façon d'atteindre ces compétences. Nous avons utilisé le modèle de développement des programmes d'études de Kern pour créer un programme QIPS pour le programme de résidence en médecine d'urgence (EM) local. Le programme a été conçu selon les recommandations des meilleures pratiques pour la formation QIPS et a pris la forme d'une expérience éducative de 10 heures comprenant deux sessions en personne. Le programme a été dispensé à un mélange de transition locale aux résidents de pratique et aux membres du corps professoral. Les participants ont déclaré des résultats favorables et ont démontré objectivement l'acquisition de connaissances QIPS. Ce programme sert de modèle qui pourrait être adapté par d'autres programmes de résidence qui cherchent à mettre en œuvre leurs propres programmes QIPS.


Asunto(s)
Curriculum , Medicina de Emergencia , Internado y Residencia , Seguridad del Paciente , Mejoramiento de la Calidad , Humanos , Medicina de Emergencia/educación , Competencia Clínica , Educación de Postgrado en Medicina , Evaluación de Programas y Proyectos de Salud , Desarrollo de Programa
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