Top emergency medicine faculty development papers since 2000: A Delphi study.

Objectives: Faculty development is essential for academic emergency physicians to maintain clinical skills and succeed in administrative and leadership roles and for career advancement and satisfaction. Faculty developers in emergency medicine (EM) may struggle to find shared resources to guide faculty development efforts in a way that builds on existing knowledge. We aimed to review the EM-specific faculty development literature since 2000 and come to a consensus about the most useful for EM faculty developers. Methods: A database search was conducted on the topic of faculty development in EM from 2000 to 2020. After identifying relevant articles, we performed a modified Delphi process in three rounds, using a team of educators with a range of experiences with faculty development and education research, to identify articles that would be most useful to a broad audience of faculty developers. Results: We identified 287 potentially relevant articles on the topic of EM faculty development, 244 from the initial literature search, 42 from manual review of the references of the papers meeting inclusion criteria, and one by our study group's recommendation. Thirty-six papers met final inclusion criteria and underwent full-text review by our team. The Delphi process yielded six articles that were deemed most highly relevant over the three rounds. Each of these articles is described here, along with summaries and implications for faculty developers. Conclusions: We present the most useful EM papers from the past two decades for faculty developers seeking to develop, implement, or revise faculty development interventions.

Prospective evaluation of airway management in pediatric out-of-hospital cardiac arrest.

OBJECTIVE: The objective of the study was to identify the association between airway management modality and time to the initial dose of epinephrine in pediatric out-of-hospital cardiac arrest (OHCA). METHODS: This was a prospective observational study conducted between April 2016 to April 2018. Ten Emergency Medical Services (EMS) agencies in 2 US metropolitan areas, which were part of the Resuscitation Outcomes Consortium research network, participated in the study. We included all EMS-treated OHCA patients less than 18 years of age during the study period. Study outcomes included time to the initial dose of epinephrine, airway management success rates, rescue techniques, and complications (e.g. pneumothorax, pneumonia). RESULTS: The study included a total of 155 patients, 67% were male, and 55% were less than age one. The airway management modality (TI, SGA, BMV) was not associated with the time to the intial dose of epinephrine in the adjusted analysis. Tracheal intubation (TI) was the most common airway management modality (47.1%) followed by bag-mask-ventilation (BMV) (40.7%), and supraglottic airways (SGA) (12.3%). Success was 65.7% for TI and 94.7% for SGA. We found a significant difference in the proportion of initial survivors diagnosed with pneumonia on chest X-ray between those with BMV (1/19) versus TI (13/21) p < 0.001. CONCLUSIONS: In this prospective study, the airway management modality was not associated with the time to the initial dose of epinephrine. Unexpectedly, pneumonia was significantly more common among children treated with TI compared to BMV. SGAs had high first-attempt success rates, while intubation success rates were low.

Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2016.

OBJECTIVES: The objectives were to critically appraise the emergency medicine (EM) medical education literature published in 2016 and review the highest-quality quantitative and qualitative studies. METHODS: A search of the English language literature in 2016 querying MEDLINE, Scopus, Education Resources Information Center (ERIC), and PsychInfo identified 510 papers related to medical education in EM. Two reviewers independently screened all of the publications using previously established exclusion criteria. The 25 top-scoring quantitative studies based on methodology and all six qualitative studies were scored by all reviewers using selected scoring criteria that have been adapted from previous installments. The top-scoring articles were highlighted and trends in medical education research were described. RESULTS: Seventy-five manuscripts met inclusion criteria and were scored. Eleven quantitative and one qualitative papers were the highest scoring and are summarized in this article. CONCLUSION: This annual critical appraisal series highlights the best EM education research articles published in 2016.

Feedback in Medical Education: A Critical Appraisal.

OBJECTIVE: The objective was to review and critically appraise the medical education literature pertaining to feedback and highlight influential papers that inform our current understanding of the role of feedback in medical education. METHODS: A search of the English language literature in querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 327 feedback-related papers using either quantitative (hypothesis-testing or observational investigations of educational interventions), qualitative methods (exploring important phenomena in emergency medicine [EM] education), or review methods.Two reviewers independently screened each category of publications using previously established exclusion criteria. Six reviewers then independently scored the remaining 54 publications using a qualitative, quantitative, or review paper scoring system. Each scoring system consisted of nine criteria and used parallel scoring metrics that have been previously used in critical appraisals of education research. RESULTS: Fifty-four feedback papers (25 quantitative studies, 24 qualitative studies, five review papers) met the a priori criteria for inclusion and were reviewed. Eight quantitative studies, nine qualitative studies, and three review papers were ranked highly by the reviewers and are summarized in this article. CONCLUSIONS: This inaugural Council of Emergency Medicine Residency Directors Academy critical appraisal highlights 20 feedback in medical education papers that describe the current state of the feedback literature. A summary of current factors that influence feedback effectiveness is discussed, along with practical implications for EM educators and the next steps for research.

Development and implementation of an asynchronous emergency medicine residency curriculum using a web-based platform.

The Residency Review Committee in Emergency Medicine requires residency programs to deliver at least 5 hours of weekly didactics. Achieving at least a 70 % average attendance rate per resident is required for residency program accreditation, and is used as a benchmark for residency graduation in our program. We developed a web-based, asynchronous curriculum to replace 1 hour of synchronous didactics, and hypothesized that the curriculum would be feasible to implement, well received by learners, and improve conference participation. This paper describes the feasibility and learner acceptability of a longitudinal asynchronous curriculum, and describes its impact on postgraduate year-1(PGY-1) resident conference participation and annual in-training examination scores. Using formal curriculum design methods, we developed modules and paired assessment exercises to replace 1 hour of weekly didactics. We measured feasibility (development and implementation time and costs) and learner acceptability (measured on an anonymous survey). We compared pre- and post-intervention conference participation and in-service training examination scores using a two sample t test. The asynchronous curriculum proved feasible to develop and implement. PGY-1 resident conference participation improved compared to the pre-intervention year (85.6 vs. 62 %; 95 % CI 0.295-0.177; p < 0.001). We are unable to detect a difference between in-training examination results in either the PGY-1 group or across all residents by the introduction of this intervention. 18/31 (58 %) residents completed the post-intervention survey. 83 % reported satisfaction with curriculum changes. Strengths of the curriculum included clarity and timeliness of assignments. Weaknesses included technical difficulties with the online platform. Our curriculum is feasible to develop and implement. Despite technical difficulties, residents report high satisfaction with this new curriculum. Among PGY-1 residents there is improved conference participation compared to the prior year.

The Milestones Passport: A Learner-Centered Application of the Milestone Framework to Prompt Real-Time Feedback in the Emergency Department.

BACKGROUND: In July 2013, emergency medicine residency programs implemented the Milestone assessment as part of the Next Accreditation System. OBJECTIVE: We hypothesized that applying the Milestone framework to real-time feedback in the emergency department (ED) could affect current feedback processes and culture. We describe the development and implementation of a Milestone-based, learner-centered intervention designed to prompt real-time feedback in the ED. METHODS: We developed and implemented the Milestones Passport, a feedback intervention incorporating subcompetencies, in our residency program in July 2013. Our primary outcomes were feasibility, including faculty and staff time and costs, number of documented feedback encounters in the first 2 months of implementation, and user-reported time required to complete the intervention. We also assessed learner and faculty acceptability. RESULTS: Development and implementation of the Milestones Passport required 10 hours of program coordinator time, 120 hours of software developer time, and 20 hours of faculty time. Twenty-eight residents and 34 faculty members generated 257 Milestones Passport feedback encounters. Most residents and faculty reported that the encounters required fewer than 5 minutes to complete, and 48% (12 of 25) of the residents and 68% (19 of 28) of faculty reported satisfaction with the Milestones Passport intervention. Faculty satisfaction with overall feedback in the ED improved after the intervention (93% versus 54%, P  =  .003), whereas resident satisfaction with feedback did not change significantly. CONCLUSIONS: The Milestones Passport feedback intervention was feasible and acceptable to users; however, learner satisfaction with the Milestone assessment in the ED was modest.