14 research outputs found
Male influence on infant feeding in rural Guatemala and implications for child nutrition interventions
Male Influence on Infant Feeding in Rural Guatemala and Implications for Child Nutrition Interventions
Expectations of health care quality among rural Maya villagers in Sololá Department, Guatemala: a qualitative analysis
It Takes Courage to Pause: Rapid Goals-of-Care Conversations in the Emergency Department
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Recommended from our members
Addressing Racism in Medicine Through a Resident-Led Health Equity Retreat
Racism impacts patient care and clinical training in emergency medicine (EM), but dedicated racism training is not required in graduate medical education. We designed an innovative health equity retreat to teach EM residents about forms of racism and skills for responding to racial inequities in clinical environments. The three-hour retreat occurred during the residency didactic conference to maximize resident participation. We prioritized facilitated reflection on residents’ own experiences of race and racism in medicine in order to emphasize these concepts’ relevance to all participants. We used workshop, small group, and panel formats to optimize interactivity and discussion. Post-retreat survey respondents indicated that the curriculum successfully promoted awareness of racism in the workplace. Participants also expressed interest in continued discussions about racism in medicine as well as desire for greater faculty and nursing participation in the curriculum. Residency programs should consider incorporating similar educational sessions in core didactic curricula
Recommended from our members
Addressing Racism in Medicine Through a Resident-Led Health Equity Retreat
Racism impacts patient care and clinical training in emergency medicine (EM), but dedicated racism training is not required in graduate medical education. We designed an innovative health equity retreat to teach EM residents about forms of racism and skills for responding to racial inequities in clinical environments. The three-hour retreat occurred during the residency didactic conference to maximize resident participation. We prioritized facilitated reflection on residents’ own experiences of race and racism in medicine in order to emphasize these concepts’ relevance to all participants. We used workshop, small group, and panel formats to optimize interactivity and discussion. Post-retreat survey respondents indicated that the curriculum successfully promoted awareness of racism in the workplace. Participants also expressed interest in continued discussions about racism in medicine as well as desire for greater faculty and nursing participation in the curriculum. Residency programs should consider incorporating similar educational sessions in core didactic curricula
A Patient Navigation System to Minimize Barriers for Peritoneal Dialysis in Rural, Low-Resource Settings: Case Study From Guatemala
Level of Comfort in Evaluating Older Patients Amongst Medical Students and Emergency Medicine Residents
Introduction
As the population ages, emergency physicians must be better equipped to manage the complex needs of older patients. While geriatric core competencies have been developed for medical students and emergency medicine (EM) residents, little work has been done to evaluate EM trainees’ comfort with these competencies, or their interest in and barriers to learning more about Geriatric Emergency Medicine (GEM).
Methods
We conducted a cross-sectional study of EM residents and medical students in their clinical years of training with interest in EM. We used an online self-administered survey to evaluate trainees’ self-reported comfort with previously reported geriatric competency domains, in addition to exploring GEM education and interest.
Results
169 trainees participated in the survey, 71% of which were medical students and 29% of which were residents. A majority of medical students (66%) and residents (92%) overall reported comfort evaluating and managing older patients in the ED, but comfort varied with each competency domain. Year of training within these groups was not reliably predictive of increased comfort across the various domains. Common barriers to learning more about GEM identified include exposure in medical education and training for medical students and residents, at 59% and 65% respectively. Medical students also noted that more exposure in preclinical and clinical training would increase interest in GEM, at 57% and 54%, respectively. For residents, learning more about what a career in GEM looks like would increase interest in GEM (51%). Common resources used to learn about older patients were society guidelines for medical students (56%) and UpToDate for residents (82%). Only 30% of medical students noted that their medical school offers a dedicated geriatric curriculum, and medical students whose medical school offered a geriatrics curriculum reported more comfort in evaluating and managing older patients in the ED.
Conclusion
While the majority of trainees surveyed felt comfortable in the geriatric core competencies, increased geriatrics exposure in preclinical and clinical training could increase interest in GEM. Such exposure may be best accomplished earlier in medical training and will be important in creating a future EM physician workforce that is competent in caring for this complex and important patient population
A Survey of Delirium Self-Reported Knowledge and Practices among Emergency Physicians in the United States
Objective: This study aimed to evaluate United States emergency physicians’ self-reported knowledge and practices regarding the detection, prevention, and management of delirium, a common and deadly syndrome that disproportionately affects older emergency department (ED) patients. Knowledge and practices of the broader emergency physician community about these priority topics in geriatric emergency medicine are understudied.
Design: Electronic self-administered online survey
Setting: United States
Participants: One-hundred ninety-seven emergency physicians of the American College of Emergency Physicians Emergency Medicine Practice Research Network
Measures: Descriptive statistics were generated from survey responses.
Results: Of 734 physicians in the research network who were sent the survey, 197 (27%) responded. Most respondents reported intermediate (46%) or advanced (46%) knowledge of delirium detection and management and intermediate (61%) or advanced (21%) knowledge of delirium prevention. Forty percent reported low concern or neutrality over discharging a patient with delirium from the ED. There was high variability in respondents’ perception about the prioritization of delirium in their EDs, and only 14% reported the ED where they worked had a protocol addressing delirium. Participants identified multiple challenges in diagnosing, preventing, and managing delirium, including the physical space and logistics of the emergency care environment (82%), challenges identifying delirium in patients with dementia (75%), and time constraints (64%). Most (69%) perceived utility in increased clinician education on delirium.
Conclusions: Surveyed emergency physicians self-report a high knowledge of delirium detection and management, in contrast to prior research demonstrating low ED delirium detection rates. The variable institutional prioritization of delirium reported also does not align with that of geriatric emergency medicine experts and associations, suggesting a need for strategies to bridge this gap