Comments On The Name “Wichita”

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99659/1/aa.1942.44.1.02a00350.pd

The Auxiliary Verb in Natchez

Natchez verbs are inflected for person (first, second, and third), for number (singular, dual, and plural), and for tense-mode (present, past, optative). There are two main kinds of verbs. There are, first, active verbs which are directly inflected only for the distinction between singular and plural. All the rest of the inflectional paraphernalia is carried by the auxiliary verb with which it obligatorily occurs. Secondly, there are inflected verbs which occur in two subcategories, (i) inpendent inflected verbs and auxiliary verbs. The two inflected subcategories are inflected alike except for the plural number. The independent inflected verbs have their own special type of plural formation. The auxiliary verbs, on the other hand, do not since that is shown by the active verb

Too Big Too Fast? Potential Implications of the Rapid Increase in Emergency Medicine Residency Positions

Emergency medicine (EM) has expanded rapidly since its inception in 1979. Workforce projections from current data demonstrate a rapid rise in the number of accredited EM residency programs and trainee positions. Based on these trends, the specialty may soon reach a point of saturation, particularly in urban areas. This could negatively impact future trainees entering the job market as well as the career plans of medical students. More time and resources should be devoted to obtaining accurate projections, assessing the distribution of emergency physicians in rural versus urban settings, and implementing central workforce planning to protect the future of graduating trainees.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154425/1/aet210400.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154425/2/aet210400_am.pd

The Parallel Encounter: An Alternative to the Traditional Serial Trainee–Attending Patient Evaluation Model

BackgroundThe emergency department environment requires the clinician‐educator to use adaptive teaching strategies to balance education with efficiency and patient care. Recently, alternative approaches to the traditional serial trainee–attending patient evaluation model have emerged in the literature.MethodsThe parallel encounter involves the attending physician and resident seeing the patient independently. Instead of the trainee delivering a traditional oral case presentation, the trainee does not present the history and examination to the attending physician. Rather, the attending and trainee come together following their independent evaluations to jointly discuss and formulate the assessment and plan.ResultsThe parallel encounter has the potential to enhance the teaching encounter by emphasizing clinical reasoning, reduce cognitive bias by integrating two independent assessments of the same patient, increase attending workflow flexibility and efficiency, and improve patient satisfaction and outcomes by reducing time to initial provider contact. The attending must be mindful of protecting resident autonomy. This model tends to work better for more senior learners.ConclusionsThe parallel encounter represents a novel approach to the traditional serial trainee–attending patient evaluation model that may enhance the teaching encounter and improve patient care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163487/2/aet210491_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163487/1/aet210491.pd

Zooming In Versus Flying Out: Virtual Residency Interviews in the Era of COVID‐19

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163370/2/aet210486.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163370/1/aet210486_am.pd

In Crisis: Medical Students in the COVID‐19 Pandemic

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156130/2/aet210450.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156130/1/aet210450_am.pd

Training in the Management of Psychobehavioral Conditions: A Needs Assessment Survey of Emergency Medicine Residents

ObjectiveMental health–related ED visits are increasing. Despite this trend, most emergency medicine (EM) residency programs devote little time to psychiatry education. This study aimed to identify EM residents’ perceptions of training needs in emergency psychiatry and self‐confidence in managing patients with psychobehavioral conditions.MethodsA needs assessment survey was distributed to residents at 15 Accreditation Council for Graduate Medical Education–accredited EM programs spanning the U.S. Survey items addressed amount and type of training in psychiatry during residency, perceived training needs in psychiatry, and self‐confidence performing various clinical skills related to emergency psychiatric care. Residents used a 5‐point scale (1 = nothing; 5 = very large amount) to rate their learning needs in a variety of topic areas related to behavioral emergencies (e.g., medically clearing patients, substance use disorders). Using a scale from 0 to 100, residents rated their confidence in their ability to independently perform various clinical skills related to emergency psychiatric care (e.g., differentiating a psychiatric presentation from delirium).ResultsOf the 632 residents invited to participate, 396 (63%) responded. Twelve percent of respondents reported completing a psychiatry rotation during EM residency. One of the 15 participating programs had a required psychiatry rotation. Residents reported that their program used lectures (56%) and/or supervised training in the ED (35%) to teach residents about psychiatric emergencies. Most residents reported minimal involvement in the treatment of patients with psychiatric concerns. The majority of residents (59%) believed that their program should offer more education on managing psychiatric emergencies. Only 14% of residents felt “quite” or “extremely” prepared to treat psychiatric patients. Overall, residents reported the lowest levels of confidence and highest need for more training related to counseling suicidal patients and treating psychiatric issues in special populations (e.g., pregnant women, elderly, and children).ConclusionsMost EM residents desire more training in managing psychiatric emergencies than is currently provided.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152005/1/aet210377-sup-0001-DataSupplementS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152005/2/aet210377.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152005/3/aet210377_am.pd

What’s in a Name? Use of Brand versus Generic Drug Names in United States Outpatient Practice

BACKGROUND: The use of brand rather than generic names for medications can increase health care costs. However, little is known at a national level about how often physicians refer to drugs using their brand or generic names. OBJECTIVE: To evaluate how often physicians refer to drugs using brand or generic terminology. DESIGN AND PARTICIPANTS: We used data from the 2003 National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of 25,288 community-based outpatient visits in the United States. After each visit, patient medications were recorded on a survey encounter form by the treating physician or transcribed from office notes. MEASUREMENTS: Our main outcome measure was the frequency with which medications were recorded on the encounter form using their brand or generic names. RESULTS: For 20 commonly used drugs, the median frequency of brand name use was 98% (interquartile range, 81–100%). Among 12 medications with no generic competition at the time of the survey, the median frequency of brand name use was 100% (range 92–100%). Among 8 medications with generic competition at the time of the survey (“multisource” drugs), the median frequency of brand name use was 79% (range 0–98%; P < .001 for difference between drugs with and without generic competition). CONCLUSIONS: Physicians refer to most medications by their brand names, including drugs with generic formulations. This may lead to higher health care costs by promoting the use of brand-name products when generic alternatives are available

Rapid Adaptation to Remote Didactics and Learning in GME

Weekly didactic conference in emergency medicine education has traditionally united residents and faculty for learning and fostered community within the residency program. The global pandemic Coronavirus Disease-19 (COVID-19) has fueled a rapid transition to remote learning that has disrupted the typical in-person format. To maintain ACGME educational experiences and requirements for residents in a safe manner, many residencies have moved to videoconferencing platforms such as Zoom™, Teams™, and WebEX.™ Given the importance of didactic conference as a ritual, educational experience and community-building activity, most residency programs have worked to maintain an active and robust didactic conference despite the many logistical challenges. Engaging residency program members in the transition to remote learning and utilizing opportunities for innovation can help to maintain normalcy and combat isolation resulting from the loss of weekly in-person contact. Herein, we propose practical tips for optimizing remote learning for weekly emergency medicine residency didactics