Council of Emergency Medicine Residency Directors/ Academic Emergency Medicine Supplement - The Inaugural Edition

The author reports that there are no conflicts of financial interest.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78672/1/j.1553-2712.2009.00595.x.pd

Should We Screen for Depression in the Emergency Department?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73525/1/j.1553-2712.2004.tb01430.x.pd

Poster 385: The Management of Patients With Chronic Spinal Cord Injury in Emergency Departments: A Knowledge Survey of Emergency Medicine Residents

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146856/1/pmr2s169a.pd

Optimizing the post-graduate institutional program evaluation process

Abstract Background Reviewing program educational efforts is an important component of postgraduate medical education program accreditation. The post-graduate review process has evolved over time to include centralized oversight based on accreditation standards. The institutional review process and the impact on participating faculty are topics not well described in the literature. Methods We conducted multiple Plan-Do-Study-Act (PDSA) cycles to identify and implement areas for change to improve productivity in our institutional program review committee. We also conducted one focus group and six in-person interviews with 18 committee members to explore their perspectives on the committee’s evolution. One author (MLL) reviewed the transcripts and performed the initial thematic coding with a PhD level research associate and identified and categorized themes. These themes were confirmed by all participating committee members upon review of a detailed summary. Emergent themes were triangulated with the University of Michigan Medical School’s Admissions Executive Committee (AEC). Results We present an overview of adopted new practices to the educational program evaluation process at the University of Michigan Health System that includes standardization of meetings, inclusion of resident members, development of area content experts, solicitation of committed committee members, transition from paper to electronic committee materials, and focus on continuous improvement. Faculty and resident committee members identified multiple improvement areas including the ability to provide high quality reviews of training programs, personal and professional development, and improved feedback from program trainees. Conclusions A standing committee that utilizes the expertise of a group of committed faculty members and which includes formal resident membership has significant advantages over ad hoc or other organizational structures for program evaluation committees.http://deepblue.lib.umich.edu/bitstream/2027.42/117363/1/12909_2016_Article_586.pd

Competence and Challenges of Emergency Medicine Training as Reported by Emergency Medicine Residents

Background The American Board of Emergency Medicine conducts an annual survey of residents in Emergency Medicine, the Longitudinal Study of Residents in Emergency Medicine survey. Objective: This study was undertaken to describe self-reported competence and challenges facing Emergency Medicine (EM) residents. Methods In this descriptive, observational analysis of the Longitudinal Study of Residents in Emergency Medicine survey, survey data from 1996–2008 were compared for 70 survey items. Responses were analyzed with means and 95% confidence intervals by post-graduate year (PGY) and over time. Results A total of 496 residents were included in this study. Most participated for 3 years, for a total of 1320 total responses. The most serious day-to-day challenges reported by residents (overall median scores of 3 or more) included knowing enough, keeping up with the medical literature, having enough time for personal life, ancillary support, and having enough time for family. Current level of competence in areas deemed weakest by residents included grant writing, contract negotiation, academic writing, disaster planning, research, and financial management. Residents reported improved competence in most (15 out of 16) areas from PGY-1 to PGY-3 year of training. Resident reports of competence did not change significantly over time from 1998–2008 (15 out of 16 items). Conclusions Emergency Medicine residents identified several important day-to-day problems, including knowing enough, keeping up with the medical literature, and having enough time for a personal life. PGY-3 residents reported improved competence in almost all aspects of EM work and clinical EM as compared to PGY-1 residents. Knowledge of perceived competence and problems among EM residents is crucial to the development of improved educational approaches to address these issues

Competence and Challenges of Emergency Medicine Training as Reported by Emergency Medicine Residents

Background The American Board of Emergency Medicine conducts an annual survey of residents in Emergency Medicine, the Longitudinal Study of Residents in Emergency Medicine survey. Objective: This study was undertaken to describe self-reported competence and challenges facing Emergency Medicine (EM) residents. Methods In this descriptive, observational analysis of the Longitudinal Study of Residents in Emergency Medicine survey, survey data from 1996–2008 were compared for 70 survey items. Responses were analyzed with means and 95% confidence intervals by post-graduate year (PGY) and over time. Results A total of 496 residents were included in this study. Most participated for 3 years, for a total of 1320 total responses. The most serious day-to-day challenges reported by residents (overall median scores of 3 or more) included knowing enough, keeping up with the medical literature, having enough time for personal life, ancillary support, and having enough time for family. Current level of competence in areas deemed weakest by residents included grant writing, contract negotiation, academic writing, disaster planning, research, and financial management. Residents reported improved competence in most (15 out of 16) areas from PGY-1 to PGY-3 year of training. Resident reports of competence did not change significantly over time from 1998–2008 (15 out of 16 items). Conclusions Emergency Medicine residents identified several important day-to-day problems, including knowing enough, keeping up with the medical literature, and having enough time for a personal life. PGY-3 residents reported improved competence in almost all aspects of EM work and clinical EM as compared to PGY-1 residents. Knowledge of perceived competence and problems among EM residents is crucial to the development of improved educational approaches to address these issues

Emergency Medicine Residents\u27 Perspectives on Patient Safety and Duty Hours

In 2003, the Accreditation Council for Graduate Medical Education implemented standards on duty hours, to promote resident learning and patient safety. In 2008, the Institute of Medicine released a report “Resident Duty Hours: Enhancing Sleep, Supervision, and Safety.” In 2011, the Accreditation Council for Graduate Medical Education implemented additional regulations on duty hours and supervision

Emergency Medicine Residents\u27 Perspectives on Patient Safety and Duty Hours

In 2003, the Accreditation Council for Graduate Medical Education implemented standards on duty hours, to promote resident learning and patient safety. In 2008, the Institute of Medicine released a report “Resident Duty Hours: Enhancing Sleep, Supervision, and Safety.” In 2011, the Accreditation Council for Graduate Medical Education implemented additional regulations on duty hours and supervision

Prevalence of Horizontal Violence Among Emergency Attending Physicians, Residents, and Physician Assistants

ABSTRACT Introduction Horizontal Violence (HV) is malicious behavior perpetrated by healthcare workers against each other. These include bullying, verbal or physical threats, purposeful disruptive behavior, and other malicious behaviors. This pilot study investigates the prevalence of HV among Emergency Department (ED) attending physicians, residents, and mid-level providers (MLPs).  Methods An electronic survey was sent to Emergency Medicine attending physicians (n=67), residents (n=25), and MLPs (n=24) in 3 unique EDs within a single multi-hospital medical system. The survey consisted of 18 questions that asked participants to indicate with what frequency (never, once, a few times, monthly, weekly, or daily) they have witnessed or experienced a particular behavior in the previous 12 months. Seven additional questions aimed to elicit the impact of HV on the participant, the work environment, or the patient care.  Results Of the 122 survey invitations, 91 were completed yielding a response rate of 74.6%. Of the respondents 64.8% were male and 35.2% were female. Attending physicians represented 41.8%, residents 37.4%, and MLPs 19.8% of respondents. Prevalence of reported behaviors ranged from 1.1% (Q18: physical assault) to 34.1% (Q4: been shouted at). Fourteen of these behaviors were most prevalent in the attending cohort, 6 were most prevalent in the MLP cohort, and 3 of the behaviors were most prevalent in the resident cohort.   Conclusion The horizontal violence behaviors investigated in this pilot study were similar to data previously published in nursing cohorts. Furthermore, nearly a quarter of participants (22.2%) indicated that HV has affected care for their patients, suggesting further studies are warranted to assess prevalence and the impact HV has on staff and patients

Development of a Data Collection Instrument for Violent Patient Encounters against Healthcare Workers

Introduction: Healthcare and social workers have the highest incidence of workplace violence of any industry. Assaults toward healthcare workers account for nearly half of all nonfatal injuries from occupational violence. Our goal was to develop and evaluate an instrument for prospective collection of data relevant to emergency department (ED) violence against healthcare workers.Methods: Participants at a high-volume tertiary care center were shown 11 vignettes portraying verbal and physical assaults and responded to a survey developed by the research team and piloted by ED personnel addressing the type and severity of violence portrayed. Demographic and employment groups were compared using the independent-samples Mann-Whitney U Test.Results: There were 193 participants (91 male). We found few statistical differences when comparing occupational and gender groups. Males assigned higher severity scores to acts of verbal violence versus females (mean M,F=3.08, 2.70; p<0.001). While not achieving statistical significance, subgroup analysis revealed that attending physicians rated acts of verbal violence higher than resident physicians, and nurses assigned higher severity scores to acts of sexual, verbal, and physical violence versus their physician counterparts.Conclusion: This survey instrument is the first tool shown to be accurate and reliable in characterizing acts of violence in the ED across all demographic and employment groups using filmed vignettes of violent acts. Gender and occupation of ED workers does not appear to play a significant role in perception of severity workplace violence. [West J Emerg Med. 2012;13(5):429-433.