Mentoring in Emergency Medicine: Challenges and Future Directions

Academic emergency physicians aspire to be mentors for a wide array of adult learners, including emergency medicine residents, other specialty residents, medical students, and numerous other adult learners, including other emergency medicine faculty. Despite this universal goal in academic emergency medicine, few published data exist regarding specific modalities proven effective in mentorship

Mentoring in Emergency Medicine: Challenges and Future Directions

Academic emergency physicians aspire to be mentors for a wide array of adult learners, including emergency medicine residents, other specialty residents, medical students, and numerous other adult learners, including other emergency medicine faculty. Despite this universal goal in academic emergency medicine, few published data exist regarding specific modalities proven effective in mentorship

A low-cost, tablet-based option for prehospital neurologic assessment

ObjectivesIn this 2-center study, we assessed the technical feasibility and reliability of a low cost, tablet-based mobile telestroke option for ambulance transport and hypothesized that the NIH Stroke Scale (NIHSS) could be performed with similar reliability between remote and bedside examinations.MethodsWe piloted our mobile telemedicine system in 2 geographic regions, central Virginia and the San Francisco Bay Area, utilizing commercial cellular networks for videoconferencing transmission. Standardized patients portrayed scripted stroke scenarios during ambulance transport and were evaluated by independent raters comparing bedside to remote mobile telestroke assessments. We used a mixed-effects regression model to determine intraclass correlation of the NIHSS between bedside and remote examinations (95% confidence interval).ResultsWe conducted 27 ambulance runs at both sites and successfully completed the NIHSS for all prehospital assessments without prohibitive technical interruption. The mean difference between bedside (face-to-face) and remote (video) NIHSS scores was 0.25 (1.00 to -0.50). Overall, correlation of the NIHSS between bedside and mobile telestroke assessments was 0.96 (0.92-0.98). In the mixed-effects regression model, there were no statistically significant differences accounting for method of evaluation or differences between sites.ConclusionsUtilizing a low-cost, tablet-based platform and commercial cellular networks, we can reliably perform prehospital neurologic assessments in both rural and urban settings. Further research is needed to establish the reliability and validity of prehospital mobile telestroke assessment in live patients presenting with acute neurologic symptoms