No abstract

The standard treatment of cutaneous abscesses in the emergency department is incision and drainage (I&D). The purpose of this investigation is to determine the feasibility of using a povodine-iodine topical antiseptic solution (PVP-I) as a clinical adjunct in the treatment of superficial skin abscesses after I&D, and the data is related to “Pilot Study to Evaluate the Adjunct Use of a Povidone-Iodine Topical Antiseptic in Patients with Soft Tissue Abscesses” [Olson et al., 2019]. The data aims to determine if the daily application of PVP-I in the wound cavity and as an antiseptic hand wash would confer any benefit over I&D alone. The primary outcome was clinical cure 7–10 days after I&D. The secondary outcomes were rate of new abscess development and spread of infection in household contacts (HC) within 30 days.

IntroductionNow widespread in emergency medicine (EM) residency programs, asynchronous curriculum (AC) moves education outside of classic classrooms. Our program’s prior AC had residents learning in isolation, achieving completion via quizzes before advancing without the benefit of deliberate knowledge reinforcement. We sought to increase engagement and spaced repetition by creating a social AC using gamification.MethodsWe created a website featuring monthly options from textbooks and open-access medical education. Residents selected four hours of material, and then submitted learning points. Using these learning points, trivia competitions were created. Residents competed in teams as “houses” during didactic conference, allowing for spaced repetition. Residents who were late in completing AC assignments caused their “house” to lose points, thus encouraging timely completion.ResultsCompletion rates prior to deadline are now >95% compared to ~30% before intervention. Surveys show increased AC enjoyment with residents deeming it more valuable clinically and for EM board preparation.ConclusionSocially synchronized AC offers a previously undescribed method of increasing resident engagement via gamification.

Introduction: While burnout is occupation-specific, depression affects individuals comprehensively. Research on interventions for depression in emergency medicine (EM) residents is limited. Objectives: We sought to obtain longitudinal data on positive depression screens in EM residents, assess their association with burnout, and determine whether implementation of a wellness curriculum affected the rate of positive screens. Methods: In February 2017, we administered the Maslach Burnout Inventory and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire two-question depression screen at 10 EM residencies. At five intervention sites, a year-long wellness curriculum was then introduced while five control sites agreed not to introduce new wellness initiatives during the study period. Study instruments were re-administered in August 2017 and February 2018. Results: Of 382 residents, 285 participated in February 2017; 40% screened positive for depression. In August 2017, 247/386 residents participated; 27.9% screened positive for depression. In February 2018, 228/386 residents participated; 36.2% screened positive. A positive depression screen was associated with higher burnout. There were similar rates of positive screens at the intervention and control sites. Conclusion: Rates of positive depression screens in EM residents ranged between 27.9% and 40%. Residents with a positive screen reported higher levels of burnout. Rates of a positive screen were unaffected by introduction of a wellness curriculum.

No abstract