BackgroundRelatively little is understood about which factors influence students’ choice of specialty and when learners ultimately make this decision.ObjectiveThe objective is to understand how experiences of medical students relate to the timing of selection of Emergency Medicine (EM) as a specialty. Of specific interest were factors such as how earlier and more positive specialty exposure may impact the decision-making process of medical students.MethodsA cross-sectional survey study of EM bound 4th year US medical students (MD and DO) was performed exploring when and why students choose EM as their specialty. An electronic survey was distributed in March 2015 to all medical students who applied to an EM residency at 4 programs representing different geographical regions. Descriptive analyses and multinomial logistic regressions were performed.Results793/1372 (58%) responded. Over half had EM experience prior to medical school. When students selected EM varied: 13.9% prior to, 50.4% during, and 35.7% after their M3 year. Early exposure, presence of an EM residency program, previous employment in the ED, experience as a pre-hospital provider, and completion of an M3 EM clerkship were associated with earlier selection. Delayed exposure to EM was associated with later selection of EM.ConclusionsEarly exposure and prior life experiences were associated with choosing EM earlier in medical school. The third year was identified as the most common time for definitively choosing the specialty.
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Study Objectives: Point-of-care ultrasound (POCUS) is integral to the care of patients in the emergency department. Unfortunately, ultrasound probes can act as fomites for pathogen transmission from patient to patient despite various cleaning methods and barrier precautions. It is pertinent to understand what factors contribute to this and how we can best reduce this risk. The objective of this study was to detect growth of methicillin-sensitive Staphylococcus aureus (MSSA) from POCUS probes after scanning an inoculated pork model with several types of conduction media to investigate the difference in pathogen transmission.Methods: A portion of store-bought pork shoulder was disinfected with chlorhexidine and allowed to dry. One mL of a cultured sample of abscessconcentration MSSA was used to inoculate the specimen. A linear transducer was cleansed with a sterilizing cloth and the end of the probe was then covered with a Tegaderm (3M, Maplewood, MN). One of three conduction media was applied to the pork shoulder: sterile saline, chlorhexidine, or sterile gel. The probe was then used to perform a soft tissue scan of the pork shoulder for one minute. After this, the probe was swabbed and cultured to detect transmission of MSSA. This was done four times for each of the three media types.Results: None of the four saline or four chlorhexidine probe swabs grew MSSA when cultured. Three of the four sterile gel probe swabs grew MSSA.Conclusions: These results suggest that sterile ultrasound gel may be more likely to transmit skin pathogens to the probe during POCUS in a simulated environment. However, larger studies and further exploration into this topic are necessary to draw clinical conclusions.
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