I arrived to my shift early, nervous about caring for critically ill patients as a first-year fellow. I sat in the workroom alone, paralyzed, not sure how to preround despite being months into fellowship. The senior fellow appeared minutes before sign-out; fresh, knowledgeable, and calm, despite her busy night and lack of sleep. She asked me how I was doing. With tears in my eyes, my emotions poured out. I explained that I felt lost, unsure of myself, my place, and my knowledge. For the first time, I confessed out loud, “I don’t think I’m supposed to be here. I have no idea what I’m doing.” I could trust her in a way I couldn’t trust others. She was like me: othered by her identity, minoritized by society. Though different from my own, her identity allowed her to understand my own experiences. We were different from one another and we were also the same. Unlike the senior faculty, it was safe to talk to her. And, unlike my other cofellows, there was a kinship between us in our otherness. She looked at me, closed the door, and shared words of strength that I needed to hear. I belonged. I was more than enough. She shared that the pressure I was experiencing was common among systematically minoritized individuals; she too had felt it before. Sitting with her, I was finally seen, supported, and comforted. As a peer mentor from a minoritized background, she provided a sense of security and belonging that had not been provided in my training and was distinct from the support of senior faculty.
Objectives: Despite decades of literature recognizing racial disparities (RDs) in emergency medicine (EM), published curricula dedicated to addressing them are sparse.We present details of our novel RD curriculum for EM clerkships and its educational outcomes. Methods:We created a 30-min interactive didactic module on the topic designed for third-and fourth-year medical students enrolled in our EM clerkships. Through a modified Delphi process, education faculty and content experts in RD developed a 10-question multiple-choice test of knowledge on RD that the students completed immediately prior to and 2 weeks following the activity. Students also completed a Likert-style learner satisfaction survey. Median pre-and posttest scores were compared using a paired Wilcoxon signed-rank test and presented using medians and 95% confidence intervals (CIs). Satisfaction survey responses were dichotomized into favorable and neutral/not favorable.Results: For the 36 students who completed the module, the median pretest score was 40% (95% CI 36%-50%) and the posttest score was 70% (95% CI 60%-70%) with a p-value of <0.001. Thirty-five of the 36 students improved on the posttest with a mean increase of 24.2% (95% CI 20.2-28.2). The satisfaction survey also showed a positive response, with at least 83% of participants responding favorably to all statements (overall mean favorable response 93%, 95% CI 90%-96%). ConclusionsThis EM-based module on RD led to improvement in students' knowledge on the topic and positive reception by participants. This is a feasible option for educating students in EM on the topic of RD. of 5 | RACIAL DISPARITIES IN EMERGENCY MEDICINE NEED FOR INNOVATIONRacial disparities (RDs) in health care outcomes due to racism and provider bias is well documented in the literature. Despite this, progress across a multitude of key health metrics has been lacking over the past two decades. 1 Widespread education on the topic in medical training is needed to address this problem. To date, there is no established, standardized curriculum for students in emergency medicine (EM) to address the numerous RDs in this patient population and potential biases that exist in this learner group. BACKG ROU N DRDs in the emergency department (ED) are ubiquitous. For instance, Black patients are less likely than their White counterparts to receive pain medicine, 2-5 be triaged appropriately, 6,7 and receive basic testing for chest pain. 3 In addition, Black patients are more likely to be accused of child abuse, 8 be physically restrained, 9,10 get questioned about drug use, and undergo drug testing. 11The National Academy of Medicine, in their 2003 landmark report "Unequal Treatment," lauded education as a primary means to address these RDs. 12 This sentiment has been consistently reinforced in literature. [13][14][15] Studies have demonstrated a substantial need for education in the medical student population. One investigation found that half of White medical students had misconceptions regarding race including the belief Black p...
Patients with multidrug-resistant tuberculosis (MDR-TB) who received regimens containing high dose isoniazid (INHHD) had similar time to culture conversion and treatment outcomes as patients who received regimens with bedaquiline (BDQ). INHHD is an inexpensive and safe medication which may contribute additive efficacy in combination regimens.
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