Surveying Emergency Medicine

Mello, Michael J.; Merchant, Roland C.; Clark, Melissa A.

doi:10.1111/acem.12103

Cited by 50 publications

(57 citation statements)

References 9 publications

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“…Survey results were reported in accordance with best practices as outlined in Academic Emergency Medicine. 13 The survey was designed by consensus of the five authors who were informed by similar surveys in anesthesia and EM residents. 5,8,14 It was hosted on Fluid Surveys.…”

Section: Methodsmentioning

confidence: 99%

The use of free online educational resources by Canadian emergency medicine residents and program directors

Purdy

Thoma

Bednarczyk

et al. 2015

CJEM

133

129

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Introduction: Online educational resources (OERs) are increasingly available for emergency medicine (EM) education. This study describes and compares the use of free OERs by the Royal College of Physicians and Surgeons of Canada (RCPSC) EM residents and program directors (PDs) and investigates the relationship between the use of OERs and peer-reviewed literature. Methods: A bilingual, online survey was distributed to RCPSC-EM residents and PDs using a modified Dillman method. The chi-square test and Fisher's exact test were used to compare the responses of residents and PDs. Results: The survey was completed by 214/350 (61%) residents and 11/14 (79%) PDs. Free OERs were used by residents most frequently for general EM education (99.5%), procedural skills training (96%), and learning to interpret diagnostic tests (92%). OER modalities used most frequently included wikis (95%), file-sharing websites (95%), e-textbooks (94%), and podcasts (91%). Residents used wikis, podcasts, vodcasts, and file-sharing websites significantly more frequently than PDs. Relative to PDs, residents found entertainment value to be more important for choosing OERs (p < 0.01). Some residents (23%) did not feel that literature references were important, whereas all PDs did. Both groups reported that OERs increased the amount of peer-reviewed literature (75% and 60%, respectively) that they read. Conclusions: EM residents make extensive use of OERs and differ from their PDs in the importance that they place on their entertainment value and incorporation of peer-reviewed references. OERs may increase the use of peer-reviewed literature in both groups. Given the prevalence of OER use for core educational goals among RCPSC-EM trainees, future efforts to facilitate critical appraisal and appropriate resource selection are warranted.

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Section: Methodsmentioning

confidence: 99%

The use of free online educational resources by Canadian emergency medicine residents and program directors

Purdy

Thoma

Bednarczyk

et al. 2015

CJEM

133

129

View full text Add to dashboard Cite

show abstract

“…17,[32][33][34] The first stage included reviews and iterative input from eight physician experts known for their work on resource utilization and decision-making within EM. The physician experts were selected largely based on convenience in that they were either working at institutions with which the investigators had professional relationships or recommended by one of the other experts; in addition, all of these physician experts had published on the topic of resource utilization in EM.…”

Section: Survey Development and Administrationmentioning

confidence: 99%

“…Second, while we attempted to follow EM-relevant methodological guidelines for survey design, 34 it is uncertain whether or not an average EP can accurately estimate the unnecessary image ordering behavior of his/her colleagues. It is possible that because resident physicians see patients alongside multiple faculty members, they may be able to provide more accurate estimates; at the same time, however, residents may be less capable of judging medical necessity of imaging due to their relative lack of clinical experience.…”

Section: Limitationsmentioning

confidence: 99%

Emergency Physician Perceptions of Medically Unnecessary Advanced Diagnostic Imaging

Kanzaria

Hoffman

Probst

et al. 2015

Academic Emergency Medicine

162

146

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Objectives: The objective was to determine emergency physician (EP) perceptions regarding 1) the extent to which they order medically unnecessary advanced diagnostic imaging, 2) factors that contribute to this behavior, and 3) proposed solutions for curbing this practice.Methods: As part of a larger study to engage physicians in the delivery of high-value health care, two multispecialty focus groups were conducted to explore the topic of decision-making around resource utilization, after which qualitative analysis was used to generate survey questions. The survey was extensively pilot-tested and refined for emergency medicine (EM) to focus on advanced diagnostic imaging (i.e., computed tomography [CT] or magnetic resonance imaging [MRI]). The survey was then administered to a national, purposive sample of EPs and EM trainees. Simple descriptive statistics to summarize physician responses are presented.Results: In this study, 478 EPs were approached, of whom 435 (91%) completed the survey; 68% of respondents were board-certified, and roughly half worked in academic emergency departments (EDs). Over 85% of respondents believe too many diagnostic tests are ordered in their own EDs, and 97% said at least some (mean = 22%) of the advanced imaging studies they personally order are medically unnecessary. The main perceived contributors were fear of missing a low-probability diagnosis and fear of litigation. Solutions most commonly felt to be "extremely" or "very" helpful for reducing unnecessary imaging included malpractice reform (79%), increased patient involvement through education (70%) and shared decision-making (56%), feedback to physicians on test-ordering metrics (55%), and improved education of physicians on diagnostic testing (50%). Conclusions:Overordering of advanced imaging may be a systemic problem, as many EPs believe a substantial proportion of such studies, including some they personally order, are medically unnecessary. Respondents cited multiple complex factors with several potential high-yield solutions that must be addressed simultaneously to curb overimaging.ACADEMIC EMERGENCY MEDICINE 2015;22:390-398

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“…3 Finally, the survey was piloted with all EM residents within the primary institution's program to further support its validity. 4 Applicants were asked to estimate the time it took to schedule with the online system compared to other methods, and to rate their satisfaction with scheduling on a 5-point anchored scale.…”

Section: Methodsmentioning

confidence: 99%