The 2007 Model of the Clinical Practice of Emergency Medicine: The 2009 Update

Perina, Debra G.; Beeson, Michael S.; Char, Douglas; Counselman, Francis L.; Keim, Samuel M.; McGee, Douglas L.; Rosen, Carlo L.; Sokolove, Peter E.; Tantama, Stephen S.

doi:10.1111/j.1553-2712.2010.00962.x

Cited by 28 publications

(7 citation statements)

References 14 publications

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“…The development of the milestones used a substantial foundation of data in their construction. The milestones were developed from three key sources: ABEM initial certification standards (unpublished, internal document); the Model of the Clinical Practice of Emergency Medicine (EM Model) 3 ; and ACGME common competency expert panels (unpublished, internal document). The ABEM initial certification standards were developed through multiple advisory panels, an ABEM internal task force, and a national survey of 26,000 ABEM-certified physicians.…”

Section: Discussionmentioning

confidence: 99%

“…These were largely anchored on physician tasks listed in the EM Model. 3 The EM Model further provided a list of clinical procedures germane to practicing emergency physicians. Finally, the ACGME expert panels created milestones for the common competencies: professionalism, interpersonal and communication skills, systems-based practice, and practice-based learning and improvement.…”

Section: Discussionmentioning

confidence: 99%

“…Once the revisions were completed, the final version was submitted to the RRC-EM for approval. On September 7, 2012, the RRC-EM approved the validated EM Milestones, 3 making EM the first medical specialty to approve a final set of milestones.…”

Section: Discussionmentioning

confidence: 99%

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The Emergency Medicine Milestones: A Validation Study

et al. 2013

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Objectives: The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties sought to define milestones for skill and knowledge acquisition during residency training. Milestones are significant objective observable events. The milestones are listed within a structure that is derived from the ACGME general competencies. Major groups of milestones are called "subcompetencies." The original 24 subcompetencies containing 255 milestones for emergency medicine (EM) were developed through a multiorganizational group representing most EM stakeholder groups. To assure that the milestones reflected EM resident progress throughout training, the EM Milestones Working Group (EM MWG) sought to validate the individual milestones.Methods: A computer-based survey was sent to all EM residency programs. The survey period began on April 30, 2012, and concluded on May 15, 2012. Respondents were asked to assign each milestone to a specific level of skill or knowledge acquisition. These levels ranged from a beginning resident to an accomplished clinician. There were two different forms that divided the milestones into two groups of 12 subcompetencies each. Surveys were randomly assigned to programs.Results: There were five respondents (the program director and four key faculty) requested from each of the 159 residences. There were responses from 96 programs (60.4%). Of the 795 survey recipients, 28 were excluded due to prior exposure to the EM milestones. Of the remaining 767 potential respondents, 281 completed the survey (36.6%) within a 16-day period. Based on the survey results, the working group adjusted the milestones in the following ways: one entire subcompetency (teaching) was eliminated, six new milestones were created, 34 milestones were eliminated, 26 milestones were reassigned to a lower level score, and 20 were reassigned to a higher level. Nineteen milestones were edited to provide greater clarity. The final result was 227 discrete milestones among 23 subcompetencies. Conclusions:The EM milestones were validated through a milestone assignment process using a computer-based survey completed by program directors and key faculty. Milestones were revised in accordance with the results to better align assignment within each performance level.ACADEMIC EMERGENCY MEDICINE 2013; 20:730-736 © 2013 by the Society for Academic Emergency Medicine A s part of the Next Accreditation System, the Accreditation Council for Graduate Medical Education (ACGME) has proposed a new method for tracking resident acquisition of knowledge, skills, abilities, attitudes, and experiences.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Emergency Medicine Milestones: A Validation Study

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“…1 The American College of Emergency Physicians (ACEP) recommends integration of US education into the core curriculum of all EM residency programs, and the currently suggested curriculum is based on consensus recommendations from the 2008 Council of Emergency Medicine Residency Directors (CORD) conference. 2,3 The Accreditation Council for Graduate Medical Education (ACGME) recently introduced the concept of educational milestones for resident assessment, and subsequently the EM Milestones Working Group developed specialty-specific milestones.…”

mentioning

confidence: 99%

Ultrasound Competency Assessment in Emergency Medicine Residency Programs

Amini

Adhikari

Fiorello

2014

Academic Emergency Medicine

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Objectives: In the Model of the Clinical Practice of Emergency Medicine (EM), bedside ultrasound (US) is listed as one of the essential procedural skills. EM milestones released by Accreditation Council for Graduate Medical Education and American Board of Emergency Medicine require residents to demonstrate competency in bedside US. The purpose of this study was to assess the current methods used by EM residency training programs to evaluate resident competency in bedside US.Methods: This was a cross-sectional survey study. A questionnaire on US education and competency assessment was electronically sent to all EM residency program directors and emergency US directors. The survey consisted of questions regarding the US rotation, structure of US curriculum, presence of US fellowship, image archiving, quality assurance methods, feedback, competency assessment tools, and frequency of assessment. The survey responses are reported as the percentages of total respondents along with 95% confidence intervals (CIs).Results: A total of 124 of 161 EM residency programs participated in this study, representing a 77% response rate. Twenty-six percent (95% CI = 18% to 34%) of programs assess competency only at the end of the US rotation. Eight percent (95% CI = 3% to 13%) assess competency only every 6 months, and 13% (95% CI = 7% to 19%) assess competency only annually. Eight percent (95% CI = 3% to 13%) assess competency only during the final year of training. Thirty percent (95% CI = 22% to 38%) of programs assess competency with a combination of the above intervals, and 16% (95% CI = 10% to 22%) do not assess US competency. Fourteen percent (95% CI = 8% to 20%) use objective structured clinical examinations (OSCEs), and 21% (95% CI = 14% to 28%) use standardized direct observation tools (SDOTs) to assess resident competency in US. Approximately one-third (33%, 95% CI = 24% to 41%) of standardized testing for US competency is conducted with multiple-choice questions. Thirty percent (95% CI = 21% to 38%) administer practical examinations to assess US skills.Conclusions: Currently, a majority of EM residency programs assess resident competency in bedside US. However, there is significant variation in the methods of competency assessment. The Accreditation Council for Graduate Medical Education (ACGME) recently introduced the concept of educational milestones for resident assessment, and subsequently the EM Milestones Working Group developed specialty-specific milestones. 4 In October 2012, the ACGME and the American Board of Emergency Medicine (ABEM) finalized 23 milestones, and US was designated patient care skill number 12.4 This patient care skill requires EM residents to demonstrate competency in performing bedside US. [5][6][7] To successfully implement

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“…30 Assuming that our training model is similar to others, an alarm should be raised because the care of lower-acuity conditions may be a training deficit. As the use of urgent care centers and triage physicians in EDs increases; resident exposure to lower-acuity patients likely will decreases.…”

Section: Number Of Questionsmentioning

confidence: 99%

Residents need focused teaching during pediatric emergency medicine rotation to optimize their educational objectives

Alomar

Daliri

Alamer

et al. 2014

Healthc Low Resour Settings

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Pediatric Emergency Medicine (PEM) rotation provides a unique training environment for rotating residents. We aim to assess the impact of PEM rotation on the scientific knowledge of residents from different specialties and training centers by comparing the pre-and post-rotation knowledge. PEM Departments of three major tertiary care training centers were selected. Rotating pediatric and emergency medicine residents were given pre-test with twenty multiple-choice type questions related to the scientific knowledge of PEM and then re-tested with the same questions towards the end of their rotation. The t-test was used to compare mean scores. Further comparison based on specialty and training center was also done. Seventy-three residents were approached and enrolled, 48 from Pediatrics and 25 from Emergency Medicine. The mean pre-and post-scores for all residents were 15.9/20 and 15.5/20, respectively. All residents' score was less on the post-rotation compared to the pre-rotation in all centers. Pediatric residents at one center scored higher, but they were not statistically significant. There were no statistically significant differences in resident specialty. We found a statistical difference between the residents of two centers compared to the third with P=0.04 and 0.02 respectively. After one month of rotation in PEM, we observed a decrease in the post-rotation test scores as compared to the pre-rotation scores.

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The 2007 Model of the Clinical Practice of Emergency Medicine: The 2009 Update

Cited by 28 publications

References 14 publications

The Emergency Medicine Milestones: A Validation Study

The Emergency Medicine Milestones: A Validation Study

Ultrasound Competency Assessment in Emergency Medicine Residency Programs

Residents need focused teaching during pediatric emergency medicine rotation to optimize their educational objectives

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