The 2019 Model of the Clinical Practice of Emergency Medicine

Background: Despite identified inequities and disparities in lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) health, past studies have shown little or no education at the medical school or residency level for emergency physicians. With increased focus on health inequities and disparities, we sought to reexamine the status of sexual and gender minority health education in U.S. emergency medicine (EM) residencies. Objectives: Our primary objective was to determine how many EM residencies offer education on LGBTQ+ health. Secondary objectives included the number of actual versus preferred hours of LGBTQ+ training, identification of barriers to providing education, and correlation of education with program demographics. Finally, we compared our current data with past results of our 2013 study. Methods: The initial survey that sought to examine LGBTQ+ training in 2013 was used and sent in 2020 via email to EM programs accredited by the American Council for Graduate Medical Education who had at least one full class of residents in 2019. Reminder emails and a reminder post on the Council of Residency Directors in Emergency Medicine listserv were used to increase participation. Results: A total of 229 programs were eligible, with a 49.3% response rate (113/229).The majority (75%) offered education content on LGBTQ+ health, for a median (IQR) of 2 (1-3) hours and a range of 0 to 22 hours. Respondents preferred more hours of education than offered (median desired hours = 4, IQR = 2-5 hours; p < 0.001). The largest barrier identified was lack of time in curriculum (63%). The majority of programs had known LGBTQ+ faculty and residents. Inclusion and amount of education hours positively correlated with presence of LGBTQ+ faculty or residents; university-and county-based programs were more likely to deliver education content than private groups (p = 0.03). Awareness of known LGBTQ+ residents but not faculty differed by region, but there was no significant difference in actual or preferred content by region. Conclusion:The majority of respondents offer education in sexual and gender minority health, although there remains a gap between actual and preferred hours. This is

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The prevalence of lesbian, gay, bisexual, and transgender health education and training in emergency medicine residency programs: Where are we now?

Moll

Vennard

Noto

et al. 2021

“…4 Furthermore, the Model for Clinical Practice of Emergency Medicine (EM Model) put forth by the American Board of Emergency Medicine (ABEM) mentions physician tasks such as multiple patient care, further supporting the need for creating a standardized approach to teaching WFE. 5 While previous studies have demonstrated that EM residents see more patients as they advance through training, the specific ways in which WFE skills develop and are tracked over time have not been described. 6,7 To address this gap in understanding we developed a survey targeting the following questions: (1) How do EM residency programs in the United States currently teach and measure WFE and…”

Section: Introductionmentioning

confidence: 99%

“…While the Accreditation Council for Graduate Medical Education (ACGME) indirectly mentions aspects of WFE in their core competencies, they do not provide a way to meet these requirements and currently there is no standard approach to measuring and teaching this skill set during residency 4 . Furthermore, the Model for Clinical Practice of Emergency Medicine (EM Model) put forth by the American Board of Emergency Medicine (ABEM) mentions physician tasks such as multiple patient care, further supporting the need for creating a standardized approach to teaching WFE 5 . While previous studies have demonstrated that EM residents see more patients as they advance through training, the specific ways in which WFE skills develop and are tracked over time have not been described 6,7 …”

Section: Introductionmentioning

confidence: 99%

A nationwide survey of emergency medicine resident workflow efficiency: Are training programs teaching residents to be efficient?

Carmelli

Watson

Villarroel

et al. 2021

Background: Workflow efficiency (WFE) is essential to the practice of emergency medicine (EM), but a standardized approach to measuring and teaching it during residency is lacking. In this study we sought to describe how EM residency programs in the United States currently measure and teach WFE and to assess the relative importance of WFE teaching to EM residency program leaders.Methods: We conducted a cross-sectional survey of all accredited EM residency training programs in the United States in Fall 2019. We invited all allopathic EM residency programs to participate in the study by directly emailing program directors and assistant/associate program directors. We conducted the study and performed descriptive statistics using SurveyMonkey software. Results:We received a total of 133 responses out of 190 total programs (70%) with proportionate representation from 3-and 4-year programs and all regions of the United States. When asked to what extent teaching efficiency should be a priority compared to other educational goals, 65% of program leaders responded with "significant" or "moderate" priority. Most EM programs collect WFE data on their residents, either by tracking patients per hour (78%) or by written evaluations (59%). Common methods for providing WFE data to residents were: "individual data provided along with deidentified rank" (35%), "data provided only during private feedback meetings" (26%), and "no data or rank provided to residents" (16%). Regarding targeted WFE teaching to residents, 88% reported utilizing general on-shift teaching, 48% reported teaching WFE during formal didactics, and 45% during dedicated private feedback sessions. Conclusion:This national study of allopathic U.S. EM programs suggests that most EM program leaders do value WFE teaching. However, we found no consistent approach among programs for tracking or distributing resident WFE data, and many programs lack a formalized way to teach efficiency to their residents.

Holes in the FOAM: An Analysis of Curricular Comprehensiveness in Online Educational Resources

Grock

Chan

Aluisio

et al. 2020

Objectives: We sought to evaluate Free Open Access Medical Education (FOAM), defined as online educational content available free to anyone, anywhere, at any time, by classifying the most impactful FOAM content per the Social Media Index into the topics and subtopics of the American Board of Emergency Medicine's Model of the Clinical Practice of Emergency Medicine. We then analyzed FOAM's comprehensiveness by describing over-and underrepresentation among these topics and subtopics.Methods: First, we searched for FOAM resources based on the most recent 12 months of relevant content for each organ system from the top 50 Social Media Index sites. Next, we classified all 898 posts into its related topics or subtopics per the American Board of Emergency Medicine's Model of the Clinical Practice of Emergency Medicine. Finally, we analyzed how comprehensively FOAM covered each organ system and the frequency of posts that covered each organ system subtopic as well as identified the subtopics with the most frequent coverage. Results:The search yielded 898 FOAM posts, of which cardiology and neurology were significantly overrepresented and psychobehavioral; obstetrics and gynecology; and head, ears, eyes, nose, and throat were significantly underrepresented. Among subtopics, acute coronary syndrome had the highest subtopic coverage consisting of 55.5% of all cardiology content. Other highly represented subtopics include renal colic; diabetic ketoacidosis; sepsis; and stroke with 39, 40, 40, and 71% of each of their topic's content, respectively.Conclusions: Although residents and programs are frequently incorporating FOAM into the educational curriculum, these materials seem to lack comprehensiveness. Educators and learners must be aware of these deficits in creating comprehensive emergency medicine curricula.F or decades the traditional pillars of asynchronous medical education consisted of physical copies of peer-reviewed journals and medical textbooks. With the rise of the Internet, peer-reviewed publications became available through PubMed online and textbooks became available electronically. Likewise, medical educators became able to release their content online. This innovation, known as Free Open Access Medical Education (FOAM), primarily offers the opportunity for increased information dissemination and also fosters collaboration through virtual communities of practice. 1-3 From 20021-3 From to 2013