1
|
Gottlieb M, Chan TM, Clarke SO, Ilgen JS, Jordan J, Moschella P, Santen SA, Yarris LM, Coates WC. Emergency Medicine Education Research Since the 2012 Consensus Conference: How Far Have We Come and What's Next? AEM EDUCATION AND TRAINING 2020; 4:S57-S66. [PMID: 32072108 PMCID: PMC7011414 DOI: 10.1002/aet2.10404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/14/2019] [Accepted: 10/24/2019] [Indexed: 05/03/2023]
Abstract
In 2012, the Society for Academic Emergency Medicine convened a consensus conference on the state of medical education research with goals of defining and advancing a future research agenda. Since that time, emergency medicine (EM) education research has grown significantly. A task force of EM education experts was assembled and sought to understand the current state of EM education research and future directions. Among the advances are increases in medical education fellowships, advanced degree and certification programs, faculty development programs, publication venues, and funding. These findings are discussed in light of the prior objectives from the 2012 consensus conference, and recommendations for future directions are provided.
Collapse
Affiliation(s)
- Michael Gottlieb
- Department of Emergency MedicineRush University Medical CenterChicagoIL
| | - Teresa M. Chan
- Division of Emergency MedicineDepartment of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Samuel O. Clarke
- Department of Emergency MedicineUniversity of California–DavisSacramentoCA
| | | | - Jaime Jordan
- Department of Emergency MedicineRonald Reagan UCLA Medical CenterLos AngelesCA
| | | | - Sally A. Santen
- Department of Emergency MedicineVirginia Commonwealth University School of MedicineRichmondVA
| | - Lalena M. Yarris
- Department of Emergency MedicineOregon Health & Science UniversityPortlandOR
| | - Wendy C. Coates
- Department of Emergency MedicineRonald Reagan UCLA Medical CenterLos AngelesCA
| |
Collapse
|
2
|
Kraut AS, Omron R, Caretta-Weyer H, Jordan J, Manthey D, Wolf SJ, Yarris LM, Johnson S, Kornegay J. The Flipped Classroom: A Critical Appraisal. West J Emerg Med 2019; 20:527-536. [PMID: 31123556 PMCID: PMC6526887 DOI: 10.5811/westjem.2019.2.40979] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/16/2018] [Accepted: 02/16/2019] [Indexed: 11/12/2022] Open
Abstract
Introduction The objective of this study was to review and critically appraise the medical education literature pertaining to a flipped-classroom (FC) education model, and to highlight influential papers that inform our current understanding of the role of the FC in medical education. Methods A search of the English-language literature querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 296 papers related to the FC using either quantitative, qualitative, or review methods. Two reviewers independently screened each category of publications using previously established exclusion criteria. Eight reviewers then independently scored the remaining 54 publications using either a qualitative, quantitative, or review-paper scoring system. Each scoring system consisted of nine criteria and used parallel metrics that have been previously used in critical appraisals of education research. Results A total of 54 papers (33 quantitative, four qualitative, and 17 review) on FC met a priori criteria for inclusion and were critically appraised and reviewed. The top 10 highest scoring articles (five quantitative studies, two qualitative studies, and three review papers) are summarized in this article. Conclusion This installment of the Council of Emergency Medicine Residency Directors (CORD) Academy Critical Appraisal series highlights 10 papers that describe the current state of literature on the flipped classroom, including an analysis of the benefits and drawbacks of an FC approach, practical implications for emergency medicine educators, and next steps for future research.
Collapse
Affiliation(s)
- Aaron S Kraut
- University of Wisconsin School of Medicine and Public Health, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin
| | - Rodney Omron
- Johns Hopkins School of Medicine, Department of Emergency Medicine, Baltimore, Maryland
| | - Holly Caretta-Weyer
- Stanford University School of Medicine, Department of Emergency Medicine, Palo Alto, California
| | - Jaime Jordan
- David Geffen School of Medicine at UCLA, Department of Emergency Medicine, Los Angeles, California
| | - David Manthey
- Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - Stephen J Wolf
- Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado
| | - Lainie M Yarris
- Oregon Health and & Science University, Department of Emergency Medicine, Portland, Oregon
| | - Stephen Johnson
- University of Wisconsin School of Medicine and Public Health, Library Services, Madison, Wisconsin
| | - Josh Kornegay
- Oregon Health and & Science University, Department of Emergency Medicine, Portland, Oregon
| |
Collapse
|
3
|
Dubosh NM, Jordan J, Yarris LM, Ullman E, Kornegay J, Runde D, Juve AM, Fisher J. Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2016. AEM EDUCATION AND TRAINING 2019; 3:58-73. [PMID: 30680348 PMCID: PMC6339548 DOI: 10.1002/aet2.10203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 09/27/2018] [Accepted: 10/02/2018] [Indexed: 05/05/2023]
Abstract
OBJECTIVES The objectives were to critically appraise the emergency medicine (EM) medical education literature published in 2016 and review the highest-quality quantitative and qualitative studies. METHODS A search of the English language literature in 2016 querying MEDLINE, Scopus, Education Resources Information Center (ERIC), and PsychInfo identified 510 papers related to medical education in EM. Two reviewers independently screened all of the publications using previously established exclusion criteria. The 25 top-scoring quantitative studies based on methodology and all six qualitative studies were scored by all reviewers using selected scoring criteria that have been adapted from previous installments. The top-scoring articles were highlighted and trends in medical education research were described. RESULTS Seventy-five manuscripts met inclusion criteria and were scored. Eleven quantitative and one qualitative papers were the highest scoring and are summarized in this article. CONCLUSION This annual critical appraisal series highlights the best EM education research articles published in 2016.
Collapse
Affiliation(s)
- Nicole M. Dubosh
- Beth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMA
| | - Jaime Jordan
- University of California Los Angeles School of MedicineTorranceCA
| | | | - Edward Ullman
- Beth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMA
| | | | | | | | - Jonathan Fisher
- University of Arizona College of Medicine PhoenixMaricopa Medical CenterPhoenixAZ
| |
Collapse
|
4
|
Jordan J, Coates WC, Clarke S, Runde D, Fowlkes E, Kurth J, Yarris L. The Uphill Battle of Performing Education Scholarship: Barriers Educators and Education Researchers Face. West J Emerg Med 2018; 19:619-629. [PMID: 29760865 PMCID: PMC5942034 DOI: 10.5811/westjem.2018.1.36752] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/12/2018] [Accepted: 01/11/2018] [Indexed: 11/30/2022] Open
Abstract
Introduction Educators and education researchers report that their scholarship is limited by lack of time, funding, mentorship, expertise, and reward. This study aims to evaluate these groups’ perceptions regarding barriers to scholarship and potential strategies for success. Methods Core emergency medicine (EM) educators and education researchers completed an online survey consisting of multiple-choice, 10-point Likert scale, and free-response items in 2015. Descriptive statistics were reported. We used qualitative analysis applying a thematic approach to free-response items. Results A total of 204 educators and 42 education researchers participated. Education researchers were highly productive: 19/42 reported more than 20 peer-reviewed education scholarship publications on their curricula vitae. In contrast, 68/197 educators reported no education publications within five years. Only a minority, 61/197 had formal research training compared to 25/42 education researchers. Barriers to performing research for both groups were lack of time, competing demands, lack of support, lack of funding, and challenges achieving scientifically rigorous methods and publication. The most common motivators identified were dissemination of knowledge, support of evidence-based practices, and promotion. Respondents advised those who seek greater education research involvement to pursue mentorship, formal research training, collaboration, and rigorous methodological standards. Conclusion The most commonly cited barriers were lack of time and competing demands. Stakeholders were motivated by the desire to disseminate knowledge, support evidence-based practices, and achieve promotion. Suggested strategies for success included formal training, mentorship, and collaboration. This information may inform interventions to support educators in their scholarly pursuits and improve the overall quality of education research in EM.
Collapse
Affiliation(s)
- Jaime Jordan
- Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California
| | - Wendy C Coates
- Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, California
| | - Samuel Clarke
- UC Davis Medical Center, Department of Emergency Medicine, Sacramento, California
| | - Daniel Runde
- University of Iowa, Department of Emergency Medicine, Iowa City, Iowa
| | - Emilie Fowlkes
- University of Iowa, Department of Emergency Medicine, Iowa City, Iowa
| | - Jaqueline Kurth
- UCLA Ronald Reagan/Olive View, Department of Emergency Medicine, Los Angeles, California
| | - Lalena Yarris
- Oregon Health and Science University, Department of Emergency Medicine, Portland, Oregon
| |
Collapse
|
5
|
Hunter CL, Silvestri S, Ralls G, Stone A, Walker A, Mangalat N, Papa L. Comparing Quick Sequential Organ Failure Assessment Scores to End-tidal Carbon Dioxide as Mortality Predictors in Prehospital Patients with Suspected Sepsis. West J Emerg Med 2018; 19:446-451. [PMID: 29760838 PMCID: PMC5942006 DOI: 10.5811/westjem.2018.1.35607] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 12/13/2017] [Accepted: 01/22/2018] [Indexed: 01/20/2023] Open
Abstract
Introduction Early identification of sepsis significantly improves outcomes, suggesting a role for prehospital screening. An end-tidal carbon dioxide (ETCO2) value ≤ 25 mmHg predicts mortality and severe sepsis when used as part of a prehospital screening tool. Recently, the Quick Sequential Organ Failure Assessment (qSOFA) score was also derived as a tool for predicting poor outcomes in potentially septic patients. Methods We conducted a retrospective cohort study among patients transported by emergency medical services to compare the use of ETCO2 ≤ 25 mmHg with qSOFA score of ≥ 2 as a predictor of mortality or diagnosis of severe sepsis in prehospital patients with suspected sepsis. Results By comparison of receiver operator characteristic curves, ETCO2 had a higher discriminatory power to predict mortality, sepsis, and severe sepsis than qSOFA. Conclusion Both non-invasive measures were easily obtainable by prehospital personnel, with ETCO2 performing slightly better as an outcome predictor.
Collapse
Affiliation(s)
- Christopher L Hunter
- Orlando Regional Medical Center, Department of Emergency Medicine, Orlando, Florida.,University of Central Florida College of Medicine, Department of Emergency Medicine, Orlando, Florida
| | - Salvatore Silvestri
- Orlando Regional Medical Center, Department of Emergency Medicine, Orlando, Florida.,University of Central Florida College of Medicine, Department of Emergency Medicine, Orlando, Florida
| | - George Ralls
- Orlando Regional Medical Center, Department of Emergency Medicine, Orlando, Florida
| | - Amanda Stone
- Orlando Regional Medical Center, Department of Emergency Medicine, Orlando, Florida
| | - Ayanna Walker
- Orlando Regional Medical Center, Department of Emergency Medicine, Orlando, Florida.,University of Central Florida College of Medicine, Department of Emergency Medicine, Orlando, Florida
| | - Neal Mangalat
- St Mary's Hospital, Department of Emergency Medicine, St. Louis, Missouri
| | - Linda Papa
- Orlando Regional Medical Center, Department of Emergency Medicine, Orlando, Florida.,University of Central Florida College of Medicine, Department of Emergency Medicine, Orlando, Florida
| |
Collapse
|
6
|
Heitz CR, Coates W, Farrell SE, Fisher J, Juve AM, Yarris LM. Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2015. Acad Emerg Med 2017; 24:1212-1225. [PMID: 28857348 DOI: 10.1111/acem.13305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The objectives were to critically appraise the medical education research literature of 2015 and review the highest-quality quantitative and qualitative examples. METHODS A total of 434 emergency medicine (EM)-related articles were discovered upon a search of ERIC, PsychINFO, PubMED, and SCOPUS. These were both quantitative and qualitative in nature. All were screened by two of the authors using previously published exclusion criteria, and the remaining were appraised by all authors using a previously published scoring system. The highest scoring articles were then reviewed. RESULTS Sixty-one manuscripts were scored, and 10 quantitative and two qualitative papers were the highest scoring and are reviewed and summarized in this article. CONCLUSIONS This installment in this critical appraisal series reviews 12 of the highest-quality EM-related medical education research manuscripts published in 2015.
Collapse
Affiliation(s)
- Corey R. Heitz
- Carilion Clinic/Virginia Tech Carilion School of Medicine; Roanoke VA
| | - Wendy Coates
- Harbor/University of California Los Angeles Medical Center; Los Angeles CA
| | | | - Jonathan Fisher
- Maricopa Medical Center/University of Arizona College of Medicine-Phoenix; Phoenix AZ
| | | | | |
Collapse
|
7
|
Heitz CR, Coates W, Farrell SE, Fisher J, Juve AM, Yarris LM. Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2015. AEM EDUCATION AND TRAINING 2017; 1:255-268. [PMID: 30051043 PMCID: PMC6001510 DOI: 10.1002/aet2.10063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The objectives were to critically appraise the medical education research literature of 2015 and review the highest-quality quantitative and qualitative examples. METHODS A total of 434 emergency medicine (EM)-related articles were discovered upon a search of ERIC, PsychINFO, PubMED, and SCOPUS. These were both quantitative and qualitative in nature. All were screened by two of the authors using previously published exclusion criteria, and the remaining were appraised by all authors using a previously published scoring system. The highest scoring articles were then reviewed. RESULTS Sixty-one manuscripts were scored, and 10 quantitative and two qualitative papers were the highest scoring and are reviewed and summarized in this article. CONCLUSIONS This installment in this critical appraisal series reviews 12 of the highest-quality EM-related medical education research manuscripts published in 2015.
Collapse
Affiliation(s)
- Corey R. Heitz
- Carilion Clinic/Virginia Tech Carilion School of MedicineRoanokeVA
| | - Wendy Coates
- Harbor/University of California Los Angeles Medical CenterLos AngelesCA
| | | | - Jonathan Fisher
- Maricopa Medical Center/University of Arizona College of Medicine–PhoenixPhoenixAZ
| | | | | |
Collapse
|
8
|
Kornegay JG, Kraut A, Manthey D, Omron R, Caretta‐Weyer H, Kuhn G, Martin S, Yarris LM. Feedback in Medical Education: A Critical Appraisal. AEM EDUCATION AND TRAINING 2017; 1:98-109. [PMID: 30051017 PMCID: PMC6001508 DOI: 10.1002/aet2.10024] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 05/24/2023]
Abstract
OBJECTIVE The objective was to review and critically appraise the medical education literature pertaining to feedback and highlight influential papers that inform our current understanding of the role of feedback in medical education. METHODS A search of the English language literature in querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 327 feedback-related papers using either quantitative (hypothesis-testing or observational investigations of educational interventions), qualitative methods (exploring important phenomena in emergency medicine [EM] education), or review methods.Two reviewers independently screened each category of publications using previously established exclusion criteria. Six reviewers then independently scored the remaining 54 publications using a qualitative, quantitative, or review paper scoring system. Each scoring system consisted of nine criteria and used parallel scoring metrics that have been previously used in critical appraisals of education research. RESULTS Fifty-four feedback papers (25 quantitative studies, 24 qualitative studies, five review papers) met the a priori criteria for inclusion and were reviewed. Eight quantitative studies, nine qualitative studies, and three review papers were ranked highly by the reviewers and are summarized in this article. CONCLUSIONS This inaugural Council of Emergency Medicine Residency Directors Academy critical appraisal highlights 20 feedback in medical education papers that describe the current state of the feedback literature. A summary of current factors that influence feedback effectiveness is discussed, along with practical implications for EM educators and the next steps for research.
Collapse
Affiliation(s)
- Joshua G. Kornegay
- Department of Emergency MedicineOregon Health & Science UniversityPortlandOR
| | - Aaron Kraut
- BerbeeWalsh Department of Emergency MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWI
| | - David Manthey
- Department of Emergency MedicineWake Forest University Baptist HealthWinston‐SalemNC
| | - Rodney Omron
- Department of Emergency MedicineJohns Hopkins School of MedicineBaltimoreMD
| | - Holly Caretta‐Weyer
- Department of Emergency MedicineOregon Health & Science UniversityPortlandOR
| | - Gloria Kuhn
- Department of Emergency MedicineWayne State UniversityDetroitMI
| | - Sandra Martin
- Department of Emergency MedicineWayne State UniversityDetroitMI
| | - Lalena M. Yarris
- Department of Emergency MedicineOregon Health & Science UniversityPortlandOR
| |
Collapse
|
9
|
de Araujo Guerra Grangeia T, de Jorge B, Franci D, Martins Santos T, Vellutini Setubal MS, Schweller M, de Carvalho-Filho MA. Cognitive Load and Self-Determination Theories Applied to E-Learning: Impact on Students' Participation and Academic Performance. PLoS One 2016; 11:e0152462. [PMID: 27031859 PMCID: PMC4816554 DOI: 10.1371/journal.pone.0152462] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 03/15/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Emergency clerkships expose students to a stressful environment that require multiple tasks, which may have a direct impact on cognitive load and motivation for learning. To address this challenge, Cognitive Load Theory and Self Determination Theory provided the conceptual frameworks to the development of a Moodle-based online Emergency Medicine course, inspired by real clinical cases. METHODS Three consecutive classes (2013-2015) of sixth-year medical students (n = 304) participated in the course, during a curricular and essentially practical emergency rotation. "Virtual Rounds" provided weekly virtual patients in narrative format and meaningful schemata to chief complaints, in order to simulate real rounds at Emergency Unit. Additional activities such as Extreme Decisions, Emergency Quiz and Electrocardiographic challenge offered different views of emergency care. Authors assessed student´s participation and its correlation with their academic performance. A survey evaluated students´ opinions. Students graduating in 2015 answered an online questionnaire to investigate cognitive load and motivation. RESULTS Each student produced 1965 pageviews and spent 72 hours logged on. Although Clinical Emergency rotation has two months long, students accessed the online course during an average of 5.3 months. Virtual Rounds was the most accessed activity, and there was positive correlations between the number of hours logged on the platform and final grades on Emergency Medicine. Over 90% of students felt an improvement in their clinical reasoning and considered themselves better prepared for rendering Emergency care. Considering a Likert scale from 1 (minimum load) to 7 (maximum load), the scores for total cognitive load were 4.79±2.2 for Virtual Rounds and 5.56±1.96 for real medical rounds(p<0,01). CONCLUSIONS A real-world inspired online course, based on cognitive and motivational conceptual frameworks, seems to be a strong tool to engage students in learning. It may support them to manage the cognitive challenges involved in clinical care and increase their motivation for learning.
Collapse
Affiliation(s)
- Tiago de Araujo Guerra Grangeia
- Department of Internal Medicine, Division of Emergency Medicine, Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| | - Bruno de Jorge
- Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| | - Daniel Franci
- Department of Internal Medicine, Division of Emergency Medicine, Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| | - Thiago Martins Santos
- Department of Internal Medicine, Division of Emergency Medicine, Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| | | | - Marcelo Schweller
- Department of Internal Medicine, Division of Emergency Medicine, Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| | - Marco Antonio de Carvalho-Filho
- Department of Internal Medicine, Division of Emergency Medicine, Faculty of Medical Sciences at State University of Campinas (Unicamp), São Paulo, Brazil
| |
Collapse
|
10
|
Yarris LM, Juve AM, Coates WC, Fisher J, Heitz C, Shayne P, Farrell SE. Critical Appraisal of Emergency Medicine Education Research: The Best Publications of 2014. Acad Emerg Med 2015; 22:1327-36. [PMID: 26473396 DOI: 10.1111/acem.12801] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 07/22/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective was to critically appraise and highlight rigorous education research study articles published in 2014 whose outcomes advance the science of emergency medicine (EM) education. METHODS A search of the English language literature in 2014 querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 243 EM-related articles using either quantitative (hypothesis-testing or observational investigations of educational interventions) or qualitative (exploring important phenomena in EM education) methods. Two reviewers independently screened all of the publications using previously established exclusion criteria. Six reviewers then independently scored the 25 selected publications using either a qualitative or a quantitative scoring system. Each scoring system consisted of nine criteria. Selected criteria were based on accepted educational review literature and chosen a priori. Both scoring systems use parallel scoring metrics and have been used previously within this annual review. RESULTS Twenty-five medical education research papers (22 quantitative, three qualitative) met the criteria for inclusion and were reviewed. Five quantitative and two qualitative studies were ranked most highly by the reviewers as exemplary and are summarized in this article. CONCLUSIONS This annual critical appraisal series highlights seven excellent EM education research studies, meeting a priori criteria and published in 2014. Methodologic strengths in the 2014 papers are noted, and current trends in medical education research in EM are discussed.
Collapse
Affiliation(s)
- Lalena M. Yarris
- Department of Emergency Medicine; Oregon Health & Science University; Portland OR
| | - Amy Miller Juve
- Department of Anesthesiology & Perioperative Medicine; Oregon Health & Science University; Portland OR
| | - Wendy C. Coates
- Department of Emergency Medicine and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center; University of California; Los Angeles David Geffen School of Medicine; Los Angeles CA
| | - Jonathan Fisher
- Departments of Emergency Medicine; Maricopa Medical Center & University of Arizona COM-Phoenix Campus; Phoenix AZ
| | - Corey Heitz
- Department of Emergency Medicine; Virginia Tech Carilion School of Medicine; Roanoke VA
| | - Philip Shayne
- Department of Emergency Medicine; Emory University School of Medicine; Atlanta GA
| | - Susan E. Farrell
- Partners Healthcare International and Department of Emergency Medicine; Harvard Medical School; Boston MA
| |
Collapse
|
11
|
Farrell SE, Kuhn GJ, Coates WC, Shayne PH, Fisher J, Maggio LA, Lin M. Critical appraisal of emergency medicine education research: the best publications of 2013. Acad Emerg Med 2014; 21:1274-83. [PMID: 25377406 DOI: 10.1111/acem.12507] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 07/27/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The objective was to critically appraise and highlight methodologically superior medical education research articles published in 2013 whose outcomes are pertinent to teaching and education in emergency medicine (EM). METHODS A search of the English-language literature in 2013 querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 251 EM-related studies using hypothesis-testing or observational investigations of educational interventions. Two reviewers independently screened all of the publications and removed articles using established exclusion criteria. Six reviewers then independently scored the remaining 43 publications using either a qualitative a or quantitative scoring system, based on the research methodology of each article. Each scoring system consisted of nine criteria. Selected criteria were based on accepted educational review literature and chosen a priori. Both scoring systems used parallel scoring metrics and have been used previously within this annual review. RESULTS Forty-three medical education research papers (37 quantitative and six qualitative studies) met the a priori criteria for inclusion and were reviewed. Six quantitative and one qualitative study were scored and ranked most highly by the reviewers as exemplary and are summarized in this article. CONCLUSIONS This annual critical appraisal article aims to promote superior research in EM-related education, by reviewing and highlighting seven of 43 major education research studies, meeting a priori criteria, and published in 2013. Common methodologic pitfalls in the 2013 papers are noted, and current trends in medical education research in EM are discussed.
Collapse
Affiliation(s)
- Susan E. Farrell
- The Partners Healthcare International Harvard Medical School Boston MA
| | - Gloria J. Kuhn
- The Wayne State University School of Medicine Detroit MI
| | - Wendy C. Coates
- Harbor–UCLA Medical Center University of California at Los Angeles Los Angeles CA
| | | | - Jonathan Fisher
- Beth Israel Deaconess Medical Center Harvard Medical School Boston MA
| | | | | |
Collapse
|
12
|
Lin M, Fisher J, Coates WC, Farrell SE, Shayne P, Maggio L, Kuhn G. Critical appraisal of emergency medicine education research: the best publications of 2012. Acad Emerg Med 2014; 21:322-33. [PMID: 24628758 DOI: 10.1111/acem.12336] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 11/16/2013] [Accepted: 12/07/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective was to critically appraise and highlight medical education research published in 2012 that was methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine (EM). METHODS A search of the English language literature in 2012 querying Education Resources Information Center (ERIC), PsychInfo, PubMed, and Scopus identified EM studies using hypothesis-testing or observational investigations of educational interventions. Two reviewers independently screened all of the publications and removed articles using established exclusion criteria. This year, publications limited to a single-site survey design that measured satisfaction or self-assessment on unvalidated instruments were not formally reviewed. Six reviewers then independently ranked all remaining publications using one of two scoring systems depending on whether the study methodology was primarily qualitative or quantitative. Each scoring system had nine criteria, including four related to methodology, that were chosen a priori, to standardize evaluation by reviewers. The quantitative study scoring system was used previously to appraise medical education published annually in 2008 through 2011, while a separate, new qualitative study scoring system was derived and implemented consisting of parallel metrics. RESULTS Forty-eight medical education research papers met the a priori criteria for inclusion, and 33 (30 quantitative and three qualitative studies) were reviewed. Seven quantitative and two qualitative studies met the criteria for inclusion as exemplary and are summarized in this article. CONCLUSIONS This critical appraisal series aims to promote superior education research by reviewing and highlighting nine of the 48 major education research studies with relevance to EM published in 2012. Current trends and common methodologic pitfalls in the 2012 papers are noted.
Collapse
Affiliation(s)
- Michelle Lin
- The Department of Emergency Medicine; University of California at San Francisco; San Francisco CA
| | - Jonathan Fisher
- The Department of Emergency Medicine; Beth Israel Deaconess Medical Center; Boston MA
| | - Wendy C. Coates
- The Department of Emergency Medicine; Harbor-UCLA Medical Center, Los Angeles Biomedical Research Institute at Harbor-UCLA; University of California at Los Angeles-David Geffen School of Medicine; Los Angeles CA
| | - Susan E. Farrell
- The Office of Graduate Medical Education; Partners Healthcare System; Center for Teaching and Learning; Harvard Medical School, Department of Emergency Medicine; Brigham and Women's Hospital; Boston MA
| | - Philip Shayne
- The Department of Emergency Medicine; Emory University School of Medicine; Atlanta GA
| | - Lauren Maggio
- The Lane Medical Library; Stanford University School of Medicine; Stanford CA
| | - Gloria Kuhn
- The Department of Emergency Medicine; Wayne State University; Detroit MI
| |
Collapse
|
13
|
Fisher J, Lin M, Coates WC, Kuhn GJ, Farrell SE, Maggio LA, Shayne P. Critical appraisal of emergency medicine educational research: the best publications of 2011. Acad Emerg Med 2013; 20:200-8. [PMID: 23406080 DOI: 10.1111/acem.12070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 08/21/2012] [Accepted: 08/30/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective was to critically appraise and highlight medical education research studies published in 2011 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine (EM). METHODS A search of the English language literature in 2011 querying PubMed, Scopus, Education Resources Information Center (ERIC), and PsychInfo identified EM studies that used hypothesis-testing or observational investigations of educational interventions. Six reviewers independently ranked all publications based on 10 criteria, including four related to methodology, that were chosen a priori to standardize evaluation by reviewers. This method was used previously to appraise medical education published in 2008, 2009, and 2010. RESULTS Forty-eight educational research papers were identified. Comparing the literature of 2011 to that of 2008 through 2010, the number of published educational research papers meeting the criteria increased over time from 30, to 36, to 41, and now to 48. Five medical education research studies met the a priori criteria for inclusion as exemplary and are reviewed and summarized in this article. The number of funded studies remained fairly stable over the past 3 years, at 13 (2008), 16 (2009), 9 (2010), and 13 (2011). As in past years, research involving the use of technology accounted for almost half (n = 22) of the publications. Observational study designs accounted for 28 of the papers, while nine studies featured an experimental design. CONCLUSIONS Forty-eight EM educational studies published in 2011 and meeting the criteria were identified. This critical appraisal reviews and highlights five studies that met a priori quality indicators. Current trends and common methodologic pitfalls in the 2011 papers are noted.
Collapse
Affiliation(s)
- Jonathan Fisher
- Department of Emergency Medicine; Beth Israel Deaconess Medical Center; Boston; MA
| | - Michelle Lin
- The Department of Emergency Medicine; University of California at San Francisco; San Francisco; CA
| | - Wendy C. Coates
- The Department of Emergency Medicine; Harbor-UCLA Medical Center; University of California, Los Angeles-David Geffen School of Medicine, and Los Angeles Biomedical Research Institute at Harbor-UCLA; Los Angeles; CA
| | - Gloria J. Kuhn
- The Department of Emergency Medicine; Wayne State University; Farming Hills; MI
| | - Susan E. Farrell
- The Office of Graduate Medical Education; Partners Healthcare System; Center for Teaching and Learning; Harvard Medical School; and Department of Emergency Medicine; Brigham and Women's Hospital; Boston; MA
| | - Lauren A. Maggio
- The Lane Medical Library; Stanford University School of Medicine; Stanford; CA
| | - Philip Shayne
- and The Department of Emergency Medicine; Emory University School of Medicine; Atlanta; GA
| |
Collapse
|
14
|
LaMantia J, Deiorio NM, Yarris LM. Executive summary: Education research in emergency medicine-opportunities, challenges, and strategies for success. Acad Emerg Med 2012; 19:1319-22. [PMID: 23230895 DOI: 10.1111/acem.12027] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 07/03/2012] [Indexed: 11/29/2022]
Abstract
The 2012 Academic Emergency Medicine (AEM) consensus conference "Education Research In Emergency Medicine: Opportunities, Challenges, and Strategies for Success" convened a diverse group of stakeholders in medical education to target gaps in emergency medicine (EM) education research and identify priorities for future study. A total of 175 registrants collaborated in preparatory and conference-day activities to explore subtopics in educational interventions, learner assessment, faculty development, and research funding and infrastructure. The conference was punctuated by didactic sessions led by key international medical education experts and ended with consensus formation in many domains. This issue of AEM presents the exciting results of this process.
Collapse
Affiliation(s)
- Joseph LaMantia
- Department of Emergency Medicine; North Shore University Hospital; Manhasset; NY
| | - Nicole M. Deiorio
- Department of Emergency Medicine; Oregon Health & Science University; Portland; OR
| | - Lalena M. Yarris
- Department of Emergency Medicine; Oregon Health & Science University; Portland; OR
| |
Collapse
|
15
|
Choo EK, Fernandez R, Hayden EM, Schneider JI, Clyne B, Ginsburg S, Gruppen LD. An agenda for increasing grant funding of emergency medicine education research. Acad Emerg Med 2012; 19:1434-41. [PMID: 23252424 DOI: 10.1111/acem.12041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 06/05/2012] [Indexed: 11/28/2022]
Abstract
Funding is a perennial challenge for medical education researchers. Through a consensus process, the authors developed a multifaceted agenda for increasing funding of education research in emergency medicine (EM). Priority agenda items include developing resources to increase the competitiveness of medical education research faculty in grant applications, identifying means by which departments may bolster their faculty's grant writing success, taking long-term steps to increase the number of grants available to education researchers in the field, and encouraging a shift in cultural attitudes toward education research.
Collapse
Affiliation(s)
- Esther K. Choo
- Department of Emergency Medicine; Warren Alpert Medical School of Brown University; Providence; RI
| | | | - Emily M. Hayden
- Department of Emergency Medicine; Massachusetts General Hospital; Boston; MA
| | - Jeffrey I. Schneider
- Department of Emergency Medicine; Boston Medical Center; Boston University School of Medicine; Boston; MA
| | - Brian Clyne
- Department of Emergency Medicine; Warren Alpert Medical School of Brown University; Providence; RI
| | - Shiphra Ginsburg
- Department of Medicine; Wilson Centre for Research in Education; Faculty of Medicine; University of Toronto; Toronto; Ontario; Canada
| | - Larry D. Gruppen
- Department of Medical Education; University of Michigan Medical School; Ann Arbor; MI
| |
Collapse
|
16
|
Yarris LM, Gruppen LD, Hamstra SJ, Anders Ericsson K, Cook DA. Overcoming barriers to addressing education problems with research design: a panel discussion. Acad Emerg Med 2012; 19:1344-9. [PMID: 23252365 DOI: 10.1111/acem.12025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 06/28/2012] [Indexed: 12/28/2022]
Abstract
A plenary panel session at the 2012 Academic Emergency Medicine consensus conference "Education Research in Emergency Medicine: Opportunities, Challenges, and Strategies for Success" discussed barriers educators face in imagining, designing, and implementing studies to address educational challenges. This proceedings article presents a general approach to getting started in education research. Four examples of studies from the medical education literature that illustrate a distinct way to approach specific research questions are discussed. The study designs used are applicable to a variety of education research problems in emergency medicine (EM). Potential applications of studies are discussed, as well as effects and lessons learned.
Collapse
Affiliation(s)
- Lalena M. Yarris
- Department of Emergency Medicine; Oregon Health & Science University; Portland; OR
| | - Larry D. Gruppen
- Department of Medical Education; University of Michigan Medical School; Ann Arbor; MI
| | - Stanley J. Hamstra
- Academy for Innovation in Medical Education; University of Ottawa Skills and Simulation Centre; Ottawa; Ontario; Canada
| | | | - David A. Cook
- Division of General Internal Medicine; Office of Education Research; Mayo Clinic College of Medicine; Rochester; MN
| |
Collapse
|
17
|
Tintinalli JE, Shofer F, Biese K, Phipps J, Rabinovich S. Toward a new paradigm: goal-based residency training. Acad Emerg Med 2011; 18 Suppl 2:S71-8. [PMID: 21999562 DOI: 10.1111/j.1553-2712.2011.01174.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Many factors affect the clinical training experience of emergency medicine (EM) residents, and length of training currently serves as a proxy for clinical experience. Very few studies have been published that provide quantitative information about clinical experience. The goals of this study were to determine the numbers of clinical encounters for each resident in emergency department (ED) rotations during training in a 3-year program, to characterize these encounters by patient acuity and age, to determine the numbers of encounters for selected clinical disorders, and to assess the variation in clinical experience between residents. METHODS This was a retrospective analysis of the ED clinical and administrative databases at two hospitals that provide EM training for a southeastern U.S. EM residency program. Data were gathered for three complete cohorts of residents, with entering years of 2003, 2004, and 2005, so the total study period was 2003-2008. ED clinical encounter information included hospital training site (tertiary or community), postgraduate year (PGY) of the resident, patient triage acuity reflected by the Emergency Severity Index (ESI); patient International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic code; and patient age group. RESULTS There were 25 residents with 120,240 total ED clinical encounters from 2003 to 2008. The median number of ED clinical encounters for a resident during his or her training was 4,836 (range = 3,831 to 5,780), based on a maximum of an 80-hour work week, and 24 or 25 four-week blocks of EM rotations. Overall, clinical encounters increased by 30% from PGY 1 to PGY 2, and another 14% from PGY 2 to PGY 3. There was 30% to 60% variation in clinical encounters between individual residents. Variability was most prominent in the care of children and in the care of time-sensitive critical illness. Resident encounters with lower-acuity problems during training were much less than the anticipated lower-acuity burden during practice. Additionally, residents did not encounter some high-risk conditions clinically during the study period. CONCLUSIONS Methods should be developed to decrease resident variance in both numbers and types of clinical encounters and to provide curriculum supplementation for individuals and for the entire residency cohort in areas that are important for the clinical practice of EM, but that are rare or not encountered during residency training.
Collapse
Affiliation(s)
- Judith E Tintinalli
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | | | | | | | | |
Collapse
|
18
|
Shayne P, Coates WC, Farrell SE, Kuhn GJ, Lin M, Maggio LA, Fisher J. Critical appraisal of emergency medicine educational research: the best publications of 2010. Acad Emerg Med 2011; 18:1081-9. [PMID: 21996074 DOI: 10.1111/j.1553-2712.2011.01191.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective was to critically appraise and highlight medical education research studies published in 2010 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine (EM). METHODS A search of the English language literature in 2010 querying PubMed, Scopus, Education Resources Information Center (ERIC), and PsychInfo identified 41 EM studies that used hypothesis-testing or observational investigations of educational interventions. Five reviewers independently ranked all publications based on 10 criteria, including four related to methodology, that were chosen a priori to standardize evaluation by reviewers. This method was used previously to appraise medical education published in 2008 and 2009. RESULTS Five medical education research studies met the a priori criteria for inclusion and are reviewed and summarized here. Comparing the literature of 2010 to 2008 and 2009, the number of published educational research papers increased from 30 to 36 and then to 41. The number of funded studies remained fairly stable over the past 3 years at 13 (2008), 16 (2009), and 9 (2010). As in past years, research involving the use of technology accounted for a significant number of publications (34%), including three of the five highlighted studies. CONCLUSIONS Forty-one EM educational studies published in 2010 were identified. This critical appraisal reviews and highlights five studies that met a priori quality indicators. Current trends and common methodologic pitfalls in the 2010 papers are noted.
Collapse
Affiliation(s)
- Philip Shayne
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA.
| | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
As medical educators strive to adopt an evidence-based, outcomes-driven approach to teaching, education research in emergency medicine (EM) is burgeoning. Many educational challenges prompt specific research questions that are well suited to investigative study, but educators face numerous barriers to translating exciting ideas into research publications. This primer, intended for educators in EM, provides a brief overview of the current scope and essential elements of education research. We present an approach to identifying research problems and conceptual frameworks and defining specific research questions. A common approach to curricular development is reviewed, as well as a fundamental overview of qualitative and quantitative methods that can be applied to educational research questions. Finally, suggestions for disseminating results and overcoming common barriers to conducting research are discussed.
Collapse
Affiliation(s)
- Lalena M Yarris
- Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, USA.
| | | |
Collapse
|
20
|
|
21
|
Cloutier RL, Walthall JDH, Mull CC, Nypaver MM, Baren JM. Best educational practices in pediatric emergency medicine during emergency medicine residency training: guiding principles and expert recommendations. Acad Emerg Med 2010; 17 Suppl 2:S104-13. [PMID: 21199076 DOI: 10.1111/j.1553-2712.2010.00893.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The state of pediatric emergency medicine (PEM) education within emergency medicine (EM) residency programs is reviewed and discussed in the context of shifting practice environments and new demands for a greater focus on the availability and quality of PEM services. The rapid growth of PEM within pediatrics has altered the EM practice landscape with regard to PEM. The authors evaluate the composition, quantity, and quality of PEM training in EM residency programs, with close attention paid to the challenges facing programs. A set of best practices is presented as a framework for discussion of future PEM training that would increase the yield and relevance of knowledge and experiences within the constraints of 3- and 4-year residencies. Innovative educational modalities are discussed, as well as the role of simulation and pediatric-specific patient safety education. Finally, barriers to PEM fellowship training among EM residency graduates are discussed in light of the shortage of practitioners from this training pathway and in recognition of the ongoing importance of the EM voice in PEM.
Collapse
Affiliation(s)
- Robert L Cloutier
- Department of Emergency Medicine, Oregon Health and Science University, Portland, OR, USA.
| | | | | | | | | |
Collapse
|
22
|
Kuhn GJ, Shayne P, Coates WC, Fisher J, Lin M, Maggio LA, Farrell SE. Critical appraisal of emergency medicine educational research: the best publications of 2009. Acad Emerg Med 2010; 17 Suppl 2:S16-25. [PMID: 21199079 DOI: 10.1111/j.1553-2712.2010.00899.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective was to critically appraise and highlight methodologically superior medical education research specific to emergency medicine (EM) published in 2009. METHODS A search of the English language literature in 2009 querying Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE 1950 to Present, Web of Science, Education Resources Information Center (ERIC), and PsychInfo identified 36 EM studies that used hypothesis-testing or observational investigations of educational interventions. Six reviewers independently ranked all publications based on 10 criteria, including four related to methodology, that were chosen a priori to standardize evaluation by reviewers. This was a refinement of the methods used to appraise medical education published in 2008. RESULTS Seven studies met the standards as determined by the averaged rankings and are highlighted and summarized here. This year, 16 of 36 (44%) identified studies had funding, compared to 11 of 30 (36%) identified last year; five of seven (71%) highlighted publications were funded in 2009 compared to three of five (60%) highlighted in 2008. Use of technology in medical education was reported in 14 identified and four highlighted publications, with simulation being the most common technology studied. Five of the seven (71%) featured publications used a quasi-experimental or experimental design, one was observational, and one was qualitative. Practice management topics, including patient safety, efficiency, and revenue generation, were examined in seven reviewed studies. CONCLUSIONS Thirty-six medical education publications published in 2009 focusing on EM were identified. This critical appraisal reviews and highlights seven studies that met a priori quality indicators. Current trends are noted.
Collapse
Affiliation(s)
- Gloria J Kuhn
- Department of Emergency Medicine, Wayne State, University, Detroit, MI, USA.
| | | | | | | | | | | | | |
Collapse
|