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Taskin O, Disel NR, Yilmaz M. Amidst the clamor: Effects of emergency department noise on Physicians' health and attention. Am J Emerg Med 2024; 76:87-92. [PMID: 38006637 DOI: 10.1016/j.ajem.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/27/2023] [Accepted: 11/07/2023] [Indexed: 11/27/2023] Open
Abstract
OBJECTIVE This study aims to assess effects of noise on physicians' stress levels and attention capacities within an emergency department. METHODS In this prospective cross-sectional study, 15 physicians from a state hospital emergency department with 300,000 annual visits provided demographics, work factors, and physiologic data. Attention was evaluated through smartphone-based Stroop tests, while noise and heart rates were monitored via smartwatches. RESULTS Median physician age was 26, with 16 months' emergency department experience. Average sound intensity was 68.80 dB. Despite noise, physicians in green/yellow areas showed increased Stroop scores (p = 0.002). Heart rate responses correlated with noise changes. End-of-shift surveys highlighted physicians' adaptability and resilience to high noise levels. CONCLUSION Noisy emergency departments pose health risks to physicians, but noise-related stress did not significantly affect attention, beneficial for patient care.
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Affiliation(s)
- Omer Taskin
- Emergency Service, Yuregir State Hospital, Adana, Turkey.
| | - Nezihat Rana Disel
- Department of Emergency Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Mustafa Yilmaz
- Department of Emergency Medicine, Faculty of Medicine, Firat University, Elazig, Turkey
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Kou M, Baghdassarian A, Khanna K, Jamal N, Carney M, Fein DM, Kim I, Langhan ML, Rose JA, Zuckerbraun NS, Roskind CG. Guiding Fellows to Independent Practice: Current Trends in Pediatric Emergency Medicine Fellow Supervision. Pediatr Emerg Care 2022; 38:517-520. [PMID: 35353795 DOI: 10.1097/pec.0000000000002676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent studies highlight the importance of physician readiness to practice beyond graduate training. The Accreditation Council for Graduate Medical Education mandates that pediatric emergency medicine (PEM) fellows be prepared for independent practice by allowing "progressive responsibility for patient care." Prior unpublished surveys of program directors (PDs) indicate variability in approaches to provide opportunities for more independent practice during fellowship training. OBJECTIVES The aims of the study were to describe practices within PEM fellowship programs allowing fellows to work without direct supervision and to identify any barriers to independent practice in training. DESIGN/METHODS An anonymous electronic survey of PEM fellowship PDs was performed. Survey items were developed using an iterative modified Delphi process and pilot tested. Close-ended survey responses and demographic variables were summarized with descriptive statistics. Responses to open-ended survey items were reviewed and categorized by theme. RESULTS Seventy two of 84 PDs (88%) responded to the survey; however, not all surveys were completed. Of the 68 responses to whether fellows could work without direct supervision (as defined by the Accreditation Council for Graduate Medical Education) during some part of their training, 31 (45.6%) reported that fellows did have this opportunity. In most programs, clinical independence was conditional on specific measures including the number of clinical hours completed, milestone achievement, and approval by the clinical competency committee. Reported barriers to fellow practice without direct oversight included both regulatory and economic constraints. CONCLUSIONS Current training practices that provide PEM fellows with conditional clinical independence are variable. Future work should aim to determine best practices of entrustment, identify ideal transition points, and mitigate barriers to graduated responsibility.
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Affiliation(s)
| | | | - Kajal Khanna
- Stanford University School of Medicine, Stanford, CA
| | - Nazreen Jamal
- Columbia University Irving Medical Center, New York, NY
| | | | - Daniel M Fein
- Albert Einstein College of Medicine/Children's Hospital at Montefiore, New York City, NY
| | - In Kim
- University of Louisville, Louisville, KY
| | | | - Jerri A Rose
- UH Rainbow Babies and Children's Hospital, Cleveland, OH
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French HM, Leeman KT, Wambach JA, Malik SK, Reber KM. Essentials of Neonatal-Perinatal Medicine fellowship: an overview. J Perinatol 2022; 42:269-276. [PMID: 33649441 DOI: 10.1038/s41372-021-00973-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/04/2021] [Accepted: 01/27/2021] [Indexed: 11/09/2022]
Abstract
Neonatal-Perinatal Medicine (NPM) fellowship programs have undergone constant evolution since their first appearance in the 1960s. This article is the first in a seven-part series (Table 1) that critically evaluates the essentials of neonatology fellowship clinical and research education, performance assessment, and administrative support necessary to support NPM fellowship programs. This overview article will provide background on the history of NPM fellowship programs and provide a framework for the article series. Table 1 Essentials of NPM fellowship article series. Essentials of NPM fellowship Part 1: Overview of NPM fellowship Description of the evolution of NPM Fellowship Part 2: Clinical education and experience Strengths, weaknesses, opportunities, and threats of clinical education in NPM fellowship Part 3: Scholarship opportunities and threats Scholarship requirements during NPM fellowship Part 4: Innovations in medical education Critical analysis of current educational practices and andragogical innovations in NPM fellowship Part 5: Evaluation of competence and proficiency using milestones Assessment of NPM fellows during training using competency-based medical education principles Part 6: Program administration Administrative infrastructure and stakeholders necessary to run a NPM fellowship program Part 7: Careers in NPM Career preparation and opportunities for NPM fellowship graduates.
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Affiliation(s)
- Heather M French
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
| | - Kristen T Leeman
- Department of Pediatrics, Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jennifer A Wambach
- Washington University School of Medicine, St. Louis, MO, USA.,St. Louis Children's Hospital, St. Louis, MO, USA
| | - Sabrina K Malik
- Department of Pediatrics, Division of Neonatology, Joseph M. Sanzari Children's Hospital, Hackensack, NJ, USA.,Hackensack Meridian Health School of Medicine, Hackensack, NJ, USA
| | | | - Kristina M Reber
- Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University College of Medicine, Columbus, OH, USA
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Moreira ME, Doty CI, Gallahue FE. We Need Our Village: CORD's Response to the ACGME's Common Program Requirements. THE WESTERN JOURNAL OF EMERGENCY MEDICINE 2019; 20:538-540. [PMID: 31316690 PMCID: PMC6625687 DOI: 10.5811/westjem.2019.7.44138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 07/01/2019] [Accepted: 07/01/2019] [Indexed: 11/21/2022]
Affiliation(s)
- Maria E Moreira
- Denver Health and Hospital Authority, Department of Emergency Medicine, Denver, Colorado.,University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Christopher I Doty
- University of Kentucky-Chandler Medical Center, Department of Emergency Medicine, Lexington, Kentucky
| | - Fiona E Gallahue
- The University of Washington, Harborview Medical Center, Department of Emergency Medicine, Seattle, Washington
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Moreira M, Doty C, Gallahue F. We Need Our Village: CORD’s Response to the ACGME’s Common Program Requirements. West J Emerg Med 2019. [DOI: 10.5811//westjem.2019.7.44138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Maria Moreira
- Denver Health and Hospital Authority, Department of Emergency Medicine, Denver, Colorado
| | - Christopher Doty
- University of Kentucky-Chandler Medical Center, Department of Emergency Medicine, Lexington, Kentucky
| | - Fiona Gallahue
- The University of Washington, Harborview Medical Center, Department of Emergency Medicine, Seattle, Washington
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Cleland J, Durning SJ. Education and service: how theories can help in understanding tensions. MEDICAL EDUCATION 2019; 53:42-55. [PMID: 30357894 DOI: 10.1111/medu.13738] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/09/2018] [Accepted: 06/18/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES This paper reviews why tensions between service and education persist and highlights that this is an area of medical education research (MER) that, to date, lacks a robust body of theory-driven research. After carrying out a review of the literature on service-education tensions in medical education and training, we turn to consider how theory can help provide new insights into service-education tensions. METHODS We conducted a search of the literature on service-education tensions since 1998 to examine the use of theory in studies on this topic. RESULTS We identified 44 out of 603 relevant papers. Their focus fell into four broad categories: time residents spent on 'service' and 'education'; perceptions of the balance between service and education; considerations of how best to define service and education, and the impact of structural and systems changes on education/training. Of the papers reporting primary research, the dominant methodology was the bespoke survey. Rarely were the precise natures of tensions or how different factors interact to cause tensions examined in detail. DISCUSSION Through discussion and reflection, we then agreed on the applicability of four sociocultural theories for illuminating some examples of service-education tensions. We present four sociocultural theories: Holland's figured worlds, Kemmis et al.'s practice architectures, Lave and Wenger's situated learning and Engeström's cultural-historical activity theory (CHAT or AT). We describe each and then briefly illustrate how each theory can support new ways of thinking and potential directions for research focusing on education-service tensions. CONCLUSIONS The use of theory in research studies will not resolve service-education tensions. However, what theory can do is illuminate and magnify different aspects of service-education tensions, to generate new insight and knowledge that can then be used to inform future research and changes in practice.
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Affiliation(s)
- Jennifer Cleland
- Centre for Healthcare Education Research and Innovation (CHERI), School of Medicine, Dentistry and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Steven J Durning
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Counselman FL, Kowalenko T, Marco CA, Joldersma KB, Korte RC, Reisdorff EJ. The Relationship Between ACGME Duty Hour Requirements and Performance on the American Board of Emergency Medicine Qualifying Examination. J Grad Med Educ 2016; 8:558-562. [PMID: 27777667 PMCID: PMC5058589 DOI: 10.4300/jgme-d-15-00591.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted requirements that limited the number of hours residents could spend on duty, and in 2011, it revised these requirements. OBJECTIVE This study explored whether the implementation of the 2003 and 2011 duty hour limits was associated with a change in emergency medicine residents' performance on the American Board of Emergency Medicine (ABEM) Qualifying Examination (QE). METHODS Beginning with the 1999 QE and ending with the 2014 QE, candidates for whom all training occurred without duty hour requirements (Group A), candidates under the first set of duty hour requirements (Group C), and candidates under the second set of duty hour requirements (Group E) were compared. Comparisons included mean scores and pass rates. RESULTS In Group A, 5690 candidates completed the examination, with a mean score of 82.8 and a 90.2% pass rate. In Group C, 8333 candidates had a mean score of 82.4 and a 90.5% pass rate. In Group E, there were 1269 candidates, with a mean score of 82.5 and an 89.4% pass rate. There was a small but statistically significant decrease in the mean scores (0.04, P < .001) after implementation of the first duty hour requirements, but this difference did not occur after implementation of the 2011 standards. There was no difference among pass rates for any of the study groups (χ2 = 1.68, P = .43). CONCLUSIONS We did not identify an association between the 2003 and 2011 ACGME duty hour requirements and performance of test takers on the ABEM QE.
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Affiliation(s)
- Francis L. Counselman
- Corresponding author: Francis L. Counselman, MD, Eastern Virginia Medical School, Raleigh Building, Room 304, 600 Gresham Drive, Norfolk, VA 23507, 757.388.3397,
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Stowell JR, Vohra TT, Luber SD. Emergency Medicine Resident Clinical Hours: A National Survey. J Emerg Med 2015; 48:474-80.e1-4. [DOI: 10.1016/j.jemermed.2014.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 10/29/2014] [Accepted: 11/16/2014] [Indexed: 10/24/2022]
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Emergency medicine residents' perspectives on patient safety and duty hours. Am J Emerg Med 2015; 33:459-60. [DOI: 10.1016/j.ajem.2014.11.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 11/18/2014] [Accepted: 11/19/2014] [Indexed: 11/21/2022] Open
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Nable JV, Greenwood JC, Abraham MK, Bond MC, Winters ME. Implementation of a team-based physician staffing model at an academic emergency department. West J Emerg Med 2014; 15:682-6. [PMID: 25247043 PMCID: PMC4162729 DOI: 10.5811/westjem.2014.5.20700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Accepted: 05/05/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction There is scant literature regarding the optimal resident physician staffing model of academic emergency departments (ED) that maximizes learning opportunities. A department of emergency medicine at a large inner-city academic hospital initiated a team-based staffing model. Its pre-interventional staffing model consisted of residents and attending physicians being separately assigned patients, resulting in residents working with two different faculty providers in the same shift. This study aimed to determine if the post-interventional team-based system, in which residents were paired with a single attending on each shift, would result in improved residents’ learning and clinical experiences as manifested by resident evaluations and the number of patients seen. Methods This retrospective before-and-after study at an academic ED with an annual volume of 52,000 patients examined the mean differences in five-point Likert-scale evaluations completed by residents assessing their ED rotation experiences in both the original and team-based staffing models. The residents were queried on their perceptions of feeling part of the team, decision-making autonomy, clinical experience, amount of supervision, quality of teaching, and overall rotational experience. We also analyzed the number of patients seen per hour by residents. Paired sample t-tests were performed. Residents who were in the program in the year preceding and proceeding the intervention were eligible for inclusion. Results 34 of 38 eligible residents were included (4 excluded for lack of evaluations in either the pre- or post-intervention period). There was a statistically significant improvement in resident perception of the quality and amount of teaching, 4.03 to 4.27 (mean difference=0.24, p=0.03). There were non-statistically significant trends toward improved mean scores for all other queries. Residents also saw more patients following the initiation of the team-based model, 1.24 to 1.56 patients per hour (mean difference=0.32, p=0.0005). Conclusion Adopting a team-based physician staffing model is associated with improved resident perceptions of quality and amount of teaching. Residents also experience a greater number of patient evaluations in a team-based model.
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Affiliation(s)
- Jose V Nable
- University of Maryland Baltimore County, Department of Emergency Health Services, Baltimore, Maryland ; University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland
| | - John C Greenwood
- University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland
| | - Michael K Abraham
- University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland
| | - Michael C Bond
- University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland
| | - Michael E Winters
- University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland
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Ethical Challenges in Emergency Medical Services: Controversies and Recommendations. Prehosp Disaster Med 2013; 28:488-97. [DOI: 10.1017/s1049023x13008728] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractEmergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Although provider judgment plays a large role in the resolution of conflicts at the scene, it is important to establish protocols and policies, when possible, to address these high-risk and complex situations. This article describes some of the common situations with ethical underpinnings encountered by EMS personnel and managers including denying or delaying transport of patients with non-emergency conditions, use of lights and sirens for patient transport, determination of medical futility in the field, termination of resuscitation, restriction of EMS provider duty hours to prevent fatigue, substance abuse by EMS providers, disaster triage and difficulty in switching from individual care to mass-casualty care, and the challenges of child maltreatment recognition and reporting. A series of ethical questions are proposed, followed by a review of the literature and, when possible, recommendations for management.BeckerTK, Gausche-HillM, AsweganAL, BakerEF, BookmanKJ, BradleyRN, De LorenzoRA, SchoenwetterDJ for the American College of Emergency Physicians’ EMS Committee. Ethical challenges in Emergency Medical Services: controversies and recommendations. Prehosp Disaster Med. 2013;28(5):1-10.
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Takakuwa KM, Biros MH, Ruddy RM, FitzGerald M, Shofer FS. A national survey of academic emergency medicine leaders on the physician workforce and institutional workforce and aging policies. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2013; 88:269-275. [PMID: 23269295 DOI: 10.1097/acm.0b013e31827c026e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE To describe the policies, practices, and attitudes of academic emergency medicine (EM) leaders regarding workforce issues, shift work, and accommodating the academic and personal needs of aging physicians. METHOD In 2009, the authors and the Society for Academic Emergency Medicine's Aging and Generational Issues taskforce developed, pilot tested, and deployed a survey of academic leaders at EM residency programs in the United States. They used descriptive statistics to analyze the results and chi-square or Fisher exact test for additional comparisons. RESULTS Seventy-eight of 146 (53%) invited EM leaders completed the survey. Forty-four of those 78 (56%) respondents reported formal or informal policies at their institutions for accommodating aging faculty, and 55 (71%) reported policies for accommodating faculty for reasons not related to age. Fifty-six (73%) reported employing physicians who work primarily overnight shifts, whereas only 23 (30%) reported employing physicians who work primarily weekend shifts. Fifty-five (71%) supported considering age in assigning shift type (overnight, weekend, etc.), but only 26 (33%) supported considering age in determining number of shifts. Sixty-six (86%) supported considering a faculty member's academic role in determining number of shifts. Only 26 (34%) supported considering a faculty member's academic rank in determining number of shifts, and 15 (20%) supported considering rank in assigning shift type. CONCLUSIONS EM leaders have considered the implications of issues related to clinical shift work and aging physicians. The findings of this report indicate some of the ways that leaders have begun to adapt their programs to ensure the field's future success.
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Affiliation(s)
- Kevin M Takakuwa
- Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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Marco CA, Kowalenko T. Competence and challenges of emergency medicine training as reported by emergency medicine residents. J Emerg Med 2012; 43:1103-9. [PMID: 22883717 DOI: 10.1016/j.jemermed.2012.05.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 04/21/2012] [Accepted: 05/20/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND The American Board of Emergency Medicine conducts an annual survey of residents in Emergency Medicine, the Longitudinal Study of Residents in Emergency Medicine survey. OBJECTIVE This study was undertaken to describe self-reported competence and challenges facing Emergency Medicine (EM) residents. METHODS In this descriptive, observational analysis of the Longitudinal Study of Residents in Emergency Medicine survey, survey data from 1996-2008 were compared for 70 survey items. Responses were analyzed with means and 95% confidence intervals by post-graduate year (PGY) and over time. RESULTS A total of 496 residents were included in this study. Most participated for 3 years, for a total of 1320 total responses. The most serious day-to-day challenges reported by residents (overall median scores of 3 or more) included knowing enough, keeping up with the medical literature, having enough time for personal life, ancillary support, and having enough time for family. Current level of competence in areas deemed weakest by residents included grant writing, contract negotiation, academic writing, disaster planning, research, and financial management. Residents reported improved competence in most (15 out of 16) areas from PGY-1 to PGY-3 year of training. Resident reports of competence did not change significantly over time from 1998-2008 (15 out of 16 items). CONCLUSIONS Emergency Medicine residents identified several important day-to-day problems, including knowing enough, keeping up with the medical literature, and having enough time for a personal life. PGY-3 residents reported improved competence in almost all aspects of EM work and clinical EM as compared to PGY-1 residents. Knowledge of perceived competence and problems among EM residents is crucial to the development of improved educational approaches to address these issues.
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Affiliation(s)
- Catherine A Marco
- Department of Emergency Medicine, University of Toledo College of Medicine, Toledo, Ohio 43614, USA
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Lefebvre DC. Perspective: Resident physician wellness: a new hope. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:598-602. [PMID: 22450179 DOI: 10.1097/acm.0b013e31824d47ff] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Residency training is a challenging period in a physician's career owing to a multitude of stressors perhaps not previously encountered. In some cases, these stressors may culminate in a state of burnout. In response, much has been written about the issues of personal wellness during residency training. Recently, duty hours reform has been the major focus of addressing resident wellness; however, this intervention has established little benefit and has created unintended negative consequences. Alternatively, an emerging solution may be the implementation of resident wellness programs into residency training. Such programs are defined by a combination of active and passive initiatives targeting the various domains of physical, mental, social, and intellectual wellness. In contrast to duty hours reform, resident wellness programs are generally free from controversy and have been shown to improve resident wellness and enhance empathy.This article highlights the salient causes of burnout as it applies to present-day resident physicians and the patient care they provide. Moreover, in the wake of the controversy surrounding duty hours reform, a novel approach to resident wellness involving structured resident wellness programs is discussed. Specifically included are the fundamental components of a wellness program, the advantages held over duty hours reform, methods to evaluate program efficacy, and the current evidence to support these initiatives. Formal wellness curricula, including an evaluative process, should be an integral component of physician training. These programs represent a new hope in the solution to the long-debated issue of burnout and wellness during residency training.
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Affiliation(s)
- Dennis C Lefebvre
- Department of Emergency Medicine, University of Alberta, Edmonton, Canada.
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Meguerdichian DA, Heiner JD, Younggren BN. Emergency medicine simulation: a resident's perspective. Ann Emerg Med 2011; 60:121-6. [PMID: 21944898 DOI: 10.1016/j.annemergmed.2011.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 08/16/2011] [Accepted: 08/16/2011] [Indexed: 10/17/2022]
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