Simulated video-based telehealth training for emergency physicians

Introduction

Little exists in the literature describing video-based telehealth training, especially for practicing Emergency Physicians.

Materials and methods

This was a retrospective, pre- and post-assessment of physicians' knowledge and confidence on video-based telehealth after two simulated telehealth encounters. Attending physicians voluntarily participated in Zoom-based trainings and received feedback from the patient actors immediately after each simulation. Post-experience surveys queried participants on the training, aspects of telehealth, and confidence in features of optimal telehealth practice.

Results

The survey had 100% response rate (13/13 physicians). Participants recommended the simulated training experience, mean of 8.38 (SD 1.89; 0 = Not at all likely, 10 = Extremely likely). Pre- and post-response means increased in two questions: "I can describe at least two ways to improve my video-based clinical care": delta: 1.54, t(12) = 3.83, p = 0.002, Cohen's d effect size of 1.06, and "I know when video-based telehealth could be helpful in clinical practice": delta: 0.99, t(12) = 3.09, p = 0.009, Cohen's d effect size of 0.86.

Conclusion

In this pilot, participants viewed telehealth more favorably after the experience and indicated improved confidence in focused telehealth skills. Further study is needed to determine what simulated case content provides the most value for decision-making via telehealth.

Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care

STUDY OBJECTIVE

Given the popularity of educational blogs and podcasts in medicine, learners and educators need tools to identify trusted and impactful sites. The Social Media Index was a multi-sourced formula to rank the effect of emergency medicine and critical care blogs. In 2022, a key data point for the Social Media Index became unavailable. This bibliometric study aimed to develop a new measure, the Digital Impact Factor, as a replacement.

METHODS

The Digital Impact Factor incorporated modern measures of website authority and reach. This formula was applied to a cross-sectional study of active emergency medicine and critical care blogs and podcasts. For each website, we generated a Digital Impact Factor score based on Ahrefs Domain Rating and the follower count of the websites' pages from 8 social media platforms. A series of Spearman correlations provided evidence of association by comparing a rank-ordered list to rank lists derived from the Social Media Index over the last 5 years. The Bland-Altman analysis assessed for agreement.

RESULTS

The authors identified 88 relevant websites with a median Ahrefs Domain Rating of 28 (range 0 to 71, maximum 100) and total social media followership count across 8 platforms of 1,828,557. The Domain Rating and individual social media followership scores were normalized based on the highest recorded values to yield the Digital Impact Factor (median 4.57; range 0.02 to 9.50, maximum 10). The correlation between the 2022 Digital Impact Factor and the 2021 Social Media Index was 0.94 (95% confidence interval 0.89 to 0.97; p<.001; n=41 rankings correlated), suggesting that they measure similar constructs. The Bland-Altman plot also demonstrated fair agreement between the 2 scores.

CONCLUSION

The Digital Impact Factor is a measure of the relative effect of educational blogs and podcasts within emergency medicine and critical care.

A Fork in the Road for Emergency Medicine and Critical Care Blogs and Podcasts: Cross-sectional Study

BACKGROUND

Free open-access meducation (FOAM) refers to open-access, web-based learning resources in medicine. It includes all formats of digital products, including blogs and podcasts. The number of FOAM blog and podcast sites in emergency medicine and critical care increased dramatically from 2002 to 2013, and physicians began to rely on the availability of these resources. The current landscape of these FOAM sites is unknown.

OBJECTIVE

This study aims to (1) estimate the current number of active, open-access blogs and podcasts in emergency medicine and critical care and (2) describe observed and anticipated trends in the FOAM movement using the Theory of Disruptive Innovation by Christensen as a theoretical framework.

METHODS

The authors used multiple resources and sampling strategies to identify active, open-access blogs and podcasts between April 25, 2022, and May 8, 2022, and classified these websites as blogs, podcasts, or blogs+podcasts. For each category, they reported the following outcome measures using descriptive statistics: age, funding, affiliations, and team composition. Based on these findings, the authors projected trends in the number of active sites using a positivist paradigm and the Theory of Disruptive Innovation as a theoretical framework.

RESULTS

The authors identified 109 emergency medicine and critical care websites, which comprised 45.9% (n=50) blogs, 22.9% (n=25) podcasts, and 31.2% (n=34) blogs+podcasts. Ages ranged from 0 to 18 years; 27.5% (n=30) sold products, 18.3% (n=20) used advertisements, 44.0% (n=48) had institutional funding, and 27.5% (n=30) had no affiliation or external funding sources. Team sizes ranged from 1 (n=26, 23.9%) to ≥5 (n=60, 55%) individuals.

CONCLUSIONS

There was a sharp decline in the number of emergency medicine and critical care blogs and podcasts in the last decade, dropping 40.4% since 2013. The initial growth of FOAM and its subsequent downturn align with principles in the Theory of Disruptive Innovation by Christensen. These findings have important implications for the field of medical education.

Medical Care at a Large Vertical Running Event

OBJECTIVE

Vertical running events, during which participants race up the stairwells of skyscrapers, are becoming increasingly popular. Such events have unique and specific operational and clinical considerations for event medical directors, but descriptions of the medical care provided at these events are lacking. We sought to perform a descriptive analysis of the medical care delivered at a single, large vertical running event.

METHODS

A retrospective chart review of medical encounters at a large vertical running event from 2011-2017 was performed. Participants competed in either the full course (94 stories) or half course (54 stories); potential patients also included observers. Medical staffing included a main medical station at the finish line, medical way stations along the routes (within stairwells), and medical response teams. Descriptive statistics were used for analysis.

RESULTS

During the study period, a total of 23,920 participants completed the event, with 84.6% participating in the full course. Medical staff treated 150 unique patients during 154 medical encounters (0.6% treatment rate). The median age of patients was 36 (IQR 27, 43), and 40.3% were male. Most encounters (66.4%) occurred at the finish line main medical area. Of medical encounters occurring along the race routes, 56.1% of encounters occurred before the halfway point in the full course. Encounters were clustered around medical way stations along the half course. The most common chief complaints were gastrointestinal (27.3%), respiratory (25.3%), syncope/near-syncope (24.7%), trauma (12.3%), and chest pain (10.4%). One cardiac arrest was observed. The most frequent interventions were oral fluids or food (40.3%), respiratory care (18.2%), and minor trauma care (12.3%). An electrocardiogram (ECG) was obtained in 10.4% of encounters, and intravenous fluids were started on 1.9% of patients. Eleven patients (7.3% of treated patients and 0.05% of all participants) were transported by ambulance.

CONCLUSIONS

Medical encounters during vertical running events, the majority of which are not life-threatening, mainly occur at the finish line but can occur at any point along the route. Understanding the nature and location of medical encounters along a vertical running event route can help inform event medical directors supervising care at these increasingly popular events.

A review of human sensory dynamics for application to models of driver steering and speed control

In comparison with the high level of knowledge about vehicle dynamics which exists nowadays, the role of the driver in the driver-vehicle system is still relatively poorly understood. A large variety of driver models exist for various applications; however, few of them take account of the driver's sensory dynamics, and those that do are limited in their scope and accuracy. A review of the literature has been carried out to consolidate information from previous studies which may be useful when incorporating human sensory systems into the design of a driver model. This includes information on sensory dynamics, delays, thresholds and integration of multiple sensory stimuli. This review should provide a basis for further study into sensory perception during driving.