Physician perceptions of documentation methods in electronic health records.

This study sought to determine physician, specialty and practice factors influencing choice of method for electronic health record (EHR) documentation: direct typing (DT), electronic transcription (ET), human transcription (HT), and scribes. A survey assessing physician documentation practices was developed and distributed online. The primary outcome was the proportion of physicians using each method.

Expanding OSCE-related Learning Opportunities For Pre-Clerkship Students: Insights From an Assessment for Learning Curriculum.

Pre-clerkship clinical skills courses at many medical schools use objective structured clinical examinations (OSCEs) to assess students' development as it relates to the foundational clinical skills of history taking, communication, and physical examination. The authors report on a curriculum in which OSCEs also serve as a springboard for additional learning by linking them to activities that include patient write-ups, oral presentations, clinical reasoning discussions, clinical question generation, and video review with faculty. The rationale for using OSCEs as an assessment for learning tool is discussed, and some lessons learned are reported.

The Reliability of 2-Station Clerkship Objective Structured Clinical Examinations in Isolation and in Aggregate.

Background: Most medical schools in the United States report having a 5- to 10-station objective structured clinical examination (OSCE) at the end of the core clerkship phase of the curriculum to assess clinical skills. We set out to investigate an alternative OSCE structure in which each clerkship has a 2-station OSCE. This study looked to determine the reliability of clerkship OSCEs in isolation to inform composite clerkship grading, as well as the reliability in aggregate, as a potential alternative to an end-of-third-year examination.

Recording Out-of-Hospital Cardiac Arrest Treatment via a Mobile Smartphone Application: A Feasibility Simulation Study.

Background: Given the demanding nature of out-of-hospital cardiac arrest (OHCA) resuscitations, recordings of the times of interventions in EMS patient care reports (PCRs) are often inaccurate. The American Heart Association developed Full Code Pro (FCP), a smartphone application designed to assist EMS personnel in recording the timing of interventions performed. Through OHCA simulations, this study assessed the group size necessary to use the FCP recording functions accurately and safely without compromising patient care.

Medical students review of formative OSCE scores, checklists, and videos improves with student-faculty debriefing meetings.

Background: Performance feedback is considered essential to clinical skills development. Formative objective structured clinical exams (F-OSCEs) often include immediate feedback by standardized patients. Students can also be provided access to performance metrics including scores, checklists, and video recordings after the F-OSCE to supplement this feedback.

The Impact of Medical Student Participation in Emergency Medicine Patient Care on Departmental Press Ganey Scores.

Introduction: Press Ganey (PG) scores are used by public entities to gauge the quality of patient care from medical facilities in the United States. Academic health centers (AHCs) are charged with educating the new generation of doctors, but rely heavily on PG scores for their business operation. AHCs need to know what impact medical student involvement has on patient care and their PG scores.

Use of a secure social media platform to facilitate reflection in a residency program.

Background: Reflective writing is used to promote learning and professional growth in medical education. Sharing reflections with peers and supervisors facilitates feedback that enhances understanding.

Objective: We explored the feasibility of using a secure social media platform to share reflections and promote reflective discussions in an emergency medicine residency program.

A tiered mentorship program improves number of students with an identified mentor.

Background: Mentorship is critical to professional development and academic success. Unfortunately, only about 40% of medical students can identify a mentor. While group mentorship has been evaluated - the concept of a specialty specific, tiered group mentorship program (TGMP) has not.

Emergency medicine residents' attitudes and opinions of in-training exam preparation.

Purpose: Emergency Medicine (EM) residents take the American Board of Emergency Medicine (ABEM) in-training exam, and performance on this exam has been shown to correlate to performance on the ABEM qualifying exam. Though many residencies have in-training exam preparation activities, there is little data on the effectiveness of these efforts. This study aimed to elicit resident perspectives about the exam and exam preparation in order to generate hypotheses and better inform future preparation efforts.

Medical student self-assessment narratives: perceived educational needs during fourth-year emergency medicine clerkship.

Background: The educational needs of medical students in the 4th-year of training are not well defined in the literature.

Purpose: The specific aim of this investigation is to characterize the perceived educational needs of 4th-year medical students during an Emergency Medicine clerkship.

Methods: This was a thematic analysis of informed self-assessment narratives.

Developing and assessing initiatives designed to improve clinical teaching performance.

To improve the teaching performance of emergency physicians, it is necessary to understand the attributes of expert teachers and the optimal methods to deliver faculty development. A working group of medical educators was formed to review the literature, summarize what is known on the topic, and provide recommendations for future research. This occurred as a track of the 2012 Academic Emergency Medicine (AEM) consensus conference "Education Research in Emergency Medicine: Opportunities, Challenges, and Strategies for Success.

The use of reflection in emergency medicine education.

Reflection is a cognitive process in which new information and experiences are integrated into existing knowledge structures and mental models, resulting in meaningful learning. Reflection often occurs after an experience is over, promoting professional development and lifelong learning. However, a reflective emergency physician (EP) is also able to apply reflection in real time: self-monitoring, coping with the unexpected, and quickly thinking on his or her feet to solve complicated, unique, and challenging clinical problems.

The impact of two clinical shift allocation models on student experiences in an emergency medicine clerkship.

Background: Medical students on Emergency Medicine (EM) clerkships are traditionally assigned work shifts in a manner that provides a mix of daytime, evening, overnight, and weekend shifts. Whether or not this shift allocation model provides the optimal educational experience remains unclear.

Purpose: The purpose of this study was to compare the impact of two different shift allocation models on the student's clerkship experience.

Pseudohyperkalemia without reported haemolysis in a patient with chronic lymphocytic leukaemia.

Hyperkalemia is a medical condition that requires immediate recognition and treatment to prevent the development of life-threatening arrhythmias. Pseudohyperkalemia is most commonly due to specimen haemolysis and is often recognised by laboratory scientists who subsequently report test results with cautionary warnings. The authors present a case of pseudohyperkalemia in a patient with chronic lymphocytic leukaemia that was the result of white blood cell lysis during phlebotomy.

Faculty prefer continuity with medical students in the emergency department.

Introduction: The aim of this investigation was to better understand emergency medicine (EM) faculty opinions as they relate to continuity with students.

Methods: This was a prospective cohort study of faculty supervising students completing an EM clerkship. Student schedules were aligned to maximise continuity with faculty.

Advanced topics in emergency medicine: curriculum development and initial evaluation.

Background: Emergency medicine (EM) is a young specialty and only recently has a recommended medical student curriculum been developed. Currently, many schools do not require students to complete a mandatory clerkship in EM, and if one is required, it is typically an overview of the specialty.

Objectives: We developed a 10-month longitudinal elective to teach subject matter and skills in EM to fourth-year medical students interested in the specialty.

Feedback in the emergency medicine clerkship.

Objective: Feedback is a technique used in medical education to help develop and improve clinical skills. A comprehensive review article specifically intended for the emergency medicine (EM) educator is lacking, and it is the intent of this article to provide the reader with an in-depth, up-to-date, and evidence-based review of feedback in the context of the EM clerkship.

Methods: The review article is organized in a progressive manner, beginning with the definition of feedback, the importance of feedback in medical education, the obstacles limiting the effective delivery of feedback, and the techniques to overcome these obstacles then follows.

Medical student professionalism narratives: a thematic analysis and interdisciplinary comparative investigation.

Background: Professionalism development is influenced by the informal and hidden curriculum. The primary objective of this study was to better understand this experiential learning in the setting of the Emergency Department (ED). Secondarily, the study aimed to explore differences in the informal curriculum between Emergency Medicine (EM) and Internal Medicine (IM) clerkships.

Clinical teaching site does not affect test performance in an emergency medicine clerkship.

Objectives: Increasing the size of medical school classes has resulted in the use of community hospitals for emergency medicine (EM) clerkships. While differences in clinical experience are expected, it is unclear if they are significant. The authors set out to investigate whether or not clinical site affects student performance on a standard written exam as a measure of medical knowledge.

Metastatic prostate cancer mimicking polymyalgia rheumatica.

A 59-year-old male presented to the emergency department with a four-month progressive history of proximal muscle pain and weakness with elevated erythrocyte sedimentation rate and C-reactive protein. He was initially diagnosed with polymyalgia rheumatica (PMR) and admitted to the hospital. During his hospitalization he was found to have metastatic prostate cancer, which was thought to be responsible for his PMR-like syndrome.

Delayed presentation of thoracic esophageal perforation after blunt trauma.

Thoracic esophageal perforation after blunt trauma is a rare injury with high mortality. Prompt recognition and aggressive treatment are paramount to survival. We report a case of delayed presentation that emphasizes the diagnostic difficulties in this traumatic injury.

Postal survey methodology to assess patient satisfaction in a suburban emergency medical services system: an observational study.

Background: Patient satisfaction is of growing importance to providers of emergency medical services (EMS). Prior reports of patient satisfaction have frequently used resource-intensive telephone follow-up to assess satisfaction. We determine the feasibility of using a single mailing, anonymous postal survey methodology for collecting patient satisfaction data from a suburban EMS system.