Understanding clerkship experiences in emergency medicine and their potential influence on specialty selection: A qualitative study.

Objectives: The specialty of emergency medicine (EM) is experiencing a significant decrease in student interest. In addition, women are historically underrepresented within the specialty at all levels of training and practice. We sought to understand how clinical experiences and perceptions of EM influence specialty selection by medical students, particularly women.

Institutional Review Boards' Assessment of Local Context: A Mixed Methods Study.

The nature of the review of local context by institutional review boards (IRBs) is vague. Requirements for single IRB review of multicenter trials create a need to better understand interpretation and implementation of local-context review and how to best implement such reviews centrally. We sought a pragmatic understanding of IRB local-context review by exploring stakeholders' attitudes and perceptions.

Cultural Humility Curriculum to Address Healthcare Disparities for Emergency Medicine Residents.

Introduction: Emergency medicine (EM) residency programs have variable approaches to educating residents on recognizing and managing healthcare disparities. We hypothesized that our curriculum with resident-presented lectures would increase residents' sense of cultural humility and ability to identify vulnerable populations.

Methods: At a single-site, four-year EM residency program with 16 residents per year, we designed a curriculum intervention from 2019-2021 where all second-year residents selected one healthcare disparity topic and gave a 15-minute presentation overviewing the disparity, describing local resources, and facilitating a group discussion.

Creating opportunities to engage with prospective historically marginalized trainees with clinical simulation.

Background: Recruiting a diverse group of medical students, house officers, and faculty in medicine is challenging-particularly for predominantly white, midwest institutions that may not be racially or ethnically diverse.

Purpose: To evaluate a novel clinical simulation program, SiMfest, for recruiting house officers from historically marginalized populations to our institution to demonstrate our leadership's commitment to high-quality education and recruitment of these students to enhance diversity in academic medicine.

Methods: The Office for Health Equity and Inclusion, institutional leadership, and clinical department chairs developed a novel and engaging series of clinical simulations, SiMfest, to engage the pipeline of historically marginalized trainees and demonstrate our leadership's commitment to high-quality education.

Facemasks: Perceptions and use in an ED population during COVID-19.

Study Objective: Facemask use is associated with reduced transmission of SARS-CoV-2. Most surveys assessing perceptions and practices of mask use miss the most vulnerable racial, ethnic, and socio-economic populations. These same populations have suffered disproportionate impacts from the pandemic.

The Experiences and Needs of Families of Comatose Patients After Cardiac Arrest and Severe Neurotrauma: The Perspectives of National Key Stakeholders During a National Institutes of Health-Funded Workshop.

Objectives: Severe acute brain injury (SABI) from cardiac arrest and traumatic brain injury happens suddenly and unexpectedly, carrying high potential for lifelong disability with substantial prognostic uncertainty. Comprehensive assessments of family experiences and support needs after SABI are lacking. Our objective is to elicit "on-the-ground" perspectives about the experiences and needs of families of patients with SABI.

Developing an electronic health record-derived health equity dashboard to improve learner access to data and metrics.

Objectives: It is essential to engage learners in efforts aimed at dismantling racism and other contributors to health care disparities. Barriers to their involvement include limited access to data. The objective of our study was to create a data dashboard using an existing quality improvement (QI) infrastructure and provide resident access to data to facilitate exploratory analysis on disparities in emergency department (ED) patient care.

Untold stories: Emergency medicine residents' experiences caring for diverse patient populations.

Objectives: The Accreditation Council for Graduate Medical Education expects specialties to teach and assess proficiency in culturally competent care. However, little guidance has emerged to achieve these goals. Clinical training within socioeconomically disparate settings may provide an experiential learning opportunity.

The Rapid Evaluation of COVID-19 Vaccination in Emergency Departments for Underserved Patients Study.

Study Objective: Emergency departments (EDs) often serve vulnerable populations who may lack primary care and have suffered disproportionate COVID-19 pandemic effects. Comparing patients having and lacking a regular source of medical care and other ED patient characteristics, we assessed COVID-19 vaccine hesitancy, reasons for not wanting the vaccine, perceived access to vaccine sites, and willingness to get the vaccine as part of ED care.

Methods: This was a cross-sectional survey conducted from December 10, 2020, to March 7, 2021, at 15 safety net US EDs.

Meeting unique requirements: Community consultation and public disclosure for research in emergency setting using exception from informed consent.

Background: Exception from informed consent (EFIC) regulations for research in emergency settings contain unique requirements for community consultation and public disclosure. These requirements address ethical challenges intrinsic to this research context. Multiple approaches have evolved to accomplish these activities that may reflect and advance different aims.

Beneficiaries' perspectives on improved oral health and its mediators after Medicaid expansion in Michigan: a mixed methods study.

Objective: To investigate self-reported improved oral health and its mediators, and job-related outcomes, of Medicaid expansion beneficiaries in Michigan.

Methods: This cross-sectional mixed-methods study of adult "Healthy Michigan Plan" (HMP) Medicaid expansion beneficiaries included qualitative interviews with a convenience sample of 67 beneficiaries enrolled for ≥6 months, a stratified random sample survey of 4,090 beneficiaries enrolled for ≥12 months; and Medicaid claims data. We examined unadjusted associations between demographic variables and awareness of dental coverage, self-reported dental care access, dental visits, and self-reported oral health; and between improved oral health and job seeking and job performance.

To Be Seen, Heard, and Valued: Strategies to Promote a Sense of Belonging for Women and Underrepresented in Medicine Physicians.

Lingering unconscious biases and daily cues continue to permeate and persist in academic medicine environments in the form of the exclusion of physicians who are women or racially/ethnically underrepresented in medicine. Academic medicine environments must change so that women and underrepresented in medicine racial/ethnic groups are seen, heard, and valued. A shared awareness among faculty, administrators, and trainees can inform the development of intentional strategies to alter individual behaviors, academic spaces, and institutional processes to cultivate a sense of belonging.

Association of Medicaid Expansion With Enrollee Employment and Student Status in Michigan.

Importance: Medicaid community engagement requirements (work, school, job searching, or community service) are being implemented by several states for the first time, but the association of Medicaid coverage with enrollees' employment and school attendance is unclear.

Objective: To assess longitudinal changes in enrollees' employment or student status after Michigan's Medicaid expansion.

Design, Setting, And Participants: This survey study included 4090 nonelderly, adult Healthy Michigan Plan enrollees from March 1, 2017, to January 31, 2018.

Health Risk Assessments in Michigan's Medicaid Expansion: Early Experiences in Primary Care.

Introduction: Michigan is one of 3 states that have implemented health risk assessments for enrollees as a feature of its Medicaid expansion, the Healthy Michigan Plan. This study describes primary care providers' early experiences with completing health risk assessments with enrollees and examines provider- and practice-level factors that affect health risk assessment completion.

Methods: All primary care providers caring for ≥12 Healthy Michigan Plan enrollees (n=4,322) were surveyed from June to November 2015, with 2,104 respondents (55.

Factors influencing primary care providers' decisions to accept new Medicaid patients under Michigan's Medicaid expansion.

Objectives: Michigan expanded Medicaid under the Affordable Care Act (ACA) through a federal waiver that permitted state-mandated features, including an emphasis on primary care. We investigated the factors associated with Michigan primary care providers (PCPs)' decision to accept new Medicaid patients under Medicaid expansion.

Study Design: Statewide survey of PCPs informed by semistructured interviews.

Changes in Health and Ability to Work Among Medicaid Expansion Enrollees: a Mixed Methods Study.

Background: Michigan expanded Medicaid under the Affordable Care Act (Healthy Michigan Plan [HMP]) to improve the health of low-income residents and the state's economy.

Objective: To understand HMP's impact on enrollees' health, ability to work, and ability to seek employment DESIGN: Mixed methods study, including 67 qualitative interviews and 4090 computer-assisted telephone surveys (response rate 53.7%) PARTICIPANTS: Non-elderly adult HMP enrollees MAIN MEASURES: Changes in health status, ability to work, and ability to seek employment KEY RESULTS: Half (47.

Value of Near-Peer Mentorship from Protégé and Mentor Perspectives: A Strategy to Increase Physician Workforce Diversity.

Purpose: Mentorship is a critical aspect of personal and professional development in academic medicine and helps to improve career satisfaction, productivity, and social networking. However, individuals from communities underrepresented in medicine (URiM) across the training continuum experience difficulty obtaining mentors, even prior to college. The value of near-peer mentorship is less well studied in medicine relative to other fields.

Primary Care Clinicians' Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study.

Background: Michigan's approach to Medicaid expansion, the Healthy Michigan Plan (HMP), emphasizes primary care, prevention, and incentives for patients and primary care practitioners (PCPs).

Objective: Assess PCPs' perspectives about the impact of HMP on their patients and practices.

Design: In 2014-2015, we conducted semi-structured interviews then a statewide survey of PCPs.

A systematic review of Federal Drug Administration Docket for community consultation and public disclosure in exception from informed consent trials.

Background: Exception from informed consent imposes community consultation and public disclosure requirements on clinical investigation in critically ill and injured patients. In 2011, the Food and Drug Administration instructed sponsors to submit publically disclosed information to the Food and Drug Administration Docket, but to date there has been no comprehensive analysis of available data. We summarized the community consultation and public disclosure practices of exception from informed consent trials published on the Food and Drug Administration Docket in order to better understand the breadth of common practices that exists among acute care clinical research.

Patient and Surrogate Views of Community Consultation for Emergency Research.

Objective: Pretrial community consultation (CC) is required for emergency research conducted under an exception from informed consent (EFIC) in the United States. CC remains controversial and challenging, and minimal data exist regarding the views of individuals enrolled in EFIC trials on this process. It is important to know whether participants perceive CC to be meaningful and, if so, whom they believe should be consulted.

The Importance of the Premedical Experience in Diversifying the Health Care Workforce.

In light of national calls for increased diversity in medicine, it is critical for academic medicine to remain actively engaged in the conversation about the value of diversity in higher education, specifically for students from underrepresented backgrounds. Too often, the undergraduate premedical experience is excluded from conversations about diversity in medicine. The undergraduate premedical experience, however, is a critical junction for many students from backgrounds underrepresented in medicine, especially for those who enter college underprepared for the academic rigor of the premedical experience.

Emergency department hospitalization volume and mortality in the United States.

Study Objective: Although numerous studies have demonstrated a relationship between higher volume and improved outcomes in the delivery of health services, it has not been extensively explored in the emergency department (ED) setting. Therefore, we seek to examine the association between ED hospitalization volume and mortality for common high-risk conditions.

Methods: Using data from the Nationwide Inpatient Sample, a national sample of hospital discharges, we evaluated mortality overall and for 8 different diagnoses between 2005 and 2009 (total admissions 17.

Racial differences in disability after stroke: results from a nationwide study.

Objective: We sought to characterize racial differences in disability among older stroke survivors.

Methods: A cross-sectional study of 806 self-reported stroke survivors from the 2011 National Health and Aging Trends Study was performed. Race was based on self-report.

When coverage expands: children's health insurance program as a natural experiment in use of health care services.

Background: Expanding insurance coverage is designed to improve access to primary care and reduce use of emergency department (ED) services. Whether expanding coverage achieves this is of paramount importance as the United States prepares for the Affordable Care Act.

Objectives: Emergency and outpatient department use was examined after the State Children's Health Insurance Program (CHIP) coverage expansion, focusing on adolescents (a major target group for CHIP) versus young adults (not targeted).