Intern Orthopedic Rotation Versus Emergency Medicine Procedure Month: Which one Derives More Opportunity?

Introduction: The American College of Graduate Medical Education (ACGME) defines 18 "key procedures" as requirements in emergency medicine (EM) residency programs. The post-graduate year-1 (PGY-1) curriculum provides an early foundation for EM trainees to gain procedural experience, but traditional PGY-1 rotations may not provide robust procedural opportunities. Our objective was to replace a traditional orthopedic rotation with a 4-week rotation that emphasized EM procedure acquisition and comprehension.

Fluctuation of Public Interest in COVID-19 in the United States: Retrospective Analysis of Google Trends Search Data.

Background: In the absence of vaccines and established treatments, nonpharmaceutical interventions (NPIs) are fundamental tools to control coronavirus disease (COVID-19) transmission. NPIs require public interest to be successful. In the United States, there is a lack of published research on the factors that influence public interest in COVID-19.

Social Media Usage Among Nurses: Perceptions and Practices.

Objective: This study aims to examine the existing perceptions and social media practices of nurses in a large academic medical center.

Background: Limited data are available about the perceptions and social media practices among healthcare providers. An understanding of the social networking landscape within the nursing profession is necessary to inform policy and develop effective guidelines.

Determinants of medical specialty competitiveness.

Background: Although the concept of medical specialty competitiveness may seem intuitive, there are very little existing empirical data on the determinants of specialty competitiveness in USA. An understanding of the determinants of specialty competitiveness may inform career choices among students and their advisors. Specialty competitiveness correlates with availability and appeal.

Standardized Letters of Concern and Remediation Contracts: Templates for Program Directors.

Background: Remediation of the struggling resident is a universal phenomenon, and the majority of program directors will remediate at least 1 resident during their tenure.

Objective: The goal of this project was to create a standardized template for program directors to use at all stages of remediation.

Methods: Between 2017 and 2018, the Council of Residency Directors in Emergency Medicine (CORD-EM) Remediation Committee searched for best practices in the medical literature and compiled a survey that was e-mailed to the CORD-EM listserv.

A Narrative Review of the Evidence Supporting Factors Used by Residency Program Directors to Select Applicants for Interviews.

Background: Residency applicants feel increasing pressure to maximize their chances of successfully matching into the program of their choice, and are applying to more programs than ever before.

Objective: In this narrative review, we examined the most common and highly rated factors used to select applicants for interviews. We also examined the literature surrounding those factors to illuminate the advantages and disadvantages of using them as differentiating elements in interviewee selection.

The Golden Opportunity: Multidisciplinary Simulation Training Improves Trauma Team Efficiency.

Objective: Every trauma patient has a golden hour, and resuscitation efficiency within that hour has large implications for patients. We instituted simulation based trauma resuscitation training with the hypothesis that it would improve trauma team efficiency.

Methods: Five simulation training sessions were conducted with immediate debriefing.

Intern Passport: Orienting New Travelers to the Emergency Department.

The objective of the Intern Passport (IP) curriculum was to implement a structured orientation for incoming interns that effectively defined and distinguished various personnel and assets within the emergency department (ED). The method of training was an on-the-job orientation that required interns to obtain "stamps" (signatures) on their passports during visits to eight "countries" (specialists) within the ED. Topics covered during the visit included introductions, tasks and capabilities, expectations, and pearls and pitfalls.

Examining the Effects of Narrative Commentary on Evaluators' Summative Assessments of Resident Performance.

Anchor-based, end-of-shift ratings are commonly used to conduct performance assessments of resident physicians. These performance evaluations often include narrative assessments, such as solicited or "free-text" commentary. Although narrative commentary can help to create a more detailed and specific assessment of performance, there are limited data describing the effects of narrative commentary on the global assessment process.

The HEART Pathway Randomized Controlled Trial One-year Outcomes.

Objective: The objective was to determine the impact of the HEART Pathway on health care utilization and safety outcomes at 1 year in patients with acute chest pain.

Methods: Adult emergency department (ED) patients with chest pain (N = 282) were randomized to the HEART Pathway or usual care. In the HEART Pathway arm, ED providers used the HEART score and troponin measures (0 and 3 hours) to risk stratify patients.

Efficient and secure outsourcing of genomic data storage.

Background: Cloud computing is becoming the preferred solution for efficiently dealing with the increasing amount of genomic data. Yet, outsourcing storage and processing sensitive information, such as genomic data, comes with important concerns related to privacy and security. This calls for new sophisticated techniques that ensure data protection from untrusted cloud providers and that still enable researchers to obtain useful information.

Validation of the No Objective Testing Rule and Comparison to the HEART Pathway.

Background: The no objective testing rule (NOTR) is a decision aid designed to safely identify emergency department (ED) patients with chest pain who do not require objective testing for coronary artery disease.

Objectives: The objective was to validate the NOTR in a cohort of U.S.

Erratum: This Article Corrects: "Trends in NRMP Data from 2007-2014 for U.S. Seniors Matching into Emergency Medicine".

[This corrects the article on p. 105 in vol. 18, PMID: 28116018.

Trends in NRMP Data from 2007-2014 for U.S. Seniors Matching into Emergency Medicine.

Introduction: Since 1978, the National Residency Matching Program (NRMP) has published data demonstrating characteristics of applicants who have matched into their preferred specialty in the NRMP main residency match. These data have been published approximately every two years. There is limited information about trends within these published data for students matching into emergency medicine (EM).

Use of the HEART Pathway with high sensitivity cardiac troponins: A secondary analysis.

Objectives: The HEART Pathway combines a decision aid and serial contemporary cardiac troponin I (cTnI) measures to achieve >99% sensitivity for major adverse cardiac events (MACE) at 30days and early discharge rates >20%. However, the impact of integrating high-sensitivity troponin (hs-cTn) measures into the HEART Pathway has yet to be determined. In this analysis we compare test characteristics of the HEART Pathway using hs-cTnI, hs-cTnT, or cTnI.

Cost analysis of the History, ECG, Age, Risk factors, and initial Troponin (HEART) Pathway randomized control trial.

Introduction: The HEART Pathway is a diagnostic protocol designed to identify low-risk patients presenting to the emergency department with chest pain that are safe for early discharge. This protocol has been shown to significantly decrease health care resource utilization compared with usual care. However, the impact of the HEART Pathway on the cost of care has yet to be reported.

Social Media in Professional Medicine: New Resident Perceptions and Practices.

Background: For younger generations, unconstrained online social activity is the norm. Little data are available about perceptions among young medical practitioners who enter the professional clinical arena, while the impact of existing social media policy on these perceptions is unclear.

Objective: The objective of this study was to investigate the existing perceptions about social media and professionalism among new physicians entering in professional clinical practice; and to determine the effects of formal social media instruction and policy on young professionals' ability to navigate case-based scenarios about online behavior in the context of professional medicine.

Chest Pain Risk Stratification: A Comparison of the 2-Hour Accelerated Diagnostic Protocol (ADAPT) and the HEART Pathway.

Background: The 2-hour accelerated diagnostic protocol (ADAPT) and the history electrocardiogram age risk factors troponin (HEART) Pathway are decision aids designed to identify Emergency Department (ED) patients with chest pain who are safe for early discharge. Both have demonstrated high sensitivity (>99%) for major adverse cardiac events (MACE) at 30 days and early discharge rates ≥20%. The objective of this study is to compare the sensitivity and early discharge rates of the ADAPT and HEART Pathway decision aids in a cohort of ED patients with acute chest pain.

Adherence to an Accelerated Diagnostic Protocol for Chest Pain: Secondary Analysis of the HEART Pathway Randomized Trial.

Objectives: Accelerated diagnostic protocols (ADPs), such as the HEART Pathway, are gaining popularity in emergency departments (EDs) as tools used to risk stratify patients with acute chest pain. However, provider nonadherence may threaten the safety and effectiveness of ADPs. The objective of this study was to determine the frequency and impact of ADP nonadherence.

Performance of the EDACS-accelerated Diagnostic Pathway in a Cohort of US Patients with Acute Chest Pain.

Background: The Emergency Department Assessment of Chest pain Score-Accelerated Diagnostic Protocol (EDACS-ADP) is a decision aid designed to safely identify emergency department (ED) patients with chest pain for early discharge. Derivation and validation studies in Australasia have demonstrated high sensitivity (99%-100%) for major adverse cardiac events (MACE).

Objectives: To validate the EDACS-ADP in a cohort of US ED patients with symptoms suspicious for acute coronary syndrome (ACS).

The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge.

Background: The HEART Pathway is a decision aid designed to identify emergency department patients with acute chest pain for early discharge. No randomized trials have compared the HEART Pathway with usual care.

Methods And Results: Adult emergency department patients with symptoms related to acute coronary syndrome without ST-elevation on ECG (n=282) were randomized to the HEART Pathway or usual care.

Subcutaneous emphysema in the lower extremities-always an emergency? Complications from minimally invasive surgery-a case report.

Background: Lower-extremity subcutaneous emphysema is an unusual presentation in the emergency department, and it is often associated with gas-forming bacterial infections that confer significant morbidity and mortality. Because the presence of subcutaneous emphysema in an extremity can be alarming, physicians often pursue aggressive diagnostic and therapeutic strategies to identify and treat the underlying cause. In some cases, however, subcutaneous emphysema does not represent a life-threatening medical condition.

Increasing Faculty Attendance at Emergency Medicine Resident Conferences: Does CME Credit Make a Difference?

Background: Faculty involvement in resident teaching events is beneficial to resident education, yet evidence about the factors that promote faculty attendance at resident didactic conferences is limited.

Objective: To determine whether offering continuing medical education (CME) credits would result in an increase in faculty attendance at weekly emergency medicine conferences and whether faculty would report the availability of CME credit as a motivating factor.

Methods: Our prospective, multi-site, observational study of 5 emergency medicine residency programs collected information on the number of faculty members present at CME and non-CME lectures for 9 months and collected information from faculty on factors influencing decisions to attend resident educational events and from residents on factors influencing their learning experience.