Developing and authenticating an electronic health record-based report card for assessing residents' clinical performance.

Purpose: The electronic health record (EHR) is frequently identified as a source of assessment data regarding residents' clinical performance. To better understand how to harness EHR data for education purposes, the authors developed and authenticated a prototype resident report card. This report card used EHR data exclusively and was authenticated with various stakeholders to understand individuals' reactions to and interpretations of EHR data when presented in this way.

Facilitating Residents' Understanding of Electronic Health Record Report Card Data Using Faculty Feedback and Coaching.

Purpose: Feedback continues to present a challenge for competency-based medical education. Clear, consistent, and credible feedback is vital to supporting one's ongoing development, yet it can be difficult to gather clinical performance data about residents. This study sought to determine whether providing residents with electronic health record (EHR)-based report cards, as well as an opportunity to discuss these data with faculty trained using the R2C2 model, can help residents understand and interpret their clinical performance metrics.

"EMERGing" Electronic Health Record Data Metrics: Insights and Implications for Assessing Residents' Clinical Performance in Emergency Medicine.

Objectives: Competency-based medical education requires that residents are provided with frequent opportunities to demonstrate competence as well as receive effective feedback about their clinical performance. To meet this goal, we investigated how data collected by the electronic health record (EHR) might be used to assess emergency medicine (EM) residents' independent and interdependent clinical performance and how such information could be represented in an EM resident report card.

Methods: Following constructivist grounded theory methodology, individual semistructured interviews were conducted in 2017 with 10 EM faculty and 11 EM residents across all 5 postgraduate years.

Elucidating system-level interdependence in electronic health record data: What are the ramifications for trainee assessment?

Context: The electronic health record (EHR) has been identified as a potential site for gathering data about trainees' clinical performance, but these data are not collected or organised for this purpose. Therefore, a careful and rigorous approach is required to explore how EHR data could be meaningfully used for assessment purposes. The purpose of this study was to identify EHR performance metrics that represent both the independent and interdependent clinical performance of emergency medicine (EM) trainees and explore how they might be meaningfully used for assessment and feedback.

Current State of Point-of-care Ultrasound Usage in Canadian Emergency Departments.

Background Point-of-care ultrasound (POCUS) has many applications in emergency medicine, which have been proven to improve patient outcomes. Training programs and well-established guidelines for its use are available, but Canadian adoption rates and attitudes toward this technology have not been recently assessed. Objectives This study aimed to provide a national assessment of the current use of POCUS in Canadian emergency departments (ED) including patterns of use, attitudes towards its role, descriptors of training experience, as well as barriers to increased utilization.

Physical activity prescription by Canadian Emergency Medicine Physicians.

An increase in physical activity has been shown to improve outcomes in many diseases. An estimated 600 000 Canadians receive their primary health care from emergency departments (ED). This study aims to examine physical activity prescription by emergency medicine physicians (EPs) to determine factors that influence decisions to prescribe physical activity.

Risk Factors Associated with Urologic Intervention in Emergency Department Patients with Suspected Renal Colic.

Background: Whereas most patients with urolithiasis pass their stones spontaneously and require only symptomatic management, a minority will require urologic intervention.

Objective: Our primary objective was to confirm previously reported risk factors and to identify additional predictors of urologic intervention within 90 days, for emergency department (ED) patients with suspected renal colic.

Methods: We conducted a prospective cohort study of adult patients presenting to one of two tertiary care EDs with suspected renal colic over a 20-month period.

Normal renal sonogram identifies renal colic patients at low risk for urologic intervention: a prospective cohort study.

Introduction: Determining which patients with ureterolithiasis are likely to require urologic intervention is a common challenge in the emergency department (ED). The objective was to determine if normal renal sonogram could identify low-risk renal colic patients, who were defined as not requiring urologic intervention within 90 days of their initial ED visit and can be managed conservatively.

Methods: This was a prospective cohort study involving adult patients presenting to the EDs of a tertiary care centre with suspected renal colic over a 20-month period.

When guidelines don't guide: the effect of patient context on management decisions based on clinical practice guidelines.

Purpose: This study examines the influence of patient social context on physicians' adherence to clinical practice guidelines (CPGs).

Method: Expert emergency medicine (EM) physicians and novice physicians (EM residents) were surveyed using an Internet-based program between January and July of 2013. Participants were presented clinical cases and were asked to indicate if they would order or prescribe a specified test or treatment.

Emergency medicine training in Canada: a survey of medical students' knowledge, attitudes, and preferences.

Objectives: The objective of this study was to assess medical students' knowledge of and attitudes toward the two Canadian emergency medicine (EM) residency programs (Fellow of the Royal College of Physicians of Canada [FRCPC] and Certificant of the College of Family Physicians-Emergency Medicine [CCFP-EM]). Additionally, medical students interested in EM were asked to select factors affecting their preferred choice of residency training program and their intended future practice.

Methods: Medical students enrolled at The University of Western Ontario for the 2008-2009 academic year were invited to complete an online 47-item questionnaire pertaining to their knowledge, opinions, and attitudes toward EM residency training.

Acute allergic reaction due to the administration of fibrinolytic therapy for ST-segment elevation myocardial infarction: case report and discussion.

Although a rare phenomenon, acute allergic reactions to fibrinolytic and heparin therapy have been described in the literature. We report the case of a 63-year-old woman who experienced a severe anaphylactic reaction while undergoing fibrinolytic therapy with tissue plasminogen activator for an ST-segment elevation myocardial infarction. Overall outcome was successful, but patient morbidity was increased because of the reaction and the subsequent therapy administered.