Why do we need quality measures in emergency medicine?

Quality measures increasingly influence the delivery and reimbursement of care provided in emergency departments. While emergency physicians are accustomed to using quality measures to improve care delivery, payors, including the Centers for Medicare and Medicaid Services (CMS), are increasingly adjusting reimbursement to measure performance as a means to bend the cost curve and improve the value of healthcare services. The American College of Emergency Physicians Quality and Patient Safety Committee presents this whitepaper to guide practicing emergency physicians through the policy context of implementing measures in emergency care and understanding its impact reimbursement.

ChatG-PD? Comparing large language model artificial intelligence and faculty rankings of the competitiveness of standardized letters of evaluation.

Background: While faculty have previously been shown to have high levels of agreement about the competitiveness of emergency medicine (EM) standardized letters of evaluation (SLOEs), reviewing SLOEs remains a highly time-intensive process for faculty. Artificial intelligence large language models (LLMs) have shown promise for effectively analyzing large volumes of data across a variety of contexts, but their ability to interpret SLOEs is unknown.

Objective: The objective was to evaluate the ability of LLMs to rate EM SLOEs on competitiveness compared to faculty consensus and previously developed algorithms.

SPARK mentorship program for emergency services assistants underrepresented in medicine interested in physician assistant programs.

Background: Increasing diversity in the health care workforce has been shown to improve patient health care and create psychological safety for employees who feel marginalized and underrepresented. While several measures exist for increasing racial and ethnic diversity in the physician workforce, few programs target expanding representation among physician assistants (PAs). Despite increasing the role and responsibility of PAs in the emergency department (ED), there remains a significant lack of diversity within this group.

Alleviating stressfeeding in the emergency department: Elucidating the tensions induced by workplace lactation space issues.

Objectives: Women remain underrepresented in the emergency medicine (EM) workforce, academic EM, and institutional leadership. In order to support women physicians in EM, we must explore factors that contribute to attrition and workplace satisfaction. For example, tensions between workplace and familial roles are important to consider as women navigate careers in EM.

A guide to creating an educator's portfolio for the 21st century.

An educator's portfolio is (EP) a collection of materials for demonstrating and assessing a clinician educator's performance and perspective. Although not all academic institutions require faculty to maintain an EP, it can serve as a valuable tool for both personal reflection and professional advancement. With newer advancements in technology and social media, there are also opportunities to enhance the EP for the digital era.

Changes in low-acuity patient volume in an emergency department after launching a walk-in clinic.

Objective: Unscheduled low-acuity care options are on the rise and are often expected to reduce emergency department (ED) visits. We opened an ED-staffed walk-in clinic (WIC) as an alternative care location for low-acuity patients at a time when ED visits exceeded facility capacity and the impending flu season was anticipated to increase visits further, and we assessed whether low-acuity ED patient visits decreased after opening the WIC.

Methods: In this retrospective cohort study, we compared patient and clinical visit characteristics of the ED and WIC patients and conducted interrupted time-series analyses to quantify the impact of the WIC on low-acuity ED patient visit volume and the trend.

A case of iatrogenic Cushing syndrome and subsequent adrenal insufficiency from a hidden ingredient in the supplement Artri Ajo King.

Dietary supplement use is common in the United States. Supplements are regulated by the US Food and Drug Administration (FDA) under a separate set of guidelines from typical food and drug products. This case report describes a patient who presented to the emergency department (ED) with abdominal pain, vomiting, and generalized weakness.

The role of emergency physicians in the fight against health misinformation: Implications for resident training.

Emergency physicians on the frontlines of the COVID-19 pandemic are first-hand witnesses to the direct impact of health misinformation and disinformation on individual patients, communities, and public health at large. Therefore, emergency physicians naturally have a crucial role to play to steward factual information and combat health misinformation. Unfortunately, most physicians lack the communications and social media training needed to address health misinformation with patients and online, highlighting an obvious gap in emergency medicine training.

Trends in point-of-care ultrasound use among emergency medicine residency programs over a 10-year period.

Background: Point-of-care ultrasound (POCUS) is increasingly utilized in emergency medicine (EM). While residents are required by the Accreditation Council for General Medical Education to complete a minimum of 150 POCUS examinations before graduation, the distribution of examination types is not well-described. This study sought to assess the number and distribution of POCUS examinations completed during EM residency training and evaluate trends over time.

Trends in emergency medicine resident procedural reporting over a 10-year period.

Background: Procedural competency is expected of all emergency medicine (EM) residents upon graduation. The ACGME requires a minimum number of essential procedures to successfully complete training. However, data are limited on the actual number of procedures residents perform and prior studies are limited to single institutions over short time periods.

The next generation of researchers: One-year outcome data from the SAEM Advanced Research Methodology Evaluation and Design in Medical Education (ARMED MedEd) program.

Introduction: As the field of medical education evolves, there is a need to increase the quality of education scholarship and develop a cadre of research scholars; however, clinician educators (CEs) considering this career transition have limited formal training in education research methodology to heed this call. Therefore, a program that provides more advanced training in education scholarship for CEs without the financial and resource barriers of fellowships and masters programs is needed.

Methods: The SAEM Advanced Research Methodology Evaluation and Design in Medical Education (ARMED MedEd) program is a longitudinal program for the beyond-beginner CE, seeking advanced training in education research.

"Faces on a screen": A qualitative study of the virtual and in-person conference experience.

Introduction: The strengths and weaknesses of virtual and in-person formats within continuing professional development (CPD) are incompletely understood. This study sought to explore attendees' perspectives across multiple specialties regarding benefits and limitations of conference formats and strategies for successful virtual and hybrid (i.e.

Is it worth it? A qualitative analysis of the impact of medical education fellowships on careers.

Objectives: Medical education fellowships provide training in teaching, assessment, educational program administration, and scholarship. The longitudinal impact of this training is unknown. The objective of this study was to explore the impact of medical education fellowships on the careers of graduates.

Education Theory Made Practical: Creating open educational resources via an apprenticeship model.

Introduction: Clinical faculty may have limited knowledge of education theories and best practices in health professions education. Many faculty development programs focus on passive learning with limited application to practice. There is a need for more active engagement for early career educators.

A workforce study of emergency medicine medical education fellowship directors: Describing roles, responsibilities, support, and priorities.

Introduction: Despite emergency medicine (EM) medical education fellowships increasing in number, the position of the medical education fellowship director (FD) remains incompletely defined. The goal of this study was to characterize the roles, responsibilities, support, and priorities for medical education FDs.

Methods: We adapted and piloted an anonymous electronic survey consisting of 31 single-answer, multiple-answer, and free-response items.

The OSSE: Development and validation of an "Objective Structured Supervision Evaluation".

Background: Trainee supervision and teaching are distinct skills that both require faculty physician competence to ensure patient safety. No standard approach exists to teach physician supervisory competence, resulting in variable trainee oversight and safety threats. The Objective Structured Teaching Evaluation (OSTE) does not adequately incorporate the specific skills required for effective supervision.

From intern to "accepted": A guide to preparing for fellowship in emergency medicine.

Introduction: The number of fellowship options for emergency medicine (EM) physicians continues to expand. While guides exist to help residents explore individual fellowship pathways, we aimed to create a comprehensive guide for all residents considering fellowship.

Methods: At the direction of the Society for Academic Emergency Medicine (SAEM) Board, 9 members of the Fellowship Guide Workgroup, including members of the Fellowship Approval Committee, and 2 members of SAEM Residents and Medical Students (RAMS) group collaboratively developed the guide using available evidence and expert opinion when high-quality evidence was unavailable.

A mixed-methods needs assessment to identify pharmacology education objectives for emergency medicine residents.

Objectives: Medication errors represent a significant threat to patient safety. Pharmacotherapy is one of the 23 Accreditation Council of Graduate Medical Education milestones for emergency medicine, yet there is minimal understanding of what content should be prioritized during training. The study aim was to develop objectives for a patient-safety focused pharmacology curriculum for emergency medicine residents.

Mastery learning improves simulated central venous catheter insertion by emergency medicine teaching faculty.

Objectives: Routine competency assessments of procedure skills, such as central venous catheter (CVC) insertion, do not occur beyond residency training. Evidence suggests variable, suboptimal attending physician procedure skills. Our study aimed to assess CVC insertion skill by academic emergency physicians, determine whether a simulation-based mastery learning (SBML) intervention improves performance and investigate for variables that predict competence.

Leveling the field: Development of reliable scoring rubrics for quantitative and qualitative medical education research abstracts.

Background: Research abstracts are submitted for presentation at scientific conferences; however, criteria for judging abstracts are variable. We sought to develop two rigorous abstract scoring rubrics for education research submissions reporting (1) quantitative data and (2) qualitative data and then to collect validity evidence to support score interpretation.

Methods: We used a modified Delphi method to achieve expert consensus for scoring rubric items to optimize content validity.

Faculty development using a virtual community of practice: Three-year outcomes of the Academic Life in Emergency Medicine Faculty Incubator program.

Introduction: The Academic Life in Emergency Medicine (ALiEM) Faculty Incubator program is a longitudinal, 1-year, virtual faculty development program for early- and mid-career faculty members that crosses specialties and institutions. This study sought to evaluate the outcomes among 3 years of participants.

Methods: This cross-sectional survey study evaluated postcourse and 1-year outcomes from three graduated classes of the ALiEM Faculty Incubator program.