Annals of emergency medicine
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One hundred forty-one medical schools were surveyed to determine the emergency medicine core content topics and skills being taught in the curricula. Responses were obtained from 96 schools through two mailings and a telephone followup. Most topics surveyed were offered in the vast majority of medical schools (greater than 92%) with the exception of emergency medical services (offered in 79% of schools). ⋯ The survey showed a similar pattern of these skills being offered in most schools, but required in a smaller number. For example, while C-spine immobilization is taught in 90% of schools, it is required in only 46%. Educators must consider a coherent, interdisciplinary knowledge base and skills list for their medical school curricula.
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To determine the status of undergraduate education in emergency medicine, questionnaires were sent to 141 medical schools. Of the 135 schools responding, 15.2% require emergency medicine courses in the fourth year (mean, 164 hours); 11.9% require these courses (average, 84 hours) in the third year. Emergency medicine is offered in 21.8% of second-year and 37.9% of first-year curriculums. ⋯ Osteopathic schools require more time for emergency medicine in the clinical years but less time in formal lectures. Schools with a residency program in emergency medicine more frequently offer emergency medicine in the preclinical years. This survey provides some basic data on the status of undergraduate emergency medicine education in medical school curriculums, and it encourages medical educators to review the undergraduate curriculum to ensure that students receive adequate exposure to the essentials of emergency medicine.
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In many institutions it is the "standard of care" to obtain serum chemistries and anticonvulsant levels as part of the emergency department evaluation of seizure patients. To determine the efficacy of such a workup in the ED, 163 seizure patients presenting to an inner-city teaching hospital were studied in a standardized, prospective manner. After the clinical examination all patients had CBC, serum electrolyte, BUN, creatinine, glucose, calcium, magnesium, and if indicated, anticonvulsant drug level determinations performed. ⋯ The clinical examination successfully predicted those abnormalities in all but two cases (one each of hyperglycemia and subdural hematoma). We contend tha routine serum chemistries in patients presenting to the ED are of extremely low yield, and that the clinical examination can predict accurately the need to obtain these studies. CCT scanning is useful in selected patients, and was found to be abnormal in five of 19 (25%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
Comparison of a videotape instructional program with a traditional lecture series for medical student emergency medicine teaching.
An emergency medicine faculty has reported that the use of the videotape medium for presenting curricular material to medical students is both cost effective and well suited to the educational milieu of the emergency department. In order to compare the effectiveness of videotape instruction with that of a traditional lecture, groups of students received instruction in one topic by videotape and in another topic by lecture. ⋯ The students scored 76.1% (683 of 898 questions) on material taught by lecture and 76.2% (673 of 883 questions) on material taught by videotape (P greater than 0.7). We conclude that videotape instruction is as effective an educational tool as the traditional lecture for an emergency medicine course.
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Although many emergency medicine residency programs are located in major trauma centers, trauma often is managed by a multispecialty team. In order to define the role of the emergency medicine resident at such centers, we sent surveys to the directors of all 64 approved emergency medicine residency programs. Of the 54 programs (84%) responding, 39 (72%) had trauma teams. ⋯ With the exceptions of peritoneal lavage and intubation, resuscitation procedures were shared between the general surgery and emergency medicine residents. Thirty-one percent of the respondents had air ambulances, 70% of which were staffed by emergency physicians. We conclude that emergency medicine residents are active trauma team leaders and providers.