Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Use of the visual analog scale to rate and monitor severity of nausea in the emergency department.
The objective was to describe the association between verbal descriptors of nausea severity and visual analog scale (VAS) ratings in an undifferentiated emergency department (ED) population and to calculate the minimum clinically significant difference (MCSD) in VAS rating of nausea severity in this population. ⋯ There is very good correlation between verbal descriptors of nausea and VAS ratings. The MCSD for VAS nausea ratings in an ED population is 22 mm.
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Effective feedback is critical to medical education. Little is known about emergency medicine (EM) attending and resident physician perceptions of feedback. The focus of this study was to examine perceptions of the educational feedback that attending physicians give to residents in the clinical environment of the emergency department (ED). The authors compared attending and resident satisfaction with real-time feedback and hypothesized that the two groups would report different overall satisfaction with the feedback they currently give and receive in the ED. ⋯ Attending physician satisfaction with the quality, timeliness, and frequency of feedback given is higher than resident physician satisfaction with feedback received. Attending and resident physicians have differing perceptions of who initiates feedback and how long it takes to provide effective feedback. Knowledge of these differences in perceptions about feedback may be used to direct future educational efforts to improve feedback in the ED.
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Recent position statements from health care organizations have placed a strong emphasis on continuous quality improvement (CQI). CQI finds many of its roots in kaizen, which emphasizes small, low-cost, low-risk improvements. Based on the successful Kaizen Programs at organizations such as Toyota, the authors thought the emergency department (ED) would be an ideal environment to benefit from such a program. ⋯ Over the past 4 years, the Kaizen Program at Vanderbilt has been widely and frequently used within the ED. It has resulted in over 400 changes in our adult ED system and has met the challenge of using CQI to drive ED improvements. There are limitations to this study, including the fact that its impact on patient outcomes remains unknown. However, this Kaizen Program may be an excellent tool for other departments to assist with quality improvement and should be studied with a multicenter prospective approach.
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Comparative Study
Variation in the type, rate, and selection of patients for out-of-hospital airway procedures among injured children and adults.
The objective was to compare the type, rate, and selection of injured patients for out-of-hospital airway procedures among emergency medical services (EMS) agencies in 10 sites across North America. ⋯ Among 10 sites across North America, there was wide variation in the types of out-of-hospital airway procedures performed, population-based rates of airway intervention, and the selection of injured patients for such procedures.
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The residency review committee for emergency medicine (EM) requires residents to have greater than 70% attendance of educational conferences during residency training, but it is unknown whether attendance improves clinical competence or scores on the American Board of Emergency Medicine (ABEM) in-training examination (ITE). This study examined the relationship between conference attendance and ITE scores. The hypothesis was that greater attendance would correlate to a higher examination score. ⋯ Greater conference attendance does not correlate with performance on an individual's ITE scores. Conference attendance may represent an important part of EM residency training but perhaps not of ITE performance.