Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
Little empiric evidence exists to guide emergency department (ED) disposition of patients presenting with soft tissue infections. This study's objective was to generate a clinical decision rule to predict the need for greater than 24-hour hospital admission for patients presenting to the ED with soft tissue infection. ⋯ Although we were unable to generate a high-sensitivity decision rule to identify ED patients with soft tissue infection requiring >24-hour admission, the presence of a fever (either by initial ED vital signs or by history) was the strongest predictor of need for >24-hour hospital stay. These findings may help guide disposition of patients presenting to the ED with nonfacial soft tissue infections.
-
Many emergency medicine (EM) residency programs have recently received citations for their residents' responses to Question 19 of the Accreditation Council on Graduate Medical Education annual survey, which asks residents to rate their program's emphasis on clinical education over service obligations. To the best of our knowledge, no prior investigations or consensus statements exist that specifically address the appropriate balance between educational activity and clinical service in EM residency training. The objective of this project was to create a consensus statement based on the shared insights of academic faculty and educators in EM, with specific recommendations to improve the integration of education with clinical service in EM residency training programs. ⋯ Participants examined the current literature on resident service and education and shared with the conference at large their collective insight and experience and possible solutions to this challenge. A consensus statement of specific recommendations and effective educational techniques aimed at balancing service and education requirements was created, based on the contributions of a diverse group of academic emergency physicians. Recommendations included identifying the teachable moment in all clinical service; promoting resident understanding of program goals and expectations from the beginning; educating residents about the ACGME resident survey; and engaging hospitals, institutional graduate medical education departments, and residents in finding solutions.
-
Four distinct generations of physicians currently coexist within the emergency medicine (EM) workforce, each with its own unique life experience, perspective, attitude, and expectation of work and education. To the best of our knowledge, no investigations or consensus statements exist that specifically address the effect of intergenerational differences on undergraduate and graduate medical education in EM. ⋯ Recommendations included early establishment of clear expectations and consequences, emphasis on timely feedback and individualized guidance during training, explicit reinforcement of a patient-centered care model, use of peer modeling and support, and emphasis on more interactive and small-group learning techniques.
-
Comparative Study
Serious bacterial infection in recently immunized young febrile infants.
The objective of this study was to investigate the prevalence of serious bacterial infection (SBI) in febrile infants without a source aged 6-12 weeks who have received immunizations in the preceding 72 hours. ⋯ Among febrile infants, the prevalence of SBI is less in the initial 24 hours following immunizations. However, there is still a substantial risk of UTI. Therefore, urine testing should be considered in febrile infants who present within 24 hours of immunization. Infants who present greater than 24 hours after immunizations with fever should be managed similarly to infants without RIs.
-
Nationwide survey findings that most U. S. emergency medicine clerkship directors were interested in participating in a methodologically rigorous student testing program prompted the development of the Society for Academic Emergency Medicine (SAEM) Medical Student Online Testing Service (SAEM Tests). ⋯ Specifically, we review the construction of SAEM Tests and present validity and difficulty statistics obtained at the first analysis of test performance 6 months after its release and again 12 months later after revisions aimed at enhancing test performance. We then review the current status of SAEM Tests and summarize future goals and directions.