Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To examine the responses of emergency medicine residents (EMRs) to ethical dilemmas in high-fidelity patient simulations as a means of assessing resident professionalism. ⋯ Senior residents had better overall performance than incoming interns, suggesting that professional behaviors are learned through some facet of residency training. Although limited by small sample size, the application of this performance-assessment tool showed the ability to discriminate between experienced and inexperienced EMRs with respect to a variety of aspects of professional competency. These findings suggest a need for improved resident education in areas of professionalism and ethics.
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To determine the association between emergency medicine (EM) program format (postgraduate year [PGY] 1-3, 2-4, or 1-4) and two dependent variables: fellowship training and academic career. ⋯ Four-year formats, especially 1-4, were associated with more common pursuit of fellowships and academics than the 1-3 format. Fellowship pursuit was uncommon (4% to 9% of graduates), whereas 18% to 34% initially chose academics.
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Studies have shown erroneous claims of authorship by medical students applying for residency. Authors have hypothesized that investigation of advanced degrees, Alpha Omega Alpha (AOA) status, and peer-reviewed publications all show important rates of inaccuracy. ⋯ Applications for EM residency contain frequent inaccuracies in publications listed, AOA status, and advanced degrees. Careful review of applications is necessary to ensure appropriate credit is given for claims of these types.
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To determine the effect of intravenous (IV) magnesium sulfate on the length of stay (LOS) for children admitted with sickle cell pain crisis. ⋯ IV magnesium appears to decrease the LOS for children with sickle cell pain crisis.
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Pelvic ultrasound performed by emergency physicians can identify a definite diagnosis in the majority of symptomatic first-trimester pregnant patients on the initial emergency department (ED) visit. However, a significant minority of such patients are diagnosed as having an indeterminate pregnancy state requiring further testing and consultation. The authors investigated the final outcome of patients with an initial indeterminate ED first-trimester pelvic ultrasound examination in the setting of an interdepartmental protocol to rule out ectopic pregnancy. ⋯ The outcome of symptomatic first-trimester patients with indeterminate ED pelvic ultrasounds is poor, with significantly high rates of embryonic demise and ectopic pregnancy. However, those indeterminate patients with the eventual diagnosis of ectopic pregnancy have a higher rate of medical methotrexate treatment and a reduced rate of invasive surgical treatment compared with ectopic pregnancy patients diagnosed at initial ED visit.