Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine the number of emergency medicine (EM) residency programs in which residents serve as helicopter emergency medical services (HEMS) crew, the extent of training provided for this role, and how HEMS residents are evaluated. ⋯ The training of residents for their role as flight physicians is highly variable, considering the amount of air transport time they perform. Direct faculty supervision, proficiency testing, and written feedback are rarely utilized.
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To determine emergency department (ED) patients' preferences about having medical students perform procedures as part of medical student clinical training. ⋯ Patients are reluctant to be a medical student's first patient when it comes to procedures in the ED. This has implications for medical training and informed consent.
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There is convincing evidence that racial and ethnic disparities exist in the provision of health care, including the provision of emergency care; and that stereotyping, biases, and uncertainty on the part of health care providers all contribute to unequal treatment. Situations, such as the emergency department (ED), that are characterized by time pressure, incomplete information, and high demands on attention and cognitive resources increase the likelihood that stereotypes and bias will affect diagnostic and treatment decisions. It is likely that there are many as-yet-undocumented disparities in clinical emergency practice. ⋯ The potential for disparate treatment includes the timing and intensity of ED therapy as well as patterns of referral, prescription choices, and priority for hospital admission and bed assignment. At a national roundtable discussion, strategies suggested to address these disparities included: increased use of evidence-based clinical guidelines; use of continuous quality improvement methods to document individual and institutional disparities in performance; zero tolerance for stereotypical remarks in the workplace; cultural competence training for emergency providers; increased workforce diversity; and increased epidemiologic, clinical, and services research. Careful scrutiny of the clinical practice of emergency medicine and diligent implementation of strategies to prevent disparities will be required to eliminate the individual behaviors and systemic processes that result in the delivery of disparate care in EDs.
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This study sought to identify demographic, socioeconomic, and clinical predictors of aftercare noncompliance by pediatric emergency department (ED) patients. ⋯ Disparity in health insurance has been shown to be a predictor of poor aftercare compliance for pediatric ED patients within the patient population.