The western journal of emergency medicine
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One published strategy for improving educational experiences for medical students in the emergency department (ED) while maintaining patient care has been the implementation of dedicated teaching attending shifts. To leverage the advantages of the ED as an exceptional clinical educational environment and to address the challenges posed by the rapid pace and high volume of the ED, our institution developed a clerkship curriculum that incorporates a dedicated clinical educator role - the teaching attending - to deliver quality bedside teaching experiences for students in a required third-year clerkship. The purpose of this educational innovation was to determine whether a dedicated teaching attending experience on a third-year required emergency medicine (EM) clerkship would improve student-reported clinical teaching evaluations and student-reported satisfaction with the overall quality of the EM clerkship. ⋯ The use of a dedicated teaching attending shift is a successful educational innovation for improving student self-reported evaluation items in a third-year required EM clerkship.
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Randomized Controlled Trial
Efficacy of and Satisfaction with an In-house Developed Natural Rubber Cardiopulmonary Resuscitation Manikin.
A barrier to cardiopulmonary resuscitation (CPR) training in low-income countries is limited resources. Our goal was to build a CPR training model of simple design that would provide a good feedback system. ⋯ The in-house developed CPR manikin employing real-time feedback by simple mechanics is effective compared with a commercial manikin. The advantage of our manikin is that it is easy to build and costs substantially less than a commercial manikin. The use of an in-house developed manikin could make effective CPR training more available in limited-resource areas.
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The National Residency Matching Program (NRMP) allows post-interview contact between residency applicants and residency programs. Thank-you communications represent one of the most common forms, but data on their value to applicants and program directors (PD) are limited. The objective of this study was to assess the effect of thank-you communications on applicant- and residency-program rank lists. ⋯ The majority of applicants to EM are sending thank-you communications. A significant minority of applicants and PDs changed their rank list due to post-interview thank-you communications.
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Three pathways are available to students considering a pediatric emergency medicine (PEM) career: pediatric residency followed by PEM fellowship (Peds-PEM); emergency medicine residency followed by PEM fellowship (EM-PEM); and combined EM and pediatrics residency (EM&Peds). Questions regarding differences between the training pathways are common among medical students. We present a comparative analysis of training pathways highlighting major curricular differences to aid in students' understanding of these training options. ⋯ All three pathways exceed pediatric-focused training required for EM or pediatric residency. Peds-PEM has the most research EUs, EM-PEM the most EM EUs, and EM&Peds the most critical care EUs. All prepare graduates for a pediatric emergency medicine career. Understanding the difference in emphasis between pathways can inform students to select the best pathway for their own careers.
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Prehospital pediatric endotracheal intubation has lower first-pass success rates compared to adult intubations and in general may not offer a survival benefit. Increasingly, emergency medical services (EMS) systems are deploying prehospital extraglottic airways (EGA) for primary pediatric airway management, yet little is known about their efficacy. We evaluated the impact of a pediatric prehospital airway management protocol change, inclusive of EGAs, on airway management and patient outcomes in children in cardiac arrest or respiratory failure. ⋯ Implementation of an evidenced-based airway management algorithm for pediatric patients, inclusive of an EGA device for all age groups, was associated with fewer prehospital intubations. Intubation success may be negatively impacted due to decreases in procedural frequency.