Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care.

STUDY OBJECTIVE: Given the popularity of educational blogs and podcasts in medicine, learners and educators need tools to identify trusted and impactful sites. The Social Media Index was a multi-sourced formula to rank the effect of emergency medicine and critical care blogs. In 2022, a key data point for the Social Media Index became unavailable. This bibliometric study aimed to develop a new measure, the Digital Impact Factor, as a replacement. METHODS: The Digital Impact Factor incorporated modern measures of website authority and reach. This formula was applied to a cross-sectional study of active emergency medicine and critical care blogs and podcasts. For each website, we generated a Digital Impact Factor score based on Ahrefs Domain Rating and the follower count of the websites' pages from 8 social media platforms. A series of Spearman correlations provided evidence of association by comparing a rank-ordered list to rank lists derived from the Social Media Index over the last 5 years. The Bland-Altman analysis assessed for agreement. RESULTS: The authors identified 88 relevant websites with a median Ahrefs Domain Rating of 28 (range 0 to 71, maximum 100) and total social media followership count across 8 platforms of 1,828,557. The Domain Rating and individual social media followership scores were normalized based on the highest recorded values to yield the Digital Impact Factor (median 4.57; range 0.02 to 9.50, maximum 10). The correlation between the 2022 Digital Impact Factor and the 2021 Social Media Index was 0.94 (95% confidence interval 0.89 to 0.97; p<.001; n=41 rankings correlated), suggesting that they measure similar constructs. The Bland-Altman plot also demonstrated fair agreement between the 2 scores. CONCLUSION: The Digital Impact Factor is a measure of the relative effect of educational blogs and podcasts within emergency medicine and critical care.

Medical Care at a Large Vertical Running Event.

OBJECTIVE: Vertical running events, during which participants race up the stairwells of skyscrapers, are becoming increasingly popular. Such events have unique and specific operational and clinical considerations for event medical directors, but descriptions of the medical care provided at these events are lacking. We sought to perform a descriptive analysis of the medical care delivered at a single, large vertical running event. METHODS: A retrospective chart review of medical encounters at a large vertical running event from 2011-2017 was performed. Participants competed in either the full course (94 stories) or half course (54 stories); potential patients also included observers. Medical staffing included a main medical station at the finish line, medical way stations along the routes (within stairwells), and medical response teams. Descriptive statistics were used for analysis. RESULTS: During the study period, a total of 23,920 participants completed the event, with 84.6% participating in the full course. Medical staff treated 150 unique patients during 154 medical encounters (0.6% treatment rate). The median age of patients was 36 (IQR 27, 43), and 40.3% were male. Most encounters (66.4%) occurred at the finish line main medical area. Of medical encounters occurring along the race routes, 56.1% of encounters occurred before the halfway point in the full course. Encounters were clustered around medical way stations along the half course. The most common chief complaints were gastrointestinal (27.3%), respiratory (25.3%), syncope/near-syncope (24.7%), trauma (12.3%), and chest pain (10.4%). One cardiac arrest was observed. The most frequent interventions were oral fluids or food (40.3%), respiratory care (18.2%), and minor trauma care (12.3%). An electrocardiogram (ECG) was obtained in 10.4% of encounters, and intravenous fluids were started on 1.9% of patients. Eleven patients (7.3% of treated patients and 0.05% of all participants) were transported by ambulance. CONCLUSIONS: Medical encounters during vertical running events, the majority of which are not life-threatening, mainly occur at the finish line but can occur at any point along the route. Understanding the nature and location of medical encounters along a vertical running event route can help inform event medical directors supervising care at these increasingly popular events.

A review of human sensory dynamics for application to models of driver steering and speed control.

In comparison with the high level of knowledge about vehicle dynamics which exists nowadays, the role of the driver in the driver-vehicle system is still relatively poorly understood. A large variety of driver models exist for various applications; however, few of them take account of the driver's sensory dynamics, and those that do are limited in their scope and accuracy. A review of the literature has been carried out to consolidate information from previous studies which may be useful when incorporating human sensory systems into the design of a driver model. This includes information on sensory dynamics, delays, thresholds and integration of multiple sensory stimuli. This review should provide a basis for further study into sensory perception during driving.

Trends and predictors of unfilled emergency medicine residency positions: A comparative analysis of the 2023 and 2024 Match cycles.

Background: The emergency medicine (EM) landscape has evolved due to the increasing number of programs paired with fewer applicants. This study analyzed the characteristics of EM residency programs associated with unfilled positions during the 2024 Match and compared them with data from the 2023 Match to identify persistent and emerging trends influencing these outcomes. Methods: In this cross-sectional, observational study, we investigated factors associated with unfilled EM residency positions in the 2024 Match. We used publicly accessible data from the National Resident Matching Program. To identify program-level predictors of unfilled positions, we constructed a Bayesian hierarchical logistic regression model, incorporating data from the 2023 Match season. Results: In 2024, 54 out of 281 (19.2%) residency programs remained unfilled. Our Bayesian analysis reaffirmed that smaller program size, geographical location, prior osteopathic accreditation, and corporate ownership continue to be significant factors. Programs with vacancies in the previous year were also more likely to remain unfilled. Thus, several factors identified in 2023 remained associated with this year's Match outcomes, with the impact of previous unfilled positions being particularly pronounced. Conclusions: This study identified several factors associated with a greater likelihood of having unfilled EM residency positions, with previous unfilled positions emerging as the most significant predictor. These findings offer critical insights for residency programs and governing bodies, providing a basis for enhancing recruitment strategies, addressing the cyclical nature of unfilled positions, and tackling workforce challenges in EM.

Simulated video-based telehealth training for emergency physicians.

Introduction: Little exists in the literature describing video-based telehealth training, especially for practicing Emergency Physicians. Materials and methods: This was a retrospective, pre- and post-assessment of physicians' knowledge and confidence on video-based telehealth after two simulated telehealth encounters. Attending physicians voluntarily participated in Zoom-based trainings and received feedback from the patient actors immediately after each simulation. Post-experience surveys queried participants on the training, aspects of telehealth, and confidence in features of optimal telehealth practice. Results: The survey had 100% response rate (13/13 physicians). Participants recommended the simulated training experience, mean of 8.38 (SD 1.89; 0 = Not at all likely, 10 = Extremely likely). Pre- and post-response means increased in two questions: "I can describe at least two ways to improve my video-based clinical care": delta: 1.54, t(12) = 3.83, p = 0.002, Cohen's d effect size of 1.06, and "I know when video-based telehealth could be helpful in clinical practice": delta: 0.99, t(12) = 3.09, p = 0.009, Cohen's d effect size of 0.86. Conclusion: In this pilot, participants viewed telehealth more favorably after the experience and indicated improved confidence in focused telehealth skills. Further study is needed to determine what simulated case content provides the most value for decision-making via telehealth.

A Fork in the Road for Emergency Medicine and Critical Care Blogs and Podcasts: Cross-sectional Study.

BACKGROUND: Free open-access meducation (FOAM) refers to open-access, web-based learning resources in medicine. It includes all formats of digital products, including blogs and podcasts. The number of FOAM blog and podcast sites in emergency medicine and critical care increased dramatically from 2002 to 2013, and physicians began to rely on the availability of these resources. The current landscape of these FOAM sites is unknown. OBJECTIVE: This study aims to (1) estimate the current number of active, open-access blogs and podcasts in emergency medicine and critical care and (2) describe observed and anticipated trends in the FOAM movement using the Theory of Disruptive Innovation by Christensen as a theoretical framework. METHODS: The authors used multiple resources and sampling strategies to identify active, open-access blogs and podcasts between April 25, 2022, and May 8, 2022, and classified these websites as blogs, podcasts, or blogs+podcasts. For each category, they reported the following outcome measures using descriptive statistics: age, funding, affiliations, and team composition. Based on these findings, the authors projected trends in the number of active sites using a positivist paradigm and the Theory of Disruptive Innovation as a theoretical framework. RESULTS: The authors identified 109 emergency medicine and critical care websites, which comprised 45.9% (n=50) blogs, 22.9% (n=25) podcasts, and 31.2% (n=34) blogs+podcasts. Ages ranged from 0 to 18 years; 27.5% (n=30) sold products, 18.3% (n=20) used advertisements, 44.0% (n=48) had institutional funding, and 27.5% (n=30) had no affiliation or external funding sources. Team sizes ranged from 1 (n=26, 23.9%) to ≥5 (n=60, 55%) individuals. CONCLUSIONS: There was a sharp decline in the number of emergency medicine and critical care blogs and podcasts in the last decade, dropping 40.4% since 2013. The initial growth of FOAM and its subsequent downturn align with principles in the Theory of Disruptive Innovation by Christensen. These findings have important implications for the field of medical education.