A Guide to the Medical School Curriculum Vitae.

Audience: Although this lecture is aimed at medical students, it can also be utilized for residents, fellows, and junior faculty. Background: The topic of teaching medical students about the fundamentals of creating a curriculum vitae (CV) is important because a CV serves as a record of scholastic and professional experiences.1 Thus, their CV will undoubtedly play a vital role in residency applications.2,3 Intentional instruction about the elements to incorporate in a CV are especially important for first-generation and underrepresented students in the medical field because they may not have had as much exposure to both the requirements of a residency application nor qualities of an effective CV. Educational Objectives: After this lecture, learners should be able to: 1) elaborate on the significance of a CV for medical students and discuss its purpose, 2) outline the elements that should and should not be included on a CV, 3) integrate knowledge gleaned from basic principles with provided examples to establish the foundation of their own CV. Educational Methods: A PowerPoint lecture was used to explain the purpose of a CV and the elements to include in a personal CV for medical students. The lecture took place via Zoom and was provided at no cost to all UCISOM medical students. Research Methods: Students were given a short survey after the session to assess their understanding of why it is important to create and maintain a CV, including an evaluation of their overall satisfaction with the lecture presentation. Results: All the respondents (n=10) found the workshop to be useful and enjoyed the ability to see student examples while 80% of the respondents (n=8) found their knowledge of CVs increased because of the session. On a Likert scale from 1-5, with a 1 indicating "very unconfident" and 5 indicating "very confident," 90% of respondents (n=9) indicated they are now confident or very confident in building or updating their CV after this session. Discussion: Overall, the educational content was found to be effective. Although the sample size from the survey was modest at best, we feel the survey data and comments from attendees during and after the session indicate the effectiveness of the content. From its initial implementation, we learned that this lecture can be given by any level of medical education professional (student, administrator, etc) due to the comprehensiveness of the presentation. We also learned that using video conferencing such as Zoom was an effective administration method but could also be replaced by in-person learning without much difficulty. Overall, we deem this presentation to be easy to administer, thorough, full of examples, and educationally effective. Topics: Curriculum vitae, CV, medical student, residency application, electronic residency application service, ERAS.

Gender Evaluation and Numeric Distribution in Emergency Medicine Residencies (GENDER): A Retrospective Analysis of Gender Ratios Among Residents and Residency Directors from 2014-2017.

INTRODUCTION: While females make up more than half of medical school matriculants, they only comprise about one third of emergency medicine (EM) residents. We examined EM residency cohorts with entering years of 2014-2017 to estimate the ratio of males to females among residents and program leadership to determine what correlation existed, if any, between program leadership and residency gender distributions. METHODS: We identified 171 accredited EM residency programs in the United States with resident cohorts entering between 2014-2017 with publicly available data that were included in the study. The number of male and female residents and program directors were counted. We then confirmed the counts by contacting the programs directly to confirm accuracy of the data collected from program websites. RESULTS: Within the included 171 programs, the overall male to female EM resident ratio was 1.78:1. Individual program ratios ranged from 0.85-8.0. Only eight programs (5.6%) had a female-predominant ratio. Among program directors, the overall male to female ratio was 2.17:1. TThe gender of the program director did not have a statistically significant correlation with the male to female ratio among its residents (P = .93). CONCLUSION: Within 171 residency programs across the US with entering cohorts between 2014-2017, the average male to female ratio among residents is nearly 2:1. No significant correlation exists between the gender distribution among a program's leadership and its residents.

Comparing the Psychological Effects of Manikin-Based and Augmented Reality-Based Simulation Training: Within-Subjects Crossover Study.

BACKGROUND: Patient simulators are an increasingly important part of medical training. They have been shown to be effective in teaching procedural skills, medical knowledge, and clinical decision-making. Recently, virtual and augmented reality simulators are being produced, but there is no research on whether these more realistic experiences cause problematic and greater stress responses as compared to standard manikin simulators. OBJECTIVE: The purpose of this research is to examine the psychological and physiological effects of augmented reality (AR) in medical simulation training as compared to traditional manikin simulations. METHODS: A within-subjects experimental design was used to assess the responses of medical students (N=89) as they completed simulated (using either manikin or AR) pediatric resuscitations. Baseline measures of psychological well-being, salivary cortisol, and galvanic skin response (GSR) were taken before the simulations began. Continuous GSR assessments throughout and after the simulations were captured along with follow-up measures of emotion and cortisol. Participants also wrote freely about their experience with each simulation, and narratives were coded for emotional word use. RESULTS: Of the total 86 medical students who participated, 37 (43%) were male and 49 (57%) were female, with a mean age of 25.2 (SD 2.09, range 22-30) years and 24.7 (SD 2.08, range 23-36) years, respectively. GSR was higher in the manikin group adjusted for day, sex, and medications taken by the participants (AR-manikin: -0.11, 95% CI -0.18 to -0.03; P=.009). The difference in negative affect between simulation types was not statistically significant (AR-manikin: 0.41, 95% CI -0.72 to 1.53; P=.48). There was no statistically significant difference between simulation types in self-reported stress (AR-manikin: 0.53, 95% CI -2.35 to 3.42; P=.71) or simulation stress (AR-manikin: -2.17, 95% CI -6.94 to 2.59; P=.37). The difference in percentage of positive emotion words used to describe the experience was not statistically significant between simulation types, which were adjusted for day of experiment, sex of the participants, and total number of words used (AR-manikin: -4.0, 95% CI -0.91 to 0.10; P=.12). There was no statistically significant difference between simulation types in terms of the percentage of negative emotion words used to describe the experience (AR-manikin: -0.33, 95% CI -1.12 to 0.46; P=.41), simulation sickness (AR-manikin: 0.17, 95% CI -0.29 to 0.62; P=.47), or salivary cortisol (AR-manikin: 0.04, 95% CI -0.05 to 0.13; P=.41). Finally, preexisting levels of posttraumatic stress disorder, perceived stress, and reported depression were not tied to physiological responses to AR. CONCLUSIONS: AR simulators elicited similar stress responses to currently used manikin-based simulators, and we did not find any evidence of AR simulators causing excessive stress to participants. Therefore, AR simulators are a promising tool to be used in medical training, which can provide more emotionally realistic scenarios without the risk of additional harm.

The Applied Weighted Slide Metric (AWSM) Tool: Creation of a Standard Slide Design Rubric.

Introduction: Lectures are a standard aspect across all realms of medical education. Previous studies have shown that visual design of presentation slides can affect learner outcomes. The purpose of this study was to develop a slide design rubric grounded in evidence-based, multimedia principles to enable objective evaluation of slide design. Method: Using the principles described in Mayers' Principles of Multimedia Learning and Duarte's Slide:ology, the authors extracted nineteen items important for slide design. We developed an online, rank-item, survey tool to identify the importance of each item among medical educators. Respondents selected which slide design principles they felt were important when attending a lecture/didactic session and ranked their relative importance. Results: We received 225 responses to the survey. When asked to specifically rank elements from most important to least important, participants gave the most weight to "readability of figures and data" and "[lack of] busy-ness of slide." The lowest ranked elements were "transitions and animations" and "color schemes". Using the results of the survey, including the free response, we developed a rubric with relative weighting that followed our survey data. Conclusion: With this information we have applied values to the various aspects of the rubric for a total score of 100. We hope that this rubric can be used for self-assessment or to evaluate and improve slides for educators. Future research will be focused on implementing and validating the slide design survey and ensuring it is easily usable with a high inter-rater reliability and whether self-assessment with the rubric improves presentation design and education quality.

No difference in factual or conceptual recall comprehension for tablet, laptop, and handwritten note-taking by medical students in the United States: a survey-based observational study

PURPOSE: Technological advances are changing how students approach learning. The traditional note-taking methods of longhand writing have been supplemented and replaced by tablets, smartphones, and laptop note-taking. It has been theorized that writing notes by hand requires more complex cognitive processes and may lead to better retention. However, few studies have investigated the use of tablet-based note-taking, which allows the incorporation of typing, drawing, highlights, and media. We therefore sought to confirm the hypothesis that tablet-based note-taking would lead to equivalent or better recall as compared to written note-taking. METHODS: We allocated 68 students into longhand, laptop, or tablet note-taking groups, and they watched and took notes on a presentation on which they were assessed for factual and conceptual recall. A second short distractor video was shown, followed by a 30-minute assessment at the University of California, Irvine campus, over a single day period in August 2018. Notes were analyzed for content, supplemental drawings, and other media sources. RESULTS: No significant difference was found in the factual or conceptual recall scores for tablet, laptop, and handwritten note-taking (P=0.61). The median word count was 131.5 for tablets, 121.0 for handwriting, and 297.0 for laptops (P=0.01). The tablet group had the highest presence of drawing, highlighting, and other media/tools. CONCLUSION: In light of conflicting research regarding the best note-taking method, our study showed that longhand note-taking is not superior to tablet or laptop note-taking. This suggests students should be encouraged to pick the note-taking method that appeals most to them. In the future, traditional note-taking may be replaced or supplemented with digital technologies that provide similar efficacy with more convenience.

Influence of Factors Relating to Sex and Gender on Rank List Decisions and Perceptions of Residency Training: Survey Study.

BACKGROUND: Females make up more than half of medical school matriculants but only one-third of emergency medicine (EM) residents. Various factors may contribute to why fewer females choose the field of EM, such as the existing presence of females in the specialty. OBJECTIVE: This study is a follow-up to previous work, and a survey is used to assess current residents' attitudes and perceptions on various factors, including those relating to sex and gender on creating rank lists as medical students and in perceived effects on residency education. METHODS: A web-based survey consisting of Likert scale questions regarding a variety of factors influencing a student's decision to create a rank list and in perceived effects on residency education was sent to current EM residents in 2020. RESULTS: Residents from 17 programs participated in the survey with an 18.2% (138/758) response rate. The most important factors in creating a rank list were the personality of residents in the program, location, and facility type. For factors specifically related to gender, respondents who answered affirmatively to whether the gender composition of residents affected the selection of a program in making a rank list were more likely to also answer affirmatively to subsequent questions related to the gender of program leadership (P<.001) and gender composition of attending physicians (P<.001). The personality of residents was also the most important factor perceived to affect residency education. For factors influencing rank list and residency education, female respondents placed higher importance on subcategories related to gender (ie, gender composition of the residents, of the program leadership, and of the attending physicians) to a significant degree compared with their male counterparts. CONCLUSIONS: Although factors such as location and resident personality show the most importance in influencing residency selection, when stratifying based on respondent sex, females tend to indicate that factors relating to gender have more influence on rank list and residency education compared with males.

Frequency of Social Media and Digital Scholarship Keywords in U.S. Medical Schools' Promotion and Tenure Guidelines.

PURPOSE: Medical schools must have clear policies and procedures for promotion and tenure (P&T) of faculty. Social media and digital scholarship (SMDS) is an emerging form of scholarship capable of reaching audiences quickly, conveniently, and in a wide variety of formats. It is unclear how frequently SMDS is considered during P&T reviews. The authors sought to determine whether current P&T guidelines at medical schools consider SMDS. METHOD: The authors acquired P&T guidelines from any U.S. Liaison Committee on Medical Education-accredited medical school (or their governing university) that were available online between October and December 2020. Using an iterative process, they developed a bank of keywords that were specific to SMDS or that could include SMDS between October and December 2020. The authors searched each school's guidelines for each keyword and determined whether the word was being used in relation to crediting faculty for SMDS in the context of P&T procedures. The primary outcome measure was the dichotomous presence or absence of SMDS-specific keywords in each school's P&T guidelines. RESULTS: The authors acquired P&T guidelines from 145/154 (94%) medical schools. After removing duplicate documents, the authors considered 139 guidelines. The keyword bank included 59 terms, of which 49 were specific to SMDS and 10 were umbrella terms that could be inclusive of SMDS. Of the 139 guidelines, 121 (87%) contained at least 1 SMDS-specific keyword. Schools had a median of 3 SMDS-specific keywords in their P&T guidelines. CONCLUSIONS: As the presence and impact of SMDS increase, schools should provide guidance on its role in the P&T process. Faculty should receive clear guidance on how to document quality SMDS for their promotion file.

Evaluating Applicant Perceptions of the Impact of Social Media on the 2020-2021 Residency Application Cycle Occurring During the COVID-19 Pandemic: Survey Study.

BACKGROUND: Due to challenges related to the COVID-19 pandemic, residency programs in the United States conducted virtual interviews during the 2020-2021 application season. As a result, programs and applicants may have relied more heavily on social media-based communication and dissemination of information. OBJECTIVE: We sought to determine social media's impact on residency applicants during an entirely virtual application cycle. METHODS: An anonymous electronic survey was distributed to 465 eligible 2021 Match applicants at 4 University of California Schools of Medicine in the United States. RESULTS: A total of 72 participants (15.5% of eligible respondents), applying to 16 specialties, responded. Of those who responded, 53% (n=38) reported following prospective residency accounts on social media, and 89% (n=34) of those respondents were positively or negatively influenced by these accounts. The top three digital methods by which applicants sought information about residency programs included the program website, digital conversations with residents and fellows of that program, and Instagram. Among respondents, 53% (n=38) attended virtual information sessions for prospective programs. A minority of applicants (n=19, 26%) adjusted the number of programs they applied to based on information found on social media, with most (n=14, 74%) increasing the number of programs to which they applied. Survey respondents ranked social media's effectiveness in allowing applicants to learn about programs at 6.7 (SD 2.1) on a visual analogue scale from 1-10. Most applicants (n=61, 86%) felt that programs should use social media in future application cycles even if they are nonvirtual. CONCLUSIONS: Social media appears to be an important tool for resident recruitment. Future studies should seek more information on its effect on later parts of the application cycle and the Match.

Anxiety, PTSD, and stressors in medical students during the initial peak of the COVID-19 pandemic.

PURPOSE: To assess psychological effects of the initial peak phase of the COVID-19 pandemic on United States (US) medical students in clinical training to anticipate sequelae and prepare for future outbreaks. METHODS: Authors emailed a cross-sectional survey in April-May, 2020 to students in clinical training years at six US medical schools which included validated General Anxiety Disorder (GAD-7) and Primary Care-PTSD (PC-PTSD-5) screening tools, and asked students about pandemic-related stress and specific concerns. Authors used quantitative and thematic analysis to present results. RESULTS: Of 2511 eligible students, 741 responded (29.5%). Most students (84.1%) reported at least "somewhat" increased levels of stress and anxiety related to the pandemic. On the GAD-7, 34.3% showed mild, 16.1% moderate, and 9.5% severe anxiety symptoms, with 39.6% demonstrating no/minimal symptoms. One quarter (25.4%) screened positive for PTSD risk symptoms. Top concerns of students chosen from a pre-populated list included inadequate COVID-19 testing, undiagnosed or asymptomatic spread and racial or other disparities in the pandemic. In thematic analysis, students' reactions to removal from clinical learning included: understanding the need to conserve PPE (32.2%), a desire to help (27.7%), worry over infectious risk to others (25.4%) and self (21.2%), and lost learning opportunities (22.5%). Female students were significantly more likely to report anxiety and PTSD risk symptoms. Asian students had a greater risk of moderate anxiety and those underrepresented in medicine (UIM) had greater risk of moderate and severe anxiety symptoms compared to white students. CONCLUSIONS: During the initial peak phase of COVID-19, over 60% of US medical students screened positive for pandemic-related anxiety and one quarter were at risk for PTSD. Female and UIM students were significantly more affected. Medical schools should consider broad support of students, and targeted outreach to female and UIM students.

Utilization of Educational Videos to Improve Communication and Discharge Instructions.

INTRODUCTION: When discharging a patient from the emergency department (ED), it is crucial to make sure that they understand their disposition and aftercare instructions. However, numerous factors make it difficult to ensure that patients understand their next steps. Our objective was to determine whether patient understanding of ED discharge and aftercare instructions could be improved through instructional videos in addition to standard written discharge instructions. METHODS: This was a prospective pre- and post-intervention study conducted at a single-center, academic tertiary care ED. Patients presenting with the five selective chief complaints (closed head injury, vaginal bleeding, laceration care, splint care, and upper respiratory infection) were given questionnaires after their discharge instructions to test comprehension. Once video discharge instructions were implemented, patients received standard discharge instructions in addition to video discharge instructions and were given the same questionnaire. A total of 120 patients were enrolled in each group. RESULTS: There were significantly better survey scores after video discharge instructions (VDI) vs standard discharge instructions (SDI) for the closed head injury (27% SDI vs 46% VDI, P = 0.003); upper respiratory infection (28% SDI vs 64% VDI; P < 0.0001); and vaginal bleeding in early pregnancy groups (20% SDI vs 60% VDI, P < 0.0001). There were no significant differences in survey scores between the splint care (53% SDI vs 66% VDI; P = 0.08) and suture care groups (29% SDI vs 31% VDI; P = 0.40). CONCLUSION: Video discharge instructions supplementing standard written instructions can help improve patient comprehension and information retention. This better understanding of aftercare instructions is essential to patient follow-up and has been shown to improve patient outcomes.

Planning Engaging, Remote, Synchronous Didactics in the COVID-19 Pandemic Era.

As part of the Accreditation Council for Graduate Medical Education requirements, residents must participate in structured didactic activities. Traditional didactics include lectures, grand rounds, simulations, case discussions, and other forms of in-person synchronous learning. The COVID-19 pandemic has made in-person activities less feasible, as many programs have been forced to transition to remote didactics. Educators must still achieve the goals and objectives of their didactic curriculum despite the new limitations on instructional strategies. There are several strategies that may be useful for organizing and creating a remote residency didactic curriculum. Educators must master new technology, be flexible and creative, and set rules of engagement for instructors and learners. Establishing best practices for remote didactics will result in successful, remote, synchronous didactics; reduce the impact of transitioning to a remote learning environment; and keep educators and learners safe as shelter-at-home orders remain in place.

Effects of the COVID-19 pandemic on medical students: a multicenter quantitative study.

BACKGROUND: The COVID-19 pandemic disrupted the United States (US) medical education system with the necessary, yet unprecedented Association of American Medical Colleges (AAMC) national recommendation to pause all student clinical rotations with in-person patient care. This study is a quantitative analysis investigating the educational and psychological effects of the pandemic on US medical students and their reactions to the AAMC recommendation in order to inform medical education policy. METHODS: The authors sent a cross-sectional survey via email to medical students in their clinical training years at six medical schools during the initial peak phase of the COVID-19 pandemic. Survey questions aimed to evaluate students' perceptions of COVID-19's impact on medical education; ethical obligations during a pandemic; infection risk; anxiety and burnout; willingness and needed preparations to return to clinical rotations. RESULTS: Seven hundred forty-one (29.5%) students responded. Nearly all students (93.7%) were not involved in clinical rotations with in-person patient contact at the time the study was conducted. Reactions to being removed were mixed, with 75.8% feeling this was appropriate, 34.7% guilty, 33.5% disappointed, and 27.0% relieved. Most students (74.7%) agreed the pandemic had significantly disrupted their medical education, and believed they should continue with normal clinical rotations during this pandemic (61.3%). When asked if they would accept the risk of infection with COVID-19 if they returned to the clinical setting, 83.4% agreed. Students reported the pandemic had moderate effects on their stress and anxiety levels with 84.1% of respondents feeling at least somewhat anxious. Adequate personal protective equipment (PPE) (53.5%) was the most important factor to feel safe returning to clinical rotations, followed by adequate testing for infection (19.3%) and antibody testing (16.2%). CONCLUSIONS: The COVID-19 pandemic disrupted the education of US medical students in their clinical training years. The majority of students wanted to return to clinical rotations and were willing to accept the risk of COVID-19 infection. Students were most concerned with having enough PPE if allowed to return to clinical activities.

Two-Screen Virtual Board Game Didactic for Teaching Wilderness and Environmental Medicine Topics to Emergency Medicine Residents.

Audience: This game is appropriate for medical students, interns, junior and senior residents. Introduction: The COVID-19 pandemic has forced a transition from in-person to virtual learning, and educators must innovate and adapt to keep learners engaged. One way to achieve this is through gamification.1 The authors employed a novel approach to gamification of virtual learning which engaged not only learners' computers but also their mobile phones. Learners worked in teams communicating by text message to answer ABEM board-style questions and occupy sites on the virtual board. Educational Objectives: By the end of this didactic, the learner will:1. Describe the basics of the presentation of each topic listed above2. Recall the basics of management of each topic listed above3. Improve learners' preparedness for the Emergency Medicine Inservice Exam and Written Board Examination. Educational Methods: Wilderness and environmental medicine topics were selected from the list of topics covered on the ABEM boards. Questions were then written by the authors teaching these concepts. Research Methods: Learners were surveyed immediately following the session using an evaluation tool containing both Likert-scale questions on quality and applicability as well as open-ended questions on strengths and areas for improvement. The response rate to this survey was 100%. Results: Feedback was overwhelmingly positive, with 19/20 respondents rating the sessions 5/5 for effectiveness and value of teaching compared with other sessions, and 1/20 rating the session 4/5. Nineteen out of twenty respondents rated the content as "highly relevant"; 1/20 rated it as "mostly relevant." Nineteen out of twenty respondents rated the session 5/5 for being engaging and holding their attention; 1/20 rated it as somewhat engaging. Discussion: Learners rated the session as highly relevant and engaging. We hypothesize that by engaging two screens and forcing learners to work together by text message, we were able to turn what would normally be a distraction (texting co-residents during resident conference) into a tool for learning. Topics: Electrical injury, lightning strike, thermal burns, inhalational injury, chemical burns, acute radiation syndrome, snake bites, scorpion envenomation, stingray envenomation, jellyfish stings, black widow spider bites, mammalian bites, rabies, murine typhus, bear encounters, decompression sickness, arterial gas embolism, drowning, dehydration, heat stroke, exercise-associated hyponatremia, frostbite, hypothermia, CO poisoning, hydrogen sulfide poisoning, giardia.

#MDsToo: A student mistreatment prevention curriculum for faculty members and residents.

BACKGROUND: Medical student mistreatment has detrimental effects on student well-being and poses a patient safety risk, yet 40% of medical school graduates report being mistreated during their training. Unfortunately, this statistic has not changed significantly since 2013. The 'hidden curriculum' contributes to the pervasiveness of mistreatment in medical schools in the USA. The #MDsToo curriculum was developed to mitigate the effects of the hidden curriculum by sensitising faculty members and residents to mistreatment. METHODS: During the curriculum, participants are introduced to the KIND (knowledge-sharing, inclusive, non-discriminatory, developmentally appropriate) framework for modelling positive teacher-learner interactions and detecting mistreatment. Using KIND, faculty members and residents identify and categorise mistreatment in eight video cases depicting mistreatment, and reflect on their own experiences with mistreatment. RESULTS: Two hundred and forty-eight participants responded to a course survey. Most had experienced mistreatment. After the training, almost half stated that there were situations in the past that they did not recognize as mistreatment that they would now classify as mistreatment, and most stated that they were likely to report mistreatment now. CONCLUSION: The #MDsToo curriculum may provide an effective design for mistreatment prevention training. Next steps include multi-institutional implementation and longitudinal outcome studies.

Which Applicant Factors Predict Success in Emergency Medicine Training Programs? A Scoping Review.

BACKGROUND: Program directors (PDs) in emergency medicine (EM) receive an abundance of applications for very few residency training spots. It is unclear which selection strategies will yield the most successful residents. Many authors have attempted to determine which items in an applicant's file predict future performance in EM. OBJECTIVES: The purpose of this scoping review is to examine the breadth of evidence related to the predictive value of selection factors for performance in EM residency. METHODS: The authors systematically searched four databases and websites for peer-reviewed and gray literature related to EM admissions published between 1992 and February 2019. Two reviewers screened titles and abstracts for articles that met the inclusion criteria, according to the scoping review study protocol. The authors included studies if they specifically examined selection factors and whether those factors predicted performance in EM residency training in the United States. RESULTS: After screening 23,243 records, the authors selected 60 for full review. From these, the authors selected 15 published manuscripts, one unpublished manuscript, and 11 abstracts for inclusion in the review. These studies examined the United States Medical Licensing Examination (USMLE), Standardized Letters of Evaluation, Medical Student Performance Evaluation, medical school attended, clerkship grades, membership in honor societies, and other less common factors and their association with future EM residency training performance. CONCLUSIONS: The USMLE was the most common factor studied. It unreliably predicts clinical performance, but more reliably predicts performance on licensing examinations. All other factors were less commonly studied and, similar to the USMLE, yielded mixed results.

Not Another Boring Resident Didactic Conference.

BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) requires that residency programs in emergency medicine plan at least 5 hours of didactic experiences per week. Instructional methods should include small-group techniques, problem-based learning, or computer-based instruction. Despite recommendations from the ACGME, many programs' conference didactics continue to include primarily lecture-based instruction. METHODS: The authors describe instructional methods that promote active learning and may be superior to traditional lecture-based education. RESULTS: These methods include varying instructional methods, case-based learning, team-based learning and the flipped classroom, audience response systems, simulation, "wars," oral boards, escape rooms and scavenger hunts, expert panel discussions, debates, clinical pathologic cases, and leaderboards. The authors discuss how these methods can be implemented to make emergency medicine didactic conferences more varied and interactive for learners. CONCLUSIONS: While there is minimal research on the efficacy of these methods in graduate medical education, many have shown to improvement engagement of learners and to be effective in undergraduate medical education. Further research will be needed to determine if long-term learning outcomes can be improved with these strategies.

Does Applicant Gender Have an Effect on Standardized Letters of Evaluation Obtained During Medical Student Emergency Medicine Rotations?

BACKGROUND: The standardized letter of evaluation (SLOE) in emergency medicine (EM) is one of the most important items in a student's application to EM residency and replaces narrative letters of recommendation. The SLOE ranks students into quantile categories in comparison to their peers for overall performance during an EM clerkship and for their expected rank list position. Gender differences exist in several assessment methods in undergraduate and graduate medical education. No authors have recently studied whether there are differences in the global assessment of men and women on the SLOE. OBJECTIVES: The objective of this study was to determine if there is an effect of student gender on the outcome of a SLOE. METHODS: This was a retrospective observational study examining SLOEs from applications to a large urban, academic EM residency program from 2015 to 2016. Composite scores (CSs), comparative rank scores (CRSs), and rank list position scores (RLPSs) on the SLOE were compared for female and male applicants using Mann-Whitney U-test. RESULTS: From a total 1,408 applications, 1,038 applicants met inclusion criteria (74%). We analyzed 2,092 SLOEs from these applications. Female applicants were found to have slightly lower and thus better CRSs, RLPSs, and CSs than men. The mean CRS for women was 2.27 and 2.45 for men (p < 0.001); RLPS for women was 2.32 and 2.52 for men (p < 0.001) and CS was 4.59 for women and 4.97 for men (p < 0.001). CONCLUSIONS: Female applicants have somewhat better performance on the EM SLOE than their male counterparts.

Pediatric Seizure Team-based Learning.

Audience: The target audiences for this team-based learning are emergency medicine and emergency medicine-pediatric resident physicians. Introduction/Background: Pediatric seizure is a common presenting complaint in the emergency department. It is said that over 470,000 children have a diagnosed seizure disorder1 and 2%-5% of children aged 6 months to five years will have a febrile seizure at some point during childhood.2 While there are many published educational materials related to pediatric seizure, they are simulation-based, and/or isolated to management of one underlying diagnosis.3,4,5,6 Therefore, this team-based learning uses four cases to provide an understanding of the possible causes of seizure in children, as well as the management, workup, and disposition for emergency medicine residents in training. Educational Objectives: By the end of this TBL session, learners should be able to:Define features of simple versus complex febrile seizureDiscuss which patients with seizure may require further diagnostic workupSummarize a discharge discussion for a patient with simple febrile seizuresIdentify a differential diagnosis for pediatric patients presenting with seizureDefine features of status epilepticusReview an algorithm for the pharmacologic management of status epilepticusIndicate medication dosing and routes of various benzodiazepine treatmentsObtain a thorough history in an infant patient with seizures to recognize hyponatremia due to improperly prepared formulaChoose the appropriate treatment for a patient with a hyponatremic seizureDescribe the anatomy of a ventriculoperitoneal (VP) shuntRelate a differential diagnosis of VP shunt malfunctionCompare and contrast the neuroimaging options for a patient with a VP shunt. Educational Methods: This team-based learning is a classic TBL because it contains learner responsible content (LRC), an individual readiness assessment test (iRAT), a multiple-choice group RAT (gRAT) with immediate feedback assessment technique (IF/AT), and a group application exercise (GAE). Research Methods: We received formative feedback through conversations with learners afterwards, who stated they enjoyed the activity and felt it was highly useful for their learning; in addition, instructors discussed after the session and made changes accordingly. Results: We collected verbal feedback from instructors and learners after the session. Learners and instructors felt that it was very successful with limited modifications, in particular, the need for more time to complete the activity. Therefore, we suggest a 90 minute rather than 60-minute timeframe to adequately cover all material. Discussion: Pediatric seizure is a common complaint in the emergency department. It can be a difficult subject for the emergency medicine resident to master based on the variety of presentations. Indeed, the cause, management, and disposition may vary greatly; the etiology may range from benign to life-threatening, sometimes requiring minimal and at other times an extensive workup, with an ultimate disposition of either discharge home or admission to a pediatric intensive care unit. Therefore, team-based learning is well-suited to work through some of the complexities of such cases, and we found this educational session to be highly effective. Topics: Pediatric seizure, simple febrile seizure, complex febrile seizure, status epilepticus, hyponatremic seizure, ventriculoperitoneal (VP) shunt, team-based learning.