Academic Life in Emergency Medicine (ALiEM) Blog and Podcast Watch: Renal and Genitourinary Emergencies.

The Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) series and Approved Instruction Resources Professional (AIR-Pro) series were created in 2014 and 2015, respectively, to address the need for the curation of online educational content as well as a nationally available curriculum that meets individualized interactive instruction criteria. These two programs identify high-quality educational blog and podcast content using an expert-based approach. The AIR series is a continuously building curriculum originally based on the Council of Emergency Medicine Directors (CORD) testing schedule. Using the ALiEM AIR scoring instrument, 49 blog posts and podcasts relevant to renal and genitourinary emergencies published within the previous 12 months were evaluated by eight attending physicians. We summarize the 13 posts that met our a priori determined quality criteria per evaluation by the reviewers. The ALiEM Blog and Podcast Watch series identifies high-quality educational blogs and podcasts for emergency medicine clinicians through its expert panel, using a validated scoring instrument. While this article focuses on renal and genitourinary emergencies, additional AIR modules address other topics in emergency medicine. The AIR and AIR-Pro series provide post-publication accreditation and curation of recent online content to identify and recommend high-quality educational social media content for the EM clinician.

Academic Life in Emergency Medicine Blog and Podcast Watch: Respiratory Emergencies.

The Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) Series and Approved Instruction Resources Professional (AIR-Pro) Series were created in 2014 and 2015, respectively, to address the need for curation of online educational content as well as a nationally available curriculum that meets individualized interactive instruction criteria. These two programs identify high-quality educational blog and podcast content using an expert-based approach. We summarize the accredited posts on respiratory emergencies that met our a priori determined quality criteria per evaluation by eight experienced faculty educators in emergency medicine.

How well will you FIT? Use of a modified MMI to assess applicants' compatibility with an emergency medicine residency program.

PURPOSE: Emergency medicine residency programs have evaluated the use of Multiple Mini Interviews (MMIs) for applicants. The authors developed an MMI-style method called the Fast Interview Track (FIT) to predict an applicant's 'fit' within an individual residency program. METHODS: Applicants meet with up to five residents and are asked one question by each. Residents score the applicant using a Likert scale from 1 to 5 on two questions: 'How well does the applicant think on his/her feet?' and 'How well do you think the applicant will fit in here?'. To assess how well these questions predicted a resident's 'fit', current residents scored fellow residents on these same questions. These scores were compared with the residents' interview FIT scores. A postmatch survey of applicants who did not match at this program solicited applicants' attitudes toward the FIT sessions. RESULTS: Among the junior class, the correlation between interview and current scores was significant for question 1 (rho=0.5192 [p=0.03]) and question 2 (rho=0.5753 [p=0.01]). Among seniors, Spearman's rho was statistically significant for question 2, though not statistically significant for question 1. The chi-square measure of high scores (4-5) versus low scores (1-3) found a statistically significant association between interview and current scores for interns and juniors. Of the 29 responses to the postmatch survey, 16 (55%) felt FIT sessions provided a good sense of the program's personality and only 6 (21%) disagreed. Nine (31%) felt FIT sessions positively impacted our program's ranking and 11 (38%) were 'Neutral'. Only two (7%) reported that FIT sessions negatively impacted their ranking of our program. CONCLUSIONS: FIT provided program leadership with a sense of an applicant's 'fit' within this program. Interview day scores correlated with scores received during residency. Most applicants report a positive experience with FIT sessions. FIT provides a useful tool to recruit applicants who fit with the residency program.

Development of a novel sports medicine rotation for emergency medicine residents.

Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents.

Sleep disturbances predict prospective declines in resident physicians' psychological well-being.

BACKGROUND: Medical residency can be a time of increased psychological stress and sleep disturbance. We examine the prospective associations between self-reported sleep quality and resident wellness across a single training year. METHODS: Sixty-nine (N=69) resident physicians completed the Brief Resident Wellness Profile (M=17.66, standard deviation [SD]=3.45, range: 0-17) and the Pittsburgh Sleep Quality Index (M=6.22, SD=2.86, range: 12-25) at multiple occasions in a single training year. We examined the 1-month lagged effect of sleep disturbances on residents' self-reported wellness. RESULTS: Accounting for residents' overall level of sleep disturbance across the entire study period, both the concurrent (within-person) within-occasion effect of sleep disturbance (B=-0.20, standard error [SE]=0.06, p=0.003, 95% confidence interval [CI]: -0.33, -0.07) and the lagged within-person effect of resident sleep disturbance (B=-0.15, SE=0.07, p=0.037, 95% CI: -0.29, -0.009) were significant predictors of decreased resident wellness. Increases in sleep disturbances are a leading indicator of resident wellness, predicting decreased well-being 1 month later. CONCLUSIONS: Sleep quality exerts a significant effect on self-reported resident wellness. Periodic evaluation of sleep quality may alert program leadership and the residents themselves to impending decreases in psychological well-being.

Implementation of the Introductory Clinician Development Series: an optional boot camp for Emergency Medicine interns.

BACKGROUND: The transition from medical student to first-year intern can be challenging. The stress of increased responsibilities, the gap between performance expectations and varying levels of clinical skills, and the need to adapt to a new institutional space and culture can make this transition overwhelming. Orientation programs intend to help new residents prepare for their new training environment. OBJECTIVE: To ease our interns' transition, we piloted a novel clinical primer course. We believe this course will provide an introduction to basic clinical knowledge and procedures, without affecting time allotted for mandatory orientation activities, and will help the interns feel better prepared for their clinical duties. METHODS: First-year Emergency Medicine residents were invited to participate in this primer course, called the Introductory Clinician Development Series (or "intern boot camp"), providing optional lecture and procedural skills instruction prior to their participation in the mandatory orientation curriculum and assumption of clinical responsibilities. Participating residents completed postcourse surveys asking for feedback on the experience. RESULTS: Survey responses indicated that the intern boot camp helped first-year residents feel more prepared for their clinical shifts in the Emergency Department. CONCLUSION: An optional clinical introductory series can allow for maintenance of mandatory orientation activities and clinical shifts while easing the transition from medical student to clinician.

Online research article discussion board to increase knowledge translation during emergency medicine residency.

BACKGROUND: Many clinicians have difficulties reading current best practice journal articles on a regular basis. Discussion boards are one method of online asynchronous learning that facilitates active learning and participation. We hypothesized that an online repository of best practice articles with a discussion board would increase journal article reading by emergency medicine residents. METHODS: PARTICIPANTS ANSWERED THREE QUESTIONS WEEKLY ON A DISCUSSION BOARD: What question does this study address? What does this study add to our knowledge? How might this change clinical practice? A survey regarding perceived barriers to participating was then distributed. RESULTS: Most participants completed an article summary once or twice in total (23/32, 71.9%). Only three were involved most weeks (3/32, 9.4%) whereas 5/32 (15.6%) participated monthly. The most common barriers were lack of time (20/32, 62.5%), difficulty logging on (7/32, 21.9%), and forgetting (6/32, 18.8%). CONCLUSION: Although subjects were provided weekly with an article link, email, and feedback, journal article reading frequency did not increase.