Virtual Interviews and the Pediatric Emergency Medicine Match Geography: A National Survey.

Introduction: Virtual interviews (VI) are now a permanent part of pediatric emergency medicine (PEM) recruitment, especially given the cost and equity advantages. Yet inability to visit programs in person can impact decision-making, leading applicants to apply to more programs. Moreover, the cost advantages of VI may encourage applicants to apply to programs farther away than they might otherwise have been willing or able to travel. This could create unnecessary strain on programs. We conducted this study to determine whether PEM fellowship applicants would apply to a larger number of programs and in different geographic patterns with VI (2020 and 2021) as compared to in-person interviews (2018 and 2019). Methods: We conducted an anonymous national survey of all PEM fellows comparing two cohorts: current fellows who interviewed inperson (applied in 2018/2019) and fellows who underwent VIs in 2020/2021 (current fellows and those recently matched in 2021). The study took place in March-April 2022. Questions focused on geographic considerations during interviews and the match. We used descriptive statistics, chi-square and t-tests for analysis. Results: Overall response rate was 42% (231/550); 32% (n = 74) interviewed in person and 68% (n = 157) virtually. Fellows applied to a median of 4/6 geographic regions (interquartile range 2, 5). Most applied for fellowship both in the same region as residency (216, 93%) and outside (192, 83%). Only the Pacific region saw a statistically significant increase in applicants during VI (59.9% vs 43.2%, P = 0.02). There was no statistical difference in the number of programs applied to during in-person vs VI (mean difference (95% confidence interval 0.72, -2.8 - 4.2). A majority matched in their preferred state both during VI (60.4%) and in-person interviews (65.7%). The difference was not statistically significant (P = 0.45). Conclusion: While more PEM fellowship applicants applied outside the geographic area where their residency was and to the Pacific region, there was no overall increase in the number of programs or geographic areas PEM applicants applied to during VI as compared to in-person interview seasons. As this was the first two years of VI, ongoing data collection will further identify trends and the impactof VI.

Top emergency medicine faculty development papers since 2000: A Delphi study.

Objectives: Faculty development is essential for academic emergency physicians to maintain clinical skills and succeed in administrative and leadership roles and for career advancement and satisfaction. Faculty developers in emergency medicine (EM) may struggle to find shared resources to guide faculty development efforts in a way that builds on existing knowledge. We aimed to review the EM-specific faculty development literature since 2000 and come to a consensus about the most useful for EM faculty developers. Methods: A database search was conducted on the topic of faculty development in EM from 2000 to 2020. After identifying relevant articles, we performed a modified Delphi process in three rounds, using a team of educators with a range of experiences with faculty development and education research, to identify articles that would be most useful to a broad audience of faculty developers. Results: We identified 287 potentially relevant articles on the topic of EM faculty development, 244 from the initial literature search, 42 from manual review of the references of the papers meeting inclusion criteria, and one by our study group's recommendation. Thirty-six papers met final inclusion criteria and underwent full-text review by our team. The Delphi process yielded six articles that were deemed most highly relevant over the three rounds. Each of these articles is described here, along with summaries and implications for faculty developers. Conclusions: We present the most useful EM papers from the past two decades for faculty developers seeking to develop, implement, or revise faculty development interventions.

Loss of cytoplasmic incompatibility and minimal fecundity effects explain relatively low Wolbachia frequencies in Drosophila mauritiana.

Maternally transmitted Wolbachia bacteria infect about half of all insect species. Many Wolbachia cause cytoplasmic incompatibility (CI) and reduced egg hatch when uninfected females mate with infected males. Although CI produces a frequency-dependent fitness advantage that leads to high equilibrium Wolbachia frequencies, it does not aid Wolbachia spread from low frequencies. Indeed, the fitness advantages that produce initial Wolbachia spread and maintain non-CI Wolbachia remain elusive. wMau Wolbachia infecting Drosophila mauritiana do not cause CI, despite being very similar to CI-causing wNo from Drosophila simulans (0.068% sequence divergence over 682,494 bp), suggesting recent CI loss. Using draft wMau genomes, we identify a deletion in a CI-associated gene, consistent with theory predicting that selection within host lineages does not act to increase or maintain CI. In the laboratory, wMau shows near-perfect maternal transmission; but we find no significant effect on host fecundity, in contrast to published data. Intermediate wMau frequencies on the island of Mauritius are consistent with a balance between unidentified small, positive fitness effects and imperfect maternal transmission. Our phylogenomic analyses suggest that group-B Wolbachia, including wMau and wPip, diverged from group-A Wolbachia, such as wMel and wRi, 6-46 million years ago, more recently than previously estimated.

Marching on the Road to Quality: Army Public Health Experience Adopting NACCHO's Roadmap to a Culture of Quality Framework.

The US Army Public Health Center (APHC) adopted the National Association of County and City Health Officials' (NACCHO) Roadmap to a Culture of Quality (CoQ) Improvement framework to define its current culture and adapted the NACCHO's Organizational CoQ Self-Assessment Tool for applicability to a federal agency and workforce. More than 500 Civilian and Military personnel completed the self-assessment in October 2017. The results indicated that the APHC was categorized in the third of six total phases of the NACCHO's Roadmap to a CoQ (Phase 3: Informal or Ad Hoc QI Activities), which generated 13 transitional strategies to advance the APHC toward a CoQ. The APHC demonstrated that a federal public health organization can use and apply results from currently available self-assessment tools and frameworks related to a CoQ. By doing so, the APHC is optimizing its ability to ensure America's Soldiers and the Army Family receive essential and effective public health services.