Endowed faculty positions in academic emergency medicine: 5 years later.

BACKGROUND: In 2004, we examined the number of endowed faculty positions (both chair and professorship) in Academic Departments of Emergency Medicine (ADEMs) in the United States (US). OBJECTIVE: To survey ADEMs in the United States concerning their number of endowed faculty positions and compare the results to the 2004 study. METHODS: A survey was sent to the chairs of all ADEMs in the United States belonging to the Association of Academic Chairs of Emergency Medicine. We requested information on: number of endowed chair and professorship positions, amount required to fund, date established, source of funding, and future plans. RESULTS: Seventy-three chairs responded, for a 100% response rate. Eight chairs reported one endowed chair position each. One chair reported two such positions and one chair reported three chair positions. In total, 10 ADEMs (13.7%) reported 13 endowed chair positions. For endowed professorships, eight chairs reported one professorship each and two chairs reported two such positions. A total of 10 ADEMs (13.7%) reported having 12 endowed professorships. In all, 19 ADEMs (26%) reported a total of 25 such positions. The typical amount allowed to spend was 4-5% of the value of the endowment annually. The average amount necessary to fund an endowed chair position was $1.5 million, and $1 million for an endowed professorship. CONCLUSION: Twenty-six percent of all US ADEMs now have an endowed faculty position. There has been a nearly threefold increase in the number of endowed faculty positions over the past 5 years.

Comparison of traditional versus high-fidelity simulation in the retention of ACLS knowledge.

OBJECTIVE: We performed a single-blinded, randomized controlled trial to evaluate the retention of advanced cardiac life support (ACLS) knowledge between high-fidelity simulation training (HFST) and traditional training (TT) in medical students. METHODS: Medical students were randomized to HFST or TT for their ACLS training. Students were then tested on 2 different mega-code scenarios immediately after their training and then 1-year later. A survey was performed asking their satisfaction of ACLS training and confidence of ACLS knowledge with a 10-point rating scale. RESULTS: 93 students were randomized with 86 completing the study (HFST=45, TT=41). The HFST group scored a higher percentage correct on initial testing than the TT group (83% vs. 70%, P<0.0001). However at 1-year follow up, both groups performed the same (66% vs. 66%, P=0.84). Satisfaction with training was higher with the HFST compared to the TT group (9.0 vs. 7.8, P<0.0001). Confidence in ACLS knowledge between HFST and TT groups were similar at baseline (6.9 vs. 6.5, P=0.18) and at 1-year (4.8 vs. 4.5, P=0.46). CONCLUSION: Students demonstrated greater ACLS knowledge initially with HFST than with TT. However, after 1-year, both groups performed the same. Satisfaction with training was higher with HFST compared to TT. Confidence in ACLS knowledge was the same initially and decreased similarly over a 1-year time period regardless of the type of ACLS training. Further studies will need to determine optimal strategies to retain ACLS knowledge.

Frequency of incidental findings on computed tomography of trauma patients.

OBJECTIVE: To determine the incidence and frequency of follow-up instructions for incidental findings on computed tomography (CT) scanning of the abdomen and pelvis in trauma patients. METHODS: We performed a retrospective chart review of all adult patients triaged to the trauma service at a Level I trauma center between July 1, 2003 and June 30, 2004. Included patients were 16 years of age and older who underwent abdomen and pelvic CT scans as part of their primary evaluation. We excluded patients under the age of 16 years, patients unable to complete radiographic studies due to deterioration in condition, patients with missing CT scan reports, and transferred patients who had CT scans done at outside facilities. RESULTS: A total of 1,633 patients presented to the trauma service during the study period; 922 patients met inclusion criteria. Of these, 392 had incidental findings noted on the formal radiology report. Twenty patients with incidental findings either received additional workup during their hospital admission for their trauma injuries or were notified of the findings on discharge. Nine died prior to discharge. One hundred twenty-two patients with incidental findings had those findings noted in the history and physical or discharge summary with no documentation of follow-up. There was no documentation of any incidental findings in the electronic record for the majority of patients (242) with incidental findings. CONCLUSION: The majority of incidental findings discovered on abdomen and pelvic CT scanning of trauma patients are not documented; therefore, many patients may not receive the appropriate recommended follow up.