scholarly journals An Environmental Scan of Academic Emergency Medicine at the 17 Canadian Medical Schools: Why Does this Matter to Emergency Physicians?

CJEM ◽  
2016 ◽  
Vol 19 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Ian G. Stiell ◽  
Jennifer D. Artz ◽  
Eddy S. Lang ◽  
Jonathan Sherbino ◽  
Laurie J. Morrison ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Schools ◽  
Pediatric Emergency ◽  
Teaching Hospitals ◽  
Lead Author ◽  
Environmental Scan ◽  
Academic Activities ◽  
Academic Practices ◽  
Major Teaching ◽  
Teaching Programs

AbstractObjectiveWe sought to conduct a major objective of the CAEP Academic Section, an environmental scan of the academic emergency medicine programs across the 17 Canadian medical schools.MethodsWe developed an 84-question questionnaire, which was distributed to academic heads. The responses were validated by phone by the lead author to ensure that the questions were answered completely and consistently. Details of pediatric emergency medicine units were excluded from the scan.ResultsAt eight of 17 universities, emergency medicine has full departmental status and at two it has no official academic status. Canadian academic emergency medicine is practiced at 46 major teaching hospitals and 13 specialized pediatric hospitals. Another 69 Canadian hospital EDs regularly take clinical clerks and emergency medicine residents. There are 31 full professors of emergency medicine in Canada. Teaching programs are strong with clerkships offered at 16/17 universities, CCFP(EM) programs at 17/17, and RCPSC residency programs at 14/17. Fourteen sites have at least one physician with a Master’s degree in education. There are 55 clinical researchers with salary support at 13 universities. Sixteen sites have published peer-reviewed papers in the past five years, ranging from four to 235 per site. Annual budgets range from $200,000 to $5,900,000.ConclusionThis comprehensive review of academic activities in emergency medicine across Canada identifies areas of strengths as well as opportunities for improvement. CAEP and the Academic Section hope we can ultimately improve ED patient care by sharing best academic practices and becoming better teachers, educators, and researchers.

scholarly journals An environmental scan of academic pediatric emergency medicine at Canadian medical schools: Identifying variability across Canada

CJEM ◽  
2018 ◽  
Vol 20 (5) ◽  
pp. 693-701 ◽  
Author(s):  
Jennifer D. Artz ◽  
Garth Meckler ◽  
Niran Argintaru ◽  
Roderick Lim ◽  
Ian G. Stiell
Keyword(s):  
Emergency Medicine ◽  
Medical Schools ◽  
Fellowship Training ◽  
Pediatric Emergency ◽  
Academic Program ◽  
Faculty Members ◽  
Teaching Hospitals ◽  
Pediatric Emergency Medicine ◽  
Environmental Scan ◽  
Question Form

ABSTRACTObjectiveTo complement our environmental scan of academic emergency medicine departments, we conducted a similar environmental scan of the academic pediatric emergency medicine programs offered by the Canadian medical schools.MethodsWe developed an 88-question form, which was distributed to pediatric academic leaders at each medical school. The responses were validated via email to ensure that the questions were answered completely and consistently.ResultsFourteen of the 17 Canadian medical schools have some type of pediatric emergency medicine academic program. None of the pediatric emergency medicine units have full departmental status, while nine are divisions, two are sections, and three have no status. Canadian academic pediatric emergency medicine is practised at 13 major teaching hospitals and one specialized pediatric emergency department. There are 394 pediatric emergency medicine faculty members, including 13 full professors and 64 associate professors. Eight sites regularly take pediatric undergraduate clinical clerks, and all 14 provide resident education. Fellowship training is offered at 10 sites, with five offering advanced pediatric emergency medicine fellowship training. Half of the sites have at least one physician with a Master’s degree in education, totalling 18 faculty members across Canada. There are 31 clinical researchers with salary support at nine universities. Eleven sites have published peer-reviewed papers (n=423) in the past five years, ranging from two to 102 per site. Annual academic budgets range from $10,000 to $2,607,515.ConclusionsThis comprehensive review of academic activities in pediatric emergency medicine across Canada identifies the variability across the country, including the recognition of sites above and below the national average, which may prompt change at individual sites. Sharing these academic practices may inspire sites to provide more support to teachers, educators, and researchers.

scholarly journals An environmental scan of wellness initiatives and programs at Canadian academic emergency medicine programs: How far have we come?

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 857-863
Author(s):  
Rodrick Lim ◽  
Brittany Cameron ◽  
Sara Gray ◽  
Louise Rang ◽  
Kristine Van Aarsen
Keyword(s):  
Emergency Medicine ◽  
Gender Equity ◽  
Wellness Programs ◽  
Lead Author ◽  
Environmental Scan ◽  
Fiscal Transparency ◽  
Canadian Association ◽  
Critical Issues ◽  
The University ◽  
Future Work

ABSTRACTObjectivesWe sought to conduct a major objective of the Canadian Association of Emergency Physicians (CAEP) Wellness Committee, an environmental scan of the academic emergency medicine programs across the 17 Canadian medical schools.MethodsAn 89-question questionnaire was distributed to academic heads or wellness leads. The responses were verified by the lead author to ensure that the questions were answered completely and consistently.ResultsWhile formal wellness programs may exist in varying degrees across the 17 universities, most were found to exist only at local, divisional, or departmental levels. A broad variability of established leadership positions exists. Shift practices varied greatly. In day to day practice, availability for food and debriefing were high and childcare, sleep rooms, and follow-up following critical incidents were low. Sabbaticals existed in the majority of centers. Roughly 50% of departments have gender equity program and annual retreats. Centers report programs for the initiation of leaves (82%), onboarding (64%), and reorientation (94%). Support of health benefits (76%) and pensions (76%) depended on type of appointment and relationship to the university. Fiscal transparency was reported in 53% of programs.ConclusionWellness and burnout are critical issues for emergency medicine in Canada. This comprehensive review of wellness programs identifies areas of strength, but also allows identification of areas of improvement for future work. Individual centers can identify common options when developing or expanding their wellness programs.

scholarly journals An Environmental Scan of Academic Emergency Medicine at the 17 Canadian Medical Schools: Why Does this Matter to Emergency Physicians? – CORRIGENDUM

CJEM ◽  
2017 ◽  
Vol 19 (3) ◽  
pp. 247-247 ◽  
Author(s):  
G. Stiell ◽  
J. D. Artz ◽  
E. S. Lang ◽  
J. Sherbino ◽  
L. J. Morrison ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Schools ◽  
Emergency Physicians ◽  
Environmental Scan

Exploring the Differences in Macrocognition Between Experts and Non-CHD Experts Managing Congenital Heart Disease (CHD)

2021 ◽  
Vol 10 (1) ◽  
pp. 335-339
Author(s):  
Azadeh Assadi ◽  
Peter C. Laussen ◽  
Patricia Trbovich
Keyword(s):  
Decision Making ◽  
Emergency Medicine ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pediatric Emergency ◽  
Acute Management ◽  
Naturalistic Decision Making ◽  
The Face

Background and aims: Children with congenital heart disease (CHD) are at risk of deterioration in the face of common childhood illnesses, and their resuscitation and acute management is often best achieved with the guidance of CHD experts. Access to such expertise may be limited outside specialty heart centers and the fragility of these patients is cause for discomfort among many emergency medicine physicians. An understanding of the differences in macrocognition of these clinicians could shed light on some of the causes of discomfort and facilitate the development of a sociotechnological solution to this problem. Methods: Cardiac intensivists (CHD experts) and pediatric emergency medicine physicians (non-CHD experts) in a major academic cardiac center were interviewed using the critical decision method. Interview transcripts were coded deductively based on Klein’s macrocognitive framework and inductively to allow for new or modified characterization of dimensions. Results: While both CHD-experts and non-CHD experts relied on the macrocognitive functions of sensemaking, naturalistic decision making and detecting problems, the specific data and mental models used to understand the patients and course of therapy differed between CHD-experts and non-CHD experts. Conclusion: Characterization of differences between the macrocognitive processes of CHD experts and non-CHD experts can inform development of sociotechnological solutions to augment decision making pertaining to the acute management of pediatric CHD patients.

Milestones Comparisons from Residency to Pediatric Emergency Medicine Fellowship: Resetting Expectations

2021 ◽  
Author(s):  
Tien T. Vu ◽  
Jerri A. Rose ◽  
Veronika Shabanova ◽  
Maybelle Kou ◽  
Noel S. Zuckerbraun ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Pediatric Emergency ◽  
Pediatric Emergency Medicine

Pediatric Emergency Medicine Fellows’ Milestone Evaluations: Do they all meet the targets for graduation?

2021 ◽  
Author(s):  
Cindy G. Roskind ◽  
Kathryn Leonard ◽  
Aline Baghdassarian ◽  
Maybelle Kou ◽  
Kelly Levasseur ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Pediatric Emergency ◽  
Pediatric Emergency Medicine

scholarly journals Feasible and effective use of a simulation-based curriculum for post-graduate emergency medicine trainees in India to improve learner self-efficacy, knowledge, and skills

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
T. Ahluwalia ◽  
S. Toy ◽  
C. Gutierrez ◽  
K. Boggs ◽  
K. Douglass
Keyword(s):  
Emergency Medicine ◽  
Self Efficacy ◽  
Pediatric Emergency ◽  
Pediatric Care ◽  
Procedural Skills ◽  
Knowledge And Skills ◽  
Post Graduate ◽  
Pediatric Emergencies ◽  
Simulation Based

Abstract Background Pediatric emergency medicine training is in its infancy in India. Simulation provides an educational avenue to equip trainees with the skills to improve pediatric care. We hypothesized that a simulation-based curriculum can improve Indian post-graduate emergency medicine (EM) trainees’ self-efficacy, knowledge, and skills in pediatric care. Methods We designed a simulation-based curriculum for management of common pediatric emergencies including sepsis, trauma, and respiratory illness and pediatric-specific procedures including vascular access and airway skills. Training included didactics, procedural skill stations, and simulation. Measures included a self-efficacy survey, knowledge test, skills checklist, and follow-up survey. Results were analyzed using the Wilcoxon signed-rank test and paired-samples t test. A 6-month follow-up survey was done to evaluate lasting effects of the intervention. Results Seventy residents from four academic hospitals in India participated. Trainees reported feeling significantly more confident, after training, in performing procedures, and managing pediatric emergencies (p < 0.001). After the simulation-based curriculum, trainees demonstrated an increase in medical knowledge of 19% (p < 0.01) and improvement in procedural skills from baseline to mastery of 18%, 20%, 16%, and 19% for intubation, bag-valve mask ventilation, intravenous access, and intraosseous access respectively (p < 0.01). At 6-month follow-up, self-efficacy in procedural skills and management of pediatric emergencies improved from baseline. Conclusions A simulation-based curriculum is an effective and sustainable way to improve Indian post-graduate EM trainees’ self-efficacy, knowledge, and skills in pediatric emergency care.

scholarly journals Characterizations of Clinical Isolates of Clostridium difficile by Toxin Genotypes and by Susceptibility to 12 Antimicrobial Agents, Including Fidaxomicin (OPT-80) and Rifaximin: a Multicenter Study in Taiwan

2012 ◽  
Vol 56 (7) ◽  
pp. 3943-3949 ◽  
Author(s):  
Chun-Hsing Liao ◽  
Wen-Chien Ko ◽  
Jang-Jih Lu ◽  
Po-Ren Hsueh
Keyword(s):  
Clostridium Difficile ◽  
Care Setting ◽  
Antimicrobial Agents ◽  
Teaching Hospitals ◽  
Binary Toxin ◽  
Content Type ◽  
Vancomycin Mics ◽  
Major Teaching ◽  
Southern Taiwan

ABSTRACTA total of 403 nonduplicate isolates ofClostridium difficilewere collected at three major teaching hospitals representing northern, central, and southern Taiwan from January 2005 to December 2010. Of these 403 isolates, 170 (42.2%) were presumed to be nontoxigenic due to the absence of genes for toxins A or B or binary toxin. The remaining 233 (57.8%) isolates carried toxin A and B genes, and 39 (16.7%) of these also had binary toxin genes. The MIC90of all isolates for fidaxomicin and rifaximin was 0.5 μg/ml (range, ≤0.015 to 0.5 μg/ml) and >128 μg/ml (range, ≤0.015 to >128 μg/ml), respectively. All isolates were susceptible to metronidazole (MIC90of 0.5 μg/ml; range, ≤0.03 to 4 μg/ml). Two isolates had reduced susceptibility to vancomycin (MICs, 4 μg/ml). Only 13.6% of isolates were susceptible to clindamycin (MIC of ≤2 μg/ml). Nonsusceptibility to moxifloxacin (n= 81, 20.1%) was accompanied by single or multiple mutations ingyrAandgyrBgenes in all but eight moxifloxacin-nonsusceptible isolates. Two previously unreportedgyrBmutations might independently confer resistance (MIC, 16 μg/ml), Ser416 to Ala and Glu466 to Lys. Moxifloxacin-resistant isolates were cross-resistant to ciprofloxacin and levofloxacin, but some moxifloxacin-nonsusceptible isolates remained susceptible to gemifloxacin or nemonoxacin at 0.5 μg/ml. This study found the diversity of toxigenic and nontoxigenic strains ofC. difficilein the health care setting in Taiwan. All isolates tested were susceptible to metronidazole and vancomycin. Fidaxomicin exhibited potentin vitroactivity against all isolates tested, while the more than 10% of Taiwanese isolates with rifaximin MICs of ≥128 μg/ml raises concerns.

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