Kevin R. Scott

Integration of Social Media in Emergency Medicine Residency Curriculum

INTRODUCTION As education moves away from the age of pen and paper, the digital platform has become a rapidly growing resource for both emergency medicine educators and learners. Social media are any Internet-based applications that enable content sharing and rapid interactions between large populations. The growth and influence of social media technologies have allowed the distribution of ideas far beyond geographic borders. During the past decade, an estimated 141 blogs and 42 podcasts related to emergency medicine and critical care have been developed in 24 countries. Free open access meducation (FOAM), defined as a community of open access resources for learning in medicine, leverages the powerful sharing and interactive qualities of social media to rapidly disseminate educational materials and expert insights. Social media resources are being used frequently by emergency medicine training programs; a recent survey of 226 emergency medicine residents at 12 different residency programs showed that almost 98% use some form of social media for learning for at least 1 hour per week. Many emergency medicine residency programs across the United States and Canada have started their own Twitter accounts (Table), largely through the work of the group at Academic Life in Emergency Medicine (ALiEM). Despite the strong tendency to use social media for learning, there remains a lack of understanding or science of how to implement it effectively. Our primary goal is to describe the different social media modalities and how our program and others have created a presence in these platforms.Wewill also offer specific examples of how these modalities can be integrated asynchronously or in conjunction with didactic sessions. Last, wewill highlight the potential struggles and barriers that may be associated with the implementation and integration of social media in residency education. We hope that this article will spark further discussion on social media use and inspire future studies to examine the effectiveness of its integration in emergency medicine residency curricula.

Opportunities for Exploring and Reducing Prescription Drug Abuse Through Social Media.

The rising toll of opioid overdoses in the past decade has been declared a prescription drug epidemic by the Centers for Disease Control. In that same period, internet platforms, such as Facebook and Twitter, have grown exponentially, being used primarily by a population similar to new initiates of substance abuse. Researchers have utilized social media to gain insights into use patterns and prevailing attitudes about various substances. Social media has potential to enhance screening, prevention, and treatment of addiction. With future funding, they should be leveraged to advance understanding of prescription drug use and improve treatment and prevention of abuse.

Assessing EM Patient Safety and Quality Improvement Milestones Using a Novel Debate Format.

Graduate medical education is increasingly focused on patient safety and quality improvement; training programs must adapt their curriculum to address these changes. We propose a novel curriculum for emergency medicine (EM) residency training programs specifically addressing patient safety, systems-based management, and practice-based performance improvement, called “EM Debates.” Following implementation of this educational curriculum, we performed a cross-sectional study to evaluate the curriculum through resident self-assessment. Additionally, a cross-sectional study to determine the ED clinical competency committee’s (CCC) ability to assess residents on specific competencies was performed. Residents were overall very positive towards the implementation of the debates. Of those participating in a debate, 71% felt that it improved their individual performance within a specific topic, and 100% of those that led a debate felt that they could propose an evidence-based approach to a specific topic. The CCC found that it was easier to assess milestones in patient safety, systems-based management, and practice-based performance improvement (sub-competencies 16, 17, and 19) compared to prior to the implementation of the debates. The debates have been a helpful venue to teach EM residents about patient safety concepts, identifying medical errors, and process improvement.

Academic Primer Series: Key Papers About Peer Review

Introduction Peer review, a cornerstone of academia, promotes rigor and relevance in scientific publishing. As educators are encouraged to adopt a more scholarly approach to medical education, peer review is becoming increasingly important. Junior educators both receive the reviews of their peers, and are also asked to participate as reviewers themselves. As such, it is imperative for junior clinician educators to be well-versed in the art of peer reviewing their colleagues’ work. In this article, our goal was to identify and summarize key papers that may be helpful for faculty members interested in learning more about the peer-review process and how to improve their reviewing skills. Methods The online discussions of the 2016–17 Academic Life in Emergency Medicine (ALiEM) Faculty Incubator program included a robust discussion about peer review, which highlighted a number of papers on that topic. We sought to augment this list with further suggestions by guest experts and by an open call on Twitter for other important papers. Via this process, we created a list of 24 total papers on the topic of peer review. After gathering these papers, our authorship group engaged in a consensus-building process incorporating Delphi methods to identify the papers that best described peer review, and also highlighted important tips for new reviewers. Results We found and reviewed 24 papers. In our results section, we present our authorship group’s top five most highly rated papers on the topic of peer review. We also summarize these papers with respect to their relevance to junior faculty members and to faculty developers. Conclusion We present five key papers on peer review that can be used for faculty development for novice writers and reviewers. These papers represent a mix of foundational and explanatory papers that may provide some basis from which junior faculty members might build upon as they both undergo the peer-review process and act as reviewers in turn.

Medical Students in the Emergency Department and Patient Length of Stay.

Quantitative assessments of how trainees affect patient care have been limited, especially in the emergency department (ED). A US study by Pitts et al found that supervised resident visits were associated with greater resource use, including longer length of stay (LOS) in the ED. As EDs host more core clerkship courses, less experienced students have become involved in bedside care. This study examined the association between the presence of medical students in the ED and patient LOS, an established patient-centered outcome and marker of ED performance. Disciplines Life Sciences | Medicine and Health Sciences | Physical Sciences and Mathematics | Social and Behavioral Sciences Author(s) Kimon Ionnides, Mira Mamtani, Frances S. Shofer, Dylan S. Small, Sean Hennessey, Benjamin Abella, and Kevin Scott This journal article is available at ScholarlyCommons: http://repository.upenn.edu/statistics_papers/66

Implicit Bias Education and Emergency Medicine Training: Step One? Awareness

Prior research suggests that health care providers are susceptible to implicit biases, specifically prowhite biases, and that these may contribute to health care disparities by influencing physician behavior. Despite these findings, implicit bias training is not currently embedded into emergency medicine (EM) residency training and few studies exist that evaluate the effectiveness of implicit bias training on awareness during residency conference. We sought to conduct a mixed‐methods program evaluation of a formalized educational intervention targeted on the topic of implicit bias.

Presence of Medical Students and Length of Stay in the Emergency Department—Reply

EnglishMr Ioannides and colleagues1 examined 15 years of emergency department (ED) data and determined that length of stay was 5 minutes longer when medical students were present vs when they were absent. We agree that this is unlikely to be clinically significant. The authors provided substantial ED data, acknowledged the absence of visit-level data, but omitted what the students actually did during their clerships. They stated “… students were assigned approximately nine 8- to-12-hour shifts over 3 weeks, during which they were expected to evaluate and follow-up several patients presenting to the ED.” EnglishThe setting of Drs McGettigan and McKendree’s study evaluating the association between the presence of students and outcomes was a rehabilitation unit,1 which is a very different setting from the EDs of our study. The ED comprises inherently dissimilar patient encounters requiring rapid evaluation, decision making, and intervention for undifferentiated acute complaints.