Faculty Bibliography

INTRODUCTION: Team collaboration is an essential for success both within academics and the clinical environment. Often, team collaboration is not explicitly taught during medical school or even residency, and must be learned during one's early career. In this article, we aim to summarize five key papers about team collaboration for early career clinician educators. METHODS: We conducted a consensus-building process among the writing team to generate a list of key papers that describe the importance or significance of team collaboration, seeking input from social media sources. The authors then used a three-round voting methodology akin to a Delphi study to determine the most important papers from the initially generated list. RESULTS: The five most important papers on the topic of team collaboration, as determined by this mixed group of junior faculty members and faculty developers, are presented in this paper. For each included publication, a summary was provided along with its relevance to junior faculty members and faculty developers. CONCLUSION: Five key papers about team collaboration are presented in this publication. These papers provide a foundational background to help junior faculty members with collaborating in teams both clinically and academically. This list may also inform senior faculty and faculty developers about the needs of junior faculty members.

INTRODUCTION: The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing ALiEM Approved Instructional Resources (AIR) and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of neurologic emergencies from the AIR series. METHODS: The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Director's (CORD) annual testing schedule. For each module, relevant content is collected from the top 50 Social Media Index sites published within the previous 12 months, and scored by eight board members using five equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM) score, accuracy, educational utility, evidence based, and references. Resources scoring >/=30 out of 35 available points receive an AIR label. Resources scoring 27-29 receive an honorable mention label, if the executive board agrees that the post is accurate and educationally valuable. RESULTS: A total of 125 blog posts and podcasts were evaluated. Key educational pearls from the 14 AIR posts are summarized, and the 20 honorable mentions are listed. CONCLUSION: The WestJEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. This series provides an expert-based, post-publication curation of educational social media content for EM clinicians with this installment focusing on neurologic emergencies.

Background Emergency medicine (EM) residency programs can provide up to 20% of their planned didactic experiences asynchronously through the Individualized Interactive Instruction (III) initiative. Although blogs and podcasts provide potential material for III content, programs often struggle with identifying quality online content. Objective To develop and implement a process to curate quality EM content on blogs and podcasts for resident education and III credit. Methods We developed the Approved Instructional Resources (AIR) Series on the Academic Life in Emergency Medicine website. Monthly, an editorial board identifies, peer reviews, and writes assessment questions for high-quality blog/podcast content. Eight educators rate each post using a standardized scoring instrument. Posts scoring >/= 30 of 35 points are awarded an AIR badge and featured in the series. Enrolled residents can complete an assessment quiz for III credit. After 12 months of implementation, we report on program feasibility, enrollment rate, web analytics, and resident satisfaction scores. Results As of June 2015, 65 EM residency programs are enrolled in the AIR Series, and 2140 AIR quizzes have been completed. A total of 96% (2064 of 2140) of participants agree or strongly agree that the activity would improve their clinical competency, 98% (2098 of 2140) plan to use the AIR Series for III credit, and 97% (2077 of 2140) plan to use it again in the future. Conclusions The AIR Series is a national asynchronous EM curriculum featuring quality blogs and podcasts. It uses a national expert panel and novel scoring instrument to peer review web-based educational resources.

BACKGROUND: Despite the fact that topical anesthetics provide superb analgesia to the painful eye, they are not prescribed routinely to patients when they are discharged from the emergency department because of concerns for delayed healing and corneal erosion. OBJECTIVE: To summarize the evidence for the safety of topical proparacaine and tetracaine for pain relief in patients with corneal abrasions. METHODS: This is a systematic review looking at the use of topical anesthetic agents in the treatment of corneal abrasions in the emergency department. RESULTS: Our literature search produced two emergency department-based, randomized, double blind, placebo-controlled studies on human patients with corneal abrasions. Additionally, we found four studies that investigated the application of topical anesthetics in patients who underwent photorefractive keratectomy. All six studies demonstrated that a short course of dilute topical anesthetic provided efficacious analgesia without adverse effects or delayed epithelial healing. CONCLUSION: Limited available data suggests that the use of dilute topical ophthalmologic proparacaine or tetracaine for a short duration of time is effective, though their safety for outpatient use is inconclusive.

Background. Computerized electrocardiogram (ECG) analysis has been of tremendous help for noncardiologists, but can we rely on it? The importance of ST depression and T wave inversions in lead aVL has not been emphasized and not well recognized across all specialties. Objective. This study's goal was to analyze if there is a discrepancy of interpretation by physicians from different specialties and a computer-generated ECG reading in regard to a TWI in lead aVL. Methods. In this multidisciplinary prospective study, a single ECG with isolated TWI in lead aVL that was interpreted by the computer as normal was given to all participants to interpret in writing. The readings by all physicians were compared by level of education and by specialty to one another and to the computer interpretation. Results. A total of 191 physicians participated in the study. Of the 191 physicians 48 (25.1%) identified and 143 (74.9%) did not identify the isolated TWI in lead aVL. Conclusion. Our study demonstrated that 74.9% did not recognize the abnormality. New and subtle ECG findings should be emphasized in their training so as not to miss significant findings that could cause morbidity and mortality.

Background: High-fidelity simulation is widely used in medical education. Currently, there are no universally accepted metrics for evaluation of simulation case performance. Objectives: To test each of three evaluation metrics for assessment of EM resident performance on each of six advanced cardiac life support (ACLS) simulation cases. A secondary objective is to compare case performance between PGY-1 and PGY-3 EM residents at two separate institutions. Methods: Six ACLS-based high-fidelity simulation cases and the associated critical actions were developed by a group of EM faculty from multiple institutions and piloted by 35 residents (18=PGY-1 and 17=PGY-3) at two institutions. The cases were presented to each resident in random order and the sessions were videotaped. Two faculty reviewers independently scored the performance of the residents at each institution. All cases were scored by each of three metrics: 1) total number of critical actions achieved; 2) time to each critical action; and 3) a previously validated clinical performance evaluation (CPE) score. Statistical methods included descriptive statistics, Wilcoxon rank sum tests, and repeated measures analyses of variance using generalized estimating equations. A Spearman correlation coefficient (SCC) was calculated to assess reviewer agreement for the paired reviewers at each institution. Results: The overall CPE scores were significantly different between learner levels (p=0.0001), with no difference between institutions (p=0.1) [PGY-1 CPE scores of 5.62 (institution A), 5.72 (institution B); PGY-3 scores of 7.15 (A) and 6.38 (B)]. For all of the cases, the mean proportion of critical actions did not differ between learner levels (p=0.32), yet there was a difference between institutions (p=0.0001) [PGY-1 critical action scores of 0.85 (institution A), 0.94 (institution B); PGY-3 scores of 0.87 (A) and 0.91 (B)]. For the time to critical action, there was no significant difference for the majority of the critical actions, either bet!