This is a collaboration between the editors of Academic Emergency Medicine and the Brown University Emergency Medicine Residency Program. Each podcast offers a pre-publication look at a chosen article, with an interview with its corresponding author. Visit www.brownemblog.com (AEM Early Access section) to find the links to each article and other related educational materials.
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AEM Early Access 82: Correlation of vital sign centiles with in-hospital outcomes among adults encountered by emergency medical services
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In this study, the authors first sought to empirically derive centiles for heart rate (HR), respiratory rate (RR), and systolic blood pressure (SBP) for adults with out-of-hospital emergencies who were transported to an ED. Second, they aimed to evaluate the impact of adjusting for age in the evaluation of centile curves for vital signs to identify…
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AEM Early Access 81:Initial Treatment of Uninsured Patients with ST-Elevation Myocardial Infarction by Facility PCI Capabilities
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Timely reperfusion is necessary to reduce morbidity and mortality in patients with ST-elevation myocardial infarction (STEMI). Initial care by facilities with percutaneous coronary intervention (PCI) capabilities reduces time to reperfusion. The authors sought to examine whether insurance status was associated with initial care at EDs with PCI capa…
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AEM Education and Training 54: Our responsibility to patients: Maintain competency or stop practicing
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Dr. Sally Santen and Dr. Martin Pusic discuss their team's new commentary and perspective piece in AEM Education and Training entitled, "Our responsibility to patients: Maintain competency or ... stop practicing."By Gita Pensa MD
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AEM Education and Training 53: Brain versus bot: Distinguishing letters of recommendation authored by humans compared with artificial intelligence
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The use of generative artificial intelligence (AI) tools, such as ChatGPT, are gaining popularity for a variety of academic writing tasks and offer an innovative solution to relieve the burden of letter writing. The authors conducted a study aimed at determining whether academic physicians can distinguish between AI and human-generated letters of r…
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AEM Early Access 80: The differences in code status conversation approaches reported by emergency medicine and palliative care clinicians: a mixed method study
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Conversations about code status in seriously ill patients at end of life is unfortunately a frequent event in the emergency department. Today we are discussing a paper in AEM entitled The differences in code status conversation approaches reported by emergency medicine and palliative care clinicians: a mixed method study. Lead author Dr. Kei Ouchi …
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AEM Early Access 79: A Qualitative Analysis of Patients’ Experiences with an ED Diagnosis of GI Cancer
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We discuss this new article, A Qualitative Analysis of Patients’ Experiences with an ED Diagnosis of GI Cancer, with senior author Dr. Haejin In.
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AEM Education and Training 52: Making decisions “in the dark”: Learning through uncertainty in clinical practice during Covid-19
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Today we are speaking to senior author Dr. Dmitri Papanagnou about his team’s new paper in AEM Education and Training entitled Making decisions “in the dark”: Learning through uncertainty in clinical practice during Covid-19.
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AEM Early Access 78: Association of Limited English Proficiency with Emergency Department Irregular Departures and Return Visits: A Cross-sectional Cohort Study in the Upper Midwest Between January 2018 ...
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Patients with (LEP) have been shown to experience disparities in (ED) care. The objectives of this study were to examine the LEP and irregular ED departures and return ED visits. We interview senior author Dr. Derick Jones about this new AEM paper.By Gita Pensa MD
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AEM Early Access 79: Emergency medicine physician workforce attrition differences by age and gender
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Emergency care workforce concerns have gained national prominence given recent data suggesting higher than previously estimated attrition. With little known regarding characteristics of physicians leaving the workforce, this paper sought to investigate the age and number of years since residency graduation at which male and female EM physicians exh…
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AEM Education and Training 51: Perspectives on preparedness for pediatric emergencies after residency: A needs assessment
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General emergency physicians provide most pediatric emergency care in the United States yet report more challenges managing emergencies in children than adults. Recommendations for standardized pediatric emergency medicine (PEM) curricula to address educational gaps due to variations in pediatric exposure during emergency medicine (EM) training lac…
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AEM Education and Training 50: I'd Rather See Action: “I’d rather see action”: Application and recruitment experiences of underrepresented in emergency medicine trainees
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Dr. Pensa interviews author Dr. Michelle Suh about her teams recent E&T publication, “I’d rather see action”: Application and recruitment experiences of underrepresented in emergency medicine trainees."By Gita Pensa MD
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AEM Early Access 77: Survival by Time-to-Administration of Amiodarone, Lidocaine, or Placebo in Shock- Refractory Out-of-Hospital Cardiac Arrest
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Amiodarone and lidocaine have not been shown to have a clear survival benefit compared to placebo for out-of-hospital cardiac arrest (OHCA). However, randomized trials may have been impacted by delayed administration of the study drugs. Today we’re talking with Dr. Joshua Lupton, first author on a new AEM paper entitled “ Survival by Time-to-Admini…
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AEM Early Access 76: Disparities in Emergency Department and Urgent Care Opioid Prescribing Before and After Randomized Clinician Feedback Interventions
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Demographic differences in opioid prescribing by patient race and ethnicity have been widely reported; Black and Hispanic patients receive lower rates and dosages of opioid prescriptions for the same conditions and reported pain level as white patients. At the same time, higher dosage opioid prescriptions have been associated with higher rates of n…
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AEM Early Access 75: Equity-Relevant Sociodemographic Variable Collection in Emergency Medicine: A Systematic Review, Qualitative Evidence Synthesis & Recommendations for Practice
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We speak with lead author Dr. Murdoc Leeies about his team's new AEM paper, "Equity-Relevant Sociodemographic Variable Collection in Emergency Medicine: A Systematic Review, Qualitative Evidence Synthesis & Recommendations for Practice."By Gita Pensa MD
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AEM Early Access 74: Head Computed Tomography Findings in Geriatric Emergency Department Patients with Delirium, Altered Mental Status, and Confusion: A Systematic Review
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Delirium, altered mental status or confusion among older adults are common presentations to the emergency department (ED). We discuss this new AEM paper with author Dr. Shan Liu, whose team aimed to report the proportion of older ED patients presenting with delirium who have acute abnormal findings on head imaging. We also assessed whether anticoag…
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AEM Early Access 73: Dizziness as a Missed Symptom of Central Nervous System Pathology: A Review of Malpractice Cases
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Dr. Pensa and author Summer Ghaith discuss her team's new research in AEM entitled "Dizziness as a Missed Symptom of Central Nervous System Pathology: A Review of Malpractice Cases."By Gita Pensa MD
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AEM Education and Training 49: Development of a lecture evaluation tool rooted in cognitive load theory: A modified Delphi study
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Dr. Jaime Jordan joins the podcast to discuss her team's new AEM Education and Training paper, "Development of a lecture evaluation tool rooted in cognitive load theory: A modified Delphi study."By Gita Pensa, MD
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AEM Education and Training 48: Impact and effectiveness of a mandatory competency-based simulation program for pediatric emergency medicine faculty
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Dr. Jonathan Pirie discusses his recent AEM Education and Training paper, "Impact and effectiveness of a mandatory competency-based simulation program for pediatric emergency medicine faculty."By Gita Pensa MD
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AEM Early Access 72: The Effect of Telemental versus In-person Mental Health Consults in the Emergency Department on 30-day Utilization and Processes of Care
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Dr. Jin Han joins the podcast to discuss his recent paper in AEM on telemental health care in the VA system.By Gita Pensa MD
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AEM Early Access 71: Accuracy of “TICS” Ultrasound Protocol in Detecting Simple and Complicated Diverticulitis
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Paper abstract: Point-of-care ultrasound (US) has been suggested as the primary imaging in evaluating patients with suspected diverticulitis. Discrimination between simple and complicated diverticulitis may help to expedite emergent surgical consults and determine the risk of complications. This study aimed to: (1) determine the accuracy of an US p…
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AEM Education and Training 47: Creating Master Adaptive Learners During Emergency Medicine Clerkships
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The Master Adaptive Learner (MAL) model was developed as an educational framework that teaches learners how to develop adaptive expertise. Dr. Guy Carmelli discusses his recent paper in AEM Education and Training on adapting the EM clerkship to create master adaptive learners.By Gita Pensa MD
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AEM Education and Training 46: “Faces on a Screen”: A Qualitative Study of the Virtual and In-Person Conference Experience
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The strengths and weaknesses of virtual and in-person formats within continuing professional development (CPD) are incompletely understood. This study sought to explore attendees’ perspectives across multiple specialties regarding benefits and limitations of conference formats, and strategies for successful virtual and hybrid (i.e., in-person confe…
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AEM Early Access 70: Cocaethylene Cardiotoxicity in Emergency Department Patients with Acute Drug Overdose
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Cocaine use results in over 500,000 emergency department (ED) visits annually across the U.S. and ethanol co-ingestion is reported in 34% of these. Commingling cocaine with ethanol results in the metabolite cocaethylene (CE), which is metabolically active for longer than cocaine alone. Current literature on the cardiotoxicity of CE compared to coca…
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AEM Early Access 69: Utility of Head Computed Tomography for Older Adults with Suspected Delirium in the Emergency Department. A Retrospective Observational Study
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Dr. Pensa interviews Dr. Brittany Ellis about a new paper in AEM Journal.By Gita Pensa MD
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AEM Early Access 68: Post-Roe Emergency Medicine: Policy, clinical, training, and individual implications for emergency clinicians
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Dr. Pensa interviews Dr. Margaret Samuels-Kalow about her new paper in AEM, "Post-Roe Emergency Medicine: Policy, clinical, training, and individual implications for emergency clinicians."By Gita Pensa MD
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AEM Education and Training 45: A Consensus List of Ultrasound Competencies for Graduating Emergency Medicine Residents
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Dr. Pensa discusses the new paper "A Consensus List of Ultrasound Competencies for Graduating Emergency Medicine Residents" with lead author Dr. David Haidar.By Gita Pensa MD
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AEM Education and Training 44: Bridging the Gap: Development of an Experiential Learning- Based Health Disparities Curriculum
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Dr. Pensa speaks to Dr. Holly Caretta-Weyer about her new AEM Education and Training Journal paper, "Bridging the Gap: Development of an Experiential Learning- Based Health Disparities Curriculum."By Gita Pensa MD
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AEM Early Access 67: Increased Identification of Cannabis Users Drivers Involved in Motor Vehicle Collisions Using an Expanded Cannabis Inventory
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We discuss the new AEM article, "Increased Identification of Cannabis Users Drivers Involved in Motor Vehicle Collisions Using an Expanded Cannabis Inventory" with author Dr. Esther Choo.By Gita Pensa MD
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AEM Education and Training 43: Differences in Faculty Feedback for High, Expected, and Below-Expected Clinically Performing Emergency Medicine Residents
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Author Dr. Coughlin and Dr. Pensa discuss his team's AEM Education and Training article, "Differences in Faculty Feedback for High, Expected, and Below-Expected Clinically Performing Emergency Medicine Residents."By Gita Pensa MD
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AEM Early Access 66: Restrictive Fluids Versus Standard Care in Adults with Sepsis in the Emergency Department (REFACED) – a Multicenter, Randomized Feasibility Trial
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We speak to first author Dr. Marie Jessen about a new paper in AEM entitled "Restrictive Fluids Versus Standard Care in Adults with Sepsis in the Emergency Department (REFACED) – a Multicenter, Randomized Feasibility Trial."
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AEM Education and Training 42: Coaching models, theories, and structures: an overview for teaching faculty in the emergency department and educators in the offices
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We discuss a new article in AEM Education and Training called “Coaching models, theories, and structures: an overview for teaching faculty in the emergency department and educators in the offices” with lead author Dr. Nicole Deiorio.
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AEM Early Access 65: Physician Gestalt for Emergency Department Triage: A Prospective Videotaped Study
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Appropriate triage of patients in the ED is sometimes challenging, and today we’re discussing a new article in AEM entitled “Physician Gestalt for Emergency Department Triage: A Prospective Videotaped Study.” This paper from an academic ED in Taiwan compared physician gestalt versus the Taiwan Triage and Acuity Scale (TTAS), which is standard compu…
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AEM Education and Training 41: Hopes and Fears: A Qualitative Analysis of the Intern Perspective at the Start of EM Residency
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Dr. Korie Zink discusses this new qualitative study in AEM Education and Training on fears and hopes at the start of EM orientation.
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AEM Early Access 64: Epidemiology and Management of Abdominal Injuries in Children
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Although more guideline-adherent care has been described in pediatric compared to adult trauma centers, we aimed to provide a more detailed characterization of management and resource utilization of children with intra-abdominal injury (IAI) within pediatric centers. Our primary objective was to describe the epidemiology, diagnostic evaluation, and…
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AEM Education and Training 40: Does direct observation influence the quality of workplace- based assessment documentation?
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Competency-based medical education (CBME) is a topic we have discussed often on this podcast series, and today we are discussing a critical part of it; direct observation of trainees. But as most of us know, direct observation also has its challenges in a busy ED. Today we’re discussing a new paper in AEM Education and Training entitled "Does direc…
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AEM Early Access 63: Can RV assessments improve triaging of low risk pulmonary embolism?
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We talk to Dr. Jaron Raper about a new article in AEM entitled "Can right ventricular assessments improve triaging of low risk pulmonary embolism?"By Gita Pensa MD
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AEM Early Access 62: Racial differences in low-value pediatric emergency care in general emergency departments
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We discuss this paper with first author Dr Joyce Li. They sought to evaluate racial and ethnic differences in pediatric patients across a broad range of low-value imaging studies in the general ED setting.
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AEM Education and Training 39: Implementation of a Pilot Novel Objective Peer comparison evaluation system in an emergency medicine residency program
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Most emergency medicine educators are familiar with the Milestones, the current evaluation system for emergency medicine residents, and these have been shown to be imperfect and highly subjective. Ath the same time, EM residents need to achieve competency in patient safety and quality improvement processes, Today we’re talking about a recent paper …
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AEM Education and Training 38: “The Content Expert Program: A Structured Approach to Increase Emergency Medicine Resident Scholarly Activity
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The ACGME requires residents to participate in scholarship, and programs are required to provide an environment conducive to the production of scholarship and acquiring the necessary skills involved. Today we are talking to Dr Kraftin Schreyer about a recent paper in AEM Education and Training entitled “The Content Expert Program: A Structured Appr…
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AEM Early Access 61: Predictive accuracy of adding shock index to the American College of Surgeons’ minimum criteria for full trauma team activation
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The American College of Surgeons requires trauma centers to use six minimum criteria (ACS-6) for full trauma team activation: hypotension, gunshot wound to the neck or torso, Glasgow Coma Scale (GCS) score < 9, respiratory compromise, transfers receiving blood transfusion, or physician discretion. Our goal was to evaluate the effect of adding varyi…
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AEM Education and Training 37: Qualitative description of sexual harassment and discrimination of women in emergency medicine: Giving the numbers a voice
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Gender disparities in medicine are well documented; however, little qualitative data exist. This study sought to provide a qualitative assessment of harassment and discrimination experienced by female physicians in emergency medicine (EM) specifically by colleagues or supervisors.
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AEM Education and Training 36: The Journal Club 3.0: A qualitative, multisite study examining a new educational paradigm in the era of open educational resources
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The journal club is a ubiquitous and time-honored tradition within medical education. However, in recent years, open educational resources (OERs) have become increasingly influential in how physicians interact with the medical literature across multiple specialties. The authors sought to explore how emergency medicine (EM) resident physicians recon…
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AEM Early Access 60: Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS)
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Tracheal intubation (TI) practice across pediatric emergency departments (EDs) has not been comprehensively reported. We aim to describe TI practice and outcomes in pediatric EDs in contrast to those in intensive are units (ICUs) and use the data to identify quality improvement targets.By Gita Pensa MD
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AEM Early Access 59: Patient values and preferences in pulmonary embolism testing in the emergency department
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Patient-centered care is concordant with patient values and preferences. There is a lack of research on patient values and preferences for pulmonary embolism (PE) testing in the emergency department (ED), and a poor physician understanding of patient-specific goals. Our aim was to map patient-specific values, preferences, and expectations regarding…
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AEM Early Access 58: Ketamine administration for acute painful sickle cell crisis: A randomized controlled trial
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The objective was to evaluate the efficacy and safety of single-dose ketamine infusion in adults with sickle cell disease (SCD) who presented with acute sickle vasoocclusive crisis (VOC).By Gita Pensa MD
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AEM Education and Training 35: Moving beyond personal factors: A national study of wellness interventions in emergency medicine residency programs
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In 2017, the Accreditation Council for Graduate Medical Education (ACGME) revised its Common Program Requirements to support trainees and faculty by mandating programs to provide dedicated wellness resources and education. Emergency medicine may benefit from this change due to high burnout rates within the specialty. However, the current state of w…
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AEM Education and Training 34: Factors influencing emergency medicine residency choice: diversity, community, and recruitment red flags
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Prior studies have demonstrated that EM applicants consider geography as well as modifiable/non- modifiable program factors. Less attention, however, has been paid to underrepresented groups. Additionally, the prevalence and characteristics of “red flags,” or factors that may lead an applicant to lower a program’s rank or not rank it at all, remain…
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AEM Early Access 57: Cerebrovascular Disease Hospitalizations following Emergency Department Headache Visits: A Nested Case-Control Study
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Delayed diagnosis of cerebrovascular disease (CVD) among patients can result in substantial harm. If diagnostic process failures can be identified at emergency department (ED) visits that precede CVD hospitalization, interventions to improve diagnostic accuracy can be developed.By Gita Pensa MD
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AEM Early Access 56: Histories of trauma: A qualitative analysis of lifetime traumatic experiences among emergency department patients
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Emergency medicine clinicians are excellent at identifying and treating physical trauma as a chief complaint, but are often unaware of patients’ previous experiences of trauma. The purpose of this study was to describe emergency department (ED) patients’ lifetime experiences of trauma.By Gita Pensa MD
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AEM Early Access 55: A randomized controlled trial of ibuprofen versus ketorolac versus diclofenac for acute, nonradicular low back pain
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Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line medication for acute low back pain (LBP). It is unclear if the choice of NSAID impacts outcomes. We compared ibuprofen, ketorolac, and diclofenac for the treatment of acute, nonradicular LBP.By Gita Pensa MD
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