Alstonthomas5619

People experiencing homelessness (PEH) suffer higher burdens of chronic illnesses, have higher rates of emergency medicine (ED) use and hospitalization, and ultimately are at increased risk for premature death compared to housed counterparts. Structural racism contributes to a disproportionate burden of homelessness among people of color. PEH experience not only significant medical concerns but also complex social needs that need to be addressed concurrently for effective healing, issues that have been magnified by the COVID-19 pandemic. As health disparities and structural racism intersect among PEH, it is critically important to develop PEH-centered interventions to improve care and health outcomes as part of an effort to dismantle racism. One opportunity to address these disparities in care for PEH is through training ED physicians on methods for identifying and intervening on the unique needs of vulnerable patient groups. The Accreditation Council for Graduate Medical Education has outlined health quality pathways in the clinical learning environment to address health disparities. Community-based participatory research (CBPR) is particularly well suited for this scenario as it allows experiential learning for trainees to work with and understand a diverse group of stakeholders, to deepen their knowledge of local health disparities, and to lead research and measure outcomes of interventions to tackle health disparities. In this paper, we highlight the utility of CBPR in fostering experiential learning for EM residents on tackling health disparities and the importance of community collaboration in trainee-led interventions for comprehensive ED care.

It is essential to engage learners in efforts aimed at dismantling racism and other contributors to health care disparities. Barriers to their involvement include limited access to data. The objective of our study was to create a data dashboard using an existing quality improvement (QI) infrastructure and provide resident access to data to facilitate exploratory analysis on disparities in emergency department (ED) patient care.

Focusing on patient populations that have previously been shown in the literature to suffer significant disparities in the ED, we extracted outcomes across a variety of metrics already collected as part of routine ED operations. Using data visualization software, we developed an interactive dashboard for visual exploratory analyses.

We designed a dashboard for our resident learners with views that are flexible and allow user selected filters to view clinical outcomes by patient age, treatment area, and chief complaint. Learners were also allowed to select grouping and outcomes ofat is accessible to learners. Future directions include using these data to refine hypotheses on ED disparities, understand root causes, develop interventions, and measure their impact.

We set out to develop and implement a critical race theory (CRT) curriculum to address an identified gap in emergency medicine education. Sessions explored concepts of CRT and issues of racism as they relate to the clinical and extraclinical environments.

We developed a series of five virtual workshop sessions in 2019 that were held over Zoom in June and July 2020 in the setting of the COVID-19 pandemic. Eight learners completed the curriculum. Prior to each session, learners were provided presession materials including podcasts, recorded lectures, and readings. Thought-provoking questions were also provided with presession materials to facilitate discussion during sessions. Materials were curated to provide foundational knowledge on CRT and U.S. history as well as local history of the San Francisco Bay Area.

Participants found the curriculum useful, reported increased familiarity with CRT, and were more likely to have an analytic framework for topics of race and racism. Lithium Chloride purchase Participants also reported that rticipants to gather knowledge at their own pace prior to each session, which likely contributed to more active and in-depth participation.

Our aim was to conduct a large, case-based diversity, equity, and inclusion (DEI) simulation exercise with a goal to improve the DEI pillars of cultural and structural awareness for residents.

Utilizing data resulting in poor health outcomes, the top eight themes were utilized, and via a modified Delphi approach, a diverse group of faculty developed representative cases. A mass simulation effort was organized with the assistance of our local simulation office. Twenty residents in groups of two to three rotated through all scenarios. Each resident group was allotted 15min for each scenario. After each case, resident teams received feedback from standardized patients and a debrief together with the simulation directors. Pre- and postsimulation surveys were developed and distributed to residents.

Twenty residents completed the simulation. Eighteen completed a pre- and postsimulation survey. Every resident rated the overall usefulness of this activity as a 5.0 on a scale of 1 to 5 with 5 being the highest suirements while ensuring competency clinically. Mass simulation exercises are a way to incorporate this training. This preliminary data shows promise for a solution and can be easily duplicated. Diversity, health equity, inclusivity, and cultural humility can be effectively taught by an innovative mass simulation effort.

There is no clear unified definition of "county programs" in emergency medicine (EM). Key residency directories are varied in designation, despite it being one of the most important match factors for applicants. The Council of Residency Directors EM County Program Community of Practice consists of residency program leadership from a unified collective of programs that identify as "county." This paper's framework was spurred from numerous group discussions to better understand unifying themes that define county programs.

This institutional review board-exempt work provides qualitative descriptive results via a mixed-methods inquiry utilizing survey data and quantitative data from programs that self-designate as county.

Most respondents work, identify, and trained at a county program. The majority defined county programs by commitment to care for the underserved, funding from the city or state, low-resourced, and urban setting. Major qualitative themes included mission, clinical environment, research, trato medically underserved and vulnerable patients, an urban location with city or county funding, an ED with high patient volumes, supportive of resident autonomy, and research expertise focusing on underserved populations.Racism in medicine affects patients, trainees, and practitioners and contributes to health care inequities. An effective strategy to actively oppose the structural racism ingrained in the fabric of medicine is to intentionally and systematically address diversity, equity, and inclusion (DEI) in medical education and research. As part of ARMED MedEd, a new longitudinal cohort course in advanced research methods in medical education, sponsored by the Society for Academic Emergency Medicine, the leadership team deliberately included a nested DEI curriculum. The goal of the DEI curriculum is to reduce bias in development, recruitment, and implementation of education research studies to promote equity and inclusion in medical education, research, and ultimately, patient care. A team of medical educators with expertise in DEI developed curricular elements focusing on DEI in education research. The two major components are a didactic curriculum (including implicit bias training) to teach researchers to consider equity as they design studies and a consultative service to refine research protocols to address lingering unintended bias. A dedicated focus on DEI can be incorporated into an advanced education research methodology course to raise awareness and provide tools to avoid bias in research design and implementation of interventions. Over time, the network of education researchers who are trained in DEI awareness will grow and provide equitable offerings to their learners to mitigate health inequities.

Emergency medicine (EM) physicians must recognize emergent cutaneous disorders (CDs) in patients of all skin tones. In other medical specialties, images of CDs in light-skinned individuals (LSI) are published more frequently than images of CDs in dark-skinned individuals (DSI). This study aims to determine the representation of LSI versus DSI in images of emergent CDs published in top EM journals.

This is a cross-sectional analysis of CD images published from 2015 to 2020 in the six most influential EM journals as determined by Eigenfactor. The 2016Model of the Clinical Practice of Emergency Medicine (EM Model) by the American Board of Emergency Medicine was used to classify CDs as "emergent," "nonemergent," or "not listed." The Fitzpatrick skin tone scale was used to classify skin tone as light, dark, or indeterminate. Two blinded reviewers classified each image; for disagreements, a third blinded reviewer determined the final classification. Descriptive statistics and chi-square were used to analyze the of DSI in top EM journals.

Although the number of women entering medical school and emergency medicine (EM) residencies has increased, female physicians are still proportionally underrepresented in EM. The goal of this study was to determine if there was a relationship between resident gender and program leadership gender.

A survey of residency leadership and residents was completed, and multivariate factor analysis was performed.

It was found that 31% of program directors (PDs) were women, along with 42% of associate PDs, 48% of assistant PDs, 36% of residents, and 48% of chief residents. The strongest correlation between female residents and program leadership was between female residents and female assistant PDs (0.25). Female residents were also strongly correlated with female chief residents (0.40).

Although we cannot determine the direction of causation, moving forward, programs looking to increase their female resident cohort should consider focusing efforts around increasing representation at the program leadership and chief resident level.

Although we cannot determine the direction of causation, moving forward, programs looking to increase their female resident cohort should consider focusing efforts around increasing representation at the program leadership and chief resident level.

Emergency departments serve a wide variety of racial, ethnic, socioeconomic, and gender backgrounds. It is currently unknown what characteristics of students who express interest in emergency medicine (EM) are associated with a simultaneous desire to work in medically underserved areas. We hypothesize that those who are underrepresented in medicine, are female, learn another language, and have more student debt will be more likely to practice in a medically underserved area.

Data from the National Board of Medical Examiners, Association of American Medical Colleges (AAMC) Student Record System, and the AAMC Graduation Questionnaire were collected on a national cohort of 92,013 U.S. medical students who matriculated from 2007 through 2012. Extracted variables included planned practice area, intention to practice in underserved areas, race/ethnicity, sex, medical school experiences, age at matriculation, debt at graduation, and first-attempt USMLE Step 1score.

EM-intending students who identified as female, non-Hispanic Black/African American, or Latinx/Hispanic; had a larger debt at graduation; had experiences with health education in the community; had global health experience; and had learned more than one language were more likely to report an intention to practice in underserved areas.