With COVID-19 causing a rift in schedules and long-standing educational activities while restricting in person sessions that typically foster a sense of community, residencies were left to devise new ways to come together and continue on with education. The deeply engrained tradition of a morning case-based report led by senior residents was adapted to a virtual report in the evenings. While the format for presenting cases was similar, participation increased while helping build a further reaching community. This not only allowed for a 40-year-old tradition to continue to carry on through a pandemic, it gave a space for residents, alumni, and attendings to come together and rebuild a sense of normalcy and community to help bear through life altering events.

Introduction: Emergency Medicine (EM) residency programs may be 36 or 48 months in length. The Residency Review Committee for EM requires that 48-month programs provide educational justification for the incremental 12 months. We developed additional milestones that EM training programs might use to outcomes in domains that meet this accreditation requirement. This study aims to validate these supplemental milestones using a similar methodology to that of the original EM Milestones validation study.

Methods: A panel of EM program directors and content experts at two institutions identified domains of additional training not covered by the existing EM Milestones. This led to the development of 6 novel subcompetencies: Operations and Administration, Critical Care, Leadership and Management, Research, Teaching and Learning, and Career Development. Subject-matter experts at other 48-month EM residency programs refined the milestones for these subcompetencies. Program directors of all 48-month EM programs were then asked to order the proposed milestones using the Dreyfus model of skill acquisition for each subcompetency. Data analysis mirrored that used in the original EM Milestones validation study, leading to the final version of our supplemental milestones.

Results: Twenty of 33 subjects (58.8%) completed the study. No subcompetency or individual milestone met deletion criteria. Of the 97 proposed milestones, 67 (69.1%) required no further editing and remained at the same level as proposed by the study authors. Thirty milestones underwent level changes: 15 (15.5%) were moved one level up and 13 (13.4%) were moved one level down. One milestone (1.0%) in ‘Leadership and Management’ was moved two levels up, and one milestone in ‘Operations and Administration’ was moved two levels down. One milestone in ‘Research’ was ranked by the survey respondents at one level higher than that proposed by the authors, however this milestone was kept at its original level assignment.

Introduction: Burnout is a syndrome of depersonalization, emotional exhaustion and sense of low personal accomplishment. Emergency physicians (EPs) experience the highest levels of burnout among all physicians. Burnout is associated with greater rates of self-reported suboptimal care among surgeons and internists. The association between burnout and suboptimal care among EPs is unknown. The objective of the study was to evaluate burnout rates among attending and resident EPs and examine their relationship with self-reported patient care practices. 

Methods: In this cross-sectional study burnout was measured at two university-based emergency medicine residency programs with the Maslach Burnout Inventory. We also measured depression, quality of life (QOL) and career satisfaction using validated questionnaires. Six items assessed suboptimal care and the frequency with which they were performed.

Results: We included 77 out of 155 (49.7%) responses. The EP burnout rate was 57.1%, with no difference between attending and resident physicians. Residents were more likely to screen positive for depression (47.8% vs 18.5%, p=0.012) and report lower QOL scores (6.7 vs 7.4 out of 10, p=0.036) than attendings. Attendings and residents reported similar rates of career satisfaction (85.2% vs 87.0%, p=0.744). Burnout was associated with a positive screen for depression (38.6% vs 12.1%, p=0.011) and lower career satisfaction (77.3% vs 97.0%, p=0.02). EPs with high burnout were significantly more likely to report performing all six acts of suboptimal care.

Conclusion: A majority of EPs demonstrated high burnout. EP burnout was significantly associated with higher frequencies of self-reported suboptimal care. Future efforts to determine if provider burnout is associated with negative changes in actual patient care are necessary.

Introduction: The WestJEM Blog and Podcast Watch presents high-quality, open-accesseducational blogs and podcasts in emergency medicine (EM) based on the ongoing Academic Lifein EM (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional series. Both seriescritically appraise resources using an objective scoring rubric. This installment of the Blog andPodcast Watch highlights the topic of procedure emergencies from the AIR Series.

Methods: The AIR Series is a continuously building curriculum that follows the Council ofEmergency Medicine Residency Directors’ (CORD) annual testing schedule. For each module,relevant content is collected from the top 50 Social Media Index sites published within the previous12 months, and scored by eight AIR board members using five equally weighted measurementoutcomes: Best Evidence in Emergency Medicine (BEEM) score, accuracy, educational utility,evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIRlabel. Resources scoring 27-29 receive an “honorable mention” label if the executive board agreesthat the post is accurate and educationally valuable.

Results: A total of 85 blog posts and podcasts were evaluated in June 2016. This report summarizeskey educational pearls from the three AIR posts and the 10 Honorable Mentions.

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. Thisseries provides an expert-based, post-publication curation of educational social media content forEM clinicians, with this installment focusing on procedure emergencies within the AIR series.

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