Academic Emergency Medicine Faculty Research Articles

A Double-Edged Sword: A Qualitative Study of the Minority Tax in Academic Emergency Medicine Faculty

A Double-Edged Sword: A Qualitative Study of the Minority Tax in Academic Emergency Medicine Faculty

Trends in Racial and Gender Profiles of United States Academic Emergency Medicine Faculty: Cross-Sectional Survey From 2007 to 2018

Background: Numerous studies have reported existing disparities in academic medicine. The purpose of this study was to assess racial and gender disparity in academic emergency medicine (EM) faculty positions across the United States from 2007 to 2018. Objective: The primary objective was to identify the racial and ethnic and gender distributions across academic ranks in EM. The secondary objective was to describe the racial and gender proportions across different tenure tracks and degrees. Methods: We conducted a retrospective analysis using data from the Association of American Medical Colleges. Simple descriptive statistics and time series analysis were employed to assess the trends and relationship between race and gender across academic rank, type of degree, and tenure status. Results: When averaged, 75% of all faculty members were White physicians and 67.5% were male. Asian faculty members showed an increased representation in the lower academic ranks and underrepresented minority groups demonstrated a small increase. Asian faculty members demonstrated a significantly increasing trend at the level of instructor (t = 0.02; p = 0.034; 95% CI 0.05–1.03). Female faculty members showed a significantly decreasing trend over the study period (t = –0.01; p < 0.001; 95% CI 0.68–0.75). White academic physicians and male faculty members made up most of all degree types and tenure categories. Conclusions: Despite an increase in proportional representation, the underrepresentation of female faculty members and those from minority groups persists in emergency medicine. Further studies are needed to identify and address the root causes of these differences.

216 Impact of Proposed Core Faculty Protected Time Requirements: National Survey of Emergency Medicine Faculty on Work Hours and Associated Job Satisfaction

216 Impact of Proposed Core Faculty Protected Time Requirements: National Survey of Emergency Medicine Faculty on Work Hours and Associated Job Satisfaction

Three decades of demographic trends among academic emergency physicians.

PurposeTo describe trends in emergency medicine faculty demographics, examining changes in the proportion of historically underrepresented groups including female, Black, and Latinx faculty over time.MethodsData from the Association of American Medical Colleges faculty roster (1990–2020) were used to assess the changing demographics of full‐time emergency medicine faculty. Descriptive statistics, graphic visualizations, and logistic regression modeling were used to illustrate trends in the proportion of female, Black, and Latinx faculty. Odds ratios (OR) were used to describe the estimated annual rate of change of underrepresented demographic groups.ResultsThe number of full‐time emergency medicine faculty increased from 214 in 1990 to 5874 in 2020. Female emergency medicine faculty demonstrated increases in representation overall, from 35 (16.36%) in 1990 to 2247 (38.25%) in 2020, suggesting a 3% estimated annual rate of increase (OR 1.03, 95% CI 1.03–1.04) and within each academic rank. A very small positive trend was noted among Latinx faculty (n = 3, 1.40% in 1990 to n = 326, 5.55% in 2020; OR 1.01, 95% CI 1.01–1.02), whereas an even smaller, statistically insignificant increase was observed among Black emergency medicine faculty during the 31‐year study period (N = 9, 4.21% in 1990 and N = 266, 4.53% in 2020; OR 1.00, 95% CI 0.99–1.00).ConclusionsAlthough female physicians have progressed toward equitable representation among academic emergency medicine faculty, no meaningful progress has been made toward racial parity. The persistent underrepresentation of Black and Latinx physicians in the academic emergency medicine workforce underscores the need for urgent structural changes to address contemporary manifestations of racism in academic medicine and beyond.

How we compare: Society for Academic Emergency Medicine faculty membership demographics.

The Society for Academic Emergency Medicine (SAEM) has a core value to promote a diverse workforce for patients, providers, and learners. Understanding the organization's membership demographics and how that compares to the academic emergency medicine (EM) workforce is prerequisite to the success of this core value. We obtained 2020 faculty membership data sets from the Association of American Medical Colleges (AAMC) and SAEM; data included self-reported sex, race and ethnicity, and academic rank (professor, associate professor, assistant professor, and instructor). We employed standardized mean difference (SMD) to quantify difference in proportions between data sets. We identified 5874 (AAMC) and 2785 (SAEM) faculty. The AAMC (38.3%) and the SAEM (41.3%) had similar proportions of overall female faculty (SMD 0.063) although SAEM (compared to AAMC) had a higher proportion of female full (25.5% vs. 20.5%, SMD 0.121) and assistant (46.5% vs. 41.2%, SMD 0.106) professors. With the exception of Hispanic instructors, SAEM (compared to AAMC) also had higher proportions of Black and Hispanic female faculty at all ranks (SMD ranging from 0.109 to 0.777). SAEM faculty demographics generally reflect that of the academic EM workforce demographics reported in the AAMC database and that overall, the proportions of female, Black, and Hispanic faculty in SAEM are slightly larger than those in the AAMC database. However, faculty who identify as Black or Hispanic in both the AAMC and the SAEM databases (compared to the overall U.S. population) are dramatically underrepresented.

Meeting expectations: An exploration of academic emergency medicine faculty experiences and preferences in the virtual meeting environment by age, gender and parental status.

During the COVID-19 pandemic, virtual meetings became the norm in academic emergency medicine (EM) departments. This study explores the experiences of academic EM faculty within this environment. In 2021, authors surveyed a cross-sectional convenience sample of EM faculty using a mixed-methods approach to explore perceptions of the virtual meeting environment. Authors reported data on a five-point Likert scale, summarized as percentages, and calculated differences using Pearson's chi-squared test, where p<0.05 was significant. Free text responses were analyzed qualitatively. Two-hundred-fifty-nine responses were collected, (female [55.6%], ≤40years old, [39.8%]) of which 33.2% had children ≤7years old. Most respondents felt the total number of virtual meetings had increased and were more likely to happen outside of regular business hours compared to in-person meetings. Most faculty preferred meetings during regular hours and liked the virtual format overall. Younger faculty respondents were more polarized in their preferences of timing of meetings and reported more pressure to accept meetings outside of regular hours. Female respondents with young children were more likely to dislike meetings outside regular hours and to have declined them. Women faculty, younger faculty, and women faculty with young children were significantly more likely to agree that women had been "more impacted by the new virtual work environment." Qualitative themes highlighting the flexibility provided by the virtual work environment and decreased commuting time, though many felt communication was limited in virtual meetings. Academic EM faculty mostly preferred keeping meetings during regular business hours and in a virtual format. Experiences varied by age but not by gender overall. Women with young children reported greater challenges than women without. Men did not differ by parental status. The virtual format provided increased flexibility but limited communication and engagement. Academic EM departments may use this data to inform future meeting practices.

Peer coaching increases emergency medicine faculty ability to perform and teach awake fiberoptic intubation.

This study sought to evaluate the impact of peer coaching as a continuing medical education (CME) modality to improve faculty performance and teaching of a low-frequency, high-complexity procedure, awake fiberoptic intubation (AFOI). Academic emergency medicine faculty at a single tertiary care, Level I trauma center participated in a prospective pre-/postinterventional assessment of a peer coaching educational intervention. Participants completed a preintervention online survey to identify comfort and previous experience with performing and teaching AFOI. The participants reviewed presession materials and then completed a 25-min didactic session with a peer coach. Participants were then broken into dyads where they initially each practiced the procedure and then attempted to teach the procedure to their colleague. An institutional standardized checklist for AFOI was utilized to assess participants procedural competency. Postintervention online surveys were compared to the preintervention surveys. A total of 15 faculty members were recruited for the study andcompleted pre- and postintervention surveys. All participants showed ability to perform AFOI as proven by successful completion of the procedural checklist. There was a statistically significant increase for self-perceived efficacy in performing (p<0.001, 95% confidence interval [CI]=1.34 to 3.06) and teaching AFOI (p<0.001, 95% CI=1.56 to 3.05). All participants felt more likely to attempt AFOI after a single peer coaching session and most (14/15, 93.3%) were more likely to teach AFOI. Participants identified peer coaching as more effective at instilling confidence to perform and teach the skill than other CME activities that they have experienced. This study demonstrates that peer coaching increases practicing faculty's ability to perform and teach a low-frequency, high-complexity procedure, AFOI. Peer coaching may offer an opportunity to improve the utility of learning compared to more traditional didactic-based CME initiatives.

Maintaining procedural skills for academic emergency medicine faculty: A needs assessment.

Emergency physicians require competence performing critical and routine procedures. The clinical practice of emergency medicine (EM) alone may be insufficient for the acquisition and maintenance of skills. Prior studies suggest the presence of trainees in academic settings and/or the low frequency of procedures increase the risk of skills attrition among faculty. We sought to develop a valid needs assessment survey to inform a faculty procedural skills (FPS) maintenance curriculum. A Web-based FPS survey was designed to assess experiences performing procedures, self-reported confidence with procedures, and learning preferences for skills maintenance. The survey was administered at a large academic department of EM. Responses were analyzed to determine survey construct validity, faculty attitudes about procedural attrition, and preferred learning methods. Among EM faculty, confidence was significantly higher for common versus uncommon procedures (p<0.001). EM faculty respondents reported significantly greater confidence than pediatric EM (PEM) faculty for both common adult procedures (EM mean=3.7 [±0.3], PEM=3.0 [±0.4], p<0.001), and uncommon adult procedures (EM=2.7 [±0.4], PEM=2.1 [±0.5], p<0.001). PEM faculty reported significantly greater confidence with pediatric procedures than EM faculty (PEM mean[±SD] =3.5 [±0.8], EM=2.2 [±0.8], p<0.001). Nearly all faculty (93% [52/56]) agreed that procedural attrition is a concerning problem, and 80% (44/56) had personally experienced it. The most preferred learning methods were task trainers and simulation. Faculty preferred learning environments with faculty peers (91%) over mixed groups with trainees (50%). Significant differences in procedural skills confidence between common and uncommon procedures, and between EM and PEM faculty, indicate that the FPS survey displayed appropriate construct validity. The finding that skills attrition is prevalent among EM and PEM faculty highlights the need for skill maintenance programming, preferably in peer groups employing task trainers and simulation.

Faculty Sim: Implementation of an Innovative, Simulation-based Continuing Professional Development Curriculum for Academic Emergency Physicians.

Maintaining and enhancing competence in the breadth of emergency medicine (EM) is an ongoing challenge. In particular, resuscitative care in EM involves high-risk clinical encounters that demand strong procedural skills, effective team leadership, and up-to-date clinical knowledge. Simulation-based medical education is an effective modality for enhancing technical and nontechnical skills in crisis situations and has been effectively embedded in undergraduate and postgraduate medical curricula worldwide. To our knowledge, there are few existing systematic department-wide simulation programs to address continuing professional development (CPD) for practicing academic EM faculty. We developed our novel, simulation-based CPD program following Kern's six-step model. Based on the results of a multimodal needs assessment, a longitudinal curriculum was mapped and tailored to the available resources. Institutional support was provided in the form of a departmental grant to fund a physician program lead, monthly session instructors, and operating costs. CPD simulation sessions commenced in January 2017. Our needs assessment identified two key types of educational needs: 1) crisis resource management skills and 2) frequent practice of high-stakes critical care procedures (e.g., surgical airways). Simulation sessions involve two high-fidelity simulated resuscitations and one skills lab per day. To date, 21 sessions have been delivered, reaching 161 practicing EPs. Feedback from our faculty has been positive. We have successfully introduced a curriculum of monthly simulation-based CPD based on the educational needs of our EPs. Future work will include more detailed program evaluation linked to clinical outcomes and program expansion to support nearby institutions.

Academic Emergency Medicine Faculty Experiences with Racial and Sexual Orientation Discrimination.

IntroductionDespite the increasing diversity of individuals entering medicine, physicians from racial and sexual minority groups continue to experience bias and discrimination in the workplace. The objective of this study was to determine the current experiences and perceptions of discrimination on the basis of race and sexual orientation among academic emergency medicine (EM) faculty.MethodsWe conducted a cross-sectional survey of a convenience sample of EM faculty across six programs. Survey items included the Overt Gender Discrimination at Work (OGDW) Scale adapted for race and sexual orientation, and the frequency and source of experienced and observed discrimination. Group comparisons were made using t-tests or chi-square analyses, and relationships between race or sexual orientation, and we evaluated physicians’ experiences using correlation analyses.ResultsA total of 141 out of 352 (40.1%) subjects completed at least a portion of the survey. Non-White physicians reported higher mean racial OGDW scores than their White counterparts (13.4 vs 8.6; 95% confidence interval (CI) for difference, −7.7 – −2.9). Non-White EM faculty were also more likely to report having experienced discriminatory treatment based on race than were White EM faculty (48.0% vs 12.6%; CI for difference, 16.6% – 54.2%), although both groups were equally likely to report having observed race-based discrimination of another physician. EM faculty who identified as sexual minorities reported higher mean sexual minority OGDW scores than their heterosexual counterparts (11.1 vs 7.1; 95% CI for difference, −7.3 – −0.6). There were no significant differences between sexual minority and heterosexual faculty in their reports of experiencing or observing discrimination based on sexual orientation.ConclusionEM faculty from racial and sexual minority groups perceived more discrimination based on race or sexual orientation in their workplace than their majority counterparts. EM faculty regardless of race or sexual orientation were similar in their observations of discriminatory treatment of another physician based on race or sexual orientation.

#MeToo in EM: A Multicenter Survey of Academic Emergency Medicine Faculty on Their Experiences with Gender Discrimination and Sexual Harassment.

IntroductionGender-based discrimination and sexual harassment of female physicians are well documented. The #MeToo movement has brought renewed attention to these problems. This study examined academic emergency physicians’ experiences with workplace gender discrimination and sexual harassment.MethodsWe conducted a cross-sectional survey of a convenience sample of emergency medicine (EM) faculty across six programs. Survey items included the following: the Overt Gender Discrimination at Work (OGDW) Scale; the frequency and source of experienced and observed discrimination; and whether subjects had encountered unwanted sexual behaviors by a work superior or colleague in their careers. For the latter question, we asked subjects to characterize the behaviors and whether those experiences had a negative effect on their self-confidence and career advancement. We made group comparisons using t-tests or chi-square analyses, and evaluated relationships between gender and physicians’ experiences using correlation analyses.ResultsA total of 141 out of 352 (40.1%) subjects completed at least a portion of the survey. Women reported higher mean OGDW scores than men (15.4 vs 10.2; 95% confidence interval [CI], 3.6–6.8). Female faculty were also more likely to report having experienced gender-based discriminatory treatment than male faculty (62.7% vs 12.5%; 95% CI, 35.1%–65.4%), although male and female faculty were equally likely to report having observed gender-based discriminatory treatment of another physician (64.7% vs 56.3%; 95% CI, 8.6%–25.5%). The three most frequent sources of experienced or observed gender-based discriminatory treatment were patients, consulting or admitting physicians, and nursing staff. The majority of women reported having encountered unwanted sexual behaviors in their careers, with a significantly greater proportion of women reporting them compared to men (52.9% vs 26.2%, 95% CI, 9.9%–43.4%). The majority of unwanted behaviors were sexist remarks and sexual advances. Of those respondents who encountered these unwanted behaviors, 22.9% and 12.5% reported at least somewhat negative effects on their self-confidence and career advancement.ConclusionFemale EM faculty perceived more gender-based discrimination in their workplaces than their male counterparts. The majority of female and approximately a quarter of male EM faculty encountered unwanted sexual behaviors in their careers.

Emergency Medicine Standardized Letter of Evaluation (SLOE): Findings From the New Electronic SLOE Format.

Emergency medicine (EM) uses a standardized template for residency application letters of recommendations. In 1997, the Standardized Letter of Recommendation was developed with categories for applicant comparison. Now named the Standardized Letter of Evaluation (SLOE), it is a universal requirement in the EM residency application process. In 2016, a website called "eSLOE" was launched for credentialed academic EM faculty to enter applicant data, which generates a SLOE. This article outlines website creation for the eSLOE and its successful national implementation in the 2016-2017 EM residency application cycle. We analyzed current trends in applicant assessments from the eSLOE data and compared them to prior data. Data from 2016-2017 were sorted and analyzed for each question on the eSLOE. An analysis of Global Assessment and Qualifications for EM rankings, clerkship grade, and comparison with prior SLOE data was performed. Analysis of 6715 eSLOEs for 3138 unique applicants revealed the following Global Assessment rankings: top 10%, top one-third, middle one-third, and lower one-third. There was less spread with the distribution for clerkship grade and Qualifications for EM. The 2011-2012 standard letter of recommendation global assessment data, with top 10%, top one-third, middle one-third, and lower one-third, also revealed top-clustered results with less spread compared with the ranking usage in 2016-2017. Results indicate an improved spread of all rank categories for Global Assessment, enhancing the eSLOE's applicant discrimination. There has been an overall improvement in rank designation when compared with previously published data.

Development of Hospice and Palliative Medicine Knowledge and Skills for Emergency Medicine Residents: Using the Accreditation Council for Graduate Medical Education Milestone Framework.

Emergency medicine (EM) physicians commonly care for patients with serious life-limiting illness. Hospice and palliative medicine (HPM) is a subspecialty pathway of EM. Although a subspecialty level of practice requires additional training, primary-level skills of HPM such as effective communication and symptom management are part of routine clinical care and expected of EM residents. However, unlike EM residency curricula in disciplines like trauma and ultrasound, there is no nationally defined HPM curriculum for EM resident training. An expert consensus group was convened with the aim of defining content areas and competencies for HPM primary-level practice in the ED setting. Our overall objective was to develop HPM milestones within a competency framework that is relevant to the practice of EM. The American College of Emergency Physicians Palliative Medicine Sectionassembled a committee that included academic EM faculty, community EM physicians, EM residents, and nurses, all with interest and expertise in curricular design and palliative medicine. The committee peer reviewed and assessed HPM content for validity and importance to EM residency training. A topic list was developed with three domains: provider skill set, clinical recognition of HPM needs, and logistic understanding related to HPM in the ED. The group also developed milestones in HPM-EM to identify relevant knowledge, skills, and behaviors using the framework modeled after the Accreditation Council for Graduate Medical Education (ACGME) EM milestones. This framework was chosen to make the product as user-friendly and familiar as possible to facilitate use by EM educators. Educators in EM residency programs now have access to HPM content areas and milestones relevant to EM practice that can be used for curriculum development in EM residency programs. The HPM-EM skills/competencies presented herein are structured in a familiar milestone framework that is modeled after the widely accepted ACGME EM milestones.

Current Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians.

A 2010 survey identified disparities in salaries by gender and underrepresented minorities (URM). With an increase in the emergency medicine (EM) workforce since, we aimed to 1) describe the current status of academic EM workforce by gender, race, and rank and 2) evaluate if disparities still exist in salary or rank by gender. Information on demographics, rank, clinical commitment, and base and total annual salary for full-time faculty members in U.S. academic emergency departments were collected in 2015 via the Academy of Administrators in Academic Emergency Medicine (AAAEM) Salary Survey. Multiple linear regression was used to compare salary by gender while controlling for confounders. Response rate was 47% (47/101), yielding data on 1,371 full-time faculty: 33% women, 78% white, 4% black, 5% Asian, 3% Asian Indian, 4% other, and 7% unknown race. Comparing white race to nonwhite, 62% versus 69% were instructor/assistant, 23% versus 20% were associate, and 15% versus 10% were full professors. Comparing women to men, 74% versus 59% were instructor/assistant, 19% versus 24% were associate, and 7% versus 17% were full professors. Of 113 chair/vice-chair positions, only 15% were women, and 18% were nonwhite. Women were more often fellowship trained (37% vs. 31%), less often core faculty (59% vs. 64%), with fewer administrative roles (47% vs. 57%; all p<0.05) but worked similar clinical hours (mean±SD= 1,069±371 hours vs. 1,051±393 hours). Mean overall salary was $278,631 (SD±$68,003). The mean (±SD) salary of women was $19,418 (±$3,736) less than men(p<0.001), even after adjusting for race, region, rank, years of experience, clinical hours, core faculty status, administrative roles, board certification, and fellowship training. In 2015, disparities in salary and rank persist among full-time U.S. academic EM faculty. There were gender and URM disparities in rank and leadership positions. Women earned less than men regardless of rank, clinical hours, or training. Future efforts should focus on evaluating salary data by race and developing systemwide practices to eliminate disparities.

Financial Implications of the Emergency Medicine Interview Process.

Emergency medicine (EM) residency interviews are an important, yet costly process for programs and applicants. The total economic burden of the EM interviewing process is previously unstudied. Graduate medical education funding and student finances are both fragile shifting sources, which appear to fund most of these economic expenditures. The total economic impact of the EM interview season is unknown. This study sought to calculate total dollars spent by EM residency programs and senior medical students (M4) during interview season. Potential solutions for reducing this burden will be outlined. Institutional review board-approved, piloted e-mail surveys were sent to accredited (Accreditation Council for Graduate Medical Education [ACGME] and American Osteopathic Association [AOA]) EM program directors (PDs) and M4 student members of EMRA. PDs were queried after the 2014-2015 interview season. PDs questions included demographics, estimated faculty, and resident and administrative time used, along with dollars spent during the 2014-2015 interview season. M4 questions included demographics and dollars spent during the 2015-2016 season. Results were reported using descriptive statistics. Financial data for EM programs were calculated with academic EM faculty, resident, and administrative assistant salaries along with reported hours used during the interview season. A total of 82 of 223 EM PDs completed the survey, reporting an mean annual cost of $210,649.04 per program to review, screen, and interview applicants based on time spent by faculty, resident, and administrative assistants. A total of 84.6% of EM program costs were due to faculty hours. A total of 180 of 1,425 EM-bound M4 students completed the survey, reporting a mean annual estimate of US$5,065.44 per student to apply and interview. Seventy-two percent of estimated costs were due to airfare and lodging. Loans and credit cards were the top two methods of payments of these interview costs by students. Extrapolating the cost of EM personnel with hours spent, the economic burden of an interview season for EM programs is approximately US$46,974,735.92. M4 students spent US$19,724,823.40 for application fees and interview-related expenses. Emergency medicine residency programs and applicants appear to spend over US$66 million per cycle on the interview process. EM residency programs may save resources by reducing faculty hours associated with the interview process and leveraging administrative and resident resources. Creation of regional or national fixed interview locations may also be appropriate. Applicants may reduce travel costs by participating in video interviews, reducing program applications, and attending regionalized interview days. A full conversation among all specialties and organized medicine needs to take place to reform the systems in place to reduce the economic burden on students and residency programs.

Implementation of an Education Value Unit (EVU) System to Recognize Faculty Contributions.

IntroductionFaculty educational contributions are hard to quantify, but in an era of limited resources it is essential to link funding with effort. The purpose of this study was to determine the feasibility of an educational value unit (EVU) system in an academic emergency department and to examine its effect on faculty behavior, particularly on conference attendance and completion of trainee evaluations.MethodsA taskforce representing education, research, and clinical missions was convened to develop a method of incentivizing productivity for an academic emergency medicine faculty. Domains of educational contributions were defined and assigned a value based on time expended. A 30-hour EVU threshold for achievement was aligned with departmental goals. Targets included educational presentations, completion of trainee evaluations and attendance at didactic conferences. We analyzed comparisons of performance during the year preceding and after implementation.ResultsFaculty (N=50) attended significantly more didactic conferences (22.7 hours v. 34.5 hours, p<0.005) and completed more trainee evaluations (5.9 v. 8.8 months, p<0.005). During the pre-implementation year, 84% (42/50) met the 30-hour threshold with 94% (47/50) meeting post-implementation (p=0.11). Mean total EVUs increased significantly (94.4 hours v. 109.8 hours, p=0.04) resulting from increased conference attendance and evaluation completion without a change in other categories.ConclusionIn a busy academic department there are many work allocation pressures. An EVU system integrated with an incentive structure to recognize faculty contributions increases the importance of educational responsibilities. We propose an EVU model that could be implemented and adjusted for differing departmental priorities at other academic departments.

The Relationship Between Response Time and Diagnostic Accuracy

Psychologists theorize that cognitive reasoning involves two distinct processes: System 1, which is rapid, unconscious, and contextual, and System 2, which is slow, logical, and rational. According to the literature, diagnostic errors arise primarily from System 1 reasoning, and therefore they are associated with rapid diagnosis. This study tested whether accuracy is associated with shorter or longer times to diagnosis. Immediately after the 2010 administration of the Medical Council of Canada Qualifying Examination (MCCQE) Part II at three test centers, the authors recruited participants, who read and diagnosed a series of 25 written cases of varying difficulty. The authors computed accuracy and response time (RT) for each case. Seventy-five Canadian medical graduates (of 95 potential participants) participated. The overall correlation between RT and accuracy was -0.54; accuracy, then, was strongly associated with more rapid RT. This negative relationship with RT held for 23 of 25 cases individually and overall when the authors controlled for participants' knowledge, as judged by their MCCQE Part I and II scores. For 19 of 25 cases, accuracy on each case was positively related to experience with that specific diagnosis. A participant's performance on the test overall was significantly correlated with his or her performance on both the MCCQE Part I and II. These results are inconsistent with clinical reasoning models that presume that System 1 reasoning is necessarily more error prone than System 2. These results suggest instead that rapid diagnosis is accurate and relates to other measures of competence.

Statement of Principles: APA-Industry Relationship

In recent months, the relationships between commercial enterprises and health professional associations have drawn a great deal of attention, 1 DeAngelis C.D. The influence of money on medical science. JAMA. 2006; (E1–3) Google Scholar , 2 DeAngelis C.D. Fontanarosa P.B. Ensuring integrity in industry-sponsored research: primum non nocere, revisited. JAMA. 2010; 303: 1196-1198 Crossref PubMed Scopus (43) Google Scholar , 3 Campbell E.G. Zinner D.E. Disclosing industry relationships—toward an improved federal research policy. N Engl J Med. 2010; 363: 604-606 Crossref PubMed Scopus (20) Google Scholar , 4 Institute of Medicine Committee on Conflict of Interest in Medical Research, Education, and Practice Lo B. Field M.J. Conflict of Interest in Medical Research, Education and Practice. National Academies Press, Washington, DC2009 Google Scholar , 5 Rothman D.J. McDonald W.J. Berkowitz C.D. et al. Professional medical associations and their relationship with industry: a proposal for controlling conflict of interest. JAMA. 2009; 301: 1367-1372 Crossref PubMed Scopus (255) Google Scholar , 6 Birkhahn R.H. Blomkalns A.L. Klausner H.A. et al. Academic emergency medicine faculty and industry relationships. Acad Emerg Med. 2008; 15: 819-824 Crossref PubMed Scopus (4) Google Scholar , 7 Camilleri M. Parke D.W. Perspective: conflict of interest and professional organizations: considerations and recommendations. Acad Med. 2010; 85: 85-91 Crossref PubMed Scopus (24) Google Scholar , 8 Cernadas J.M. [Auspicious changes are seen in physicians, professional medical societies and industry relationships]. Arch Argent Pediatr. 2009; 107: 195-200 PubMed Google Scholar , 9 Kofke W.A. Disclosure of industry relationships by anesthesiologists: is the conflict of interest resolved?. Curr Opin Anaesthesiol. 2010; 23: 177-183 Crossref PubMed Scopus (8) Google Scholar , 10 Lo B. Conflict of interest policies: an opportunity for the medical profession to take the lead. Acad Med. 2010; 85: 9-11 Crossref PubMed Scopus (12) Google Scholar , 11 Petak S.M. Coble Jr., Y.D. Duick D.S. et al. American Association of Clinical Endocrinologists and American College of Endocrinology position statement on physician/industry relationships. Endocr Pract. 2009; 15: 289 Crossref PubMed Scopus (4) Google Scholar and numerous associations have published positions regarding these relationships. 11 Petak S.M. Coble Jr., Y.D. Duick D.S. et al. American Association of Clinical Endocrinologists and American College of Endocrinology position statement on physician/industry relationships. Endocr Pract. 2009; 15: 289 Crossref PubMed Scopus (4) Google Scholar , 12 Coyle S.L. Ethics and Human Rights Committee, American College of Physicians–American Society of Internal Medicine Physician-industry relations. Part 1: individual physicians. Ann Intern Med. 2002; 136: 396-402 Crossref PubMed Scopus (187) Google Scholar , 13 Coyle S.L. Ethics and Human Rights Committee, American College of Physicians–American Society of Internal Medicine Physician-industry relations. Part 2: organizational issues. Ann Intern Med. 2002; 136: 403-406 Crossref PubMed Scopus (92) Google Scholar , 14 Society of General Internal Medicine. Policy on acceptance and disclosure of external funds. January 6, 2006. Available at: http://www.sgim.org/userfiles/file/SocietyInfo/ExternalFundsPolicyJan2006.pdf. Accessed August 4, 2011. Google Scholar As the Academic Pediatric Association (APA) pursues development of excellence in health care delivery models, educational and research endeavors, and public policy/advocacy on behalf of children, it sometimes considers establishing relationships with a variety of groups (eg, other associations, foundations, state and federal governmental agencies, private not-for-profit and for-profit commercial enterprises). This statement aims to provide the APA’s Board of Directors (BOD) with a set of principles to guide its deliberations when considering any potential relationship with commercial enterprises.

Microaggressions in Everyday Life: Race, Gender, and Sexual Orientation. By Derald Wing Sue. Hoboken, NJ: Wiley, 2010. Pp. 352. $45.00 (cloth).

Previous articleNext article No AccessBook ReviewMicroaggressions in Everyday Life: Race, Gender, and Sexual Orientation. By Derald Wing Sue. Hoboken, NJ: Wiley, 2010. Pp. 352. $45.00 (cloth).Kelly F. JacksonKelly F. JacksonArizona State University Search for more articles by this author Arizona State UniversityPDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Social Service Review Volume 85, Number 3September 2011 Article DOIhttps://doi.org/10.1086/663007 Views: 861Total views on this site Citations: 3Citations are reported from Crossref © 2011 by The University of Chicago. All rights reserved. For permission to reuse, please contact [email protected]PDF download Crossref reports the following articles citing this article:Tangier M. Davis, Martinque K. Jones, Isis H. Settles, Paulette Granberry Russell Barriers to the Successful Mentoring of Faculty of Color, Journal of Career Development 33 (May 2021): 089484532110133.https://doi.org/10.1177/08948453211013375Omolola P. Fakunle Commentary on Impersonating an Imposter: Minority Students and the Burden of Microaggressions, Academic Medicine 96, no.22 (Jan 2021): 227–227.https://doi.org/10.1097/01.ACM.0000733140.09088.edDave Lu, Ava Pierce, Joshua Jauregui, Sheryl Heron, Michelle Lall, Jennifer Mitzman, Danielle McCarthy, Nicholas Hartman, Tania Strout Academic Emergency Medicine Faculty Experiences with Racial and Sexual Orientation Discrimination, Western Journal of Emergency Medicine 21, no.55 (Aug 2020).https://doi.org/10.5811/westjem.2020.6.47123

Service Versus Education: Finding the Right Balance: A Consensus Statement from the Council of Emergency Medicine Residency Directors 2009 Academic Assembly “Question 19” Working Group

Many emergency medicine (EM) residency programs have recently received citations for their residents' responses to Question 19 of the Accreditation Council on Graduate Medical Education annual survey, which asks residents to rate their program's emphasis on clinical education over service obligations. To the best of our knowledge, no prior investigations or consensus statements exist that specifically address the appropriate balance between educational activity and clinical service in EM residency training. The objective of this project was to create a consensus statement based on the shared insights of academic faculty and educators in EM, with specific recommendations to improve the integration of education with clinical service in EM residency training programs. More than 80 EM program directors (PDs), associate and assistant PDs, and other academic EM faculty attending an annual conference of EM educators met to address this issue in a discussion session and working group. Participants examined the current literature on resident service and education and shared with the conference at large their collective insight and experience and possible solutions to this challenge. A consensus statement of specific recommendations and effective educational techniques aimed at balancing service and education requirements was created, based on the contributions of a diverse group of academic emergency physicians. Recommendations included identifying the teachable moment in all clinical service; promoting resident understanding of program goals and expectations from the beginning; educating residents about the ACGME resident survey; and engaging hospitals, institutional graduate medical education departments, and residents in finding solutions.