Emergency Medicine Commons^™

Using An Automated Evaluation System To Improve Medical Student Evaluation Response Rate And Reduce Administrative Burden, Chaiya Laoteppitaks, Alisha Agarwal, Jason Gonzalez, Nina Mingioni, Xiao C. Zhang

Department of Emergency Medicine Faculty Papers

BACKGROUND: Email reminders facilitate timely task completion but can create substantial administrative burdens for clerkship staff. In our emergency medicine (EM) clerkship, third-year medical students initiate digital evaluation requests after each clinical shift, requiring frequent manual reminders to maintain completion rates. The time-intensive nature of this process highlights the need for a more efficient and scalable approach.

METHODS: This multi-site, pre-post study evaluated clinical performance evaluation completion rates and time to completion during the required EM clerkship over 48 weeks before and after implementation of an automated reminder system in September 2024. The system integrated existing survey functionality with Microsoft …

From Fly On The Wall To Future Colleagues: Best Practice Recommendations For Medical Student Shadowing Programs, Molly Estes, Danielle Matonis, Mckenna Knych, Brian Barbas, Ronnie Ren, William Dixon, Michael Pasirstein, Xiao C. Zhang, Kaitlin Bowers, Ravi R. Chauhan, Laryssa A. Patti

Department of Emergency Medicine Faculty Papers

BACKGROUND: Physician shadowing is a common component of early medical education and frequently represents students' first exposure to clinical practice. Despite its prevalence, existing guidance primarily targets learners rather than physicians supervising shadowing experiences. This gap is especially relevant in the emergency department (ED), where high patient acuity, workflow demands, and complex clinical environments create challenges for providing safe and meaningful observational learning. We sought to develop consensus-based best practice recommendations for ED faculty supervising medical student shadowing.

METHODS: We conducted a modified Delphi study using an online survey platform to achieve panelist consensus. Ten emergency medicine educators with a …

Screen-Based Simulation Assessment For Emergency Medicine Learners: A Rapid Review, Patrick Zeniecki, Rebecca Kamens, Jared Kilpatrick, Dimitrios Papanagnou, Xiao C. Zhang

Department of Emergency Medicine Faculty Papers

BACKGROUND: Simulation has played a vital role in training medical professionals. The COVID-19 Pandemic has highlighted the need for physically distant educational assessment methods. Screen-based simulation (SBS) demonstrates one alternative to traditional in-person simulation methods to assess learners clinical reasoning and communication skills. This study aims to compare in-person simulation to SBS as assessment methods in Emergency Medicine (EM).

METHODS: A rapid review literature search methodology of an electronic database (PubMed) was performed in February 2022 with search terms such as "Computer Simulation," "Patient Simulation," "Simulation Training," "Education, Distance," "Virtual OSCE," "Academic Performance," or "Emergency Medicine." Reference lists of relevant …

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …

From Learners To Leaders: A Peer-Led Simulation Program For Anesthesia Procedural Skills Training In Medical Students, Noah S. Kos, Ryan Beyers, Chloe Sutlick, Benjamin Sun, Tochi Mbagwu, Dr. John D. Mitchell Md

Medical Student Research Symposium

Title: From Learners to Leaders: A Peer-Led Simulation Program for Anesthesia Procedural Skills Training in Medical Students

Authors: Noah Kos, Ryan Beyers, Chloe Sutlick, Benjamin Sun, Tochi Mbagwu, John D. Mitchell, M.D.

Background: Procedural skill competency is vital in medical education, but limited faculty availability poses challenges. We implemented a peer-led simulation program teaching peripheral IV insertion (PIV) and endotracheal intubation, with a focus on student leadership.

Methods: Sixteen peer educators, trained by attendings, conducted monthly workshops from July-October 2025. Students practiced at PIV and intubation stations, assessed via validated rubrics (17 items for PIV, 21 for intubation; 5-point scale). …

From Clinical Observation To Scholarly Question Academic Curiosity As A Professional Virtue In Emergency Medicine Introducing The Mindful Observation → Curious Inquiry → Clinical Structuring → Scholarly Sharing (Moccs) Model, James Espinosa, Alan A. Lucerna

Rowan-Virtua Research Day

Emergency Medicine generates continuous clinical observations, yet many potentially meaningful insights never progress beyond informal reflection. This poster reframes every day shift observations as the ecological foundation of scholarly inquiry. Conceptual Framework: We propose a simple, repeatable process to lower the activation energy for academic engagement The Mindful Observation → Curious Inquiry → Clinical Structuring → Scholarly Sharing (MOCCS) Model. This model centers disciplined noticing as a professional virtue. By naming and normalizing the “hmmm” and “huh?” moments, this approach validates frontline clinical wisdom, democratizes scholarly participation, and restores intellectual joy within high-stress clinical environments. Conclusion: Curiosity is not hierarchical. …

Identifying And Generalizing Best Attending Teaching Practices: A Proposal For The Use Of Appreciative Inquiry To Enhance Emergency Medicine Residency Teaching Practices, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Teaching in the Emergency Department (ED) occurs within a complex adaptive system characterized by time pressure, interruptions, and high cognitive load. Studying what works well in clinical teaching , even in such a challenging  environment for  teaching, may reveal reproducible patterns that strengthen educational culture, enhance resident learning, and accelerate the development of teaching expertise. In complex clinical environments, excellence is often present but under-recognized; An approach called Appreciative Inquiry provides a structured method for making it visible.

Conceptual Framework

Appreciative Inquiry (AI) offers an alternative approach by systematically studying successful practices rather than failures. AI explores how and …

The Ed Is Inherently Interleaved: The Learning Theory Case For Hybrid Resident Conference Curriculum Design In Emergency Medicine: Block For Onboarding And For Specialized Topics With Predominant Interleaving For Intermediate And Advanced Residents, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Emergency medicine (EM) training occurs within a clinical environment characterized by rapid context switching, diagnostic uncertainty, and frequent transitions between unrelated clinical problems. Didactic curricula that rely only on block-based topic organization may not fully reflect the cognitive demands of real emergency department practice.

Objective

To propose a developmentally adaptive hybrid model of EM curricular design that integrates early block learning during the onboarding phase of new residents, progressing to a general approach of interleaved learning. Specialized topics,  can be introduced using block learning at any time during the residency years.

Methods / Conceptual Approach

This conceptual educational model …

Towards More Effective And Efficient Ite And Board Preparation In Emergency Medicine: A Conceptual Framework Using Personality Preferences (Mbti) To Inform Study And Test-Taking Behaviors, James Espinosa, Robin Lahr, James Lee, Alan Lucerna

Rowan-Virtua Research Day

Background: Preparation for high-stakes examinations in Emergency Medicine (EM) relies heavily on question-bank practice, rapid decision-making, and targeted review. Despite standardized board-preparation resources, trainees demonstrate substantial variability in study behaviors and perceived efficiency. The Myers-Briggs Type Indicator (MBTI), widely used in medical education for communication and self-reflection, may offer a framework for understanding differences in study and test-taking behaviors, though it is not designed as a predictive psychometric tool.

Objective: To review existing literature relating MBTI preferences to learning behaviors and academic performance, and to propose a conceptual framework linking personality preferences to board-style test-taking patterns in EM trainees.

Methods: …

From Lists To Landscapes And Locations: Spatial Memory And Schema Formation (Memory Palace Adaptation) As A Neurobiologically Informed Strategy For Teaching Environmental And Toxicology Emergencies Ite And Board Review In Emergency Medicine Residency, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background:

Most emergency medicine board domains inherit spatial scaffolding from foundational anatomy education (e.g., neuroanatomy, gastrointestinal tract, cardiopulmonary structures). Environmental emergencies lack an inherent anatomic anchor and are frequently taught as disconnected lists, increasing cognitive load and impairing schema formation. Similarly, toxicology crosses age, and specialty without an inherent anatomic structural anchor.

Objective:

To describe a scene-based, learner-generated landscape model designed to reintroduce spatial structure into environmental emergency education and to situate the model within contemporary neurobiology and learning science.

Educational Innovation:

Residents construct a large-format landscape diagram (sun–water–mountain schema) during live instruction. Environmental conditions are spatially anchored in ecologically …

The Ones That Got Away:Shared Misses, Shared Mastery — A Proposal For Leveraging Spaced Retrieval, Variable Reinforcement, And Collective Learning In Emergency Medicine Residency, James Espinosa D, Robin Lahr, James Lee, Swet M. Patel, Alan Lucerna

Rowan-Virtua Research Day

Background

Residents frequently engage in individual question-bank study for board preparation; however, missed questions are typically processed in isolation. Educational psychology demonstrates that spaced retrieval and variable reinforcement enhance durable learning. Psychological safety further supports collective sense-making in professional education . The addition of a periodic, structured, collective shared-review process model may leverage these principles within residency training.

Objective

To propose a resident-driven educational initiative that transforms individually missed board-style questions into a shared, psychologically safe learning stream that promotes durable knowledge retention and community-based mastery.  The movement of this stream could be a chief resident responsibility, or could be …

Beyond Traditional Emergency Medicine Residency Match Interviews: Behavioral Questions As Stress Tests For Resident Selection A Theory-Driven Micro-Assessment Framework For Detecting High-Value Traits, Alan Lucerna, James Lee, Robin Lahr, James Espinosa

Rowan-Virtua Research Day

Background: Traditional residency selection metrics incompletely capture behavioral traits essential for emergency medicine (EM) performance.

Objective: To propose a theory-driven framework using structured behavioral questions as stress tests to detect high-value traits.

Methods: Conceptual analysis of three standardized behavioral prompts assessing execution, systems thinking, and team orientation.

Results: Distinct response patterns align with observable domains associated with reliability, performance, and leadership.

Conclusion: Behavioral stress test questions offer a scalable, low-cost method to enhance residency selection processes.

The First Cut Is The Deepest: Understanding Learner Trauma In The Emergency Medicine Clerkship, Dimitrios Papanagnou, Leela Raj, Karen E. Watkins, Xiao C. Zhang, Andres Fernandez, Md, Victoria J. Marsick

Department of Emergency Medicine Faculty Papers

BACKGROUND: As third-year medical students transition into high-stakes, high-stress clinical environments like the emergency department (ED), they may experience significant personal trauma. However, little is known about how this trauma is experienced early in their training - specifically during the transition from preclinical to clinical learning environments. This study addresses that gap by exploring third-year medical students' experiences of trauma during the emergency medicine (EM) clerkship through the lens of Trauma-Informed Care (TIC) and identifies workplace factors and intersectional demographics influencing these experiences.

METHODS: This qualitative study used the critical incident technique to explore emotionally-significant events encountered by third-year medical …

Imaging In Acute Neurovascular Emergencies: Optimizing Outcomes In Large Vessel Occlusion Stroke, Chandu Goli, Rohit Patel, Elliott Beard, Anna Liles, Saeed Saleh, Aleeza Namit, Alissa Ongaco, Kevin Steed Ph.D.

Annual Research Symposium

Purpose:

Large vessel occlusion (LVO) stroke is associated with high rates of morbidity and mortality, and patient outcomes are strongly influenced by rapid identification and timely reperfusion. Advances in acute neurovascular imaging have transformed stroke care by enabling precise patient selection, extending treatment windows, and accelerating clinical workflows. The purpose of this project is to evaluate how modern neurovascular imaging strategies influence treatment selection, workflow efficiency, and clinical outcomes in patients with acute LVO stroke.

Methods:

A narrative review of peer-reviewed literature published within the past decade was conducted. The review focused on CT-based imaging (non-contrast CT, CT angiography, CT …

The Need For Accessible Cpr Training, Madilyn Cataloni

CAFE Symposium 2026

For my project, I researched how CPR certification can affect an emergency response. From this, I researched Gettysburg College's CPR certification requirements for different departments. I then brainstormed different plans to make CPR certification more accessible to students and employees.

Assessment Of Non-Clinical Time Expenditures By Academic Emergency Medicine Faculty, Barry J. Knapp, Charles S. Graffeo, Francis L. Counselman, Donald V. Byars, Martin D. Klinkhammer, Jondavid D. Landon

Eastern Virginia Medical Journal

Introduction: In 2020, the Accreditation Council for Graduate Medical Education (ACGME) approved the Residency Review Committee for Emergency Medicine (RRC-EM) revisions to the program requirements. Revisions mandated that Program Directors (PDs) receive 50% full-time equivalent (FTE) non-clinical time, and Associate Program Directors (APDs) receive 35% FTE non-clinical time for administrative and teaching responsibilities for a program our size at the Department of Emergency Medicine, Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion University. Objective: To quantify the actual administrative time our residency leadership team— including the PD, APD, Department Chair, and core faculty— used …

Improving Sepsis Order Set Utilization Through Targeted Resident Education: A Lean Six Sigma Green Belt Quality Improvement Project, Sarah Sheikh, Puneeth Shridhar, Bushra Bangash, Valerie Chukelu, Tonya Meirhofer, Arunima Jose, Zainab Shakir, Shane Jenks, Augusto Sepulveda, Trung Nguyen, Rajeev Raghavan

Gulf Coast Division GME Research Day 2026

No abstract provided.

Cultivating Humanity: A Scalable Blueprint For Celebrating Humanism In Graduate Medical Education, Edrianna Mae Ablola, Grace Desrochers, Shuchita Jhaveri, A Charales, L Tatineni, Marelle Montanez, Shane Jenks, Rajeev Raghavan

Gulf Coast Division GME Research Day 2026

No abstract provided.

Introducing Education For Sensory Approaches In Mental Health-Related Emergency Department Visits: A Quality Improvement Project To Enhance Patient-Centered Care, Jesse O'Neill

Master's Theses and Capstones

Background: Barriers to specialty care access have resulted in emergency departments (ED) operating as temporary psychiatric hold facilities for their communities. Patients boarding in the ED are demonstrated to use a disproportionate percentage of facility resources with minimal benefit to the patient. The Institute for Healthcare Improvement identifies the impact of the healthcare environment on patient outcomes and suggests staff training to foster trauma-informed practice culture (Schall et al., 2020).

Local Problem: High-stress healthcare environments can escalate maladaptive patient behaviors and the use of restrictive interventions. Traditional use of restrictive interventions lacks supportive evidence and contradicts person-centered care goals (Molloy …

Association Between Emergency Medicine Residency Program And Diagnostic Efficiency For Pulmonary Embolism, Kerolos Abadeer, Kalyan Mantha, W Angelo Kantrales, Pranav Bommineni, Martin Wegman

South Atlantic Division GME Research Days 2026

No abstract provided.

Increasing Documentation Of Endotracheal Tube Cuff Pressures: A Quality Improvement Initiative For Flight Crew Providers, Matthew D. Noss

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: There was a lack of documentation of endotracheal tube (ETT) cuff pressures (CPs) by flight crew providers at Base 1 of HealthNet Aeromedical Services. A three-month pre-intervention data collection showed 1.8% of patients had initial CPs documented. Inadequate documentation and monitoring of ETT CPs can lead to patient complications such as tracheal injury and aspiration making this an important area for quality improvement.

Purpose: To increase documentation of ETT CPs through education and evidence-based interventions.

Intervention: This project implemented an educational in-service on ETT cuff syringe manometry for flight crew providers. The educational intervention consisted of …

American Board Of Emergency Medicine Report On Residency And Fellowship Training Information (2025-2026), Yvette Calderon, Barry Knapp, Felix K. Ankel, Ted Gaeta, Lynne Holden, Derek Linklater, Zeno St. Cyr Ii, Ernest Wang, Melissa Barton, Andrews R. Trotter, Kevin Joldersma, Robert G. Purosky, Michael Gottlieb

Department of Medicine Faculty Publications

The American Board of Emergency Medicine gathers extensive background information on Accreditation Council for Graduate Medical Education-accredited emergency medicine residency and fellowship programs, as well as the residents and fellows training in those programs. We present the 2026 annual report on the status of physicians training in Accreditation Council for Graduate Medical Education-accredited emergency medicine training programs in the United States.

Improving Dka Protocol Adherence In The Emergency Department, Anjolaoluwa Lawani

Master's Projects and Capstones

Problem There was inconsistency in implementation of the DKA protocol by nurses in the emergency department at the Hospital A. Only 58% of the nurses reported feeling comfortable following the DK protocol, and 84% of the nurses described the DKA order set as confusing. Context Hospital A is a large magnet-recognition hospital system in the Bay Area. The emergency department at Hospital A averages about 12 DKA patients per quarter. Intervention Education sessions were held during pre-shift cuddles across day and night shifts to clarify the DKA protocol and answer any questions or nurses may have. Measures Baseline surveys and …

Applying Entrustable Professional Activities Across Emergency Medicine Medical Education Fellowships: A Cross-Institutional Commentary, Carrie Maupin, Ambika Anand, Danielle Nesbit, Casey Morrone, Danielle Sultan

Department of Emergency Medicine Faculty Papers

No abstract provided.

Development Of A Longitudinal, Small-Group Pocus Curriculum For Internal Medicine Residents, Shah N. Mahmud Do, Ammar W. Bhatti Do, Ariq Rahman Md, Omar Al Qassab Md, Fraser Mackay Md

The Lahey Journal

Development of a Longitudinal, Small-Group POCUS Curriculum for Internal Medicine Residents

Introduction

Point-of-Care Ultrasound (POCUS) is integral for clinicians to enhance their diagnostic and procedural skills. Unlike Emergency Medicine or Anesthesia training programs, Internal Medicine programs often lack a structured and standardized curriculum. We thus developed a longitudinal and multi-pronged POCUS curriculum aimed at building trainee competency when utilizing ultrasound for diagnostic and procedural work-up.

Methods

The curriculum encompasses the following: basics of ultrasound, ultrasound-guided procedures, thoracic ultrasound/Bed Lung Ultrasound in Emergency (BLUE), and cardiac ultrasound/Focus-Assessed Transthoracic Echocardiography (FATE). These modules were integrated into the residents’ clinic blocks. We utilized …

Psych Assessment In The Er, Bailey J. Thompson, Addie Cowger, Hailie Hollis

Scholars Week

An immense amount of patients who enter the emergency department, whether for a psychiatric illness or not, struggle with mental health challenges. By creating a standardized routine and checklists for the care of high-risk psychiatric patients, the new quality and consistency can enhance patient experiences. This process will start at the triage stage and continue throughout their stay. Presenting the supportive research to the emergency department staff and introducing these changes gradually will help with staff buy-in and become a more sustainable process. Finally, with a structured approach, psychiatric patient outcomes will benefit significantly.

Does Cognitive Frame Affect Clinical Reasoning Among Medical Students? A Cross-Sectional Study, Xiao C. Zhang, Sara A. Belko, Andrew J Monick

Department of Emergency Medicine Faculty Papers

Background Diagnostic errors affect patient safety and lead to high costs. Cognitive bias is a key source of diagnostic error, and the framing effect poses a particular clinical challenge. The extent to which individual factors affect susceptibility to the framing bias is unclear, and the role of expertise in particular is contested across the literature. Objectives This study investigated the effects of framing bias on diagnostic reasoning among medical students. We hypothesised that the effects attributable to framing would be mediated by the number of years of medical education completed. Methods Participants were randomly assigned on an automated basis with …

Developing Empathy In Paramedic Students Using Didactic And Deliberate Practice Education Programs: A Mixed-Methods Study, Nick J. Waltrich, Jade Sheen Phd, Mathew Ling, Melissa O'Shea

Internet Journal of Allied Health Sciences and Practice

Purpose: Paramedics often attend to patients presenting with a mental illness, however research suggests paramedics have difficulties when attending to this patient cohort. Conversely, clinical psychologists receive training that focuses on developing strong therapeutic relationships with their patients through the use of empathy. As research has highlighted that paramedic students are known to demonstrate low levels of empathy, this study aimed to investigate the utility of two education methods used in clinical psychology training, didactic teaching and deliberate practice (DP), to develop the skill of empathy in paramedic students. Method: Students currently enrolled in an Australian paramedic university degree were …

Maximizing Relief: The Benefits Of Combining Lateral Femoral Cutaneous Nerve Block With Sciatic Nerve Block In The Emergency Department, Courtney Smith, Taryn Hoffman

Florida Journal of Emergency Medicine (FJEM)

Low back pain accounts for more than 2.6 million emergency department (ED) visits annually, with 40% of Americans experiencing sciatica at some point in their lives. Our case report describes a patient presenting with atraumatic right-sided low back pain and paresthesias in her right leg. We utilized a combination of a transgluteal sciatic nerve block and a lateral femoral cutaneous nerve block to achieve improved pain relief after an initial isolated transgluteal sciatic nerve block left her with persistent anterolateral thigh pain.

We detail the technique for performing this procedure under ultrasound guidance. Our patient experienced significant pain improvement and …

Being Well: Stories Of Coping And Resilience, Simiao Li-Sauerwine, Abbas Husain, Al'ai Alvarez, Gillian Baty, Manish Garg, Ryan Bodkin, Andy Grock, Marc Borenstein, Pamela Dyne

Journal of Wellness

Introduction: The approach to physician well-being has transformed from a focus on identification of distress to embracing a comprehensive model that values vulnerability, growth, self-compassion, and a sense of purpose and community in the profession. This manuscript, a collaborative effort by the Council of Residency Directors in Emergency Medicine Well-being Committee and the Society for Academic Emergency Medicine Wellness Committee, presents the personal narratives of academic emergency physicians during which they faced challenges and stressors, as well as supportive resources they found helpful. The scenarios are written by the individuals themselves as they experienced them.

Discussion: Through these shared and …