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Full-Text Articles in Emergency Medicine

Drivers Of Professional Satisfaction In Emergency Medicine Residency Training In The Us, Arvin Radfar Akhavan, Kirstin Woody Scott, Patrick Hewes, Erin Kinney, Boris Pavic, Josh Simmons, Michelle Lall, Michael Gottlieb, Yvette Calderon, Dave Lu Jul 2026

Drivers Of Professional Satisfaction In Emergency Medicine Residency Training In The Us, Arvin Radfar Akhavan, Kirstin Woody Scott, Patrick Hewes, Erin Kinney, Boris Pavic, Josh Simmons, Michelle Lall, Michael Gottlieb, Yvette Calderon, Dave Lu

Department of Emergency Medicine Faculty Papers

BACKGROUND: Physician wellness discussions often center on burnout and negative aspects of clinical practice. Less is known about what brings professional satisfaction to physicians, particularly among emergency medicine (EM) residents. Understanding drivers of professional satisfaction is important for the future of the specialty as they may influence residents' career decisions. This study aimed to identify drivers of professional satisfaction among a national cohort of EM residents.

METHODS: We conducted a mixed methods study using a survey administered following the 2024 ABEM In-Training Examination to EM residents in ACGME-accredited programs. The single-item, free-text survey question asked: "List the top 3 drivers …


Unveiling Unwritten Curricula: Enhancing Junior Faculty Development In Academic Emergency Medicine, Abagayle Bierowski, Casey Morrone, Erin Hoag, Ridhima Ghei, Michael Pasirstein, Julie Blaszczak, Dimitrios Papanagnou Jun 2026

Unveiling Unwritten Curricula: Enhancing Junior Faculty Development In Academic Emergency Medicine, Abagayle Bierowski, Casey Morrone, Erin Hoag, Ridhima Ghei, Michael Pasirstein, Julie Blaszczak, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

INTRODUCTION: The transition from resident to junior faculty in academic emergency medicine (EM) may be shaped not only by formal training and institutional policies but also by the "unwritten curriculum," a set of norms and expectations embedded in institutional culture. However, the unwritten curriculum and its potential to impact junior faculty development remains largely unexplored. Little is known about how junior faculty perceive, experience, and navigate these informal expectations, or the formal and informal structures that influence this process. In this study we aimed to explore junior faculty members' experiences with the unwritten curriculum in academic EM, with a focus …


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 Jun 2026

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 …


Where Evidence-Based Medicine Meets Ai: Promise, Pitfalls, And Practice, Sangil Lee, Joshua Davis, Ken Milne, Christina Shenvi, Lars K. Beattie, Martin Wegman, Laura Melville, Richard D. Shih, Bryan Kane Jun 2026

Where Evidence-Based Medicine Meets Ai: Promise, Pitfalls, And Practice, Sangil Lee, Joshua Davis, Ken Milne, Christina Shenvi, Lars K. Beattie, Martin Wegman, Laura Melville, Richard D. Shih, Bryan Kane

Department of Emergency Medicine Faculty Papers

No abstract provided.


Identifying Social Determinants Of Health Subgroups And Their Associations With Health Outcomes In A Prospective Us Adult Covid-19 Cohort: An Analysis Of The Inspire Registry, Yohali Burrola-Mendez, Eugene Lin, Canada Parrish, Chialing Hsu, Mandy J. Hill, Michael Gottlieb, Kristin L. Rising, Lauren E. Wisk, Nicole L. Gentile, Rachel E. Geyer, Robert A. Weinstein, Michelle Santangelo, Kristyn Gatling, Jonathan W. Dyal, Joann G. Elmore, Robert M. Rodriguez, Phillip Watts, Ji Chen, Zihan Diao, Erica S. Spatz, Kwun Cg Chan, K A. Stephens, Kelli N. O'Laughlin, Inspire Group Jun 2026

Identifying Social Determinants Of Health Subgroups And Their Associations With Health Outcomes In A Prospective Us Adult Covid-19 Cohort: An Analysis Of The Inspire Registry, Yohali Burrola-Mendez, Eugene Lin, Canada Parrish, Chialing Hsu, Mandy J. Hill, Michael Gottlieb, Kristin L. Rising, Lauren E. Wisk, Nicole L. Gentile, Rachel E. Geyer, Robert A. Weinstein, Michelle Santangelo, Kristyn Gatling, Jonathan W. Dyal, Joann G. Elmore, Robert M. Rodriguez, Phillip Watts, Ji Chen, Zihan Diao, Erica S. Spatz, Kwun Cg Chan, K A. Stephens, Kelli N. O'Laughlin, Inspire Group

Department of Emergency Medicine Faculty Papers

OBJECTIVE: To identify subgroups with similar social determinants of health (SDOH) characteristics using latent class analysis (LCA) and examine their associations with physical and mental health, cognitive function and missed workdays at 3 and 6 months post-SARS-CoV-2 infection. We hypothesised that intersecting SDOH factors would differentially influence COVID-19-related health outcomes across subgroups.

DESIGN: Prospective cohort study from the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), with longitudinal data collection and cross-sectional analyses at baseline, 3-month and 6-month follow-ups.

SETTING: Multicentre registry across eight US academic medical centres (Chicago, Dallas, Houston, Los Angeles, New Haven, Philadelphia, San Francisco and …


Young Man With Neck Pain, Sejal Patel, Steven Graver, Megan Daniels, Kelly Goodsell, Arthur K. Au Jun 2026

Young Man With Neck Pain, Sejal Patel, Steven Graver, Megan Daniels, Kelly Goodsell, Arthur K. Au

Department of Emergency Medicine Faculty Papers

No abstract provided.


Inflammatory Markers In The Emergency Department And Ptsd Symptoms In The Aurora Study: A Longitudinal Cohort Study, Kristen Nishimi, Sarah Linnstaedt, Thomas Neylan, Lauren Mckibben, Liz Marie Albertorio-Sáez, Ying Zhao, Stacey House, Francesca Beaudoin, Xinming An, Jennifer Stevens, Gari Clifford, Tanja Jovanovic, Laura Germine, Scott Rauch, John Haran, Alan Storrow, Paul Musey, Phyllis Hendry, Sophia Sheikh, Brittany Punches, Robert Swor, Jose Pascual, Mark Seamon, Elizabeth M Datner, Claire Pearson, David Peak, Roland Merchant, Robert Domeier, Niels Rathlev, Brian O'Neil, Paulina Sergot, Leon Sanchez, Steven Bruce, Steven Harte, Ronald Kessler, Karestan Koenen, Kerry Ressler, Samuel Mclean, Aoife O'Donovan May 2026

Inflammatory Markers In The Emergency Department And Ptsd Symptoms In The Aurora Study: A Longitudinal Cohort Study, Kristen Nishimi, Sarah Linnstaedt, Thomas Neylan, Lauren Mckibben, Liz Marie Albertorio-Sáez, Ying Zhao, Stacey House, Francesca Beaudoin, Xinming An, Jennifer Stevens, Gari Clifford, Tanja Jovanovic, Laura Germine, Scott Rauch, John Haran, Alan Storrow, Paul Musey, Phyllis Hendry, Sophia Sheikh, Brittany Punches, Robert Swor, Jose Pascual, Mark Seamon, Elizabeth M Datner, Claire Pearson, David Peak, Roland Merchant, Robert Domeier, Niels Rathlev, Brian O'Neil, Paulina Sergot, Leon Sanchez, Steven Bruce, Steven Harte, Ronald Kessler, Karestan Koenen, Kerry Ressler, Samuel Mclean, Aoife O'Donovan

Department of Emergency Medicine Faculty Papers

BACKGROUND: Systemic inflammation is hypothesized to contribute to post-traumatic stress disorder (PTSD) vulnerability. Few studies have examined inflammation shortly after trauma as a predictor of later PTSD symptoms. We examined whether inflammation from the emergency department (ED) post-trauma is associated with PTSD symptom severity over the following 6 months.

METHODS: Our sample included 742 AURORA participants, a longitudinal cohort of patients in 29 EDs across the United States after a traumatic stressor, followed up to 6 months. Plasma cytokines were assessed from a study blood draw in the ED: an inflammatory index (standardized sum of generally pro-inflammatory markers interleukin [IL]-6, …


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 May 2026

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 …


Contraception In The Ed: Understanding Education And Opportunities For Clinicians To Advise Patients, Hannah B. Lewis, Teagan R. Mccarthy, Dara Kass, Jennifer L. Kahoud Apr 2026

Contraception In The Ed: Understanding Education And Opportunities For Clinicians To Advise Patients, Hannah B. Lewis, Teagan R. Mccarthy, Dara Kass, Jennifer L. Kahoud

Department of Emergency Medicine Faculty Papers

Introduction: The United States faces a high rate of unwanted pregnancies. Despite this, many people continue to face barriers to accessing contraception. The emergency department (ED) can help bridge these gaps, but emergency clinicians must first feel comfortable offering contraceptive services. In this study, we sought to determine emergency clinician comfort in prescribing contraceptives and educating patients on their use. We also gauged clinician interest in receiving education specifically geared toward contraceptive care.

Methods: We conducted an online survey of ED residents, attendings, and advanced practice clinicians at Thomas Jefferson Univerity Hospital and affiliates in both the urban and suburban …


Emergency Care Outside Of The Four Walls Of The Emergency Department, Judd E. Hollander Apr 2026

Emergency Care Outside Of The Four Walls Of The Emergency Department, Judd E. Hollander

Department of Emergency Medicine Faculty Papers

No abstract available


Targeting Cardiomyocyte-Derived Extracellular Vesicle Mir-574-5p Protects Against Cognitive Impairment Induced By Ischemia-Reperfusion, Erya Chen, Xiaoyu Zhu, Haiqing Chang, Qi Li, Zhenkun Zhao, Changteng Zhang, Yu Cao, Yajing Wang, Xinliang Ma, Tao Zhu, Shu Zhang, Lu Gan, Jin Liu, Chan Chen Mar 2026

Targeting Cardiomyocyte-Derived Extracellular Vesicle Mir-574-5p Protects Against Cognitive Impairment Induced By Ischemia-Reperfusion, Erya Chen, Xiaoyu Zhu, Haiqing Chang, Qi Li, Zhenkun Zhao, Changteng Zhang, Yu Cao, Yajing Wang, Xinliang Ma, Tao Zhu, Shu Zhang, Lu Gan, Jin Liu, Chan Chen

Department of Emergency Medicine Faculty Papers

BACKGROUND:  Acute myocardial ischemia/reperfusion (MI/R) increases risk for cognitive decline, yet the underlying mechanisms mediating heart-brain communication remain poorly understood. Small extracellular vesicles (sEVs) have emerged as novel long-range signaling mediators and may play a critical role.

METHODS: MI/R was induced by transient ligation of the left anterior descending artery. Cognitive performance was assessed using multiple behavioral tests. sEVs derived from cardiomyocytes were labeled to track their distribution and cellular uptake in the brain. Heart and brain tissues were analyzed for microRNAs (miRNAs) expression using bioinformatics, qPCR, and RNAScope. The role of specific miRNAs was investigated through genetic inhibition of …


Fibrinogen-Bmal1 Signaling As A Therapeutic Target To Limit Aortic Dissection By Preserving Vsmc Contractility, Xiaohan Zhong, Dongjie Li, Yuanfei Zhao, Lu Dai, Jinzhang Li, Zhiqi Ji, Bojing Zuo, Hongshan Liu, Haixia Huang, Wei Wang, Haiyang Li, Yuyong Liu, Ming Gong, Xin-Liang Ma, Wenjian Jiang, Meili Wang, Hongjia Zhang Mar 2026

Fibrinogen-Bmal1 Signaling As A Therapeutic Target To Limit Aortic Dissection By Preserving Vsmc Contractility, Xiaohan Zhong, Dongjie Li, Yuanfei Zhao, Lu Dai, Jinzhang Li, Zhiqi Ji, Bojing Zuo, Hongshan Liu, Haixia Huang, Wei Wang, Haiyang Li, Yuyong Liu, Ming Gong, Xin-Liang Ma, Wenjian Jiang, Meili Wang, Hongjia Zhang

Department of Emergency Medicine Faculty Papers

Aortic dissection (AD) is a life-threatening vascular disease with a high mortality rate. Surgery is essential in the acute phase but carries significant risks, whereas elective surgery during the chronic phase yields better outcomes. However, no pharmacological therapy has been proven effective in slowing AD progression. In our recent pilot clinical study, an association between higher plasma fibrinogen levels and improved clinical outcomes was observed in AD patients, suggesting a potential protective role of fibrinogen. However, direct evidence supporting this hypothesis is lacking. In this study, a population-based analysis of nonsurgically managed patients with acute AD revealed a distinct association: …


The Heart’S Hidden Influencer: Epicardial Adipose Tissue In The Pathogenesis Of Heart Failure, Aobo Li, Avilash Mondal, Jianli Zhao, John Zhang, Xin-Liang Ma Feb 2026

The Heart’S Hidden Influencer: Epicardial Adipose Tissue In The Pathogenesis Of Heart Failure, Aobo Li, Avilash Mondal, Jianli Zhao, John Zhang, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

Abstract – Heart failure (HF) is a complex, multifactorial clinical syndrome with diverse etiologies and phenotypic manifestations, affecting millions of people globally. HF is broadly classified into 3 subtypes: HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction. Each subtype exhibits distinct pathophysiological mechanisms, clinical trajectories, and therapeutic responses, posing significant challenges in terms of diagnosis and management. Epicardial adipose tissue (EAT), a metabolically active visceral fat depot situated in close proximity to the myocardium, plays a dual role in physiological and pathological states, offering potential utility as a biomarker and therapeutic …


Flare Guns And Trauma: Patterns, Severity, And Clinical Implications From Case And National Surveillance Data, Ramsay Hafer, Andrew Huff, Lara Phillips Feb 2026

Flare Guns And Trauma: Patterns, Severity, And Clinical Implications From Case And National Surveillance Data, Ramsay Hafer, Andrew Huff, Lara Phillips

Department of Emergency Medicine Faculty Papers

Flare guns are pyrotechnic devices capable of causing serious injury due to high-temperature combustion and projectile discharge. Though intended for signaling in maritime or wilderness settings, improper use can result in trauma patterns distinct from those seen with typical burns or fireworks. Despite their severity, flare gun injuries remain underreported and poorly characterized. We conducted a scoping review of PubMed, Scopus, and Ovid to identify 12 case reports involving 13 patients, and reviewed US National Electronic Injury Surveillance System records from 2015 to 2024, identifying 18 flare gun-specific injuries for a combined total of 31 injuries. Demographic, injury mechanism, body …


A Case Report Of Milk-Alkali Syndrome Secondary To Excessive Antacid Use, Samir Beso, Layla Abubshait Feb 2026

A Case Report Of Milk-Alkali Syndrome Secondary To Excessive Antacid Use, Samir Beso, Layla Abubshait

Einstein Health Papers

INTRODUCTION: Milk-alkali syndrome is characterized by the triad of hypercalcemia, metabolic alkalosis, and acute kidney injury resulting from excessive intake of calcium and absorbable alkali. Despite falling out of prominence with the advent of modern ulcer treatments, milk-alkali syndrome has experienced a resurgence with the widespread availability of over-the-counter calcium preparations, which now account for up to 10% of hypercalcemia cases.

CASE REPORT: A 60-year-old man with multiple comorbidities presented to the emergency department with altered mental status after his scheduled kyphoplasty was canceled due to concerning neurological findings. Laboratory evaluation revealed severe hypercalcemia, marked metabolic alkalosis, and acute kidney …


Recurrent Miller Fisher Syndrome: A Case Report, Larry Vernier, Griffin B. Gilmore, Kelsey Van Housen, Xiao C. Zhang Feb 2026

Recurrent Miller Fisher Syndrome: A Case Report, Larry Vernier, Griffin B. Gilmore, Kelsey Van Housen, Xiao C. Zhang

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Guillain-Barré syndrome can manifest with progressive paralysis, requiring careful monitoring and treatment with steroids or intravenous (IV) immunoglobin. While this disease can be devastating and require intensive care unit level of care, there are few incidences of relapses.

CASE REPORT: A 67-year-old man with a past medical history of Miller Fisher syndrome variant of Guillain-Barré syndrome, with complete recovery, presented to the emergency department (ED) with ataxia, ophthalmoplegia, dysphonia, and ambulatory dysfunction. The patient noticed his neurologic symptoms after waking up, and he presented to the ED with physical examination positive for difficulty with upward gaze, mild right lower …


Management Of Patients Requiring High-Flow Nasal Cannula In A Pediatric Observation Unit: A Single-Center Experience, Evelyn Zhang, Yvette Calderon, Czer Anthoney Lim, Diana Hou Yan Jan 2026

Management Of Patients Requiring High-Flow Nasal Cannula In A Pediatric Observation Unit: A Single-Center Experience, Evelyn Zhang, Yvette Calderon, Czer Anthoney Lim, Diana Hou Yan

Department of Emergency Medicine Faculty Papers

BACKGROUND: Due to widespread shortages of pediatric intensive care unit (PICU) beds during the 2022–2023 respiratory virus surge, a protocol was implemented to identify and manage patients on high-flow nasal cannula (HFNC) in a pediatric observation unit (POU). This study aims to describe the characteristics and outcomes of patients who received HFNC in the observation unit.

METHODS: We performed a retrospective chart review of all patients admitted to a community pediatric observation unit who received HFNC between October 2022 and January 2023. Patients were grouped by disposition from the observation unit, either discharged home or transferred to PICU. Descriptive analysis …


From Evaluation To Elevation: Standardized Letter Of Evaluation Domains Tied To Future Emergency Medicine Chief Residents, Abagayle Bierowski, Zaid Tayyem, Casey Morrone, Carlos Rodriguez, Chaiya Laoteppitaks, Peter Tomaselli, Dimitrios Papanagnou, Xiao Chi Zhang Jan 2026

From Evaluation To Elevation: Standardized Letter Of Evaluation Domains Tied To Future Emergency Medicine Chief Residents, Abagayle Bierowski, Zaid Tayyem, Casey Morrone, Carlos Rodriguez, Chaiya Laoteppitaks, Peter Tomaselli, Dimitrios Papanagnou, Xiao Chi Zhang

Department of Emergency Medicine Faculty Papers

INTRODUCTION: The Standardized Letter of Evaluation (SLOE) is a core component of emergency medicine (EM) residency applications, designed to assess clinical performance, professionalism, and leadership potential. While its utility in selecting residency candidates is well established, its association with future leadership roles, such as chief resident, remains unclear. Identifying early indicators of leadership potential could inform both recruitment and resident development efforts. In this study we aimed to evaluate whether medical students' SLOEs are associated with subsequent selection as chief residents, offering insight into the SLOE's potential to forecast future leadership within EM.

METHODS: We conducted a retrospective review of …


Clinical Performance Of A Novel Point-Of-Care High-Sensitivity Cardiac Troponin I Assay, Alan H. B. Wu, Simon A. Mahler, Stacey L. House, Saeed A. Jortani, Michael H. Creer, Kristin L. Rising, Jason J. Bischof, Chad Crystal, Gary F. Headden, Fred S. Apple, Nicholas E. Harrison, Andrew C. Meltzer, Justin T. Baca, Brian Tiffany, Mark Sochor, Grace U. Pentecostes, Katrina P. Di Tullio, Manish S. Gupta, Adam J. Singer, James L. Januzzi Jan 2026

Clinical Performance Of A Novel Point-Of-Care High-Sensitivity Cardiac Troponin I Assay, Alan H. B. Wu, Simon A. Mahler, Stacey L. House, Saeed A. Jortani, Michael H. Creer, Kristin L. Rising, Jason J. Bischof, Chad Crystal, Gary F. Headden, Fred S. Apple, Nicholas E. Harrison, Andrew C. Meltzer, Justin T. Baca, Brian Tiffany, Mark Sochor, Grace U. Pentecostes, Katrina P. Di Tullio, Manish S. Gupta, Adam J. Singer, James L. Januzzi

Department of Emergency Medicine Faculty Papers

BACKGROUND: High-sensitivity cardiac troponin (hs-cTn) assays performed in the central laboratory have long turnaround times. This study evaluates the clinical performance of a novel bedside point-of-care (POC) hs-cTnI assay (i-STAT® hs-TnI) to aid in the diagnosis of myocardial infarction (MI).

METHODS: A prospective multisite cohort study involving emergency department (ED) patients with symptoms suggestive of acute coronary syndrome was conducted at 28 sites across the United States. Serial whole blood samples were collected at 0-1 h and >1-3 h from ED presentation. Primary outcome was MI or non-MI. Sensitivity, specificity, and negative predictive value (NPV) for MI were calculated with …


Career Plans Among Graduating Us Emergency Medicine Residents, Dave W. Lu, Bo Gu, D. Mark Courtney, Bryan G. Kane, Michelle D. Lall, Michael Gottlieb, Yvette Calderon, Christopher Bennett Jan 2026

Career Plans Among Graduating Us Emergency Medicine Residents, Dave W. Lu, Bo Gu, D. Mark Courtney, Bryan G. Kane, Michelle D. Lall, Michael Gottlieb, Yvette Calderon, Christopher Bennett

Department of Emergency Medicine Faculty Papers

IMPORTANCE: The emergency medicine (EM) workforce is undergoing complex change, including a potential projected physician surplus, the volatile and evolving interests of medical students, and the continued high rates of burnout. Understanding the career intentions of graduating residents is critical to inform workforce planning.

OBJECTIVE: To examine the career plans, anticipated career durations, and key factors associated with the career decisions of graduating US EM residents.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional survey study, which sampled graduating residents from all Accreditation Council for Graduate Medical Education-accredited categorical EM programs, was conducted after the 2023 American Board of Emergency Medicine In-Training …


Career Plans Among Graduating Us Emergency Medicine Residents, Dave W. Lu, Bo Gu, D. Mark Courtney, Bryan G. Kane, Michelle D. Lall, Michael Gottlieb, Yvette Calderon, Christopher Bennett Jan 2026

Career Plans Among Graduating Us Emergency Medicine Residents, Dave W. Lu, Bo Gu, D. Mark Courtney, Bryan G. Kane, Michelle D. Lall, Michael Gottlieb, Yvette Calderon, Christopher Bennett

Department of Emergency Medicine Faculty Papers

IMPORTANCE: The emergency medicine (EM) workforce is undergoing complex change, including a potential projected physician surplus, the volatile and evolving interests of medical students, and the continued high rates of burnout. Understanding the career intentions of graduating residents is critical to inform workforce planning.

OBJECTIVE: To examine the career plans, anticipated career durations, and key factors associated with the career decisions of graduating US EM residents.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional survey study, which sampled graduating residents from all Accreditation Council for Graduate Medical Education-accredited categorical EM programs, was conducted after the 2023 American Board of Emergency Medicine In-Training …


Applying Entrustable Professional Activities Across Emergency Medicine Medical Education Fellowships: A Cross-Institutional Commentary, Carrie Maupin, Ambika Anand, Danielle Nesbit, Casey Morrone, Danielle Sultan Dec 2025

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.


Do Patient-Important Outcomes Differ By Care Setting? Findings From Semi-Structured Interviews With Individuals With Diabetes, Amy Cunningham, Alexzandra Gentsch, Pouya Arefi, Judd E. Hollander, Marianna D Lanoue, Amanda M. B. Doty, Geoffrey Mills, Brendan Carr, Kristin L. Rising Dec 2025

Do Patient-Important Outcomes Differ By Care Setting? Findings From Semi-Structured Interviews With Individuals With Diabetes, Amy Cunningham, Alexzandra Gentsch, Pouya Arefi, Judd E. Hollander, Marianna D Lanoue, Amanda M. B. Doty, Geoffrey Mills, Brendan Carr, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

Background: Patient-important outcomes (PIOs) reflect patient values and preferences. Prior studies have elicited a variety of PIOs for diabetes. However, no studies have examined whether, or how, PIOs differ across diabetes care settings. The purpose of this study was to compare the frequencies of PIOs derived from patients with diabetes in primary care (PC), acute care (emergency department (ED)), and post-acute care (post-hospital discharge (PHD)) settings within a large delivery system. Methods: This study was an analysis of 89 interviews with patients in PC, ED, and PHD settings. Participants had moderately to poorly controlled diabetes, defined as follows: presented to …


Unveiling Humility In Emergency Medicine Chief Residents: A Thematic Exploration Of Standard Letters Of Evaluation, Abagayle Bierowski, Ridhima Ghei, Casey Morrone, Xiao C. Zhang, Dimitrios Papanagnou Nov 2025

Unveiling Humility In Emergency Medicine Chief Residents: A Thematic Exploration Of Standard Letters Of Evaluation, Abagayle Bierowski, Ridhima Ghei, Casey Morrone, Xiao C. Zhang, Dimitrios Papanagnou

Department of Medicine Faculty Papers

INTRODUCTION: Although humility is a key leadership trait linked to collaboration and trust, current residency application processes lack methods to identify it. By examining whether themes of humility appear in the Standardized Letters of Evaluation (SLOE) of medical students who later became emergency medicine (EM) chief residents, we sought to determine the presence of humility-related traits in SLOEs and explore their potential to inform the identification of applicants with leadership potential during residency selection.

METHODS: Two independent reviewers examined 104 SLOEs (52 chief, 52 non-chief) from 2015-2021, representing 43 students (21 who later assumed chief resident positions and 22 who …


Does Cognitive Frame Affect Clinical Reasoning Among Medical Students? A Cross-Sectional Study, Xiao C. Zhang, Sara A. Belko, Andrew J Monick Oct 2025

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 …


Assessing The Cardiac Safety Of A Multimodal Protocol For 'Tranq Dope' Withdrawal: A Retrospective Qtc Analysis, Kory London, Emily Deschler, Sabrina Butt, Steven Graver, Jake Figaniak, Nathan Hersh, Ariana Rucker, Bogdan Popa, Jenna Hoopes, Jennifer Kahoud, Behzad Pavri Oct 2025

Assessing The Cardiac Safety Of A Multimodal Protocol For 'Tranq Dope' Withdrawal: A Retrospective Qtc Analysis, Kory London, Emily Deschler, Sabrina Butt, Steven Graver, Jake Figaniak, Nathan Hersh, Ariana Rucker, Bogdan Popa, Jenna Hoopes, Jennifer Kahoud, Behzad Pavri

Department of Emergency Medicine Faculty Papers

BACKGROUND: "Tranq dope"-fentanyl adulterated with xylazine-has complicated the management of opioid withdrawal in emergency departments (EDs). A novel withdrawal protocol was implemented to address these challenges, utilizing concurrent agents to intentionally synergize and potentiate effects. Questions remain about the safety of its components, some of which may prolong the QT interval.

METHODS: We conducted a retrospective cohort study of adult ED patients with suspected fentanyl/xylazine exposure treated utilizing novel protocol across two urban hospitals in Philadelphia, PA between September 2022 and October 2024. Patients with both pre- and post-treatment electrocardiograms (ECGs) were included. QTc intervals were reviewed by an experienced …


Factors Associated With Corrective Actions, Remediation, And Employment Termination Of Emergency Physicians, Lyndsay Tyler, Yachana Bhakta, Michael Gottlieb, Chadd K. Kraus, Terry Kowalenko, Yvette Calderon, Samuel M. Keim, Diane L. Gorgas, Deborah B. Diercks, Lewis S. Nelson Oct 2025

Factors Associated With Corrective Actions, Remediation, And Employment Termination Of Emergency Physicians, Lyndsay Tyler, Yachana Bhakta, Michael Gottlieb, Chadd K. Kraus, Terry Kowalenko, Yvette Calderon, Samuel M. Keim, Diane L. Gorgas, Deborah B. Diercks, Lewis S. Nelson

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Medical professionalism is fundamental to the delivery of high-quality patient care. There is a paucity of data to describe behaviors associated with negative professional and employment outcomes. This study examines common factors leading to corrective actions, remediation, and termination of emergency physicians (EPs).

METHODS: This was a cross-sectional survey sent to academic chairs in emergency medicine to identify factors for corrective actions, remediation, or termination of EPs. Survey items were piloted and response process validity gathered prior to administration. Data are reported as descriptive statistics.

RESULTS: 60 of 167 (36 %) members of the Association of Academic Chairs in …


Fatal Facial Necrotizing Fasciitis: A Case Report Highlighting Diagnostic And Therapeutic Challenges, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Ali Iqbal, Muhammad Ahsan, Austin Mitchell, Azka Asad Mirza, Joshiah Gordon, Rahmat Gul Omarzai Aug 2025

Fatal Facial Necrotizing Fasciitis: A Case Report Highlighting Diagnostic And Therapeutic Challenges, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Ali Iqbal, Muhammad Ahsan, Austin Mitchell, Azka Asad Mirza, Joshiah Gordon, Rahmat Gul Omarzai

Department of Medicine Faculty Papers

BACKGROUND: Facial Necrotizing Fasciitis (FNF) is a rare but aggressive, life-threatening infection involving the face's subcutaneous tissues and underlying musculature. It can rapidly progress to septic shock and multi-organ failure if not promptly recognized and treated. The clinical course, including severe pain, disproportionate tenderness, and systemic signs, is often the most crucial factor in diagnosis. While computed tomography (CT) can aid in identifying early signs such as soft tissue swelling and gas formation, clinical suspicion remains paramount and should not be delayed by reliance on imaging alone. Without early intervention, FNF may lead to devastating outcomes, including disfigurement, blindness, or …


Sustained Impact: Long-Term Application Of Diagnostic Uncertainty Communication Training, Danielle M. Mccarthy, Jethel Hernandez, Dimitrios Papanagnou, Kenzie A. Cameron, David H, Salzman, Andrew W. Long, Alexandra D. Franiek, Kristin L. Rising Aug 2025

Sustained Impact: Long-Term Application Of Diagnostic Uncertainty Communication Training, Danielle M. Mccarthy, Jethel Hernandez, Dimitrios Papanagnou, Kenzie A. Cameron, David H, Salzman, Andrew W. Long, Alexandra D. Franiek, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

OBJECTIVES: More than one-third of discharged emergency department (ED) patients leave without a clear diagnosis for their symptoms. In 2019-2020, we implemented a simulation-based mastery learning curriculum across two academic medical centers to train emergency medicine residents to discuss diagnostic uncertainty during ED discharge, guided by the Uncertainty Communication Checklist (UCC). We sought to assess if this cohort continues to apply skills learned and to obtain trainee insights into the most valuable checklist items.

METHODS: A survey was emailed to all 109 participants who completed the training in 2019-2020. Questions assessed how often participants currently encountered uncertainty and used the …


Twelve Tips To Help Junior Faculty Review Medical Education Literature With Confidence, Abagayle Bierowski, Casey Morrone, Ridhima Ghei, Michael Pasirstein, Dimitrios Papanagnou Aug 2025

Twelve Tips To Help Junior Faculty Review Medical Education Literature With Confidence, Abagayle Bierowski, Casey Morrone, Ridhima Ghei, Michael Pasirstein, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

Peer reviews play a critical role in maintaining the quality, credibility, and advancement of medical education scholarships. While many early career faculty members are eager to contribute to the peer review process, there are few formal resources available to guide them in how to approach this work effectively. This article offers 12 practical tips tailored specifically for junior faculty who are new to reviewing medical education manuscripts. These tips cover key aspects of the review process, including how to structure feedback, evaluate methodological rigor, assess alignment with journal aims, and communicate constructively with authors and editors. The guide also emphasizes …