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Objectives: Precision medicine is data‐driven health care tailored to individual patients based on their unique attributes, including biologic profiles, disease expressions, local environments, and socioeconomic conditions. Emergency medicine (EM) has been peripheral to the precision medicine discourse, lacking both a unified definition of precision medicine and a clear research agenda. We convened a national consensus conference to build a shared mental model and develop a research agenda for precision EM. Methods: We held a conference to (1) define precision EM, (2) develop an evidence‐based research agenda, and (3) identify educational gaps for current and future EM clinicians. Nine preconference workgroups (biomedical ethics, data science, health professions education, health care delivery and access, informatics, omics, population health, sex and gender, and technology and digital tools), comprising 84 individuals, garnered expert opinion, reviewed relevant literature, engaged with patients, and developed key research questions. During the conference, each workgroup shared how they defined precision EM within their domain, presented relevant conceptual frameworks, and engaged a broad set of stakeholders to refine precision EM research questions using a multistage consensus‐building process. Results: A total of 217 individuals participated in this initiative, of whom 115 were conference‐day attendees. Consensus‐building activities yielded a definition of precision EM and key research questions that comprised a new 10‐year precision EM research agenda. The consensus process revealed three themes: (1) preeminence of data, (2) interconnectedness of research questions across domains, and (3) promises and pitfalls of advances in health technology and data science/artificial intelligence. The Health Professions Education Workgroup identified educational gaps in precision EM and discussed a training roadmap for the specialty. Conclusions: A research agenda for precision EM, developed with extensive stakeholder input, recognizes the potential and challenges of precision EM. Comprehensive clinician training in this field is essential to advance EM in this domain. [ABSTRACT FROM AUTHOR]

Background: Precision medicine, sometimes referred to as personalized medicine, is rapidly changing the possibilities for how people will engage health care in the near future. As technology to support precision medicine exponentially develops, there is an urgent need to proactively improve our understanding of precision medicine and pose important research questions (RQs) related to its inclusion in the education and training of future emergency physicians. Methods: A seven‐step process was employed to develop a research agenda exploring the intersection of precision and emergency medicine education/training. A literature search of articles about precision medicine was conducted first, which informed the creation of future four scenarios in which trainees and practicing physicians regularly discuss and incorporate precision medicine tools into their discussions and work. Based on these futurist narratives, potential education RQs were generated by an expert panel. A total of 59 initial questions were subsequently categorized and refined to a priority list through a nominal group voting method. The top/priority questions were presented at the 2023 SAEM Consensus Conference on Precision Medicine, Austin, Texas, for further input. Results: Eight high‐value education RQs were developed, reflecting a holistic view of the challenges and opportunities for precision medicine education in the knowledge, skills, and attitudes relevant to emergency medicine. These questions contend with topics such as most effective pedagogical methods; intended resulting outcomes and behaviors; the generational differences between practicing emergency physicians, educators, and future trainees; and the desires and expectations of patients. Conclusions: Emergency medicine and emergency physicians must be prepared to understand precision medicine and incorporate this information into their "toolbox" of thinking, problem solving, and communication with patients and colleagues. This research agenda on how best to educate future emergency physicians in the use of personalized data to provide optimal health care is the focus of this article. [ABSTRACT FROM AUTHOR]

Purpose: Entrustable professional activities (EPAs) are a widely used framework for curriculum and assessment, yet the variability in emergency medicine (EM) training programs mandates the development of EPAs that meet the needs of the specialty as a whole. This requires eliciting and incorporating the perspectives of multiple stakeholders (i.e., faculty, residents, and patients) in the development of EPAs. Without a shared understanding of what a resident must be able to do upon graduation, we run the risk of advancing ill‐prepared residents that may provide inconsistent care. Methods: In an effort to address these challenges, beginning in February 2020, the authors assembled an advisory board of 25 EM faculty to draft and reach consensus on a final list of EPAs that can be used across all training programs within the specialty of EM. Using modified Delphi methodology, the authors came to consensus on an initial list of 22 EPAs. The authors presented these EPAs to faculty supervisors, residents, and patients for refinement. The authors collated and analyzed feedback from focus groups of residents and patients using thematic analysis. The EPAs were subsequently refined based on this feedback. Results: Stakeholders in EM residency training endorsed a final revised list of 22 EPAs. Stakeholder focus groups highlighted two main thematic considerations that helped shape the finalized list of EM EPAs: attention to the meaningful nuances of EPA language and contextualizing the EPAs and viewing them developmentally. Conclusions: To foreground all key stakeholders within the EPA process for EM, the authors chose within the development process to draft; come to consensus; and refine EPAs for EM in collaboration with relevant faculty, patient, and resident stakeholders. Each stakeholder group contributed meaningfully to the content and intended implementation of the EPAs. This process may serve as a model for others in developing stakeholder‐responsive EPAs. [ABSTRACT FROM AUTHOR]

Background: It is essential that medical education (MedEd) fellows achieve desired outcomes prior to graduation. Despite the increase in postgraduate MedEd fellowships in emergency medicine (EM), there is no consistently applied competency framework. We sought to develop entrustable professional activities (EPAs) for EM MedEd fellows. Methods: From 2021 to 2022, we used a modified Delphi method to achieve consensus for EPAs. EM education experts generated an initial list of 173 EPAs after literature review. In each Delphi round, panelists were asked to make a binary choice of whether to include the EPA. We determined an inclusion threshold of 70% agreement a priori. After the first round, given the large number of EPAs meeting inclusion threshold, panelists were instructed to vote whether each EPA should be included in the "20 most important" EPAs for a MedEd fellowship. Modifications were made between rounds based on expert feedback. We calculated descriptive statistics. Results: Seventeen experts completed four Delphi rounds each with 100% response. After Round 1, 87 EPAs were eliminated and two were combined. Following Round 2, 46 EPAs were eliminated, seven were combined, and three were included in the final list. After the third round, one EPA was eliminated and 13 were included. After the fourth round, 11 EPAs were eliminated. The final list consisted of 16 EPAs in domains of career development, education theory and methods, research and scholarship, and educational program administration. Conclusions: We developed a list of 16 EPAs for EM MedEd fellowships, the first step in implementing competency‐based MedEd. [ABSTRACT FROM AUTHOR]

Consensus methods such as the Delphi and nominal group techniques are increasingly utilized within medical education research. This educator's blueprint paper provides practical strategies regarding five key steps for ensuring best practices when using consensus methods. These strategies include deciding which consensus method is best, developing the initial questionnaire, identifying the participants, determining the number of rounds and consensus threshold, and describing and justifying any modifications. These strategies will help guide education researchers on their next study using consensus methods. [ABSTRACT FROM AUTHOR]

Background: The increasing number of vulnerable populations served by the emergency department (ED) calls for developing and implementing curricula aimed at training residents to deliver quality care for the most marginalized groups. Objective: We aimed to address this by developing and piloting a curriculum to introduce the unique challenges and disparities encountered by our diverse ED patient population using an experiential learning approach. Methods: We engaged community partners in designing and implementing a curriculum for incoming interns. This curriculum addresses specific populations encountered within the ED including patients with psychiatric illness, patients with cognitive disabilities, intoxicated patients, violent patients, patients of various cultural backgrounds, non-English-speaking patients, and LGBTQ patients. Experiential and active learning sessions with content experts and site visits to area organizations were arranged. Pre-, post-, and time-delayed surveys were deployed to evaluate the pilot of this curriculum. Results: Thirteen incoming interns participated in the orientation curriculum. Residents' comfort with each of these various patient populations as well as familiarity with community and ED resources was assessed before, after, and 1 year delayed from each session (response 13/13, 100%). Their scores increased significantly from baseline in the postsurvey and were maintained 1 year later (p < 0.05). Residents additionally provided narrative responses regarding what they learned and what was most helpful after completing their intern year. Conclusions: This pilot curriculum demonstrates that implementing an experiential learning curriculum and engaging community leaders and resources is key to training residents to address health disparities within their unique ED patient population. As such, it is imperative that we seek to immersively introduce trainees to the unique needs of the patient population they will serve early in training. [ABSTRACT FROM AUTHOR]

Objectives: The goal of this study was to develop and evaluate a novel curriculum and assessment tool for Core Entrustable Professional Activity (EPA) 10 competencies and entrustment scoring in a cohort of medical students in their emergency medicine (EM) clerkship using a framework of individualized, ad hoc, formative assessment. Core EPA 10 is an observable workplace-based activity for graduating medical students to recognize a patient requiring urgent or emergent care and initiate evaluation and management. Methods: This is a prospective, pretest-posttest study of medical students during their EM clerkship. Using the Thomas and Kern framework, we created a curriculum of simulation cases about chest pain/cardiac arrest and respiratory distress, which included novel assessment checklists, and instructional videos about recognizing and managing emergencies. Students were individually pretested on EPA 10 competencies using the simulation cases. Two raters scored students using standardized checklists. Students then watched instructional videos, underwent a posttest with the simulation cases, and were scored again by the two raters using the checklists. Differences between pretest and posttest scores were analyzed using paired t-tests and Wilcoxon signed-rank tests. Results: Seventy-three out of 85 (86%) students completed the curriculum. Mean scores from pretest to final posttest in the chest pain/cardiac arrest and respiratory distress cases significantly improved from 14.8/19 (SD 1.91), to 17.1/19 (SD = 1.00), t(68) = 10.56, p < 0.001, and 8.5/13 (SD 1.79), to 11.1/13(SD 0.89), t(67) = 11.15, p < 0.001, respectively. The kappa coefficients were 0.909 (n = 2698, p < 0.001) and 0.931 (n = 1872, p < 0.001). Median modified Chen entrustment scores improved from 1b (i.e., "Watch me do this") to 2b (i.e., "I'll watch you") for the chest pain/cardiac arrest case (p < 0.001) and 1b/2a (i.e., "Watch me do this"/"Let's do this together") to 3a (i.e. "You go ahead, and I'll double-check all of your findings") for the respiratory distress case (p < 0.001). Conclusion: A new directed curriculum of standardized simulation cases and asynchronous instructional videos improved medical student performance in EPA 10 competencies and entrustment scores. This study provides a curricular framework to support formative individualized assessments for EPA 10. [ABSTRACT FROM AUTHOR]

Introduction: As the field of medical education evolves, there is a need to increase the quality of education scholarship and develop a cadre of research scholars; however, clinician educators (CEs) considering this career transition have limited formal training in education research methodology to heed this call. Therefore, a program that provides more advanced training in education scholarship for CEs without the financial and resource barriers of fellowships and masters programs is needed. Methods: The SAEM Advanced Research Methodology Evaluation and Design in Medical Education (ARMED MedEd) program is a longitudinal program for the beyond-beginner CE, seeking advanced training in education research. The program was created using a comprehensive needs assessment and included longitudinal training; small-group projects; dedicated project mentors; and integrated diversity, equity, and inclusion initiatives. Program participants applied for a grant upon program completion. Results: Twenty-one participants completed the course with 100% completing the baseline survey and 67% (14/21) completing the end-of-program survey. Participants reported improved perception of knowledge across all of the topics with a medium to large effect size, ranging from 0.40 to 0.62. When asked about impact on their network of potential collaborators, participants reported a median of 7 (interquartile range [IQR] 5-8) out of 9. When asked about the impact on their community of practice, participants reported a median of 7 (IQR 5-7) out of 9. When asked about the impact on their professional identity, participants reported a median of 7 (IQR 4-9) out of 9. Participants also reported an increase in both the quantity (mean of 2 ± 1 new mentors) and the quality (median score 7 [IQR 5-8] out of 9) of new research mentorship as a result of the program. Open-ended feedback was generally positive, with 100% reporting they would advise others to take this program. Conclusions: The SAEM ARMED MedEd program represents a proof of concept for an advanced education research program seeking to fill the research training gap for the beyond-beginner Clinician educators. [ABSTRACT FROM AUTHOR]

Introduction: All emergency medicine (EM) residency programs must recruit new medical school graduates each year. The process is often overwhelming, with each program receiving far more applicants than available positions. We searched for evidence‐based best practices to guide residency programs in screening, interviewing, and ranking applicants to ensure a high‐performing and diverse residency class. Methods: A literature search was conducted on the topic of residency recruitment, utilizing a call on social media as well as multiple databases. After identifying relevant articles, we performed a modified Delphi process in three rounds, utilizing junior educators as well as more senior faculty. Results: We identified 51 relevant articles on the topic of residency recruitment. The Delphi process yielded six articles that were deemed most highly relevant over the three rounds. Transparency with selection criteria, holistic application review, standardized letters of evaluation, and blinding applicant files for interviewers were among noted best practices. Conclusions: Well‐supported evidence‐based practices exist for residency recruitment, and programs may benefit from understanding which common recruitment practices offer the most value. The articles discussed here provide a foundation for faculty looking to improve their program's recruiting practices. [ABSTRACT FROM AUTHOR]