Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Predictors of emergency department patient satisfaction: stability over 17 months.
The contradictory findings reported in the emergency department (ED) patient satisfaction literature may be due to methodologic differences between studies, as well as actual differences in predictors. The authors examined the stability of predictors of ED patient satisfaction across multiple assessments over 17 months. ⋯ Using p-value cut-offs as the sole criterion for interpreting which variables are most important in determining ED patient satisfaction is ill-advised, and may lead to spurious conclusions of discrepant findings. Nevertheless, some determinants of ED satisfaction likely differ meaningfully based on the cohort that is being examined. Overgeneralizing conclusions derived from a single ED patient satisfaction study should be avoided, especially those studies that are cross-sectional and use a single site.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effectiveness of an adult-learning, self-directed model compared with traditional lecture-based teaching methods in out-of-hospital training.
Until recently, the U.S. Army Combat Medic School used a traditional teaching model with heavy emphasis on large group lectures. Skills were taught separately with minimal links to didactics. ⋯ In this study setting, an adult-learning model offers only a modest improvement in cognitive evaluation scores over traditional teaching when measured at the end of the course. Additionally, students in the traditional teaching model assess themselves as proficient more frequently than instructors, whereas instructor and student perception of proficiency more closely matched in the adult-learning model.
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No single universal definition of emergency department (ED) overcrowding exists. The authors hypothesize that a previously developed site-sampling form for academic ED overcrowding is a valid model to quantify overcrowding in academic institutions and can be used to develop a validated short form that correlates with overcrowding. ⋯ Overcrowding varied widely between academic centers during the study period. Results of a five-question reduced model are valid and accurate in predicting the degree of overcrowding in academic centers.
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No widely used triage instrument accurately assesses patient acuity. The Emergency Severity Index (ESI) promises to facilitate reliable acuity assessment and possibly predict patient disposition. However, reliability and validity of ESI scores have not been established in emergency departments (EDs) outside the original research sites, and version 3 (v.3) of the ESI has not been evaluated. The study hypothesis was that scores on the ESI v.3 show good interrater reliability and predict hospital admission, admission site, and death. ⋯ Scores on the ESI assigned by nurses have excellent interrater reliability and predict hospital admission and location of admission.