Can J Emerg Med
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The Ottawa Emergency Department Shift Observation Tool (O-EDShOT) is a workplace-based assessment designed to assess a trainee's performance across an entire shift. It was developed in response to validity concerns with traditional end-of-shift workplace-based assessments, such as the daily encounter card. The O-EDShOT previously demonstrated strong psychometric characteristics; however, it remains unknown whether the O-EDShOT facilitates measurable improvements in the quality of documented assessments compared to daily encounter cards. ⋯ The O-EDShOT yields higher quality documented assessments when compared to the traditional end-of-shift daily encounter card. Our results provide additional validity evidence for the O-EDShOT as an assessment tool for capturing trainee on-shift performance that can be used as a stimulus for actionable feedback and as a source for high-quality workplace-based assessment data to inform decisions about emergency medicine trainee progress and promotion.
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Multicenter Study
Post-concussion symptoms in sports-related mild traumatic brain injury compared to non-sports-related mild traumatic brain injury.
To compare post-concussion symptoms in patients who sustained a sports-related mild traumatic brain injury (TBI) to those with non-sports-related mild TBI at 7 and 90 days post-injury. ⋯ Patients who sustained sports-related mild TBI could be at lower risk of experiencing symptoms such as fatigue and dizziness 90 days post-injury. Clinicians should be mindful that non-sports-related mild TBI patients may experience more post-concussion symptoms and that the level of physical activity may influence the patient's rehabilitation.
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Emergency department (ED) throughput efficiency is largely dependent on staffing and process, and many operational interventions to increase throughput have been described. ⋯ Introducing a fast track and optimizing processes for important case-mix groups will likely enhance throughput efficiency. Expediting diagnostic and treatment decisions by shifting physician-patient contact to the earliest possible process point (e.g., triage) is an effective cost-neutral strategy to increase flow. Focusing ED staff on operational improvement is likely to improve performance, regardless of the intervention type.
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Little is known about how the Royal College of Emergency Medicine (RCEM) residency programs are selecting their residents. This creates uncertainty regarding alignment between current selection processes and known best practices. We seek to describe the current selection processes of Canadian RCEM programs. ⋯ We have identified elements of the selection process that will inform recommendations for programs, students, and referees. We encourage programs to conduct regular reviews of their selection process going forward to be in alignment with best practices.
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Multicenter Study
Characteristics of vomiting as a predictor of intracranial injury in pediatric minor head injury.
Vomiting is common in children after minor head injury. In previous research, isolated vomiting was not a significant predictor of intracranial injury after minor head injury; however, the significance of recurrent vomiting is unclear. This study aimed to determine the value of recurrent vomiting in predicting intracranial injury after pediatric minor head injury. ⋯ Recurrent vomiting (≥ four episodes) was a significant risk factor for intracranial injury in children after minor head injury. The probability of intracranial injury increased with the number of vomiting episodes and if accompanied by other high-risk factors, such as signs of a skull fracture or altered level of consciousness.