Can J Emerg Med
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To evaluate the impact of an emergency department (ED) automatic preauthorization policy on after-hours utilization of neuroradiology computed tomography (CT). ⋯ Implementation of an automatic preauthorization policy for after-hours neuroradiology CT studies did not result in a statistically significant increase in CT utilization. This suggests that concerns regarding the negative effects of such policies may be unfounded, and further research in this area is warranted.
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With the arrival of a technologically proficient generation of learners (often described with the moniker "digital natives") into Canadian medical schools and residency programs, there is an increasing trend toward harnessing technology to enhance education and increase teaching efficiency. We present an instructional method that allows medical educators to "reverse" the traditional classroom paradigm. Imagine that prior to an academic half-day session, learners watch an e-lecture on their own time; then during class, they do "homework" with tailored consultations from a content expert. ⋯ With this instructional method, the inefficient, repetitious delivery of recurring core lectures is no longer required. The reverse classroom is an effective instructional method. Using this technique, learners engage in high-order learning and interaction with teachers, and teachers are able to optimally share their expertise.
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Multicenter Study Observational Study
Adverse events are rare among adults 50 years of age and younger with flank pain when abdominal computed tomography is not clinically indicated according to the emergency physician.
Many emergency physicians (EPs) order "confirmatory" abdominal computed tomography (CT) in young flank pain patients, despite a high clinical suspicion of renal colic and the risk of radiation exposure. We measured the adverse outcome rate among flank pain patients identified as not requiring abdominal CT by the EP on a data form, regardless of whether CT was eventually ordered. Our secondary objective was to describe diagnoses other than renal colic identified by CT in this population. ⋯ Adverse events were rare (< 1.5%) among patients < 50 years old with flank pain when CT was not required according to the clinical assessment of the EP. Future research should assess the adverse outcomes of withholding CT in low-risk patients using a larger patient sample.