Articles: emergency-medicine.
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Africa's first conference on emergency medicine was held in October 1998 in Johannesburg, South Africa. Attended by 305 delegates from 13 countries, it was an important milestone in the development of Africa, emergency medicine's last frontier. ⋯ A session reviewing the activities of traditional healers was not only terrifyingly revealing, it also upset and offended a segment of the African audience. The conference ended positively with the creation of the Emergency Medicine Society of South Africa, a step toward recognition of emergency medicine as a specialty in Africa.
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While the teaching and assessing of technical skills have been an integral part of residency training, the demonstration of ethical and humanistic skills has been more or less left to chance. Only in the last two decades has the formal teaching of bioethics become an accepted component of Western medical education. In spite of the many ethics lectures, discussions, conferences, and courses, the clinical impact of this educational paradigm shift remains unclear. ⋯ The few prospective evaluations of trainees have focused on single-researcher observations or student attitude surveys that are fraught with observer and recall biases, respectively. More reliable and valid methods of identifying clinical ethical competence are needed. This paper reviews a variety of evaluative tools and suggests a three-level approach to monitoring the ethical knowledge, capacity, and real-time performance of emergency medicine residents.
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The purpose of this review is to present a guide to help readers critically appraise the methodologic quality of an article or articles describing a clinical decision rule. This guide will also be useful to clinical researchers who wish to answer 1 or more questions detailed in this article. We consider the 6 major stages in the development and testing of a new clinical decision rule and discuss a number of standards within each stage. We use examples from emergency medicine and, in particular, examples from our own research on clinical decisions rules for radiography in trauma.
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To evaluate the impact of environmental factors on emergency medicine (EM) resident career choice. ⋯ Modification of the EM training environment may influence the career choices of graduates. Specifically, greater commitment of departmental funds and support of resources for research may enhance the likelihood of a trainee's choosing an academic research career.
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Changing health care markets have threatened academic health centers and their traditional focus on teaching and research. ⋯ Academic EM departments are often affiliated with nonacademic ED sites. These additional sites are commonly staffed by academic EM faculty and EM residents. Academic productivity does not appear to decrease when additional ED sites are added. Reimbursement monies from these ED sites commonly supports academic activities.