Direct Observation Tools in Emergency Medicine: A Systematic Review of the Literature.
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ABSTRACT: Objectives
Direct observation is important for assessing the competency of medical learners. Multiple tools have been described in other fields, although the degree of emergency medicine-specific literature is unclear. This review sought to summarize the current literature on direct observation tools in the emergency department (ED) setting.Methods
We searched PubMed, Scopus, CINAHL, the Cochrane Central Register of Clinical Trials, the Cochrane Database of Systematic Reviews, ERIC, PsycINFO, and Google Scholar from 2012 to 2020 for publications on direct observation tools in the ED setting. Data were dual extracted into a predefined worksheet, and quality analysis was performed using the Medical Education Research Study Quality Instrument.Results
We identified 38 publications, comprising 2,977 learners. Fifteen different tools were described. The most commonly assessed tools included the Milestones (nine studies), Observed Structured Clinical Exercises (seven studies), the McMaster Modular Assessment Program (six studies), Queen's Simulation Assessment Test (five studies), and the mini-Clinical Evaluation Exercise (four studies). Most of the studies were performed in a single institution, and there were limited validity or reliability assessments reported.Conclusions
The number of publications on direct observation tools for the ED setting has markedly increased. However, there remains a need for stronger internal and external validity data.
SUBMITTER: Gottlieb M
PROVIDER: S-EPMC8138102 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundAccording to the Centers for Disease Control and Prevention, suicidality and suicidal behavior among youth continues to increase significantly each year. Many of those who die by suicide interact with health services in the year before death. This systematic review sought to identify and describe empirically tested screening tools for suicidality in youth presenting to Emergency Departments (ED).Objective(1) To identify and compare existing tools used to screen for suicidality in children and adolescents who present to the ED and (2) to ascertain the prevalence of suicidality in pediatric populations found with these tools.MethodsWe searched Ovid Medline, CINAHL, Scopus, and Cochrane databases for primary research studies that identified and evaluated screening tools for suicide risk in pediatric ED patients. A total of 7,597 publications published before August 25, 2021 met search criteria and were screened by two independent reviewers based on our inclusion and exclusion criteria, with any conflicts resolved via consensus meetings or an independent reviewer. A total of 110 papers were selected for full text review, of which 67 were excluded upon further inspection. Covidence was used to extract and synthesize results.Results43 articles were eligible for inclusion. Most studies (n = 33) took place in general pediatric EDs; the quality was generally high. Patients ranged from 4-24 years old, with most screening tested in patients 12 years and older. The most researched tools were the Ask-Suicide Screening Questions (ASQ) (n = 15), Columbia-Suicide Severity Rating Scale (C-SSRS) (n = 12), Suicidal Ideation Questionnaire (SIQ) (n = 11), and the Risk of Suicide Questionnaire (RSQ) (n = 7). Where screening was applied to all patients, about one-fifth of pediatric ED patients screened positive; where suicide screening was applied to psychiatric patients only, over half screened positive. Positive screens were more likely to be female and older than negative screens and they were more likely to be assessed and admitted.ConclusionSeveral validated screening tools exist for the purpose of screening pediatric populations in EDs for suicidality. Such tools may help to support early detection and appropriate intervention for youth at risk of suicide.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=276328, identifier: 276328.
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Project description:ObjectiveIn the era of competency-based medical education (CBME), the collection of more and more trainee data is being mandated by accrediting bodies such as the Accreditation Council for Graduate Medical Education and the Royal College of Physicians and Surgeons of Canada. However, few efforts have been made to synthesize the literature around the current issues surrounding workplace-based assessment (WBA) data. This scoping review seeks to synthesize the landscape of literature on the topic of data collection and utilization for trainees' WBAs in emergency medicine (EM).MethodsThe authors conducted a scoping review in the style of Arksey and O'Malley, seeking to synthesize and map literature on collecting, aggregating, and reporting WBA data. The authors extracted, mapped, and synthesized literature that describes, supports, and substantiates effective data collection and utilization in the context of the CBME movement within EM.ResultsOur literature search retrieved 189 potentially relevant references (after removing duplicates) that were screened to 29 abstracts and papers relevant to collecting, aggregating, and reporting WBAs. Our analysis shows that there is an increasing temporal trend toward contributions in these topics, with the majority of the papers (16/29) being published in the past 3 years alone.ConclusionThere is increasing interest in the areas around data collection and utilization in the age of CBME. The field, however, is only beginning to emerge, leaving more work that can and should be done in this area.
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