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SAEM Reports - Academy News - Interest Group Updates - Committee Info
ACADEMY NEWS
Academy of Geriatric Emergency Medicine
The ARMED Course Sets You Up for the Future
Sarah Keene, MD, PhD, a Geriatric Emergency Medicine Fellow, Beaumont Health, Royal Oak, MI, was a participant in SAEM’s Advanced Research Methodology, Evaluation, and
Dr. Sarah Keene Design (ARMED) course this past academic year. She shares her experience below: “The ARMED course is SAEM’s leading course on research methodology and grant writing. The ARMED course functionally has two components: 1) a series of lectures on research opportunities, methods, and grant writing best practices; and 2) three workshops on grant writing, with direct feedback on your grant. Lectures are spread throughout the year and are virtual. The workshops are before the ACEP annual conference, the SAEM annual conference, and an additional workshop in February, usually held in Chicago.
“Didactics range in topic from the different components of a grant to various funding opportunities. The first workshop is an intensive overview of how funding research works in emergency medicine. The second two workshops focus on your specific aims page, as this is the make-or-break section of your grant. Specific aims pages are shared and edited in small groups. I found the workshops to be the greatest value of the ARMED course. The specific aims page I wrote for the course was the first specific aims page I had ever written by myself, and it showed! Writing a specific aims page is a skill that is separate from the skill required to write the rest of a grant (or a paper), as specific aims pages must be both comprehensive and extremely succinct. Achieving one takes practice, but achieving both at the same time requires effort, dedication, and a great deal of editing. While I wouldn’t say that my first draft was the worst specific aims page ever written, it certainly was not something that would have resulted in anyone giving me money. After spending multiple days (and multiple drafts) receiving edits from both peers and the experienced leaders of the course, my specific aims page has turned into something that can be the foundation of a grant – hopefully a successful one.
“I hope to have an EM career that is productive both clinically and academically. Part of my academic success will be dependent on my ability to score funding and turn that funding into research that moves the specialty of geriatric emergency medicine forward. I feel fortunate to have had the opportunity to learn from the many generous leaders of the course. Additionally, having completed the ARMED course allows you to apply for a specific ARMED SAEM grant, which is a nice bonus for early researchers!”
Applications are now being accepted for the 2022-2023 Advanced Research Methodology Evaluation and Design (ARMED). Apply by July 31. Scholarships are available.
Clerkship Directors in Emergency Medicine
Announcing a New Mentorship Program for CDEM Members
The executive committee of SAEM’s Clerkship Directors in Emergency Medicine (CDEM) academy is pleased to announce a new mentorship program run by the CDEM Career Development and Mentorship Committee. The mentorship program will aspire to develop and provide resources, mentoring, and activities that support emergency medicine educators to transition to multiple roles in undergraduate medical education. Any CDEM member in good standing may apply to be a mentee and any CDEM member in good standing with greater than three years in a leadership position as a medical student educator may serve as a mentor. To participate in this program either as a mentor or mentee, please complete the CDEM Mentorship Form. Once you sign up, the CDEM Career Development and Mentorship Committee will match you with a mentor or mentee based on your responses and provide you with resources to optimize the relationship. For more information, please contact Juana Vazquez.
Global Emergency Medicine
Check Out the New Video from GEMA
In a new video from SAEM’s Global Emergency Medicine Academy hear about what decolonizing global health means to trainees from around the globe and how they envision the path forward. The video, “Decolonizing Global Health for The Next Generation- Perspectives of Trainees from Around the World” was produced by GEMA members Nikkole Turgeon, MD, Boston Medical Center, Oluwarotimi Vaughan-Ogunlusi, MB, BCh, BAO, Royal College of Surgeons in Ireland, and Fahad Ali, MD, Brown University.
INTEREST GROUP UPDATES
Informatics and Data Science
The SAEM Informatics and Data Science Interest Group is excited to announce new leadership and this year’s agenda.
The interest group met in May at SAEM22 in New Orleans to vote on its new leadership. Christian Rose, MD, Stanford University, and Robert Turer, MD, UT Southwestern, new chair and vice chair, respectively, assumed the reins from immediatepast chair Andrew Taylor, MD, MHS, Yale. This year, the interest group aims to share works in progress and educational sessions during monthly meetings, to be held the third Thursday of each month at 11 a.m. CT. We welcome members with varied backgrounds and experience to collaborate and create digital solutions for patients and providers alike. Joining an interest group is free for SAEM members. Simply log in to your SAEM account and clicking the button “Update (+/-) Academies and Interest Groups.”
Vice Chairs
Save the date for the 2023 SAEM Consensus Conference, Precision Emergency Medicine: Setting a Research Agenda, to take place May 15, 2023, at the JW Marriott hotel in Austin, TX. The meeting will include an innovative mix of educational, networking, and consensus-building activities aimed at developing a 10-year research agenda for fundable, high-quality, health services research in precision emergency medicine.
Precision emergency medicine is the purposeful use of big data and technology to deliver acute care safely, efficiently, and authentically for individual patients and their communities. This paradigm builds upon the concept of precision medicine, in which clinical decisions are tailored to individual patients through the application of biological, genomic, public health, and environmental data. In this model, emergency physicians could leverage many emerging sources of patient data derived from technologies such as rapid point-of-care testing, -omics, wearable and implantable devices, and community-based and public health databases. Machine learning and other artificial intelligence applications would strengthen analyses of these data and improve the accuracy of clinical decisionmaking. The use of multisource data, technology, and analyses contextualized to the local community can allow for emergency care individually tailored to patient specific needs.
Though precision emergency medicine seems decades away, the data streams and analytics are already available. The adoption of precision medicine principles would represent a paradigm shift in emergency medicine towards technologyenhanced, data-driven, higher quality, individualized care. However, most emergency providers are unfamiliar with these new data sources, how to interpret them, and how to modify their clinical practices accordingly. Research is needed to understand how to best implement precision emergency medicine in an equitable and effective manner. For this purpose, will convene experts and thought leaders from academia and the technology sector to examine the key catalysts of precision emergency medicine, identify implementation challenges, and develop an actionable research agenda with relevant patientcentered outcomes.
The conference will introduce precision emergency medicine as a conceptualization of translational science that results in timely, specific, patient-centered, emergency care. Conference outcomes will stimulate further research to examine precision emergency medicine as a higher-quality, safer, more equitable, and more accessible clinical care paradigm than current practices. To accomplish these goals, the consensus conference will meet the following aims: (1) develop a shared mental model of precision emergency medicine, (2) establish a research agenda for precision emergency medicine for the next decade, and (3) identify educational gaps that must be addressed for emergency providers.
Join this diverse group of national thought leaders in emergency medicine and precision health, industry and technology partners, policy makers, and patients to shape the future adoption of precision emergency medicine.
We welcome your engagement!
We invite your participation in one of eight pre-conference working groups: 1.) Informatics; 2.) Omics; 3.) Data Science; 4.) Technology and Digital Tools; 5.) Healthcare Delivery Systems and Access to Care; 6.) Population Health and Social Emergency Medicine; 7.) Biomedical Ethics; 8.) Health Professions Education. These working groups will meet several times in the months leading up to the conference to craft the overarching research questions to be discussed at the meeting.
To join a working group, please email Dr. Matthew Strehlow, 2023 Consensus Conference co-chair.
Evidence Based Healthcare and Implementation
The SAEM Evidence Based Healthcare and Implementation Interest Group is pleased to announce the winner of the inaugural Rakesh Engineer Award, named in honor of Dr. Rakesh Engineer (1970-2019), a leader in the field of emergency medicine implementation and knowledge translation science. The award recognizes a high quality oral or poster presentation at the SAEM Annual Meeting in implementation science showing sustained positive change. After a rigorous process of abstract review using a modified RE-AIM rubric, the final winner was selected: “Development and Implementation of ED QI Initiative to Improve the Treatment of Patients with OUD” by Natalija M. Farrell, PharmD; Jessica Taylor, MD; and Lauren M. Nentwich, MD, from Boston Medical Center.
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The winning project utilized a multidisciplinary approach to help patients with opioid use disorder engage in treatment while in the Emergency Department (ED). Working to find a creative way to meet state regulations and still reach these patients at their point of access to healthcare, their team developed “take home kits” for these patients that included doses of buprenorphine-naloxone and naloxone, along with medication education and referral information. These kits were distributed out of the ED and patients were referred to prompt follow-up at the hospital’s Faster Paths substance use disorder bridge clinic.
Their novel program showed significant success. Their ED nearly doubled the use of take-home kits from 193 to 397 over the 4-year period, their use of medication for opioid use in the ED increased 5-fold, and the percent of patients who followed up at the bridge clinic increased from 43% to 77%. Perhaps most notable is that they have not only maintained but also grown the program over their 4 years since starting it.
We interviewed the Dr. Farrell (@NatalijaFarrell) and her team about the success of their project and what learning points they had to share with others.
What made you decide to do this project, in particular?
Boston Medical Center is located at the center of the opioid epidemic in Boston. Our patients commonly present tonthe emergency department (ED) following overdose, in opioid withdrawal, or for complications related to opioid use disorder (OUD). Long boarding times also make it more likely that our patients will go into opioid withdrawal during their ED visit. Our ED has a long history of providing naloxone take home kits and connecting patients with Project ASSERT’s team of licensed drug and alcohol counselors; however, we weren’t actively treating opioid withdrawal with medications for OUD (MOUD) and had very few providers that were X-waivered. We recognized that we could be doing a lot more to make our patients more comfortable during their ED stay and better engage them with the substance use disorder (SUD) resources available at our institution.
How did you form your team?
We had ED nurse, physician, and pharmacist champions for improving the care of patients with OUD. We formed a work group of key stakeholders, which included leaders from ED nursing, ED physicians, ED pharmacists, Project ASSERT, addiction medicine, and our SUD bridge clinic (Faster Paths). We met several times early in the project to identify barriers and create solutions. Afterwards, the quality improvement project leads continued to meet regularly to assess the impact of our interventions and obtain feedback from frontline staff. The full work group received monthly updates on the project, which have since been spaced out to at least quarterly. What do you think is the take home message from your project for others?
A multidisciplinary approach is essential to successfully developing and implementing strategies that increase patient access to MOUD, naloxone, and outpatient addiction medicine services. Project goals can evolve as frontline staff and patients become more familiar with the practice change. For example, our project first focused on staff education, guideline creation, and stocking MOUD in the ED. As our ED became more comfortable treating opioid withdrawal and prescribing buprenorphine at discharge, we have been able to implement additional changes, such as buprenorphine-naloxone take home kits, applying the methadone “72-hour rule” at our SUD bridge clinic with rapid linkage to opioid treatment program, and expanding naloxone take home kit ordering privileges to pharmacists, to meet the needs of our patients. What are your future plans for this work? What do you think is the next step?
We continue to evaluate how we can further provide access to OUD treatment and harm reduction strategies to our patients. Some of our plans include to further optimize MOUD order sets, expand naloxone take home kit ordering privileges to other healthcare team members, create and assess the impact of interventions on improving MOUD access to racially and ethnically diverse patients, to evaluate the retention of patients receiving outpatient addiction medicine services, and to evaluate the impact of ED MOUD on long term ED utilization rates. We also plan to submit our work for publication. Do you have any tips for others interested in doing a similar project?
Developing and refining the care our patients with OUD receive in the ED has been rewarding. Changing culture and practice can take a long time. Implementing a limited number of key low effort, moderate to high impact interventions can help get the project started. Sharing success stories through data and patient stories always helps to create buy-in from the frontline. Sustainability is often difficult for implementation science projects. Why do you think you did so well with this?
Sustainability is challenging, but regularly engaging our frontline staff and patients have helped us maintain and build momentum. We have actively sought out and included nurses, pharmacists, resident physicians, attending physicians, medical students, and pharmacy students with interests in substance use disorders to help us determine next steps for the quality improvement initiative. Their fresh ideas and excitement continuously reinvigorate and betters the care our patients receive.
COMMITTEE INFO
Fellowship Approval
Dr. Jared Kilpatrick
A Medical Education Fellow Success Story: Dr. Jared Kilpatrick
Jared Kilpatrick, MD, Clinical Instructor Thomas Jefferson University Hospital Fellowship Type: Medical Education Year of Completion: 2022
What advice would you give to someone who was on the fence about doing a fellowship? i.e., What did you see as the cost-benefit?
I initially had hesitancy about doing a medical education fellowship during my last year of residency as it is difficult to give up on the salary of a full-time attending. The deciding factor was thinking about the time saved. I knew I wanted to have a career in academic medicine when I was looking at the opportunities that the fellowship programs offered. Specifically, the fellowship programs gave me the opportunity to complete multiple faculty development programs (ex. master’s program, ACEP teaching fellowship etc.) in a relatively short two-year period. If I was working full-time, I estimated it would have taken me 5-10 years to accomplish everything that I did in the two-year fellowship. The second deciding factor for me was the opportunity for mentoring during a fellowship. Experienced medical educators lead the programs that I was considering, and it is difficult to obtain great mentorship outside of a fellowship program, especially from someone with dedicated time and training meant for advancing my skills and career as another medical educator. The most eye-opening aspect of fellowship was the variety of career opportunities in medical education. Prior to fellowship, I thought medical education was focused on GME and Clerkship education. Through the opportunities in my fellowship, I have learned about all the opportunities for faculty development, pre-clinical medical student education, procedural education and education administration. Additionally, I was surprised by the amount of research opportunities. Medical education is an underdeveloped area of research, so it is easy to find research projects. Who is best suited for this type of fellowship?
The most important factor for a future applicant is to have a passion for education and research. If you don’t enjoy teaching and research this is going to be a very frustrating couple of years. The second most important trait is a strong work ethic. Fellowship is better than residency when it comes to worklife balance, but there will be times when you are working a residency-level schedule again.
You can’t pour from an empty cup. Take care of yourself first.
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