The flipped classroom, an educational alternative to the traditional lecture, has been widely adopted by educators at all levels of education and across many disciplines. In the flipped classroom, learners prepare in advance of the face-to-face meeting by learning content material on their own. Classroom time is reserved for application of the learned content to solving problems or discussing cases. Over the past year, we replaced most residency program lectures with small-group discussions using the flipped-classroom model, case-based learning, simulation and procedure labs. In the new model, residents prepared for conference by reviewing a patient case and studying suggested learning materials. Conference day was set aside for facilitated small-group discussions about the case. This is a cross-cohort study of emergency medicine residents who experienced the lecture-based curriculum to residents in the new flipped-classroom curriculum using paired comparisons (independent t-tests) on in-training exam scores while controlling for program year level. We also compared results of the evaluation of various program components. We observed no differences between cohorts on in-training examination scores. Small-group methods were rated the same across program years. Two program components in the new curriculum, an updated format of both adult and pediatric case conferences, were rated significantly higher on program quality. In preparation for didactics, residents in the new curriculum report spending more time on average with outside learning materials, including almost twice as much time reviewing textbooks. Residents found the new format of the case conferences to be of higher quality because of the inclusion of rapid-fire case discussions with targeted learning points.

Each year, residency programs work diligently to identify the best applicants for their respective programs, given the increasing volume of applications. Interview offers are often based on a mix of subjective and objective measures, with different programs relying more or less on each. A holistic application review involves a flexible and individualized way of assessing an applicant’s capabilities through a balanced consideration of experiences, attributes, and academic metrics. When considered collectively, these attributes may define how an individual may perform as a physician. One particular tool developed by the American Association of Medical Colleges (AAMC), the Standardized Video Interview (SVI), provides an objective measure of an applicant's professional behavior and interpersonal communication skills. The SVI may provide applicants with a chance to showcase the intangibles about themselves that are neither entered on their application nor reflected by their standardized examination scores.

Adverse reactions to food are common but only a fraction of them are due to hypersensitivity (or allergy). Of the latter, immunoglobulin (Ig)E-mediated reactions appear to be the most common and best understood. A wide variety of manifestations may affect various body systems, particularly the gastrointestinal tract, skin and respiratory tract. Diagnosis depends primarily on thorough medical history, often supplemented by skin testing or specific serum IgE antibody measurement. Verification would require appropriately designed challenge testing. At present, treatment is primarily strict avoidance of the offending food, together with crossreacting other foods. Several immunomodulatory therapeutic agents are being explored. A few studies demonstrated a potential benefit of probiotics for prophylaxis and treatment. A multicenter study is currently investigating the efficacy and safety of anti-IgE in subjects with peanut allergy. Experimental studies in mice revealed preliminary findings that promise vaccine development using novel approaches, such as modified food allergen epitopes, immunostimulatory sequence-conjugated allergens and chimeric proteins capable of complexing with IgE or its receptors.

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