Objectives: Studies have documented increased advanced radiography use in U.S. emergency departments (EDs) for injured patients over the past decade. The authors explored trends in recent years (2007 through 2010) in advanced radiography use, specifically head computed tomography (CT) and nonhead CT scans.Methods: This was a retrospective analysis of ED visits conducted using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), a representative sample of the U.S. ED visits from 2007 through 2010. All patients designated by the NHAMCS as "related to injury" were included in analyses. CT use was examined by head and nonhead use. Trends, predictors of utilization, and diagnostic yield for head and nonhead CT scans in injured ED patients were analyzed using survey-weighted logistic regression. Diagnostic yield was defined as the proportion of injury-related visits where patients imaged with CT received International Classification of Diseases, 9th Revision (ICD-9), code diagnoses of a severe head or nonhead injury.Results: Among injured ED patients, head CT use increased from 9.6% in 2007 to 11.6%, a relative increase of 20.8% (p < 0.001), and nonhead CT from 5.5% to 7.3%, a relative increase of 47.3% (p < 0.001). Diagnostic yield for head CT was unchanged (4.9% in 2007 vs. 3.4% in 2010, p = 0.093), but fell for nonhead CT from 6.4% in 2007 to 3.3% in 2010 (p = 0.04. Conclusions:Advanced radiography use has continued to increase since 2007 in injured patients, and diagnostic yield for nonhead CT has continued to fall. Head CT is more common than CTs of other body areas and may represent an opportunity for reduction given validated clinical decision rules.ACADEMIC EMERGENCY MEDICINE 2015;22:663-669

Objectives. This study was designed to compare the trainees' perception of emergency medicine (EM) training in the United States (US) and Saudi Arabia (SA) and to identify residents' levels of confidence and points of satisfaction in education, procedural skills, and work environment. Method. An IRB-exempt anonymous web-based survey was distributed to five EM residency training programs in the USA and three residency regions in SA. Results. 342 residents were polled with a 20% response rate (16.8% USA and 25.8% SA). The Saudi residents responded less positively to the questions about preparation for their boards' examinations, access to multiple educational resources, and weekly academic activities. The Saudi trainees felt less competent in less common procedures than US trainees. American trainees also more strongly agree that they have more faculty interest in their education compared to the Saudi trainees. The Saudi residents see more patients per hour compared to their US peers. Conclusion. These findings may be due to the differences in training techniques including less formal didactics and simulation experience in SA and more duty hour regulations in the USA.

Purpose Research methodology is an essential part of evidence-based medicine. Many educational programs include clinical research methodology within their curriculum. Moreover, students’ preferences for learning methods are different than before, as they now prefer alternative methods, such as peer teaching. Peer-assisted learning enhances students’ tutoring skills. Thus, the current study aimed to evaluate the effect of peer teaching on enhancing clinical research skills. Participants and Methods Peer-assisted learning was evaluated during a four-week online research methodology course designed for medical students at King Abdulaziz University. A total of 121 students’ and 38 tutors’ attitudes and perceptions of peer teaching were evaluated using a self-administered questionnaire. The effectiveness of peer teaching was assessed using pre- and post-course knowledge tests. Chi-square was used to assess the association of qualitative data, and Mann–Whitney U -test and Wilcoxon rank test were used as nonparametric tests for the variables that were not normally distributed. Results The post-course knowledge score was significantly higher than the pre-test score. Students had a positive perception of peer-assisted learning. Over 90% of the students preferred peer-assisted learning to traditional teaching. Similarly, the tutors had significantly positive perceptions of peer-assisted teaching. Younger students who had higher post-test mean knowledge scores had a good perception of peer teaching. Conclusion The current study demonstrates students’ and tutors’ positive perceptions of peer-assisted learning as well as the effectiveness of peer learning. Medical schools should pay more attention to students and prepare them for peer-teacher roles.

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