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The state of pediatric emergency medicine (PEM) education within emergency medicine (EM) residency programs is reviewed and discussed in the context of shifting practice environments and new demands for a greater focus on the availability and quality of PEM services. The rapid growth of PEM within pediatrics has altered the EM practice landscape with regard to PEM. The authors evaluate the composition, quantity, and quality of PEM training in EM residency programs, with close attention paid to the challenges facing programs. A set of best practices is presented as a framework for discussion of future PEM training that would increase the yield and relevance of knowledge and experiences within the constraints of 3-and 4-year residencies. Innovative educational modalities are discussed, as well as the role of simulation and pediatric-specific patient safety education. Finally, barriers to PEM fellowship training among EM residency graduates are discussed in light of the shortage of practitioners from this training pathway and in recognition of the ongoing importance of the EM voice in PEM.ACADEMIC EMERGENCY MEDICINE 2010; 17:S104-S113 ª 2010 by the Society for Academic Emergency Medicine Keywords: pediatric emergency medicine, guidelines, emergency medicine, residency, teaching T he Council of Emergency Medicine Residency Directors (CORD) Academic Assembly held in Orlando, Florida, in March 2010 provided a venue for emergency medicine (EM) educators to examine the state of pediatric emergency medicine (PEM) education and training within U.S. EM residency programs. The Academic Assembly planning committee invited the authors to develop a proposal for a presentation on the best educational practices for PEM within EM residency programs. The best practices recommendations were derived through a series of conference calls leading up to the presentation. The senior author (JB) developed a preliminary set of questions and best practice recommendations based on 15 years of work teaching PEM to EM residents and based on research of the PEM educational process. These were refined and revised during subsequent discussions with the remaining authors and evolved to the final set of recommendations, which were discussed during a postpresentation conference call. Comments from the session attendees were incorporated into the final set of best practice recommendations, which appear in this article. A comprehensive literature search was performed to provide material on which to base our recommendations. Overall, this article reflects the proceedings of the CORD Academic Assembly session; to enhance the discussion of best educational practices, the authors also offer expert opinion on the closely related issues of optimizing PEM education in the future, the promotion of PEM fellowship training within the specialty of EM, and PEM workforce issues.All five authors have considerable experience (average 14 years, range 5-20 years) in teaching PEM, developing curricula, and administrating large PEM educational programs. Four are...

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IntroductionFaculty educational contributions are hard to quantify, but in an era of limited resources it is essential to link funding with effort. The purpose of this study was to determine the feasibility of an educational value unit (EVU) system in an academic emergency department and to examine its effect on faculty behavior, particularly on conference attendance and completion of trainee evaluations.MethodsA taskforce representing education, research, and clinical missions was convened to develop a method of incentivizing productivity for an academic emergency medicine faculty. Domains of educational contributions were defined and assigned a value based on time expended. A 30-hour EVU threshold for achievement was aligned with departmental goals. Targets included educational presentations, completion of trainee evaluations and attendance at didactic conferences. We analyzed comparisons of performance during the year preceding and after implementation.ResultsFaculty (N=50) attended significantly more didactic conferences (22.7 hours v. 34.5 hours, p<0.005) and completed more trainee evaluations (5.9 v. 8.8 months, p<0.005). During the pre-implementation year, 84% (42/50) met the 30-hour threshold with 94% (47/50) meeting post-implementation (p=0.11). Mean total EVUs increased significantly (94.4 hours v. 109.8 hours, p=0.04) resulting from increased conference attendance and evaluation completion without a change in other categories.ConclusionIn a busy academic department there are many work allocation pressures. An EVU system integrated with an incentive structure to recognize faculty contributions increases the importance of educational responsibilities. We propose an EVU model that could be implemented and adjusted for differing departmental priorities at other academic departments.