Keeping up with the literature: A current practice survey and qualitative needs assessment among emergency physicians

Abstract

Purpose: Physicians face the challenge of staying current with a rapidly growing body of evidence and applying it to their practice. How emergency physicians (EPs) do so is unknown. The authors sought to describe and assess needs around EP patterns of evidence-based medicine (EBM) and continuing medical education (CME) resource use. Methods: The authors conducted a multicenter, cross-sectional study in 2019 across 12 tertiary care, community, and suburban emergency department (ED) sites in the greater area of Edmonton. Information on EBM/CME resource use along with barriers and facilitators to staying current was gathered using a rigorously developed survey tool, distributed electronically and by mail. Responses were tabulated and subgroups analyzed using MANOVA and ANOVA tests. Thematic analysis of comments used a phenomenological lens. Results: A total of 118 EPs (40.1%) completed the survey. Listening to podcasts, attending EM conferences, and subscription-based resources were preferred for staying current. Resource use differed by years in practice but not by age, sex, training background, or site type. EBM had an important impact on respondents' practice (average rating 3.8 out of 5, with 5 indicating "practice changing"). Time was an important barrier. Most (62.7%) felt that they did not spend enough time, despite spending a median of 4 to 5 h monthly on EBM. Facilitators (including journal club summaries or lists of practice-relevant papers) had only moderate impacts. Thematic analysis found three themes (importance of EBM, implementation challenges, and dissemination of EBM) and 13 subthemes. Conclusion: EPs preferentially chose podcasts, conferences, and subscription-based resources to stay current with EBM; time was the biggest barrier. These findings help ED leads and educators tailor CME to physician learning preferences to maximize application of EBM to clinical practice. The next steps include developing/curating resources and disseminating the survey on a larger scale to identify opportunities for shared virtual resources.

A case for lifelong learning in emergency medicine: The perspective from a rural state

“…Solutions may include regional conferences, collaborative case reviews, real‐time peer‐based decision support with telemedicine, maintenance of board certification, asynchronous, self‐directed learning through free open‐access medical education (FOAM), podcasts, textbooks or journal articles, and academic–rural partnerships that create shared faculty positions between rural and tertiary sites and rural rotations for trainees. Each of these has its limitations and time represents a major barrier 3–5 . The American Board of Emergency Medicine requires continuous learning for maintenance of certification; this is beneficial but is not tailored to the physician's practice environment 6,7 …”

“…Each of these has its limitations and time represents a major barrier. [3][4][5] The American Board of Emergency Medicine requires continuous learning for maintenance of certification; this is beneficial but is not tailored to the physician's practice environment. 6,7 Our own work in the rural state of Vermont and upstate New York has led us to offer high-acuity, low occurrence (HALO) courses at the regional academic center twice a year for both residents and practicing emergency physicians within our region and create a rural-specific simulation lab at one of our critical-access sites.…”