The Emergency Medicine Milestones 2.0: Setting the stage for 2025 and beyond

Cooney, Robert; Murano, Tiffany; Ring, Hope; Starr, Ryan; Beeson, Michael S.; Edgar, Laura

doi:10.1002/aet2.10640

Cited by 13 publications

(15 citation statements)

References 13 publications

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“…The Accreditation Council for Graduate Medical Education (ACGME) milestones provide a framework through which we can begin to forecast and organize future core competencies related to the care of obstetric emergencies for practicing emergency clinicians in a post‐ Roe world 40 . Restrictions on reproductive health will have an impact on each of the domains of physician competency (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians

Samuels‐Kalow

Agrawal

Rodriguez

et al. 2022

Academic Emergency Medicine

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On June 24, 2022, the United States Supreme Court ruled on Dobbs v. Jackson Women's Health Organization and overturned Roe v. Wade, removing almost 50 years of precedent and allowed individual states to determine restrictions on abortion. While the state-level policy landscape remains fluid, the Guttmacher Institute reports that 26 states (half of the United States) are likely to ban access to abortion, if their trigger laws have not already done so, 1 with critical implications for pregnant patients, those with reproductive potential, and the clinicians who care for them.The emergency department (ED) is an important access point for reproductive healthcare. More than 900,000 ED visits each year are for early pregnancy loss, which does not include those presenting for

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Section: Introductionmentioning

confidence: 99%

Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians

Samuels‐Kalow

Agrawal

Rodriguez

et al. 2022

Academic Emergency Medicine

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“…7,8 It is, however, an accepted paradigm that emergent airway management outside of the hospital presents a different problem set from that experienced in the ED. 9,10 Further still, data from the far-forward combat setting in Afghanistan's Helmand Province demonstrate a 36% failure rate among prehospital personnel performing ETI, which comprised the majority (86.6%) of all airway management attempts. 11,12 The alternative approach of cricothyrotomy represents only 5.8% of interventions, but comes with an overall failure rate of 28% to 33% and a 64% complication rate.…”

Section: Introductionmentioning

confidence: 99%

The Difficult Airway Redefined

Burgess

Schauer

Hood

et al. 2022

Prehosp. Disaster med.

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There is no all-encompassing or universally accepted definition of the difficult airway, and it has traditionally been approached as a problem chiefly rooted in anesthesiology. However, with airway obstruction reported as the second leading cause of mortality on the battlefield and first-pass success (FPS) rates for out-of-hospital endotracheal intubation (ETI) as low as 46.4%, the need to better understand the difficult airway in the context of the prehospital setting is clear. In this review, we seek to redefine the concept of the “difficult airway” so that future research can target solutions better tailored for prehospital, and more specifically, combat casualty care. Contrasting the most common definitions, which narrow the scope of practice to physicians and a handful of interventions, we propose that the difficult airway is simply one that cannot be quickly obtained. This implies that it is a situation arrived at through a multitude of factors, namely the Patient, Operator, Setting, and Technology (POST), but also more importantly, the interplay between these elements. Using this amended definition and approach to the difficult to manage airway, we outline a target-specific approach to new research questions rooted in this system-based approach to better address the difficult airway in the prehospital and combat casualty care settings.

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“…In 2021, The Milestones 2.0 Project replaced the original ACGME milestones—which eliminated the specific procedural competencies. 11 , 12 EUS, along with five other procedural milestones, were combined into one “general approach to procedures.” 11 , 12 This change gave programs autonomy in defining basic versus advanced procedures for their given context. 12 However, there is still no unifying consensus list of competencies for EUS training.…”

Section: Introductionmentioning

confidence: 99%

“… 11 , 12 EUS, along with five other procedural milestones, were combined into one “general approach to procedures.” 11 , 12 This change gave programs autonomy in defining basic versus advanced procedures for their given context. 12 However, there is still no unifying consensus list of competencies for EUS training. Given this, graduating residents will have various degrees of exposure to EUS which could potentially lead to varying levels of skill and comfort.…”

Section: Introductionmentioning

confidence: 99%

A consensus list of ultrasound competencies for graduating emergency medicine residents

Haidar

Peterson

Minges

et al. 2022

AEM Education and Training

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Objectives Emergency ultrasound (EUS) is a critical component of emergency medicine (EM) resident education. Currently, there is no consensus list of competencies for EUS training, and graduating residents have varying levels of skill and comfort. The objective of this study was to define a widely accepted comprehensive list of EUS competencies for graduating EM residents through a modified Delphi method. Methods We developed a list of EUS applications through a comprehensive literature search, the American College of Emergency Physicians list of core EUS benchmarks, and the Council of Emergency Medicine Residency‐Academy of Emergency Ultrasound consensus document. We assembled a multi‐institutional expert panel including 15 faculty members from diverse practice environments and geographical regions. The panel voted on the list of competencies through two rounds of a modified Delphi process using a modified Likert scale (1 = not at all important, 5 = very important) to determine levels of agreement for each application—with revisions occurring between the two rounds. High agreement for consensus was set at >80%. Results Fifteen of 15 panelists completed the first‐round survey (100%) that included 359 topics related to EUS. After the first round, 195 applications achieved high agreement, four applications achieved medium agreement, and 164 applications achieved low agreement. After the discussion, we removed three questions and added 13 questions. Fifteen of 15 panelists completed the second round of the survey (100%) with 209 of the 369 applications achieving consensus. Conclusion Our final list represents expert opinion on EUS competencies for graduating EM residents. We hope to use this consensus list to implement a more consistent EUS curriculum for graduating EM residents and to standardize EUS training across EM residency programs.

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The Emergency Medicine Milestones 2.0: Setting the stage for 2025 and beyond

Cited by 13 publications

References 13 publications

Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians

Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians

The Difficult Airway Redefined

A consensus list of ultrasound competencies for graduating emergency medicine residents

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