Michael Albert Gisondi

Feedback in graduate medical education is often felt to be inadequate, particularly in the Emergency Department where limited time and continuity hinder meaningful reflections. We introduced an emotion‐linked debriefing model at three emergency medicine residencies, using structured prompts to explore both positive and negative emotions experienced during shifts. This approach encouraged richer feedback conversations, deeper trainee engagement, and generation of specific, actionable learning goals. Emotion‐linked debriefing offers a practical strategy to enhance real‐time feedback and warrants further evaluation of its educational impact.

Background: Emergency medicine (EM) residents increasingly favor digital educational resources over traditional textbooks, with studies showing over 90% regularly using blogs, podcasts, and other online platforms. No standardized instruments exist to comparatively assess quality across both formats, leading to uncertainty in resource selection and potential inconsistencies in learning. We developed the Evaluation of Learning Resources (EvaLeR) tool and gathered initial validity evidence for its use in assessing both textbooks and digital EM educational resources.Methods: This two‐phase mixed‐methods study developed the EvaLeR tool and gathered validity evidence for its use. Phase 1 comprised a systematic literature review, quality indicator analysis, and expert consultation. In Phase 2, 34 EM faculty evaluated 20 resources (10 textbook chapters, 10 blog posts) using EvaLeR. We collected evidence for reliability, internal consistency, and relationships with other variables.Results: The EvaLeR tool showed excellent average‐measure reliability (Intraclass correlation coefficient = 0.97, 95% CI [0.94–0.99]). We found high internal consistency (Cronbach's α = 0.86) and moderate correlation with educator gestalt ratings (r = 0.53, p < 0.001). The tool performed similarly across resource types, with no significant differences between textbook chapters (13.34/18, SD 3.41) and digital resources (13.21/18, SD 3.25; p = 0.62).Conclusions: Initial validity evidence supports the use of EvaLeR for quality assessment of both textbooks and digital EM educational resources. This tool provides educators with an evidence‐based approach to resource selection, moving beyond format‐based assumptions to focus on content quality, and represents the first standardized instrument for comparative evaluation across educational resource formats.

Background: Although people with disabilities account for 40% of annual visits to U.S. emergency departments (EDs), physicians receive minimal training on caring for this population. The objective of this study was to explore emergency medicine (EM) resident preparedness and attitudes in caring for patients with disabilities and ease of providing accommodations in the ED.Methods: We developed and administered a cross‐sectional 32‐item survey to EM residents in the United States from November 2023 to January 2024. The primary outcomes were (1) self‐reported preparedness in caring for patients with disabilities, (2) attitudes toward individuals with disabilities, and (3) ease of providing accommodations. Frequency distributions for each item and associations between personal demographics and survey responses are reported.Results: A total of 209 participants completed the survey. The majority were female (51%) and White (70%). A minority (9.5%) identified with having a disability. Residents felt prepared to care for patients with physical disabilities (77%) and chronic illnesses (93%) and less prepared with patients who are nonverbal (34%) or blind/visual impairment (45%). Most residents (99%) believed that patients with disabilities deserved equitable care; however, most thought patients with disabilities had a poor quality of life (75%). Residents reported difficulty providing accommodations to patients who are blind/visual impairment (54%) and Deaf/hard of hearing (45%). For those who encountered acute care plans/health care passports for accommodations, 88% found them useful. The majority of residents (80%) desired improved disability health education, specifically on sensory and intellectual/developmental disabilities, communication skills training, and resources for accommodations.Conclusions: EM residents report feeling less prepared to care for patients with sensory disabilities and intellectual/developmental disabilities and report difficulty obtaining histories, performing physical examinations, and providing accommodations to this population. Implementing curricula focusing on disability health may improve skills, reduce bias, and provide more equitable care.

Background As graduate medical education programs implement competency-based medical education (CBME) approaches, many specialties struggle to adopt this paradigm in a way that successfully incorporates the 5 core components of CBME. Objective To develop and implement the 5 core components of CBME within 8 US emergency medicine (EM) residency programs and assess acceptability and feasibility. Methods We designed an intervention to implement the 5 core components of CBME: (1) an outcomes framework; (2) developmental progression; (3) tailored learning experiences; (4) competency-focused instruction or coaching; and (5) programmatic assessment. A consensus process to develop the framework and developmental trajectory was followed and included the development and deployment of programmatic assessment, coaching programs, and individualized learning plans using a shared model for implementation. We implemented the intervention beginning in August 2021. We surveyed site implementation leads about its feasibility and acceptability. Results The survey response rate was 100% (8 of 8). Estimated time required for the project intervention was 2 to 15 hours per month and 4 to 21.4 hours per month for the program coordinator and program leadership, respectively, with no additional salary provided. Residents and faculty received brief training about the CBME program (0.25 to 1 hours for residents and 0.5 to 1 hour for faculty), with periodic reminders afterward. Site leads perceived mixed acceptability from residents and faculty. Perceived challenges to implementation included resistance to change, time limitations, faculty discomfort with providing written assessment data, and difficulties navigating institutional barriers to technology-enhanced data collection. Conclusions CBME was estimated to require manageable time for program staff and leadership, with mixed acceptability from residents and faculty.

Context: A career in medicine is a journey of countless opportunities, challenges and choices. Determining the “right” decision for any given career choice ultimately must come from within; thus, a clear understanding of a physician's core professional identity is critical. Existing conceptualizations of professional identity within medicine focus primarily on medical training; however, it is clear that professional identity evolves throughout one's career. We propose the use of brand management principles as a novel means of understanding and expressing a physician's evolving professional identity throughout their career. Methods: We propose a conceptual framework for managing academic physician professional identity based upon brand management principles derived from marketing and consumer research literature. The four key framework elements include brand identity (“Who am I?”), brand delivery (“What actions do I choose to present myself to others”), brand experience (“How are my actions experienced by others?”) and brand image (“How do others see me?”). Successful management of one's brand starts with understanding the core professional brand identity, then determining the best way to deliver this identity through specific actions experienced by target audiences (e.g., patients, collaborators, colleagues, employers, learners, promotion committees, etc.), and ends with the target audience having a clear and compelling brand image that reflects the underlying professional identity. Alignment of these components results in an array of benefits; misalignment can result in feelings of burnout or career stalling. Conclusions: We contend that physicians can and should see themselves as their own unique brand. Though often confused with naked self‐promotion, developing a professional brand is an identity exploration and reflection experience that allows individuals to better control the course of their careers. A strong personal brand has numerous practical applications; three key examples presented herein include navigating promotion through the professoriate, managing one's reputation and achieving professional fulfilment.

Background Free open-access meducation (FOAM) refers to open-access, web-based learning resources in medicine. It includes all formats of digital products, including blogs and podcasts. The number of FOAM blog and podcast sites in emergency medicine and critical care increased dramatically from 2002 to 2013, and physicians began to rely on the availability of these resources. The current landscape of these FOAM sites is unknown. Objective This study aims to (1) estimate the current number of active, open-access blogs and podcasts in emergency medicine and critical care and (2) describe observed and anticipated trends in the FOAM movement using the Theory of Disruptive Innovation by Christensen as a theoretical framework. Methods The authors used multiple resources and sampling strategies to identify active, open-access blogs and podcasts between April 25, 2022, and May 8, 2022, and classified these websites as blogs, podcasts, or blogs+podcasts. For each category, they reported the following outcome measures using descriptive statistics: age, funding, affiliations, and team composition. Based on these findings, the authors projected trends in the number of active sites using a positivist paradigm and the Theory of Disruptive Innovation as a theoretical framework. Results The authors identified 109 emergency medicine and critical care websites, which comprised 45.9% (n=50) blogs, 22.9% (n=25) podcasts, and 31.2% (n=34) blogs+podcasts. Ages ranged from 0 to 18 years; 27.5% (n=30) sold products, 18.3% (n=20) used advertisements, 44.0% (n=48) had institutional funding, and 27.5% (n=30) had no affiliation or external funding sources. Team sizes ranged from 1 (n=26, 23.9%) to ≥5 (n=60, 55%) individuals. Conclusions There was a sharp decline in the number of emergency medicine and critical care blogs and podcasts in the last decade, dropping 40.4% since 2013. The initial growth of FOAM and its subsequent downturn align with principles in the Theory of Disruptive Innovation by Christensen. These findings have important implications for the field of medical education.

Medical education researchers are often subject to challenges that include lack of funding, collaborators, study subjects, and departmental support. The construct of a research lab provides a framework that can be employed to overcome these challenges and effectively support the work of medical education researchers; however, labs are relatively uncommon in the medical education field. Using case examples, the authors describe the organization and mission of medical education research labs contrasted with those of larger research team configurations, such as research centers, collaboratives, and networks. They discuss several key elements of education research labs: the importance of lab identity, the signaling effect of a lab designation, required infrastructure, and the training mission of a lab. The need for medical education researchers to be visionary and strategic when designing their labs is emphasized, start-up considerations and the likelihood of support for medical education labs is considered, and the degree to which department leaders should support such labs is questioned.

Background: Precision medicine, sometimes referred to as personalized medicine, is rapidly changing the possibilities for how people will engage health care in the near future. As technology to support precision medicine exponentially develops, there is an urgent need to proactively improve our understanding of precision medicine and pose important research questions (RQs) related to its inclusion in the education and training of future emergency physicians. Methods: A seven-step process was employed to develop a research agenda exploring the intersection of precision and emergency medicine education/training. A literature search of articles about precision medicine was conducted first, which informed the creation of future four scenarios in which trainees and practicing physicians regularly discuss and incorporate precision medicine tools into their discussions and work. Based on these futurist narratives, potential education RQs were generated by an expert panel. A total of 59 initial questions were subsequently categorized and refined to a priority list through a nominal group voting method. The top/priority questions were presented at the 2023 SAEM Consensus Conference on Precision Medicine, Austin, Texas, for further input. Results: Eight high-value education RQs were developed, reflecting a holistic view of the challenges and opportunities for precision medicine education in the knowledge, skills, and attitudes relevant to emergency medicine. These questions contend with topics such as most effective pedagogical methods; intended resulting outcomes and behaviors; the generational differences between practicing emergency physicians, educators, and future trainees; and the desires and expectations of patients. Conclusions: Emergency medicine and emergency physicians must be prepared to understand precision medicine and incorporate this information into their "toolbox" of thinking, problem solving, and communication with patients and colleagues. This research agenda on how best to educate future emergency physicians in

Study objective: The unprecedented number of unfilled emergency medicine post-graduate year 1 (PGY-1) residency positions in the 2023 National Resident Matching Program shocked the emergency medicine community. This study investigates the association between emergency medicine program characteristics and the likelihood of unfilled positions in the 2023 Match. Methods: This cross-sectional, observational study examined 2023 National Resident Matching Program data, focusing on program type, length, location, size, proximity to other programs, previous American Osteopathic Association (AOA) accreditation, first accreditation year, and emergency department ownership structure. We constructed a generalized linear mixed model with a logistic linking function to determine predictors of unfilled positions. Results: A total of 554 of 3,010 (18.4%) PGY-1 positions at 131 of 276 (47%) emergency medicine programs went unfilled in the 2023 Match. In our model, predictors included having unfilled positions in the 2022 Match (odds ratio [OR] 48.14, 95% confidence interval [CI] 21.04 to 110.15), smaller program size (less than 8 residents, OR 18.39, 95% CI 3.90 to 86.66; 8 to 10 residents, OR 6.29, 95% CI 1.50 to 26.28; 11 to 13 residents, OR 5.88, 95% CI 1.55 to 22.32), located in the Mid Atlantic (OR 14.03, 95% CI 2.56 to 77.04) area, prior AOA accreditation (OR 10.13, 95% CI 2.82 to 36.36), located in the East North Central (OR 6.94, 95% CI 1.25 to 38.47) area, and corporate ownership structure (OR 3.21, 95% CI 1.06 to 9.72). Conclusion: Our study identified 6 characteristics associated with unfilled emergency medicine residency positions in the 2023 Match. These findings may be used to guide student advising and inform decisions by residency programs, hospitals, and national organizations to address the complexities of residency recruitment and implications for the emergency medicine workforce.

Background Free open-access meducation (FOAM) refers to open-access, web-based learning resources in medicine. It includes all formats of digital products, including blogs and podcasts. The number of FOAM blog and podcast sites in emergency medicine and critical care increased dramatically from 2002 to 2013, and physicians began to rely on the availability of these resources. The current landscape of these FOAM sites is unknown. Objective This study aims to (1) estimate the current number of active, open-access blogs and podcasts in emergency medicine and critical care and (2) describe observed and anticipated trends in the FOAM movement using the Theory of Disruptive Innovation by Christensen as a theoretical framework. Methods The authors used multiple resources and sampling strategies to identify active, open-access blogs and podcasts between April 25, 2022, and May 8, 2022, and classified these websites as blogs, podcasts, or blogs+podcasts. For each category, they reported the following outcome measures using descriptive statistics: age, funding, affiliations, and team composition. Based on these findings, the authors projected trends in the number of active sites using a positivist paradigm and the Theory of Disruptive Innovation as a theoretical framework. Results The authors identified 109 emergency medicine and critical care websites, which comprised 45.9% (n=50) blogs, 22.9% (n=25) podcasts, and 31.2% (n=34) blogs+podcasts. Ages ranged from 0 to 18 years; 27.5% (n=30) sold products, 18.3% (n=20) used advertisements, 44.0% (n=48) had institutional funding, and 27.5% (n=30) had no affiliation or external funding sources. Team sizes ranged from 1 (n=26, 23.9%) to ≥5 (n=60, 55%) individuals. Conclusions There was a sharp decline in the number of emergency medicine and critical care blogs and podcasts in the last decade, dropping 40.4% since 2013. The initial growth of FOAM and its subsequent downturn align with principles in the Theory of Disruptive Innovation by Christensen. These findings have important implications for the field of medical education.