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This was a systematic review of the impact of medical trainees on efficiency and productivity in emergency medicine (EM). The authors found a slight increase in length of stay with medical trainees overall and an increased RVU productivity with EM residents.

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Impact of Medical Trainees on Efficiency and Productivity in the Emergency Department: Systematic Review and Narrative Synthesis. West J Emerg Med. 2024 Sep;25(5):767-776. doi: 10.5811/westjem.18574. PMID: 39319808; PMCID: PMC11418871.

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Mental practice, a cognitive rehearsal technique from sports psychology, can enhance skill retention and competency in emergency medicine, particularly for high-acuity, low-frequency procedures.

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Mental Practice: Applying Successful Strategies in Sports to the Practice of Emergency Medicine. Ann Emerg Med. 2024 Aug;84(2):159-166. doi: 10.1016/j.annemergmed.2023.12.011. Epub 2024 Jan 18. PMID: 38244027.

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This retrospective study found increased first pass success (FPS) when EM post-graduate year (PGY) PGY2s, 3s, or 4s intubated patients with Cormack-Lehane grade 3 or 4 airways compared to EM PGY1s. There was no difference in obtained views by PGY after PGY1.

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Emergency Medicine Postgraduate Year, Laryngoscopic View, and Endotracheal Tube Placement Success. Ann Emerg Med. 2024 Jul;84(1):11-19. doi: 10.1016/j.annemergmed.2024.03.004. Epub 2024 Apr 19. PMID: 38639674.

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Physician humility is crucial for tackling modern healthcare challenges, building patient trust, and fostering collaboration in medical environments. However, significant challenges exist in cultivating humility and require substantial individual and collective actions to ensure the integrity of the medical profession, enhance patient care, and support healthcare providers’ well-being.

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Physician Humility: A Review and Call to Revive Virtue in Medicine. Ann Intern Med. 2024 Jul 30. doi: 10.7326/M24-0842. Online ahead of print. PMID: 39074373.

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Residents working in the emergency department were found to do significantly worse on cognitive tests and moral performance after working 5 consecutive night shifts compared to 5 day shifts.

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Effect of serial night shifts on the cognitive, psychomotor, and moral performance of residents in the department of Emergency Medicine. Acad Emerg Med. 2024 Jul 15. doi: 10.1111/acem.14980. Online ahead of print. PMID: 39007435

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Yesterday we looked at an argument for learning DL prior to VL. Today, we are covering the counterpoint, where this group argues that DL is not the building block for learning VL.

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COUNTERPOINT: Direct Laryngoscopy: The Building Block to Airway Expertise? No. Chest. 2024 Jun;165(6):1297-1299. doi: 10.1016/j.chest.2024.01.027. PMID: 38852967

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Today we are looking at an opinion piece published in Chest where the authors provide an argument that DL should be learned prior to VL.

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POINT: Direct Laryngoscopy: The Building Block to Airway Expertise? Yes. Chest. 2024 Jun;165(6):1296-1297. doi: 10.1016/j.chest.2023.12.035. PMID: 38852966.

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The win ratio can be a useful study design that allows hierarchical ranking, by clinical relevance, of composite outcomes into a win, tie, or loss, but watch out for abuses of it. They can be "seductive."

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Use of the Win Ratio Analysis in Critical Care Trials. Am J Respir Crit Care Med. 2024 Apr 1;209(7):798-804. doi: 10.1164/rccm.202309-1644CP. PMID: 38285595

Win Ratio: A Seductive But Potentially Misleading Method for Evaluating Evidence from Clinical Trials. Circulation. 2024 May 14;149(20):1546-1548. doi: 10.1161/CIRCULATIONAHA.123.067786. Epub 2024 May 13. PMID: 38739696

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This medical news article interview highlights the risk of biased data leading to inherently biased medical AI models. The ethics of machine learning in general and approaches to minimize bias are also touched on.

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AI Developers Should Understand the Risks of Deploying Their Clinical Tools, MIT Expert Says. JAMA. 2024 Feb 27;331(8):629-631. doi: 10.1001/jama.2023.22981. PMID: 38324320.

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Bayesian analysis is becoming more common in clinical research and offers advantages over traditional frequentist methods when used appropriately. This primer can help understand Bayesian analysis better.

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Introduction to Bayesian Analyses for Clinical Research. Anesth Analg. 2024;138(3):530-541. doi:10.1213/ANE.0000000000006696