Department of Emergency Medicine, Maine Medical Center, Portland, Maine.
Tufts University School of Medicine, Portland, Maine.
West J Emerg Med. 2024 Jul;25(4):593-601. doi: 10.5811/westjem.18103.
There is recognition in the field of emergency medicine (EM) that social determinants of health (SDoH) are key drivers of patient care outcomes. Leaders in EM are calling for curricula integrating SDoH assessment and intervention, public health, and multidisciplinary approaches to EM care throughout medical school and residency. This intersection of SDoH and the emergency care system is known as social emergency medicine (SEM). Currently, there are few resources available for EM training programs to integrate this content; as a result, few EM trainees receive adequate education in SEM. To address this gap, we developed a four-part training in SEM tailored to EM residency programs and medical schools. This curriculum, known as RISE-EM (Resident Instruction in Social Emergency Medicine), uses video lectures, case examples, and group discussions to engage trainees and develop competency in providing sound care that is grounded in evidence-based principles of SEM. In the current study, we tested RISE-EM by delivering the video lectures to residents and medical students in two training programs. We administered pre- and post-course knowledge tests and a post-course participant attitudes survey to assess the acceptability and potential efficacy of the program for improving SEM knowledge and attitudes among EM learners. We found it to be both feasible and acceptable to introduce SEM content in residency conferences, with preliminary data showing statistically significant improvement in knowledge of the content and self-efficacy to apply it to their clinical practice. In summary, RISE-EM has been highly valued by EM learners and viewed as a strong supplement to their existing training, and it has been shown to successfully improve SEM knowledge and attitudes.
在急诊医学（EM）领域，人们认识到健康的社会决定因素（SDoH）是患者护理结果的关键驱动因素。EM 的领导者呼吁在整个医学院和住院医师实习期内，将 SDoH 评估和干预、公共卫生以及 EM 护理的多学科方法纳入课程。SDoH 和紧急护理系统的这种交叉点被称为社会急诊医学（SEM）。目前，EM 培训计划几乎没有可用的资源来整合这些内容；因此，很少有 EM 受训者接受过 SEM 的充分教育。为了解决这一差距，我们针对 EM 住院医师培训计划和医学院开发了一个四部分的 SEM 培训。该课程称为 RISE-EM（社会急诊医学住院医师培训），使用视频讲座、案例示例和小组讨论来吸引受训者，并培养他们在基于 SEM 的循证原则提供合理护理方面的能力。在当前的研究中，我们通过向两个培训计划中的住院医师和医学生提供视频讲座来测试 RISE-EM。我们在课程前后进行了知识测试和课程后参与者态度调查，以评估该计划在提高 EM 学习者的 SEM 知识和态度方面的可接受性和潜在效果。我们发现，在住院医师会议中引入 SEM 内容是可行且可接受的，初步数据显示，在对该内容的知识和将其应用于临床实践的自我效能方面有统计学意义的提高。总之，EM 学习者对 RISE-EM 给予了高度评价，并认为它是对其现有培训的有力补充，并且已被证明可以成功提高 SEM 知识和态度。
