This study evaluates a Massive Open Online Course (MOOC) on Emergency Medicine designed by iEM Education Project and Lecturio, using a validated checklist to assess its usability and user experience. The MOOC received a high score for cognitive connection (>4/5), in four components including interactivity, content and resources, media use, and instructional assessment. However, for learner guidance and support, the score was 2.75/5, indicating that the course did not provide clear instructions on how learners can get support or feedback from teachers when encountering problems in the course. For affective and functional connections, all components received a high overall mean score of more than 4/5. The course was impactful to the users who were in their early clinical years, as they were actively engaged and were motivated to complete the course. However, improvements should be made to better stimulate learning by improving learner feedback and providing space for collaborative learning online. Evaluation of MOOC applying the heuristics of usability and user experience identifies specific components of online learning course apart from rating the severity of acceptance or violation of instructional design principles. The information derived from usability and user experience studies can improve design and delivery of online courses.
User-Centered Design ; Educational Technology ; Emergency Medicine

COVID-19 ; Emergency Medicine ; Humans ; Pandemics ; Qualitative Research ; SARS-CoV-2

Humans ; United States ; Internship and Residency ; COVID-19 ; Emergency Medicine/education* ; Curriculum

The use of computed tomography (CT) in emergency departments has increased over several decades, as physicians increasingly depend on imaging for diagnoses. Patients and medical personnel are put at risk due to frequent exposure to and higher levels of radiation, with very little evidence of improvements in outcomes. Here, we explore why CT imaging has a tendency to be overused in emergency departments and the obstacles that medical personnel face in ensuring patient safety. The solution requires cooperation from all emergency care stakeholders as well as the continuous education of doctors on how CT scans help in particular cases.
Diagnosis ; Education ; Emergencies ; Emergency Medical Services ; Emergency Medicine ; Emergency Service, Hospital ; Humans ; Patient Safety ; Private Practice ; Radiation, Ionizing ; Risk Assessment ; Tomography, X-Ray Computed

OBJECTIVE: Data mining extracts meaningful information from large datasets. In this study, text mining techniques were used to extract keywords from the Journal of the Korean Society of Emergency Medicine, and the change trend was examined. METHODS: The rvest package in R was used to extract all papers published in the Journal of the Korean Society of Emergency Medicine from 2006 to 2016 that could be searched online. Among them, 3,952 keywords were extracted and studied. Using the selected keywords, the corpus was formed by refining keywords that did not correspond to MeSH (Medical Subject Headings) or were misspelled and had similar meanings based on agreement of researchers. Using the refined keywords, the frequencies of the keywords in the first and second halves of the studies were calculated and visualized. RESULTS: Word Cloud revealed that emergency medical service and cardiopulmonary resuscitation (CPR) were most frequently mentioned in both the first and second halves of the studies. In the first half, ultrasonography, stroke, poisoning, injury, and education were frequently mentioned, while in the second half, poisoning, injury, stroke, acute, and tomography were frequently mentioned. A pyramid graph revealed that the frequencies of emergency medical service and CPR were commonly high. CONCLUSION: Core keywords of the Journal of the Korean Society of Emergency Medicine were analyzed for correlations and trends. Changes in study topics according to key topics of interest and period were visually identified.
Cardiopulmonary Resuscitation ; Data Mining ; Dataset ; Education ; Emergencies ; Emergency Medical Services ; Emergency Medicine ; Poisoning ; Stroke ; Ultrasonography

OBJECTIVE: We investigated the opinions of experts to identify problems and prepare an improvement plan when applying the Korean Triage and Acuity Scale (KTAS) to pediatric patients in the emergency department. METHODS: The experts comprised 15 researchers at a pediatric emergency center designated by the Ministry of Health and Welfare and research team members of the Korean Society of Pediatric Emergency Medicine. The first survey was an open-ended question about the problems, application results, and remedies of applying KTAS to children through e-mail. The problems were categorized by topic, and degree of agreement was presented using a 9-point Likert scale. RESULTS: In the first survey, 67% of experts participated and 18 problems were identified. In the second survey, 73% of experts participated and eight problems were identified in four categories, validity, reliability, feasibility and other opinions. All experts pointed out that resources were not considered during pediatric triage in the KTAS. Ninety-one percent of experts said that peak expiratory flow rate measurement and Glasgow Coma Scale evaluation were unlikely to be feasible. Moreover, 91% experts were concerned that the triage level could be distorted if KTAS was interlocked with medical costs. Eighty-two percent of the respondents pointed to the high triage result of febrile children and the difference in pain score between the evaluators, etc. CONCLUSION: Based on the problems pointed out by experts and the reality of Korea's emergency departments, it is necessary to consider revision of KTAS for children.
Child ; Delphi Technique ; Electronic Mail ; Emergencies ; Emergency Medicine ; Emergency Service, Hospital ; Glasgow Coma Scale ; Humans ; Peak Expiratory Flow Rate ; Surveys and Questionnaires ; Triage

OBJECTIVE: This study investigated and compared the perspectives on emergency medicine (EM) professionalism competencies of medical students and EM residents. In addition, how they learned their EM professionalism was also investigated to develop the base of an educational program of professionalism in the field of EM. METHODS: Medical students in four medical colleges/schools and EM residents were recruited for the questionnaire. Regarding the importance and educational need for EM professionalism, 23 items for medical students and 59 items for EM residents were asked. The items were rated on a five point Likert scale. The perspectives of the two groups were compared. The learning methods for professionalism were investigated. RESULTS: A total of 198 medical students and 109 EM residents responded to the questionnaire. The residents responded with mean of 3.0 or more on all items, agreeing on the importance and educational need. On the other hand, the mean scale was less than 4.0 in communication and cooperation with society and social accountability. The students responded with a mean scale of 4.0 or more on all items and agreed on the importance and educational need. Of the 23 common items, there were differences between the two groups in 17 items, showing a higher mean value in the students. The most common methods of learning EM professionalism was bedside teaching during the clinical clerkship for students, and patient handover or board round for residents. CONCLUSION: EM residents tended to place more importance on medical care than social communication, cooperation, and ethical items. The most common learning method of EM professionalism was clinical practice-associated activities. The results of this study could help to develop a systematic and realistic educational program of EM professionalism in EM clerkship and resident training.
Clinical Clerkship ; Emergencies ; Emergency Medicine ; Hand ; Humans ; Learning ; Methods ; Patient Handoff ; Professionalism ; Social Responsibility ; Students, Medical

OBJECTIVE: It is difficult for emergency residents to attend all the lectures that are required because of the limited labor time. The Google Hangouts program for has been used as a remote videoconference to overcome the limit to provide equal opportunities and reduce the time and costs since 2015. This article reports the authors' experiences of running a residency education program using Google Hangouts. METHODS: From 2015, topics on the emergency radiology were lectured to emergency residents in three different hospitals connected by Google Hangouts. From 2017, electrocardiography analysis, emergency radiology, ventilator application, and journal review were selected for the remote videoconference. The residents' self-assessment score, and a posteducation satisfaction questionnaire were surveyed. RESULTS: Twenty-nine emergency residents responded to the questionnaire after using the Google Hangouts. The number of participants before and after Hangout increased significantly in other two hospitals. All the residents answered that the score on achieving the learning goal increased before and after the videoconference lectures. All the residents answered that the training program is more satisfactory after using the Google Hangouts than before. CONCLUSION: All emergency residents were satisfied and were more confident after the remote videoconference education using the Google Hangouts than before.
Education ; Electrocardiography ; Emergencies ; Emergency Medicine ; Internship and Residency ; Learning ; Lectures ; Running ; Self-Assessment ; Ventilators, Mechanical ; Videoconferencing

OBJECTIVE: This study aimed to achieve expert consensus for the evaluation of Emergency medical system operation fund (EMSOF) support projects using the Delphi method in Korea. METHODS: The Delphi study was performed in June 2018. Experts who are members of the policy committee of the Korean Society of Emergency Medicine (KSEM) participated in the study. Respondents were asked to express their level of agreement of appropriateness for the following 6 categories for 21 projects: project contents, amount of support, indicators, performance, overall evaluation, and need to maintain. With a possible score of 9 points, the project categories were classified into 3 groups, inappropriate, moderate and appropriate, based on the median score of the respondents' ratings in each question. RESULTS: Sixteen of the 18 policy committee members participated in the survey. Their average professional work years were 8.2 years. All 21 projects were evaluated as appropriate for content. Amount of support and indicators were evaluated as moderate. Only 5 out of the 21 projects were evaluated as having appropriate indicators. No projects were evaluated as ineffective. Comprehensive evaluation of the projects was evaluated as moderate, and no project was evaluated as inappropriate in fund support. CONCLUSION: Overall, the contents of the EMSOF assistance project were rated high; however, there was a disagreement on the amount of support and evaluation indicators for each project. The results of this study are expected to be used as basic data to improve the use of EMSOF.
Committee Membership ; Consensus ; Delphi Technique ; Emergencies ; Emergency Medicine ; Financial Management ; Korea ; Methods ; Resource Allocation ; Surveys and Questionnaires

OBJECTIVE: The aim of this study was to validate the Glasgow-Blatchford score (GBS), Pre-Rockall score (PRS), and AIMS65 score to predict active bleeding in patients with normotension and upper gastrointestinal bleeding (UGIB), and analyze the variables that can predict active bleeding to help develop new predictive factors. METHODS: Data were collected retrospectively from January 2015 to December 2017. A systolic blood pressure ≥90 mmHg were defined as normotension, and the patients were divided into active bleeding and not-active bleeding groups based on an esophagogastroduodenoscopy and levin-tube irrigation. The GBS, PRS, and AIMS65 of each group were calculated. The receiver operator characteristic (ROC) curve and area under the curve (AUC) were also calculated to obtain the predictive power for active bleeding. Furthermore, the factors that can predict active bleeding were analyzed by multivariate logistic regression. The ROC curve and AUC were calculated using the variables that were adopted as useful factors. RESULTS: Of the 250 patients included, 85 were active bleeding and 165 were not-active bleeding. The ROC curve showed GBS (AUC, 0.54; 95% confidence interval [CI], 0.47–0.61), PRS (AUC, 0.58; 95% CI, 0.50–0.65), and AIMS65 (AUC, 0.51; 95% CI, 0.43–0.59) to have low predictive power for active bleeding. Multivariate logistic regression revealed the lactate (odds ratio [OR], 1.10; 95% CI, 1.01–1.20) and shock indices (OR, 4.15; 95% CI, 1.12–15.40) to be significant predictors of active bleeding. When calculating the probability of predicting active bleeding through these variables, AUC 0.64 (95% CI, 0.57–0.71) showed higher prediction power than the previous scores. CONCLUSION: The conventional scoring systems that predict the prognosis of UGIB showed low predictability in predicting active bleeding in UGIB patients with a systolic blood pressure ≥90 mmHg. Further study suggests the development of new score using factors, such as the lactate and shock indices.
Area Under Curve ; Blood Pressure ; Emergency Medicine ; Endoscopy, Digestive System ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Lactic Acid ; Logistic Models ; Prognosis ; Retrospective Studies ; ROC Curve ; Shock