IFEM model curriculum: emergency medicine learning outcomes for undergraduate medical education.

Emergency medicine Medical school Medical students Undergraduate training

Journal

International journal of emergency medicine
ISSN: 1865-1372
Titre abrégé: Int J Emerg Med
Pays: England
ID NLM: 101469435

Informations de publication

Date de publication:
05 Aug 2024
Historique:
received: 15 03 2024
accepted: 04 07 2024
medline: 6 8 2024
pubmed: 6 8 2024
entrez: 5 8 2024
Statut: epublish

Résumé

The International Federation for Emergency Medicine (IFEM) published its model curriculum for medical student education in emergency medicine in 2009. Because of the evolving principles of emergency medicine and medical education, driven by societal, professional, and educational developments, there was a need for an update on IFEM recommendations. The main objective of the update process was creating Intended Learning Outcomes (ILOs) and providing tier-based recommendations. A consensus methodology combining nominal group and modified Delphi methods was used. The nominal group had 15 members representing eight countries in six regions. The process began with a review of the 2009 curriculum by IFEM Core Curriculum and Education Committee (CCEC) members, followed by a three-phase update process involving survey creation [The final survey document included 55 items in 4 sections, namely, participant & context information (16 items), intended learning outcomes (6 items), principles unique to emergency medicine (20 items), and content unique to emergency medicine (13 items)], participant selection from IFEM member countries and survey implementation, and data analysis to create the recommendations. Out of 112 invitees (CCEC members and IFEM member country nominees), 57 (50.9%) participants from 27 countries participated. Eighteen (31.6%) participants were from LMICs, while 39 (68.4%) were from HICs. Forty-four (77.2%) participants have been involved with medical students' emergency medicine training for more than five years in their careers, and 56 (98.2%) have been involved with medical students' training in the last five years. Thirty-five (61.4%) participants have completed a form of training in medical education. The exercise resulted in the formulation of tiered ILO recommendations. Tier 1 ILOs are recommended for all medical schools, Tier 2 ILOs are recommended for medical schools based on perceived local healthcare system needs and/or adequate resources, and Tier 3 ILOs should be considered for medical schools based on perceived local healthcare system needs and/or adequate resources. The updated IFEM ILO recommendations are designed to be applicable across diverse educational and healthcare settings. These recommendations aim to provide a clear framework for medical schools to prepare graduates with essential emergency care capabilities immediately after completing medical school. The successful distribution and implementation of these recommendations hinge on support from faculty and administrators, ensuring that future healthcare professionals are well-prepared for emergency medical care.

Sections du résumé

BACKGROUND BACKGROUND
The International Federation for Emergency Medicine (IFEM) published its model curriculum for medical student education in emergency medicine in 2009. Because of the evolving principles of emergency medicine and medical education, driven by societal, professional, and educational developments, there was a need for an update on IFEM recommendations. The main objective of the update process was creating Intended Learning Outcomes (ILOs) and providing tier-based recommendations.
METHOD METHODS
A consensus methodology combining nominal group and modified Delphi methods was used. The nominal group had 15 members representing eight countries in six regions. The process began with a review of the 2009 curriculum by IFEM Core Curriculum and Education Committee (CCEC) members, followed by a three-phase update process involving survey creation [The final survey document included 55 items in 4 sections, namely, participant & context information (16 items), intended learning outcomes (6 items), principles unique to emergency medicine (20 items), and content unique to emergency medicine (13 items)], participant selection from IFEM member countries and survey implementation, and data analysis to create the recommendations.
RESULTS RESULTS
Out of 112 invitees (CCEC members and IFEM member country nominees), 57 (50.9%) participants from 27 countries participated. Eighteen (31.6%) participants were from LMICs, while 39 (68.4%) were from HICs. Forty-four (77.2%) participants have been involved with medical students' emergency medicine training for more than five years in their careers, and 56 (98.2%) have been involved with medical students' training in the last five years. Thirty-five (61.4%) participants have completed a form of training in medical education. The exercise resulted in the formulation of tiered ILO recommendations. Tier 1 ILOs are recommended for all medical schools, Tier 2 ILOs are recommended for medical schools based on perceived local healthcare system needs and/or adequate resources, and Tier 3 ILOs should be considered for medical schools based on perceived local healthcare system needs and/or adequate resources.
CONCLUSION CONCLUSIONS
The updated IFEM ILO recommendations are designed to be applicable across diverse educational and healthcare settings. These recommendations aim to provide a clear framework for medical schools to prepare graduates with essential emergency care capabilities immediately after completing medical school. The successful distribution and implementation of these recommendations hinge on support from faculty and administrators, ensuring that future healthcare professionals are well-prepared for emergency medical care.

Identifiants

pubmed: 39103797
doi: 10.1186/s12245-024-00671-9
pii: 10.1186/s12245-024-00671-9
doi:

Types de publication

Journal Article

Langues

eng

Pagination

98

Investigateurs

Abdullah Abdulkhaliq Qazzaz (AA)
Aisha Hamed Al Khamisi (AH)
Amal Al Mandhari (A)
Amber Hathcock (A)
Aus N Jamil (AN)
Borwon Wittayachamanakul (B)
Bret Nicks (B)
Carlos E Vallejo-Bocanumen (CE)
Cem Oktay (C)
Chih-Hsien Chi (CH)
Conor Deasy (C)
Craig Beringer (C)
Doris Lorette Uwamahoro (DL)
Dorota Rutkowska (D)
Erin L Simon (EL)
Faith Joan Gaerlan (FJ)
Frida Meyer (F)
Immad S Qureshi (IS)
Janet Lin (J)
Jesús Daniel López Tapia (JDL)
Justin Kaplan (J)
Keamogetswe Molokoane (K)
Kuldeep Kaur (K)
Lars Petter Bjoernsen (LP)
Lisa Kurland (L)
Matthew Chu (M)
Miklos Szedlak (M)
Mohamed Alwi Abdul Rahman (MAA)
Mohan Kamalanathan (M)
Ndebwanimana Vincent (N)
Oscar Navea (O)
Pariwat Phungoen (P)
Pauline F Convocar (PF)
Peter Vass (P)
Philipp Martin (P)
Rahim Valani (R)
Richard Henry S Santos (RHS)
Ruth Hew Li-Shan (RH)
Sabrina Berdouk (S)
Saleem A Varachhia (SA)
Sam Thenabadu (S)
Sameer Thapa (S)
Sean Kivlehan (S)
Sofia Basauri (S)
Syed Ghazanfar Saleem (SG)
Valerie Krym (V)
Victor Lee (V)
Wee Choon Peng Jeremy (WCP)
Zsolt Kozma (Z)

Informations de copyright

© 2024. The Author(s).

Références

Gismalla MD, Alawad AA. Undergraduate emergency medicine education: problems and challenges. Austin Emerg Med. 2017;3(1):1049.
Cameron P, Hobgood C, Mulligan T. Developments in international emergency medicine. Emerg Med Australas. 2009;21(5):339–41. https://doi.org/10.1111/j.1742-6723.2009.01211.x . (PMID: 19840083).
doi: 10.1111/j.1742-6723.2009.01211.x pubmed: 19840083
Hobgood C, Anantharaman V, Bandiera G, Cameron P, Halpern P, Holliman CJ, Jouriles N, Kilroy D, Mulligan T, International Federation for Emergency Medicine. Singer A International Federation for Emergency Medicine model curriculum for medical student education in emergency medicine. Int J Emerg Med. 2010;3(1):1–7. https://doi.org/10.1007/s12245-009-0142-7 . PMID: 20414375; PMCID: PMC2850981.
doi: 10.1007/s12245-009-0142-7 pubmed: 20414375 pmcid: 2850981
Manthey DE, Ander DS, Gordon DC, Morrissey T, Sherman SC, Smith MD, Rimple D, Thibodeau LG, Clerkship Directors in Emergency Medicine (CDEM) Curriculum Revision Group. Emergency medicine clerkship curriculum: an update and revision. Acad Emerg Med. 2010;17(6):638–43. https://doi.org/10.1111/j.1553-2712.2010.00750.x . PMID: 20624144.
doi: 10.1111/j.1553-2712.2010.00750.x pubmed: 20624144
Penciner R, Woods RA, McEwen J, Lee R, Langhan T, Bandiera G, Canadian Association of Emergency Physicians Undergraduate Education Committee. Core competencies for emergency medicine clerkships: results of a Canadian consensus initiative. CJEM. 2013;15(1):24–33 PMID: 23283120.
doi: 10.2310/8000.2012.120686 pubmed: 23283120
Santen SA, Peterson WJ, Khandelwal S, House JB, Manthey DE, Sozener CB. Medical student milestones in emergency medicine. Acad Emerg Med. 2014;21(8):905–11. https://doi.org/10.1111/acem.12443 . (Epub 2014 Aug 24 PMID: 25155021).
doi: 10.1111/acem.12443 pubmed: 25155021
Wai AK, Graham CA, Rainer TH. Undergraduate emergency medicine training: past, present and future. Hong Kong J Emerg Med. 2006;13(3):178–84.
doi: 10.1177/102490790601300310
Hodkinson PW, Wallis LA. Emergency medicine in the developing world: a Delphi study. Acad Emerg Med. 2010;17(7):765–74. https://doi.org/10.1111/j.1553-2712.2010.00791.x . (PMID: 20653593).
doi: 10.1111/j.1553-2712.2010.00791.x pubmed: 20653593
Beyene T, Tupesis JP, Azazh A. Attitude of interns towards implementation and contribution of undergraduate Emergency Medicine training: Experience of an Ethiopian Medical School. Afr J Emerg Med. 2017;7(3):108–12. https://doi.org/10.1016/j.afjem.2017.04.008 . (Epub 2017 Apr 20. Erratum in: Afr J Emerg Med. 2017 Dec;7(4):189. PMID: 30456120; PMCID: PMC6234139).
doi: 10.1016/j.afjem.2017.04.008 pubmed: 30456120 pmcid: 6234139
Cevik AA, Cakal ED, Abu-Zidan FM. Emergency medicine clerkship curriculum in a high-income developing country: methods for development and application. Int J Emerg Med. 2018;11(1):31. https://doi.org/10.1186/s12245-018-0190-y . (PMID:29882065;PMCID:PMC5991107).
doi: 10.1186/s12245-018-0190-y pubmed: 29882065 pmcid: 5991107
Mtombeni S. Identifying Procedural Core Competencies for Undergraduate Emergency Medicine Education at the University of Zimbabwe College of Health Sciences (Master’s thesis, University of Cape Town). 2018.
Mulligan T, Hobgood C, Cameron PA. Recognizing the common end-point of different emergency medicine specialty training curricula. Emerg Med Australas. 2011;23(5):525–9. https://doi.org/10.1111/j.1742-6723.2011.01490.x . (PMID: 21995465).
doi: 10.1111/j.1742-6723.2011.01490.x pubmed: 21995465
Monrouxe LV, Grundy L, Mann M, John Z, Panagoulas E, Bullock A, Mattick K. How prepared are UK medical graduates for practice? A rapid review of the literature 2009–2014. BMJ Open. 2017;7(1):e013656. https://doi.org/10.1136/bmjopen-2016-013656 . (PMID:28087554;PMCID:PMC5253586).
doi: 10.1136/bmjopen-2016-013656 pubmed: 28087554 pmcid: 5253586
Muthaura PN, Khamis T, Ahmed M, Hussain SR. Perceptions of the preparedness of medical graduates for internship responsibilities in district hospitals in Kenya: a qualitative study. BMC Med Educ. 2015;21(15):178. https://doi.org/10.1186/s12909-015-0463-6 . (PMID:26489421;PMCID:PMC4618348).
doi: 10.1186/s12909-015-0463-6
Pandit T, Ray R, Sabesan S. Review article: managing medical emergencies in rural Australia: a systematic review of the training needs. Emerg Med Australas. 2019;31(1):20–8. https://doi.org/10.1111/1742-6723.12939 . (Epub 2018 Feb 22 PMID: 29473300).
doi: 10.1111/1742-6723.12939 pubmed: 29473300
Harden RM. AMEE Guide No. 14: Outcome-based education: Part 1-An introduction to outcome-based education. Med Teach. 1999;21(1):7–14.
doi: 10.1080/01421599979969
Harden RM. Learning outcomes and instructional objectives: is there a difference? Med Teach. 2002;24(2):151–5. https://doi.org/10.1080/0142159022020687 . (PMID: 12098434).
doi: 10.1080/0142159022020687 pubmed: 12098434
American Board of Emergency Medicine. ABEM Knowledge, Skills, and Abilities & Standards, 2016. https://www.abem.org/public/docs/default-source/default-document-library/2016-ksas.pdf?sfvrsn=f3ffcef4_0 . Accessed 8 May 2023.
American College of Emergency Physicians, Emergency Medicine Practice Committee. The Role and Value of Emergency Medicine: An informational paper, 2017. https://www.acep.org/globalassets/uploads/uploaded-files/acep/clinical-and-practice-management/resources/administration/empc_vemp_0430_0117.pdf . Accessed 8 May 2023.
European Core Curriculum for Emergency Medicine Revision Group. European Core Curriculum for Emergency Medicine, 2017. https://eusem.org/images/pdf/European_Core_Curriculum_for_EM_-_Version_1.2_April_2017_final_version.pdf . Accessed 8 May 2023.
General Medical Council. Outcomes for graduates (Tomorrow’s doctors), 2015. https://www.gmc-uk.org/-/media/documents/outcomes-for-graduates-jul-15-1216_pdf-61408029.pdf . Accessed 8 May 2023.
Holmboe ES, Edgar L, Hamstra S. The milestones guidebook. Chicago: Accreditation Council for Graduate Medical Education; 2016.
Rayhan RU, Zheng Y, Uddin E, Timbol C, Adewuyi O, Baraniuk JN. Administer and collect medical questionnaires with Google documents: a simple, safe, and free system. Appl Med Inform. 2013;33(3):12–21 (PMID: 24415903; PMCID: PMC3884902).
pubmed: 24415903 pmcid: 3884902
Wald DA, Manthey DE, Kruus L, Tripp M, Barrett J, Amoroso B. The state of the clerkship: a survey of emergency medicine clerkship directors. Acad Emerg Med. 2007;14(7):629–34. https://doi.org/10.1197/j.aem.2007.02.035 . (Epub 2007 May 8 PMID: 17488948).
doi: 10.1197/j.aem.2007.02.035 pubmed: 17488948
Wald DA, Lin M, Manthey DE, Rogers RL, Zun LS, Christopher T. Emergency medicine in the medical school curriculum. Acad Emerg Med. 2010;17(Suppl 2):S26-30. https://doi.org/10.1111/j.1553-2712.2010.00896.x . (PMID: 21199080).
doi: 10.1111/j.1553-2712.2010.00896.x pubmed: 21199080
American College of Emergency Physicians. Guidelines for undergraduate education in emergency medicine. Ann Emerg Med. 1987;16(1):117–9. https://doi.org/10.1016/S0196-0644(87)80301-3 .
doi: 10.1016/S0196-0644(87)80301-3
American College of Emergency Physicians. Guidelines for Undergraduate Education in Emergency Medicine. Ann Emerg Med. 2016;68(1):150. https://doi.org/10.1016/j.annemergmed.2016.04.049 . (PMID: 27343670).
doi: 10.1016/j.annemergmed.2016.04.049
Avegno JL, Murphy-Lavoie H, Lofaso DP, Moreno-Walton L. Medical students’ perceptions of an emergency medicine clerkship: an analysis of self-assessment surveys. Int J Emerg Med. 2012;5(1):25. https://doi.org/10.1186/1865-1380-5-25 . (PMID:22647269;PMCID:PMC3419087).
doi: 10.1186/1865-1380-5-25 pubmed: 22647269 pmcid: 3419087
Binder L, Smith M. Political and Budget Issues. In: Clerkship Directors in Emergency Medicine. Rogers RL, Moayedi S(Eds.), Medical Student Educators’ Handbook. 2010; 195-204.
Cevik AA, Cakal ED, Alao D, Elzubeir M, Shaban S, Abu-Zidan F. Self-efficacy beliefs and expectations during an Emergency Medicine Clerkship. Int J Emerg Med. 2022;15(1):4. https://doi.org/10.1186/s12245-021-00406-0 . (PMID:35065608;PMCID:PMC8903584).
doi: 10.1186/s12245-021-00406-0 pubmed: 35065608 pmcid: 8903584
Yeung M, Beecker J, Marks M, Nuth J, Weitzman B, Lee AC, Frank JR. A new emergency medicine clerkship program: students’ perceptions of what works. CJEM. 2010;12(3):212–9. https://doi.org/10.1017/s1481803500012264 . (PMID: 20522286).
doi: 10.1017/s1481803500012264 pubmed: 20522286
Banh K, Ramirez R, Thabit C. Effectiveness of emergency medicine in longitudinal integrated clerkships. Med Educ Online. 2014;15(19):25429. https://doi.org/10.3402/meo.v19.25429 . (PMID:25227527;PMCID:PMC4165724).
doi: 10.3402/meo.v19.25429
Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, Harris P, Glasgow NJ, Campbell C, Dath D, Harden RM, Iobst W, Long DM, Mungroo R, Richardson DL, Sherbino J, Silver I, Taber S, Talbot M, Harris KA. Competency-based medical education: theory to practice. Med Teach. 2010;32(8):638–45. https://doi.org/10.3109/0142159X.2010.501190 . (PMID: 20662574).
doi: 10.3109/0142159X.2010.501190 pubmed: 20662574
Nendaz MR, Raetzo MA, Junod AF, Vu NV. Teaching diagnostic skills: clinical vignettes or chief complaints? Adv Health Sci Educ Theory Pract. 2000;5(1):3–10. https://doi.org/10.1023/A:1009887330078 . (PMID: 12386472).
doi: 10.1023/A:1009887330078 pubmed: 12386472
Burt CW, Arispe IE. Characteristics of emergency departments serving high volumes of safety-net patients: United States, 2000. Vital Health Stat 13. 2004;155:1–16 PMID: 15181760.
Hock MO, Ornato JP, Cosby C, Franck T. Should the Emergency Department be society’s health safety net? J Public Health Policy. 2005;26(3):269–81. https://doi.org/10.1057/palgrave.jphp.3200028 . PMID: 16167554.
doi: 10.1057/palgrave.jphp.3200028
Australian Medical Council Limited. Standards for Assessment and Accreditation of Primary Medical Programs by the Australian Medical Council 2012. https://www.amc.org.au/wp-content/uploads/2019/10/Standards-for-Assessment-and-Accreditation-of-Primary-Medical-Programs-by-the-Australian-Medical-Council-2012.pdf . Accessed 8 May 2023.
Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Royal College of Physicians and Surgeons of Canada. 2015. https://canmeds.royalcollege.ca/uploads/en/framework/CanMEDS%202015%20Framework_EN_Reduced.pdf . Accessed 8 May 2023.
Cevik AA, Rodoplu U, Holliman CJ. Update on the development of emergency medicine as a specialty in Turkey. Eur J Emerg Med. 2001;8(2):123–9. https://doi.org/10.1097/00063110-200106000-00008 . (PMID: 11436908).
doi: 10.1097/00063110-200106000-00008 pubmed: 11436908
Moawad, H. Is residency required after medical school? https://www.wolterskluwer.com/en/expert-insights/is-residency-required-after-medical-school 2020, June 26. Accessed 8 May 2023.
Biedrzycki CD, Bergmann HP, Remick KN, Qasim Z, Baker JB. Brief comparative analysis of trauma care specialties in Europe and the United States. Mil Med. 2023;188(11–12):305–9. https://doi.org/10.1093/milmed/usad164 . (PMID: 37208313).
doi: 10.1093/milmed/usad164 pubmed: 37208313
Wijnen-Meijer M, van den Broek S, Koens F, Ten Cate O. Vertical integration in medical education: the broader perspective. BMC Med Educ. 2020;20(1):509. https://doi.org/10.1186/s12909-020-02433-6 . (PMID:33317495;PMCID:PMC7737281).
doi: 10.1186/s12909-020-02433-6 pubmed: 33317495 pmcid: 7737281
Celenza A, Jelinek GA, Jacobs I, Kruk C, Graydon R, Murray L. Implementation and evaluation of an undergraduate emergency medicine curriculum. Emerg Med (Fremantle). 2001;13(1):98–103. https://doi.org/10.1046/j.1442-2026.2001.00186.x . (PMID: 11476422).
doi: 10.1046/j.1442-2026.2001.00186.x pubmed: 11476422
Hirsh DA, Ogur B, Thibault GE, Cox M. “Continuity” as an organizing principle for clinical education reform. N Engl J Med. 2007;356(8):858–66. https://doi.org/10.1056/NEJMsb061660 . (PMID: 17314348).
doi: 10.1056/NEJMsb061660 pubmed: 17314348
Irby DM, Cooke M, O’Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med. 2010;85(2):220–7. https://doi.org/10.1097/ACM.0b013e3181c88449 . (PMID: 20107346).
doi: 10.1097/ACM.0b013e3181c88449 pubmed: 20107346
Aldeen AZ, Gisondi MA. Bedside teaching in the emergency department. Acad Emerg Med. 2006;13(8):860–6. https://doi.org/10.1197/j.aem.2006.03.557 . (Epub 2006 Jun 9 PMID: 16766739).
doi: 10.1197/j.aem.2006.03.557 pubmed: 16766739
Burdick WP, Jouriles NJ, D’Onofrio G, Kass LE, Mahoney JF, Restifo KM. Emergency medicine in undergraduate education. SAEM Education Committee, Undergraduate Subcommittee, Society for Academic Emergency Medicine. Acad Emerg Med. 1998;5(11):1105–10. https://doi.org/10.1111/j.1553-2712.1998.tb02671.x . PMID: 9835475.
doi: 10.1111/j.1553-2712.1998.tb02671.x pubmed: 9835475
Johnson GA, Pipas L, Newman-Palmer NB, Brown LH. The emergency medicine rotation: a unique experience for medical students. J Emerg Med. 2002;22(3):307–11. https://doi.org/10.1016/s0736-4679(01)00497-8 . (PMID: 11932105).
doi: 10.1016/s0736-4679(01)00497-8 pubmed: 11932105
Penciner R. Emergency medicine preclerkship observerships: evaluation of a structured experience. CJEM. 2009;11(3):235–9. https://doi.org/10.1017/s1481803500011258 . (PMID: 19523272).
doi: 10.1017/s1481803500011258 pubmed: 19523272
Spencer J, McKimm J, Symons J. Patient involvement in medical education. In: Swanwick T, Forrest K, O’Brien BC, editors. Understanding medical education: Evidence, theory, and practice. Hoboken: Wiley Blackwell; 2019. p. 207–22.

Auteurs

Arif Alper Cevik (AA)

Emergency Medicine Section, Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. aacevik@uaeu.ac.ae.
Department of Emergency Medicine, Tawam Hospital, Al Ain, UAE. aacevik@uaeu.ac.ae.

Elif Dilek Cakal (ED)

Emergency Department, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK.

James Kwan (J)

Department of Emergency Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Simon Chu (S)

University of Adelaide, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia.

Sithembile Mtombeni (S)

Department of Emergency Medicine, University of Namibia, Northern Campus, Oshakati, Namibia.

Venkataraman Anantharaman (V)

Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore.

Nicholas Jouriles (N)

Department of Emergency Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA.

David Teng Kuan Peng (DTK)

Department of Emergency Medicine, Tan Tock Seng Hospital, Singapore, Singapore.

Andrew Singer (A)

Australian Government Department of Health and Aged Care, Canberra, ACT, Australia.
Australian National University Medical School, Acton, ACT, Australia.

Peter Cameron (P)

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.
The Alfred Hospital, Emergency and Trauma Centre, Melbourne, Australia.

James Ducharme (J)

McMaster University, Hamilton, Ontario, Canada.

Abraham Wai (A)

Department of Emergency Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong.

David Edwin Manthey (DE)

Department of Emergency Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA.

Cherri Hobgood (C)

Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Terrence Mulligan (T)

Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Edgardo Menendez (E)

Department of Emergency Medicine, Churruca Hospital UBA, Buenos Aires, Argentina.

Juliusz Jakubaszko (J)

Department of Emergency Medicine, Wroclaw University of Medicine, Wroclaw, Poland.

Classifications MeSH