Læknablaðið : fylgirit - 15.06.2002, Blaðsíða 32

POSTERS / ICELAND 2002: EMERGENCY MEDICINE BETWEEN CONTINENTS
irritability be an underreported clinical presentation for the diag-
nosis of influenza A.
P 44 - Education and Competency
Factors affecting the teachable moment in the ED
Esler J, Bock B, Partridge R, Becker B
Department of Emergency Medicine, Rhode Island Hospital/Brown Medical
School, United States
Objectives: The concept of the Teachable Moment in the
Emergency Department (ED) has not been formally studied. The
purpose of this study was to determine if 1) the Teachable Momenl
is affected by patients’ perception of the severity of their illness and
their anxiety levels and if 2) these perceptions influence the
retenlion of health related informalion.
Methods: Standardized information was presented to a con-
venience sample of 226 adult non-critical ED patients. We assessed
anxiety level and 20 minute word recall performance at three time
points: 1) after initial triage, 2) in acute care before physician
assessment, and 3) after physician assessment. Patients also rated
the severity of their illness/injury. Data was analyzed using SPSS
10.0 software with ANOVA and Pearson correlations.
Rcsults: Word recall was negatively correlated with patients’ percep-
tion of severity of illness/injury at time points 2 (r= -0.21 p=0.013) and
3 (r= -0.25, p=0.004). Patients’ perception of severity of illness/injury
was significantly correlated with their anxiety ratings (r=.36, p<.001).
However, anxiety levels were not associated with word recall.
Furthermore, word recall did not differ by time point.
Conclusions: Patients who perceive themselves as more severely ill
or injured do worse on memory recall, and had higher anxiety
levels. Anxiety levels and time point of intervention did not
influence recall. To enhance the effectiveness of doctor-patient
communications in the ED the ideal teachable moment must take
into account patients’ perceptions of illness severity.
P45 - Education and Competency
Is a career in emergency medicine associated with stigma?
Smith S
John Radcliffe Hospital, Oxford, UK
Objectives: Many emergency medicine staff report anecdotally that
fellow hospilal staff have a low opinion of emergency medicine. No
research into this attitude has been published. The aim of this study
is to determine whether there is stigma attached to emergency
medicine and practitioners.
Methods: A postal questionnaire of all medical staff at a district
general hospital, to evaluate the presence or absence of eight
perceplions associated with stigma.
Results: The response rate was 49.5%, with the response rate
decreasing with decreasing grade. Of the stigmatising themes tested
in this study, six of the eight were demonstrated to be associated
with negative attitudes, with the remaining two themes positive
attitudes towards emergency medicine were suggested.
Condusions: This paper demonstrates that stigmatising opinions
towards emergency medicine exist and that these negative opinions
may be widely held by hospital staff.
P 46 - Education and Competency
Specific education in emergency medicine
Del Rio Gallegos F
Hospital Clinico San Carlos, Spain
Objective: Emergency Medicine is a growing supportive activity.
Most emergency medicine doctors come from related specialties.
There is a very strong supportive responsibility plus a great
improvement in technical support that implies specific and
continuous teaching and training programmes. It is necessary to
have high quality specific education, not only in pre-graduate, but
in the post-graduate period as well.
Mefhods: We have designed an interview to find how much specific
education medical doctors have received working in emergency
services, in and out of hospital, in pre- and post-graduate periods and
if this education has been provided through their own institutions
and emergency services or by themselves. We collected the data in
the Madrid area, including 13 hospitals and 4 outpatient emergency
services. We didn't collect any information from private medicine.
Resulfs: Almost 70% of consulted people considered pregraduate
education insufficient, and were frightened in their first weeks of
employment in emergency and unable or feel sure in solving most of
the problems. 45% didn't receive any kind of education or this was
considered clearly inadequate in CPR in pregraduate training. Areas
in which they felt more safe were those relating to trauma, wounds
and minor surgery and cardiology (mostly in detection of EKG
problems). There was a feeling of being able to solve those medical
problems in which there was no vital compromise. Only 40% of
people consulted felt able to handle airvvay management at the end
of their education. Relating to postgraduate education, most of
outpatient emergency services offered training programmes and
courses to their medical staff that were evaluated to be of great help
and enough to allow management of most emergency problems. In-
hospital education, including CPR training courses, was limited to
medical residents (mainly in first year of training), and reached only
65% of hospital consulted. 92% of medical staff working in
outpatient emergency services received specific education financed
on their own and in their spare time. Only 13% of in-hospital medical
staff received these kinds of courses. Clearly more outpatient staff
had a feeling of being able to solve vital problems.
Condusions: There is a clear necessity for specific emergency
training in pre- and post-graduate periods. There is little education
in these areas in the pre-graduate, and most of the post-graduate
periods, the latter depending on workers' willpower. There is a
great interest in these programmes in most outpatient emergency
services, but this is not completely shared by hospitals. Post-
graduate courses need strict quality controls. The university offers
very few emergency courses in the post-graduate period. Scientific
societies directly related to emergency services should make a great
effort to secure this education.
P 47 - Domestic/Child Abuse and Rape
Intervention model for young victims of violence in the Trauma
Unit of the emergency department
Benin-Goren O
Tel Aviv Sourasky Medical Center, Tel Aviv*, Israel
Violence among youth is one of the complicated problems facing
32 Læknablaðið/Fylgirit 45 2002/88