EVIDENCE-BASED EMERGENCY MEDICINE

WORKING GROUP

MINUTES 6/6/00

Present: Jim Celentano, Peter Dayan, Barney Eskin, Phil Hubel, Peter Wyer and Ben Yeh.

The meeting was called to order at 5:30 PM by Peter Wyer. The meeting was adjourned at 6:10 PM so that we could join the Evidence-based Medicine Committee Meeting and reconvened at 7:00 PM.

OLD BUSINESS

Minutes of the May meeting were reviewed and approved.

Y2K EDUCATIONAL ACTIVITIES

NYAM WORKSHOP 2000

There are now 47 applicants for 16 slots. Acceptances were sent out to the first 16 applicants, who need to pay by 6/24 to reserve a spot. The majority of applicants are from academic programs. Announcement of the workshop will be in EM News next month.

Pfizer has not yet responded to our request for funding. Astra Zeneca may be interested in EBM and may be a source for funding. We probably need about $3000 to completely fund the workshop. This would include about $2600 in tutor expenses and $400 to make up the difference between the $575 fee advertised and the $600 actually charged by NYAM.

PEDIATRIC EMERGENCY MEDICINE FELLOWS' WORKSHOP

Peter Dayan reported that he has arranged for computers and rooms for the workshop. However, the curriculum and pamphlets still need to be prepared and didactic sessions arranged.

WEBSITE UPDATE

Ben Yeh reported Journal Club Bank submissions are now coming in more slowly than before, with a total of about 60 contributions so far. The suggestion to put the JCB on Palm Pilots was made since this would allow their use at the bedside. If the Palms could be linked to the CHE site, then what is used could be monitored and this would be one way of conducting educational research.

The suggestion to put powerpoint presentations on the web site was reiterated.

TREASURER'S REPORT

Phil Hubel presented the treasurer's report. Since the money is held at NYAM, to update the records, Phil Hubel will set up a meeting with Linda Gardin.

Our current assets include a $434 balance from 1999, $400 contribution from EMA (NJ), $300 from LIJ for Peter Wyer's site visit there, and $400 for Peter Wyer's participation in the Pediatric EM Fellows Workshop.

FUNDING

Up to now we have relied on industry support. However, it is cyclical, unreliable and doesn't enhance our ability to obtain future funding. We might be able to get leads for funding by looking at the SCHARR site or contacting the grants office at Columbia University. Grants from the Agency for Healthcare Research and Quality (AHRQ, formerly AHCPR), focus on educational research. Their minimum requirements include: asking questions, searching, appraising the results and applying the findings.

NEW BUSINESS

SAEM INTEREST GROUP REPORT

Peter Wyer reported on the SAEM Interest Group meeting in San Francisco at the SAEM meeting on May 22nd. Brian Zink, the incoming SAEM president, has established faculty development as a major area of emphasis for the coming year. Gloria Kuhn had sent out a survey of program directors inquiring about the level of EBM training in residencies and medical schools. AHRQ has shown an interest in this and may be making grants available to study it in the near future. Carey Chisholm, the liason to the SAEM board of directors, spoke of the need for the interest group to submit proposals for didactic presentations at the 2001 SAEM meeting (deadline: August 28th), with an emphasis on faculty development for an EBM curriculum, particularly, the knowledge and competencies needed by faculty to implement such a curriculum. Media through which this might be accomplished include workshops, web-based resources, videoconferencing, and site visits.

PLANS FOR THE YEAR 2001 AND BEYOND

Peter Wyer met with Rosanne Leipzig and Tom McGinn about the future plans of the EBM effort at NYAM. The grant that has been funding Leipzig and Eleanor Wallace's efforts runs out this year. The support from NYAM has been limited to providing help from Pat Gallagher on a part-time basis. Leipzig and Wallace are considering moving their efforts to Mt. Sinai. If so, we would probably still be able to collaborate with them. One advantage of maintaining the association with NYAM is that it has a presence that may attract people. Furthermore, we are a section of NYAM and the major part of the EM section. Peter Wyer will speak to Neal Flomenbaum about continuing our affiliation with NYAM even if the workshops are moved to Mt. Sinai.

If we were to hold separate workshops of perhaps 30-40 participants, we would not have access to outside speakers such as Mark Wilson or Roman Jaeschke who have been at the NYAM workshops in the past. However, we might get some help from Ilene Wilets on a $5000 EMA grant.

The issue of how to attract others to our monthly meetings was discussed.

SITE VISITS AND FUTURE APPROACHES TO TEACHING EBM

The role of site visits and whether they are actually helpful was discussed. Emphasis should be placed on interacting with faculty interested in EBM, approaching them with the question, "How can we help you?" Peter Wyer described the faculty development approach that was used to training some of the faculty at Lincoln in EBM.

Jim Celentano proposed that we establish a repository of tutors who are able to assist programs in the metropolitan area with their journal clubs, and, in particular, with setting up journal clubs in small group sessions. Although ideally each program should have enough tutors to do this themselves, the repository would give help to those who have yet to achieve self sufficiency through faculty development. Furthermore, this would allow cross-fertilization of ideas among programs and might even be something that could be the nidus of a grant from AHRQ.

Peter Wyer mentioned Mark Wilson's suggestion that the term "Journal Club" be eliminated and some other term such as critical pathway be substituted.

The next monthly meeting is scheduled for July 11th. Since there will be no meeting of the Evidence-based Medicine Committee over the summer, plans will be made to have the meeting via conference call or internet chat room.

There being no further business, the meeting was adjourned at 8:00 PM.

Respectfully submitted
Barney Eskin