Emergency Medicine Residents' Perspectives on Injury Prevention

doi:10.1016/S0196-0644(96)70135-X

Annals of Emergency Medicine

Volume 28, Issue 1, July 1996, Pages 31-33

Presented at the Society for Academic Emergency Medicine Annual Meeting, Washington DC, May 1994.

https://doi.org/10.1016/S0196-0644(96)70135-X Get rights and content

Abstract

Study objective: To determine emergency medicine residents' perspectives and opinions concerning the relevance of injury prevention to emergency medicine and their exposure to formal instruction and readings in this subspecialty area. Methods: A survey was mailed between November 1992 and February 1993 to all 461 residents and 1992 graduates of the 13 emergency medicine residency programs in California. Results: Three hundred ninety questionnaires (85%) were returned. Ninety-seven percent of respondents said they believed injury prevention is pertinent to emergency medicine. Sixty-two percent said they believed inadequate time in residency is devoted to this subject, and 70% said there should be a greater focus on injury prevention in their training. Only 44% of the respondents said they had received lectures and 28% of the respondents said they consistently read journal articles on injury prevention. There were no statistically significant differences between the level of the respondents' training and their answers to the questions. Conclusion: Although most emergency medicine residents consider injury prevention pertinent to emergency medicine and important to their training, most perceived a lack of formal instruction on injury prevention during their training and did not consistently read articles on this subspecialty area. [Anglin D, Hutson HR, Kyriacou DN: Emergency medicine residents' perspective on injury prevention. Ann Emerg Med July 1996;28:31-33.]

Section snippets

INTRODUCTION

There are 90 million emergency department visits per year in the United States,¹ for which injury accounts for more than 25%.² In addition, approximately 90% of injured patients in need of medical care are treated and discharged from EDs.³ Emergency physicians are therefore ideally suited to promote injury prevention. By implementing the principles of injury prevention in clinical practice, emergency physicians can educate their patients about injury prevention programs, facilitate community

MATERIALS AND METHODS

The survey was conducted between November 1992 and February 1993. All 374 emergency medicine residents and 87 1992 graduates of the 13 emergency medicine training programs in California were surveyed by mail. As many as three questionnaires were sent to each nonresponder.

We designed a series of questions to determine the respondents' opinions of the relevance of injury prevention to emergency medicine. In addition, the respondents' exposure to formal instruction and journal readings on injury

RESULTS

Of the 461 individuals we attempted to survey, 390 (85%) responded. The results of the survey are presented in the Figure. We found no statistically significant differences between the level of the respondents' training (ie, year of residency) and their answers to the questions of the survey.

DISCUSSION

From this survey of residents in California, we found that emergency physicians in training consider injury prevention important to emergency medicine and pertinent to their education. However, most emergency medicine residents stated they did not receive lectures or consistently read journal articles on this subject.

A recent educational goal established by the Accreditation Council for Graduate Medical Education is to instruct emergency physicians to provide patient and public education about

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Cited by (17)

Survey of Current Injury Prevention Practices by Registered Nurses in the Emergency Department
2008, Journal of Emergency Nursing
It has been shown that a vast majority of injured patients who seek treatment in emergency departments are seen and released. The events resulting in the individuals seeking treatment may have been preventable and some of the time spent in an emergency department could be used for injury prevention (IP) education. This study sought to determine current IP practices of registered nurses working in an emergency department, to discover whether or not they believed IP was important, and to identify perceived obstacles for incorporating IP education into clinical practice.
A convenience sample of 150 registered nurses working in the emergency departments of an adult level 1 trauma centre in Ontario, Canada was used. A descriptive survey composed of 10 questions was used. Data analysis was completed using SPSS Version 11.0.
Findings suggest current IP strategies are varied, and implemented inconsistently. Evidence indicates educating patients about IP is an important part of the emergency nurse role. However, time, education, and resources were recognized obstacles to implementation.
A better understanding of registered nurses' current IP practices will guide the development and implementation of a future adult focused injury prevention program for ED patients.
The role of health professionals in childhood injury prevention: A systematic review of the literature
2006, Patient Education and Counseling
To systematically review the literature to explore health professionals’ knowledge, attitudes and practices and their role in childhood injury prevention.
MEDLINE (1966–September Week 1 2005), EMBASE (1980–2005 Week 37), CINAHL (1982–September Week 1 2005), BRITISH NURSING INDEX (1985–September 2005) and PsychINFO (1967–August Week 5 2005) were searched using relevant ‘medical subheadings’ (for MEDLINE, EMBASE and CINAHL) and ‘thesaurus terms’ (for PsychINFO).
Twenty-five primary studies were retrieved, the majority of which were surveys. Health professionals’ knowledge was reported to be variable, although generally they have a positive attitude towards childhood injury prevention. Even with adequate knowledge and positive attitudes there appear to be barriers in prevention practice.
There continues to be a need for high quality research specifically looking at how to change practice. Nevertheless, although training may be effective at increasing health professionals’ knowledge and changing their attitudes, legislative and engineering measures may ultimately more effective at reducing the burden of childhood injuries.
Barriers to practice for health professionals need to be taken into account. No matter how knowledgeable nor how positive their attitudes to childhood injury prevention if barriers to practice are not addressed we will move no closer to reducing the burden of injuries in childhood. Those health professionals who are positive about their role may be best suited to continue to raise the issue campaigning for legislative and engineering changes which can reduce childhood injuries.
Identifying the opportunities for health promoting emergency departments
2003, Accident and Emergency Nursing
Study objective: To describe the opportunities for health promotion in emergency departments (EDs).
Methods: A comprehensive literature review and consultation with ED staff (seven focus groups) and other health professionals (workshop).
Results: Opportunities for patient health information and education within EDs are described in the literature. In contrast, the health promoting hospitals literature showcases integrated approaches for health promotion, emphasizing organisational structures, and culture changes to support effective health promotion. This type of integration has not developed in EDs, where individual issues based health promotion projects have emerged. ED staff readily described the:
- •
  existing health promotion interventions and possible improvements and
- •
  opportunities for potential health promotion interventions related to the needs of their patients, the community or their organisation.
Other health professionals supported EDs taking a greater role in health promotion and suggested organisational partnerships that would assist in developing this.
Conclusion: There are numerous opportunities to enhance health promotion in EDs. With support, EDs could deliver comprehensive health promotion programs for patients, staff, and communities.
Emergency medicine and injury prevention: Meeting at the intersection
2003, Clinical Pediatric Emergency Medicine
Emergency medicine (EM) physicians need little convincing that injury prevention is a public health priority. Clinical experience alone creates a clear appreciation for the impact that injuries have on children and their families. The role of the EM physician is evolving from primary responsibility for the acute care of injuries to a more expanded prevention role including education, research and advocacy. Many emergency department (ED)-based injury prevention projects have been developed and individual EM physicians have emerged as leaders in the field of injury prevention. However, challenges remain. Development of effective interventions which can realistically be implemented in a busy ED are lacking. Expansion of the role of the emergency health care provider outside the hospital, in the community, has great potential for success. The goal of this paper is to discuss the current status of primary injury prevention within emergency medicine, barriers that exist and areas of opportunity.
Surgeons and injury prevention: What you don't know can hurt you!
2001, Journal of the American College of Surgeons
Background:
The most effective treatment for traumatic injuries is to prevent them from occurring. Currently, few surgeons receive any formal training in injury control and prevention. This study was designed to test the knowledge of injury prevention principles among practicing surgeons, in order to identify areas in need of intensified educational efforts.
Study Design:
Survey questions designed by members of the American College of Surgeons Committee on Trauma were programmed into a specialized touch-screen computer, which was displayed at four different surgery and trauma meetings, including the ACS Clinical Congress in 1999 and 2000. Participants were questioned about their knowledge of trauma epidemiology, bicycle helmet effectiveness, child safety seat usage, suicide, and domestic violence.
Results:
Seventy-nine surveys were completed by surgeons, including 33 specializing in trauma care, and by 106 nurses attending trauma courses. Overall, the percentage of correct answers was 50%. There were no significant differences in survey scores between trauma surgeons and general surgeons, although both scored higher than trauma nurses. Areas where knowledge deficits were the most apparent included proper use of child safety seats, the effectiveness of airbags, the prevalence of suicide, and the annual cost of injury in America.
Conclusions:
The majority of practicing surgeons and nurses, including those working at trauma centers, are unaware of the basic concepts of injury prevention. Advancements in the field of injury control will require efforts to educate medical professionals and the public.
Surgical residents' knowledge of injury prevention principles
2000, American Journal of Surgery
Citation Excerpt :
Ninety-seven percent of respondents said they believed injury prevention is important to emergency medicine, and 70% believed there should be a greater emphasis on injury prevention during their training. Only 44% of surveyed emergency medicine residents had received any formal instruction in injury prevention.10 In a telephone survey of more than 900 physicians, Cassel et al11 found that 94% of internists and 87% of surgeons believe firearm violence is a major public health issue.
Background: Injury prevention is not routinely taught in medical school or surgical residency curricula. Because of the integral role surgeons play in the diagnosis and treatment of trauma, we sought to determine the knowledge base of injury prevention concepts of surgical residents training in a state’s level 1 trauma centers.
Methods: A written survey was given to general surgery residents at our state’s three level 1 trauma centers. Twenty-one questions related to injury prevention were asked in addition to demographic data. Basic concepts of injury prevention, statistical knowledge of injury patterns, and knowledge of intentional violence were tested.
Results: Sixty-two residents completed the survey. Only 9 respondents reported prior formal instruction in injury prevention. Overall performance was (mean ± SD) 10.6 ± 2.5 of 31 possible points, for a mean average score of 34% correct answers. Postgraduate year level, prior medical school instruction in injury prevention or months of experience on a trauma service did not correlate with improved scores. Specific question performance ranged from 2% to 82% correct responses. Questions regarding domestic violence (60%), risk of burns (65%), and incidence of trauma deaths (82%) were answered correctly most often, while injury prevention theory questions, such as components of the Injury Prevention Triangle (5%), definition of YPLL (2%), and annual cost attributable to injury (19%) were least often answered correctly.
Conclusions: These data indicate that general surgery residents are poorly educated regarding basic concepts of injury prevention. Importantly, a majority of respondents (69%) felt formal instruction in injury prevention should be included in their surgical residency curriculum.

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^☆: From the Departments of Emergency Medicine, Los Angeles County and University of Southern California Medical Center* and Olive View—UCLA Medical Center^‡, Los Angeles, California and the Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.^§.

^☆☆: Supported in part by a grant from the Red Blanket Society.

^★: Address for reprints: Deirdre Anglin, MD Department of Emergency Medicine Room 1011, Unit 1 LAC + USC Medical Center 1200 North State Street Los Angeles, California 90033 213-226-6667 Fax 213-226-6806

^★★: Reprint no. 47/1/73904

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Abstract

Section snippets

INTRODUCTION

MATERIALS AND METHODS

RESULTS

DISCUSSION

Ann Emerg Med

Emerg Clin North Am

Ann Emerg Med

Emerg Med Clin North Am

Ann Emerg Med

Ann Emerg Med

Injury-related visits to hospital emergency departments: United States, 1992