Faculty of Health Sciences | School of Medicine DEPARTMENT OF Emergency 2019 Medicine Annual Report

TABLE OF CONTENTS

2 Message from the Department Head 3‑6 Faculty and Staff 7‑13 What’s New in Emergency Medicine Retirees New Faculty and Staff In Memoriam Honours and Awards Incoming and Outgoing Residents 14‑18 Clinical Message from the Program Medical Directors 19‑25 Education Postgraduate Medical Education Update Fellowship Updates Undergraduate Medical Education Update Simulation-Based Medical Education Update 26‑30 Research Research Director Report Resident Research Director Report Profiles in Research 31‑33 Departmental Life 34‑40 Research Grants and Publications Listing

Department of Emergency Medicine | 1 MESSAGE FROM THE DEPARTMENT HEAD

Message from the Department Head David Messenger, MD, MM, FRCPC, FCCP Associate Professor and Department Head

I am delighted to once again share with you the accomplishments and activities of the members of the Department of Emergency Medicine at Queen’s University in this Annual Report for 2019. Leading this team of exceptional clinicians, educators, trainees, researchers, scholars, and administrators is a source of great pride for me, and also incredibly humbling.

Through our collaborative efforts, 2019 was another year of forward and as a department we have taken action in support of our strong progress and growth for our department, and the following pages will desire to ensure that emergency medicine faculty, trainees, and staff highlight many of the people and initiatives that have led our group enjoy healthy and sustainable careers and experience professional to achieve great things together. satisfaction. The creation and support of a departmental Professional Sustainability Lead has been an important undertaking to keep us A highlight of 2019 was an intensive, collaborative project to develop well, and to explore how we support one another in pursuing our a new 5‑year Strategic Plan for the Department. This exciting work clinical and academic work. was an opportunity for us to reflect on our strengths and successes, our opportunities for future growth and improvement, and a chance As we look ahead to 2020, we expect a year that will have unprecedented to recommit ourselves to being national leaders in clinical care, challenges for our department and our broader institutions and the research, education and professional sustainability. Together, we have healthcare system. And yet, I remain confident that our Queen’s created a robust set of strategic aims that will guide our collective Emergency Medicine team is ready and willing to actively engage to work in the years to come, with an emphasis on building partnerships continue our pursuit of excellence. and seeking collaborative opportunities not just among ourselves, but It is with immense gratitude to my colleagues and our entire team with our peer departments, our broader community, and beyond our that I share this annual report with you. I hope you will share my national borders. excitement for the future as you learn about the year that’s passed. Our faculty members continue to distinguish themselves and receive institutional and national recognition for their work in education, research, and mentorship. We’ve welcomed new faculty and staff to our departmental ranks this year, while we’ve also celebrated and recognized the retirement of two long‑serving senior faculty members, Rob Brison and Ken Edwards. We’ve taken pride in the achievements of the graduates of our FRCPC and CCFP‑EM residency programs, as David Messenger, MD, MM, FRCPC, FCCP well as our fellows in Resuscitation and Global Emergency Medicine, Associate Professor and Department Head and we’ve welcomed a diverse and accomplished cohort of new trainees who will enrich our department and our discipline in the years to come. Our clinical work can be quite difficult at times. Our clinical facilities are in desperate need of renewal. Our patient population requires care resources and supports like never before, while also growing steadily in numbers. Despite these challenges, we take pride in the work we do,

2 | Annual Report 2019 FACULTY AND STAFF

Dr. Susan Bartels, FRCPC Dr. Colin Bell, FRCPC Dr. Elizabeth Blackmore, Dr. Danielle Blouin, Dr. Erin Brennan, BHSC, Associate Professor Assistant Professor CCFP(EM) FRCPC, MHPE, PhD MMEd, FRCPC Assistant Professor Professor Assistant Professor

Dr. Robert Brison, MPH, Dr. Steven Brooks, MHSc, Dr. Eric Bruder, FRCPC Dr. Jennifer Carpenter, Dr. Jaelyn Caudle, FRCPC FRCPC FRCPC Assistant Professor FRCPC Assistant Professor Professor Associate Professor Assistant Professor

Dr. Timothy Chaplin, Dr. Kenneth Collins, Dr. Fran Crawford, Dr. Damon Dagnone, Dr. Stuart Douglas, FRCPC CCFP(EM) BSc, RD, FACEP, FRCPC FRCPC FRCPC Assistant Professor Assistant Professor Assistant Professor Associate Professor Assistant Professor

Department of Emergency Medicine | 3 FACULTY AND STAFF

Dr. Kenneth Edwards, Dr. Christopher Evans, Dr. Karen Graham, Dr. Andrew Hall, MMEd, Dr. Sharleen Hoffe, CCFP(EM), FRCPC MSc, FRCPC CCFP(EM) FRCPC FRCPC Assistant Professor Assistant Professor Assistant Professor Associate Professor Assistant Professor

Dr. Daniel Howes, FRCPC Dr. Gordon Jones, FRCPC Dr. Jim Landine, FRCPC Dr. Mike McDonnell, Dr. Robert McGraw, Professor Associate Professor Assistant Professor MD, FRCPC MMEd, FRCPC Assistant Professor Associate Professor

Dr. Colin Mercer, FRCPC Dr. David Messenger, Dr. Max Montalvo, Dr. Heather Murray, Dr. Joey Newbigging, Assistant Professor BSc, MM, FRCPC FRCPC MSc, FRCPC CCFP(EM), FCFP Associate Professor Assistant Professor Professor Assistant Professor

4 | Annual Report 2019 FACULTY AND STAFF

Dr. Terrence O’Brien, Dr. Michael O’Connor, Dr. Armita Rahmani, Dr. Louise Rang, RDMS, Dr. Andy Reed, FRCPC CCFP(EM), FRCPC MMEd, FRCPC CCFP(EM) FRCPC Assistant Professor Assistant Professor Professor Assistant Professor Associate Professor

Dr. Nici Rocca, FRCPC Dr. Stephanie Sibley, Dr. Craig Simpson, Dr. Marco Sivilotti, MSc, Dr. Matthew Stacey, Assistant Professor FRCPC CCFP(EM) FRCPC, FACMT, FAACT CCFP(EM) Assistant Professor Assistant Professor Professor Assistant Professor

Dr. Adam Szulewski, Dr. David Walker, FRCPC Dr. Melanie Walker, PhD Dr. Heather White, MHPE, FRCPC Professor FRCPC Associate Professor Assistant Professor

Department of Emergency Medicine | 5 ADJUNCT FACULTY FACULTY AND STAFF

Dr. Jason Bornstein Dr. Amanda Collier Dr. Sharleen Hoffe Dr. Mackenzie Howatt Dr. Graeme Ross Dr. Aaron Ruberto Dr. Zachary Warren Dr. Matthew White

Ms. Catie Chamberlain, Ms. Susan Holland Dr. Vlad Latiu Administrative Special Projects Research Coordinator Assistant Coordinator & Executive Assistant

Ms. Mary Lee Ms. Kim Marsh Ms. Jill McCreary Ms. Jessica Montagner Ms. Jackie Morris Postgraduate Program Financial Assistant Manager of Operations Research Administrator Study Coordinator Administrator

Lindsay O’Donnell Tiffany Roy, Finance Ms. Tina Wisteard Study Coordinator Coordinator & Data Entry Clerk Undergraduate Assistant

6 | Annual Report 2019 What’s new in Emergency Medicine RETIREES

he has been a clinician with Queen’s supervising 18 Masters and PhD student Emergency Medicine since 1981. In the theses and 30 undergraduate medical mid 1980’s he completed his MPH in student research projects, many of which Epidemiology and Biostatistics at the led to publications and most to abstract School of Public Health, University of presentations. Washington, Seattle. On returning to In 2018 a celebration was held in honour Queen’s he began developing a research of Rob’s successful research career and career to complement his clinical the department launched an annual practice. He became the Research RJ Brison Research Day. Director in 2003 for the Kingston General Hospital Clinical Research Centre. In 2019 Rob began a new journey, the time everyone calls ”retirement”… the Rob’s research efforts have contributed time that is for all those hobbies and to over 125 peer reviewed publications. activities we don’t have time to do when His work has received millions in funding we have a career. We are sad to see him from many sources including CIHR, the Dr. Robert Brison go but also extremely happy to see him Heart and Stroke Foundation, Health be able to start his retired life knowing Canada and the Public Health Agency of Rob is a Full Professor in the departments he has earned and deserved every Canada, US Centers for Disease Control, of Emergency Medicine and Public moment of his new path in life. National Institute for Occupational Safety Health Sciences at Queen’s University. and Health (NIOSH), Agriculture and Happy Retirement Rob!! He graduated from Queen’s University Agrofood Canada, the Ontario Neuro- School of Medicine in 1977. Upon trauma Foundation and the Ontario completing four years’ residency training Innovation Fund. He’s enjoyed

Over his career, Ken has taken on Ken has a passion for the outdoors. He is numerous leadership positions in the often found with his binoculars looking department, the hospital, and beyond. for the latest and greatest unusual bird These have included service as Medical sighting. He is an avid, expert nature Director for the Department, and more photographer, and his photographs have recently as our first Quality Improvement been a staple at our annual TMTL event. & Patient Safety Lead. Dr. Edwards His favourite charity is CACHA (Canada- was a key player in the negotiation Africa Community Health Alliance), with of the SEAMO alternate funding plan which he has participated in several agreement in his capacity as President medical missions to Kamengo, Uganda of the Clinical Teachers Association of over the years. Queen’s University. In recent years, he In February 2020 a celebration was served as the Emergency Medicine held to honour his years of service, Lead for the Southeast Local Health contributions to the department and Integration Network. Throughout his above all his mentorship and friendship tenure at Queen’s, Ken has been a Dr. Kenneth Edwards to so many over a long and successful committed teacher of medical students career. and residents. He has served as an Dr. Ken Edwards is an Assistant Professor examiner for both the College of Family in the Department of Emergency Physicians and the RCPSC exams, as Medicine and the Department of Family well as with the Medical Council of Medicine. He graduated from Queen’s Canada. His teaching has emphasized the University School of Medicine in 1980. importance of quality improvement and Since completing four years of residency patient safety in the clinical practice of training in 1983, he has practiced emergency medicine. Emergency Medicine at Queen’s University/ Kingston Health Sciences Centre.

8 | Annual Report 2019 NEW FACULTY AND STAFF

Dr. Craig Simpson, MD, CCFP(EM) Ms. Catie Chamberlain Ms. Tiffany Roy

Dr. Craig Simpson joined the Department Administrative Assistant Finance Coordinator and of Emergency Medicine on July 1, 2019 as Catie graduated with distinction, from Undergraduate Assistant an Assistant Professor. St. Lawrence College Office Administration Tiffany joined the department in June of Medical & Legal studies in 2015. During 2019 as the Finance & Administrative Dr. Simpson attended medical school at her time at St. Lawrence college she Coordinator. Before joining the team she Queen’s University graduating in 2007. completed 3 workplace placements at: worked in the Athletics & Recreation After completing his training in Family Queen’s University: School of Nursing, department for Queen’s University where Medicine and his CFPC‑EM year at Ministry of Health and long Term care, she worked for 6 years and held various Queen’s he worked in the LACGH and Lifemark. While at St. Lawrence titles such as Strategic Procurement Emergency Department for six years College Catie also had a student Officer and Coordinator of Accounts while contributing to the clinical employment as an administrative Receivable & Cash Operations. teaching of Queen’s Family Medicine assistant in the school of Justice Studies residents. After a two‑year stint in She has worked in the finance industry and Applied Arts. After graduating Catie Toronto, working with the St. Michael’s for 10+ years and is currently registered was hired on a Lifemark and has been Emergency Medicine group, he moved to as a student with Ontario Chartered working there as a customer Service Barrie’s Royal Victoria Hospital all the Professional Accountants and working Representative for the last 5 year. while maintaining his role in teaching towards earning her CPA designation. residents with the University of Toronto Growing up in Kingston Catie knows that On a personal level, she is married and a Family Medicine program. Dr. Simpson there are lots of fun things to do in the mother to 3 kids. She enjoys spending continues his strong interest in medical city. She enjoys yearly going to Artfest her free time travelling and doing education and currently teaches at Kingston, Taste of Kingston, Ribfest, The anything that gets her outside. Often you Queen’s University. Women’s Art festival, and Poutine Fest. In will find her gardening, hiking, playing her spare time Catie enjoys doing escape Dr. Simpson has a keen interest in rural soccer, or lounging around the pool. rooms with her family, baking new and remote medicine and has worked in recipes and cuddling with her cat. many of the smallest emergency departments in his role with Health Force Ontario providing locum coverage across all of Ontario.

When he is not at work Dr. Simpson enjoys golfing, cycling and spending time with his family

Department of Emergency Medicine | 9 IN MEMORIAM

“At the end of the day people won’t natural academic, speaker and advocate, remember what you said or did, and dedicated many of her remaining they will remember how you made days studying and teaching about them feel.” physician compassion to medical learners and practicing physicians through – Maya Angelou lectures and podcasts.

(a favourite quotation shared by Barb). Barbara’s courage, passion and eloquent messaging throughout her journey were truly inspirational. She continuously “Make waves, be kind.” spread joy, hope, humour and love to the people around her. She encouraged all of – Barbara Tatham us to be the best we could be, to always live with intention, and to live happy and healthy lives. She was an extraordinary individual, physician and medical Barbara Tatham MD, CCFP(EM) serve as their POCUS lead after the educator who left in incredible legacy. completion of her POCUS fellowship at Barbara Tatham joined our Emergency Western. Tragically, near the end of her We are so fortunate to have had Barbara Medicine family on July 1st, 2016 when fellowship, Barb was diagnosed with a Tatham in our lives. She will be missed. she started her CCFP‑EM residency at terrible metastatic sarcoma of her skull, Please listen to the Barbara Tatham Queen’s. Having done her Health which stopped her from ever beginning Memorial Podcast on Physician Sciences BSc, Physiotherapy MSc, MD and her emergency medicine practice in Compassion: Family Medicine training all at McMaster Toronto. University, it was a long shot that she https://emergencymedicinecases.com/ Despite a very challenging battle with would choose Queen’s for her CCFP‑EM physician-compassion-barbara-tatham/ cancer, Barbara maintained a positive year. Barb was an incredibly positive and outlook and openly shared her Please read the CPSO eDialogue article engaging individual. Her maturity, clarity experience with family and friends. In “White Coat to Blue Gown” about Barbara of thought and genuine kind‑heartedness true Barb fashion, she used her Tatham. were immediately apparent and striking experience as both a physician and upon meeting her. She clearly would https://dialogue.cpso.on.ca/2020/09/ patient with cancer navigating the health have been high on every school’s recruit white-coat-to-blue-gown/ care system, as an opportunity to help us list. When asked later why she chose all become better and more Queen’s for her EM training, she said she compassionate caregivers. Barb was a had decided immediately after her Queen’s CaRMS day. After meeting our people and seeing the warmth and passion they conveyed about our department and residency programs, she knew that Queen’s was where she wanted to come. Lucky us!

Barb was an accomplished and driven physician. After completing her CCFP‑EM residency with us at Queen’s, she went to the University of Western Ontario to complete a POCUS fellowship. During this time, she co‑founded Emergency Medicine Global, a non‑profit organization that would provide POCUS equipment, education and training to Barb with the EM Team at the last Tragically Hip Concert’s First Response Medical Tent resource limited environments in Tanzania. She was also hired as an academic emergency physician at the Toronto Western Hospital and was to

10 | Annual Report 2019 HONOURS AND AWARDS

W. Ford Connell Award – This award is determined by the graduating class under the Aesculapian Society. This is an annual award established by Squibb Canada Inc. in honour of Dr. W. Ford Connell, for a professor or instructor in the Faculty of Medicine who, in the opinion of the final year medical students, has made the most outstanding contribution to their undergraduate medical education.

Dr. Heather Murray Dr. Louise Rang

Dr. Heather Murray has been named as Louise Rang has won the Ban Righ the recipient of the 2019 Queen’s Inspiring Women Mentorship award. University Chancellor A. Charles Baillie This award is for a Queen’s University Teaching Award. faculty member who has demonstrated mentorship and knowledge‑sharing, Established in 2003, the Chancellor A. who has supported or continues to Charles Baillie Teaching Award support women in achieving their goals recognizes undergraduate or graduate or and has inspired a student or students. professional teaching that has had an outstanding influence on the quality of Distinguished Preceptor Award student learning at Queen’s University. It CCFP‑EM, chosen by the residents. is awarded annually for activities that lead to improved learning, including curriculum development, educational leadership, design and delivery of Dr. Adam Szulewski out‑of‑classroom educational experiences, or classroom teaching and supervision. Dr. Adam Szulewski received his PhD The Selection Committee comprises past from Maastricht University School of award winners, subject experts, and Health Professions Education Cum Laude educational developers. The Selection Distinction. Committee is charged with responding to the question: Who among our colleagues deserves recognition this year for his or her exceptional efforts to promote student learning?

This award is the most prominent award for teaching offered by the University, and along with the Principal’s Awards for Education (one of which Heather has already received for curriculum Dr. Andrew Reed development work), is one of the highest honours an educator at this University Dr. Andrew Reed receives Honorary can receive. Inspector of the Ontario Provincial Police.

Department of Emergency Medicine | 11 HONOURS AND AWARDS

Dr. Stuart Douglas Dr. Erin Brennan Dr. Andrew Hall

Dr. Stuart Douglas, an Emergency Dr. Erin Brennan is awarded the 2019 Dr. Andrew Hall wins the 2019 CAME Physician and Intensivist and new L.E. Dagnone Emergency Medicine – Certificate of Merit which promotes, graduate of the Master’s in Quality Teaching Award by our graduating recognizes and rewards faculty Improvement and Patient Safety (QIPS) residents for excellence in teaching. committed to medical education in at the Institute of Health Policy, Canadian medical schools. Management and Evaluation, has developed a quality improvement initiative at Kingston Health Sciences Centre that promotes better sleep for patients in the ICU. His project has also won him the Harry and Rose Perlstein Award, presented to a student whose research has the potential to improve health care services for patients in long‑term and acute care settings.

Dr. Danielle Blouin Dr. Joey Newbigging

Dr. Danielle Blouin wins best research Dr. Joey Newbigging is the 2019 recipient paper at the World Conference for of the PARO, Clinical Teaching Award. Medical Education 2019 for Purposes and The Clinical Teaching Awards Models of Quality and Regulation in acknowledge the essential role that Medical Education I for Accreditation as good clinical teachers play in the training Quality Assurance Measures of of physicians. Residents are asked to Effectiveness. outline the qualities that make their nominee an excellent teacher including patient care, quality of bedside teaching, and interest in trainees’ personal development and well‑being.

12 | Annual Report 2019 OUTGOING RESIDENTS – FRCPC INCOMING RESIDENTS – FRCPC

Dr. Emily Dr. Mackenzie Dr. Graeme Dr. Zachary Dr. Emma Dr. Connor Dr. Janie Dr. Matthew House Howatt Ross Warren Duchesne Inglis O’Leary Piaseczny

OUTGOING RESIDENTS – FELLOWS INCOMING RESIDENTS – FELLOWS

Dr. Amanda Dr. Jodie Dr. Mathieu Collier Pritchard Brunet

OUTGOING RESIDENTS – CCFP‑EM INCOMING RESIDENTS – CCFP‑EM

Gabor Bacskai Alastair Crow Sandra Huynh Philip Lee Brittany Aziz Christine Michael Daniel Hines Hanna Heseltine

Aida Owlia Andrei Garcia Sunpreet Saahil Vij Laura McInnis Sucheta Sinha Erin Tatiana Popov Sunil Slaunwhite Vukadinovic

Christopher Emily Winsor Williams

Department of Emergency Medicine | 13 Clinical Care CLINICAL CARE

Program Medical Director Updates Terrence O’Brien, MD, CCFP (EM), FRCPC Director The KGH Emergency Department continues to offer tertiary care Emergency Medicine and consultant care to the people of the South Eastern Ontario region. The Department has a staff complement of close to 40 specialist Emergency Physicians with subspecialty expertise. Areas of expertise include toxicology, trauma, critical care, medical education, patient simulation, global health, emergency medicine ultrasound (POCUS), resuscitation, emergency medicine research, tactical medicine, EMS, and disaster management.

KGH ED is also the major point of entry to inpatient units at KGH for all specialty and subspecialty services. The KGH trauma program had 291 trauma team activations. The Emergency Department is also the site for the intake of the SE Ontario Regional Stroke program and regional PCI program offered at KGH.

Patient volumes continue to increase with a significant increase in Mental Health and Addictions presentations. We are working closely with the Department of Psychiatry and our community partners to provide timely, effective and compassionate care for this patient population. We have added a Psychiatry Nurse Navigator and increased Mental Health Social work coverage for our department. “Patient volumes continue Our department has worked closely with our community to provide care needed for to increase with a mass gathering events which affect our community and our ability to deliver Emergency significant increase Care. These events include Queen’s Homecoming, St. Patrick’s Day and Halloween. in Mental Health and During these events we have opened up a Satellite Emergency Department to help deal with the large influx of EMS arrivals and to allow us to continue to provide care to all Addictions presentations. requiring Emergency Care during these events. We are working closely with the Department Patient and staff safety has become an increasing concern over the past year with an of Psychiatry and our increase in violent assaults and threats toward our staff and we are working closely with Security and the hospital QIPS program to develop strategies to deal with and prevent community partners to these episodes. provide timely, effective and compassionate We continue to work closely with Hospital Administration, LTC, Public Health and IPAC to deal with the predicted annual influenza season. care for this patient population.” Our department has created a QI lead to improve our performance in all clinical aspects of our care model.

We have also instituted an In Situ Simulation program to foster interprofessional learning and QI for our department in the areas of critical care and acute medical emergencies.

Department of Emergency Medicine | 15 CLINICAL CARE

Relevant Department statistics are presented below:

Annual Visits to KGH ED and HDH UCC % Age Groupings 70k 100

60k 80 50k

Visits 40k 60

30k 40

Number of 20k % of Total Volume % of Total 20 10k

0 0 2018 2019 2018 2019 ■ KGH Emergency 62,257 63,629 ■ 0 - 18 yrs 14.5% 14.2% ■ HDH Urgent Care 41,845 42,530 ■ 18 - 64 yrs 62.4% 62.4% Grand Total 104,102 106,159 ■ 65 + yrs 23.1% 23.4% Grand Total 100% 100%

Average LOS from Registration in ED, % of Mental Health, Substance Abuse or Other or UCC, to Time Left ED 100 1.6 1.7 5 Annual Average Daily Visits by Year, MIS Location, and CTAS 1 2 3 4 5 9 Null Grand Total 80 4 2019 2 21 60 54 9 1 31 General Emergency 2 35 89 41 6 1 34 60 Hours 3

Urgent Care 2 8 31 66 11 1 27 94.7 94.5 4.9 4.5 40 2 Number of % of Total Volume % of Total 20 1

0 3.7 3.8 0 2018 2019 2018 2019 ■ Mental Health 3.7% 3.8% ■ Average length of stay 4.5 4.9 ■ Other 94.7% 94.5% ■ Substance Abuse 1.6% 1.7% Grand Total 100% 100%

Annual Average Daily Visits by Year and CTAS

CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 2018 2 20 59 58 6 KGH Emergency 2 33 89 43 4 HDH Urgent Care 1 6 28 73 7 2019 2 21 60 54 9 KGH Emergency 2 35 89 41 6 HDH Urgent Care 2 8 31 66 11 Grand Total 2 20 61 43 15

Our multidisciplinary staff from every department at KGH works incredibly hard day and night every day of the year to offer excellent care to all of our patients.

16 | Annual Report 2019 CLINICAL CARE

Program Medical Director Updates Hotel Dieu Hospital Urgent Care Centre 2019 Karen Graham, MD, CCFP (EM), FCFP Director Our Hotel Dieu Hospital Urgent Care Centre remains one of the highest volume and highest acuity Urgent Care centres in the province. 7% 34% 3.5% Overall Volume Pt Volume >65yrs Transfer Volume (increased by 5.2% in past 5 years) (10 year trend)

In 2019:

• We served 43,234 patients • Our volume has increased approximately 7% in the past 5 years • 45% of our patients were triaged as CTAS level 1‑3 (assigned as Requiring Resuscitation, Emergent or Urgent)

We continue to provide excellent patient care and a rich learning environment for all levels of medical trainees from Queen’s Faculty of Health Sciences. This year we took part in a study which involved urgent assessment and treatment of musculoskeletal conditions by physiotherapists and physiotherapy trainees which was an exciting opportunity to work collaboratively with Queen‘s School of Rehabilitation Therapy faculty, staff and students.

We continue to observe a constant increase in patient complexity:

• Elderly presentations (>65 years) over the past 10 year period have increased by 34%* See graph on next page • Rising CTAS levels • 3.5% of cases annually are transferred to KGH, generally for admission

Department of Emergency Medicine | 17 CLINICAL CARE

Volumes by age group seen at Hotel Dieu Hospital Urgent care Centre 2010‑2019

100 15.04 15 13.98 13.61 14.07 22.02 18.01 17.68 16.74 16.56 80

60 67.64 66.55 66.93 66.71 67.16 66.99 67.17 67.43 64.15 66.76 40

% of Total Volume % of Total 20 13.83 15.24 15.77 16.33 16.74 17.80 18.01 18.85 18.75 18.50 0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Calendar Year ■ Age 0‑18 ■ Age 18‑64 ■ Age 65+

Our urgent care centre continues to proudly serve a diverse population. We work in close partnership with our community and hospital partners to deliver excellent patient care despite the many challenges facing health care today. We look forward to meeting the challenge of providing outstanding care in an era of limited fiscal resources.

18 | Annual Report 2019 Education POSTGRADUATE MEDICAL EDUCATION

Emergency Medicine Training Programs: FRCPC Jaelyn Caudle, BScOT, MD, EMDM, FRCPC Director

2019 was another hugely successful year for the FRCP Residency Program.

We continued our tradition of innovation by becoming the first emergency medicine training program to introduce a full curriculum dedicated to personal wellness and professional sustainability. Thanks to Louise Rang and countless others for their work in bringing year one of this amazing curriculum to fruition. We look forward to rolling out year 2 in the upcoming academic calendar.

The transition of Queen’s EM to a full CBME model continues. With now three years of ’true’ CBME residents in our residency program. CBME is allowing us opportunities to tailor learning experiences for our residents and is opening up new avenues for required training experiences. Together with the Academic Advisors (Erin Brennan, Gord Jones, Jim Landine, Terry O’Brien and Mike McDonnell), Andrew Hall and I continue to work on developing a seamless assessment, evaluation and promotion process for our residents so critical for the success of CBME.

Thank you all for your ongoing dedication and support to our residency program!

“With now three years of ’true’ CBME residents in our residency program. CBME is allowing us opportunities to tailor learning experiences for our residents and is opening up new avenues for required training experiences.”

20 | Annual Report 2019 POSTGRADUATE MEDICAL EDUCATION

Emergency Medicine Training Programs: CCFP(EM) Joey Newbigging, BSc, MD, CCFP (EM), FCFP Director

We had another successful year, and with the newly added Cornwall return‑of‑service program, our biggest cohort for some time… ten residents! Despite the curriculum and clinical challenges of COVID‑19, our residents had a successful year and are ready for independent practice. They have all secured jobs or fellowships upon graduation. Three residents are pursuing further fellowship training (Queen’s Resuscitation and Reanimation Fellowship (2) and Ottawa’s POCUS Fellowship (1)), and the others are joining EDs in Belleville, Brockville, Cornwall, Credit Valley Mississauga, Guelph, Kitchener‑Waterloo and Saint John, New Brunswick. The footprint of Queen’s CCFP‑EM grads continues to grow across the country!

One of the most significant changes to our curriculum this year was the introduction of our horizontal airway curriculum. This simulation curriculum emphasizes deliberate practice of part‑task airway skills, mental rehearsal, and the application of these skills into increasingly complex airway scenarios. Although objective assessment of the impact of the curriculum is pending, it was extremely well received by residents, with many faculty members noticing a significant improvement in the residents’ airway skills compared to previous years. Special thanks to Drs. Fil Gilic, Bob McGraw and Elizabeth Blackmore for their enormous efforts in creating this outstanding, and critical, learning experience for residents. Going forward we will be fine‑tuning the curriculum, recruiting more faculty airway instructors and expanding to include some FRCP‑EM residents.

This year we had our first two residents begin the Cornwall re‑entry resident. Our program is near capacity with learners, and return‑of‑service program. Cornwall rotations in emergency we have been fortunate to continue to be able to establish and medicine, orthopedics, anaesthesia and ICU were created and nurture existing ties with our community hospital partners to were successful in providing excellent teaching and learning give our residents rich learning experiences. opportunities for residents. It is hoped that even when the Cornwall I have enormous gratitude and appreciation for all of the Queen’s return‑of‑service initiative is complete (2022), that these rotations DEM and community hospital faculty and teachers for their could be recruited for use by the regular program stream. continued commitment to our program and their teaching and Looking ahead to 2020‑21, we will again have ten residents in mentorship of our residents. It would be impossible to train such the program… our typical eight Ministry sponsored residents, a large cohort of residents at Queen’s were it not for the generous one Cornwall return‑of‑service resident, and a National Defence contribution of time and effort from such talented faculty in our emergency medicine community. Thank you!

Department of Emergency Medicine | 21 POSTGRADUATE MEDICAL EDUCATION

Global Emergency Medicine Fellowship Updates Susan Bartels, BSc, MD, FRCPC, MPH Director The Global Emergency Medicine Fellowship is pleased to have had its inaugural graduation with Dr. Amanda Collier completing her training at the end of July.

In the final months of her training, Dr. Collier represented the Fellowship and the Department at a site visit to Haramaya University in Harar, Ethiopia (along with Dr. Messenger). After Fellowship graduation, Dr. Collier became a SEAMO Research Fellow and in that capacity, has continued to foster the EM collaboration between Queen’s and Haramaya, including securing a Queen’s International Fund grant ($10,000) to conduct an EM Emergency Room in Hiwot Fana Specialized Dr. Pritchard outside Ayilo Health Center 3 in needs assessment at Haramaya. Dr. Collier University Hospital, Harar, Ethiopia Adjumani District, Uganda also completed the coursework for her several refugee camps. Dr. Pritchard is also MPH degree at John Hopkins Bloomberg supporting the Haramaya project and School of Public Health. Congratulations, hopes to be actively involved in this Amanda! collaboration as it moves forward. In 2019, we were pleased to welcome our In addition to their other activities, both second Fellow to the program with Dr. Collier and Dr. Pritchard conducted Dr. Jodie Pritchard joining us from her research over the year, investigating FRCPC EM residency program at McMaster. pre‑departure training and post‑departure After getting settled into Kingston, debriefing practices for Canadian FRCPC Dr. Pritchard went to Portland to complete EM trainees who complete global health the Hostile Environment and From the Democratic Republic of Congo electives. This involved surveying both Humanitarian Principles training course residents and Program Directors as as graduates who have completed their with Medical Teams International. well as completing a desk review of Royal College training (and will work as Following that she spent two months available global health resources at attending physicians). The Fellowship working in Africa including one month at various universities. An abstract of the is also in the process of formalizing its HEAL Africa Hospital in eastern findings has been submitted to CAEP and evaluation process and has applied to Democratic Republic of Congo teaching the resulting manuscript is soon to be become a Society of Academic Emergency basic EM skills. This was followed by one submitted for peer review. Medicine (SAEM)‑approved Global EM month working clinically in northern training program. Uganda with Medical Teams International, The Global EM Fellowship continues to where she provided mentorship to local actively recruit trainees into the program health staff and helped to care for including both FRCPC residents (who will displaced South Sudanese families in join our resident clinical schedule) as well

22 | Annual Report 2019 POSTGRADUATE MEDICAL EDUCATION

Resuscitation & Reanimation Fellowship Adam Szulewski, MD, FRCPC, MHPE, PhD Director

We’ve had another successful year in the Resuscitation Fellowship thanks to our fellows’ hard work and the dedication of our faculty.

Congratulations to our 2019 graduates Mohamad and Ali! Special • We have transitioned our resuscitation ultrasound curriculum thanks to Steve, Steph, Dan, Dave, Aaron, Heather W, Chris, Bob, from a longitudinal course to a bootcamp format. Fellows Sharleen, Andrew, Tim, Erin and Marco for leading sessions will now receive the CPoCUS Resus Independent Practitioner this year. From outside our department, we’ve been fortunate Certification and have the opportunity to come back as to host Peggy Dejong (cardiology), Anupam Seghal and Bob instructors during a subsequent bootcamp. Connelly (pediatrics), Troy Neufeld (community EM) who have • We’ve successfully implemented a new longitudinal trauma also presented sessions for the fellows. Finally, special thanks radiology course sourced from an online platform this year. to alumnus Ali Tafti (winner of last year’s golden laryngoscope This has been well received by the group and will be included award) who came back to teach this year as well. in the curriculum next year as well. A few highlights from this year: • We’ve transitioned our assessment structure to the • The newly created longitudinal joint resuscitation/cardiology entrustment‑based platform used in the FRCP program. mini‑curriculum continues to be successful. Based on positive Hopefully, this will make post‑shift assessment more feedback from both groups, we have extended these sessions streamlined and efficient for our faculty group. and plan to run them during the fall of each year.

L‑R: Dr. Adam Szulewski, Dr. Areej Alwakeel, Dr. Troy Neufeld, Dr. Chris Evans, Dr. Heather White, Dr. Matthew White

Department of Emergency Medicine | 23 UNDERGRADUATE MEDICAL EDUCATION

Undergraduate Medical Education Updates Armita Rahmani, BSc, MD, CCFP (EM) Director

The Department of Emergency Medicine continues to be an active participant in Undergraduate Medical Education at Queen’s. This past year, our faculty members have again continued to be involved in multiple aspects of UGME including Clinical Skills, Clinical Reasoning, Resuscitation Rounds, Facilitated Small Group Learning, Critical Enquiry, and Case of the Week. We have also participated in Admissions file reviews and interviews and invigilated OSCE exams for UGME.

The Emergency Medicine core rotation is highly rated by the clerks. They consistently feedback that the faculty is very approachable and supportive. They appreciate all the teaching that happens on shift and wish they had more time in the ER. They also love the teaching shift where they get one on one time with faculty that observe them during their assessment of a patient and provide immediate feedback. UGME is trying to recruit more regional sites for EM to allow a few more students to do their EM core block away from KHSC.

The elective students program continues to be very popular, and the quality of the students we have been able to host has been great in the past year. EM continues to be in high demand for elective students and we are attempting to accommodate as many students as possible with some novel scheduling – including scheduling some keen learners over the holiday blocks.

The shift to CMBE evaluations has gone quite smoothly. The clerks really appreciate and value the daily feedback they get. In recent months, we have adjusted the clerk schedule to offload the Hotel Dieu and I am keeping in touch with the clerks to ensure that they continue to get exposure to procedures such as casting and suturing.

I want to thank everyone for their continued support of the department’s UGME activities.

24 | Annual Report 2019 SIMULATION‑BASED MEDICAL EDUCATION

Simulation‑Based Medical Education Update Tim Chaplin BSc, MD, FRCPC Director

2019 was another great year for #simulation within our department!

At the postgraduate education level, our longitudinal simulation rounds thrive on the energy of our residents and have evolved in response to their needs. We can be confident that we continue to set the national standard for the integration of simulation into postgraduate medical education training.

In‑situ simulation is becoming part of the culture of our department, with Dr. Rocca leading this effort. The departmental support for in‑situ simulation signals the value of interprofessional education and the importance of these sessions for improving our clinical work environment. Current projects aim to leverage in‑situ simulation for quality improvement initiatives (ask Drs. Stu Douglas and/or Sharleen Hoffe) and to practice new clinical pathways (i.e. Dr. Evans’ REBOA implementation).

Scholarship related to simulation within our department continues to grow as well; although there are too many recent publications to report here, topics include a description of curricular content for postgraduate EM training, the use of wearable technologies to individualize simulation‑based learning, comparing assessment in the simulation lab to the workplace, and a consensus paper on priorities for simulation‑based research in EM in Canada.

Yours in simulation, Tim

“We can be confident that we continue to set the national standard for the integration of simulation into postgraduate medical education training.”

Department of Emergency Medicine | 25 Research RESEARCH

Research Director Report Bob McGraw BSc, MD, MEd, FRCPC Director

It is a pleasure to report on our department’s research program for 2019. With 80 peer reviewed publications and 54 abstract presentations it was truly an exceptional year of productivity in all our core programs: clinical, educational, resuscitation and global health research.

Queen’s University Emergency Medicine researchers have continued to earn their international reputation as leaders in toxicology, clinical decision rules, resuscitation, cardiac arrest survival, global health, simulation, public health, physician wellness, point of care ultrasound, and competency based education. I would encourage everyone to read through the appendix to this report to see the outstanding work done by our researchers. The list reflects the tremendous amount of hard work, as well as the support of the research program by our entire departmental membership.

Department of Emergency Medicine Research Program Stats

90

80

70

60 Units 50

40

Number of 30

20

10

0 2015 2016 2017 2018 2019 ■ Journal Articles 82 69 68 73 80 ■ Peer‑reviewed abstracts 20 23 24 19 54 ■ Posters 16 17 19 25 14 ■ Grants 10 30 37 27 19

Department of Emergency Medicine | 27 RESEARCH

Resident Research Director Report Melanie Walker, PhD Director

This past year proved to be another very busy one in our research program.

Our faculty members, residents and medical students continue to work on a myriad of research projects in clinical research, medical education, quality improvement and global health. Our foundational research series is now in its’ third iteration and blends fundamental clinical epidemiology skills with clinical reasoning in nine cardinal emergency medicine presentations. An abbreviated e‑version of this research series was developed and launched for the CCFP‑EMs this past year with good success. Both the R2s and CCFP EMs are working on their CAT project proposals for presentation at the upcoming RJ Brison Research Day on April 1, 2020. Many of the R2s are using the CAT project this year as a launch pad to their scholarly project – a requirement in the core of discipline stage of training. At this year’s Research Day the oral presentations will focus on completed or near completed research projects led by our faculty and/or residents and we will be hosting a poster session to showcase additional ongoing research in the department including the CAT projects. In addition, for those interested in a peer reviewed publication, both CanadiEM and CJEM have opportunities for residents to publish critical appraisals on topical emergency medical articles.

Lastly, if you’re thinking about starting a research project please be sure to reach out to me in the early phases so we can ensure you’re off to a good start!

28 | Annual Report 2019 RESEARCH

Profiles in Research

Dr. Kieran Moore has been a member of infectious disease threats through Queen’s Department of Emergency surveillance partnerships with the acute Medicine since 2004. He is now the care system. Medical Officer of Health/CEO for the He has championed the need for a Kingston, Frontenac, Lennox and national Lyme disease surveillance Addington (KFL&A) Public Health unit, network to government, which resulted an agency with over 200 staff and in a national framework on Lyme disease 100 volunteers that delivers public health and a recent funding opportunity by the programs and services to nearly Safe Environment Directorate of Health 200,000 people. He is a Professor of Canada. He authored the KFL&A Action Family and Emergency Medicine at Plan on Lyme, participates in the Health Queen’s University and the director for Quality Ontario working group on Lyme, the Public Health & Preventive Medicine serves as an Ministry of Health and Residency Program. Dr. Moore received Long‑Term Care (MOHLTC) consultant and his MD from the University of Ottawa and Kieran Moore, MD, CCFP(EM), presented at the Conference to develop specialty certification in Family and FCFP, MPLc, MPH, MSc. (DM), a Federal Framework on Lyme disease. Emergency Medicine from the College of DTM&H, FRCPC Family Physicians of Canada. He has Dr. Moore is the Nominated Principal Masters degrees in Disaster Medicine, Applicant on the 4 Million dollar CIHR Public Health, and Physician Leadership approved grant and serves as the and Diplomas in Sports Medicine, Networks Director. As Network Director Tropical Medicine & Hygiene, and he will provide oversight and direction Humanitarian Assistance. Finally, he for all Network activities. He will work completed a Canadian Royal College of with KFL&A Public Health and other Physicians and Surgeons Fellowship in institutions to develop and maintain a Public Health & Preventive Medicine at Network web portal as well as a central Queen’s University. clinical electronic medical record and associated biobank. He will also work Dr. Moore has extensive experience in closely with Queen’s University surveillance systems for outbreak advancement to ensure network detection, public health, pre‑hospital longevity. care, and multidisciplinary research projects. He has lead the project called Websites highlighting his team’s work Acute Care Enhanced Surveillance (ACES) include: and Surge Monitor tool which • www.kflaphi.ca electronically links over 150 hospitals in Ontario to provide real time situational • http://mapper.kflaphi.ca/ilimapper/ awareness for any public health threat. • https://dashboard.kflaphi.ca/ Further tools include real time influenza like illness surveillance call ILI mapper. • www.clydrn.ca Further spatial tools and analytics for emergency planning and response can be found at www.kflaphi.ca. This work was based on his thesis work on methods to detect bioterrorism and emerging

Department of Emergency Medicine | 29 RESEARCH

Profiles in Research

Erin Brennan, BHSC, MD, MMEd, Veronica Harris‑McAllister, M.Sc FRCPC Lyme Network Manager

Dr. Brennan completed her medical school Veronica Harris‑McAllister is the Network in 2010 at Queen’s University where she Manager for the Canadian Lyme Disease stayed for residency in Emergency Research Network (CLyDRN). Ms. Harris- Medicine from 2010‑2015. During this time McAllister has over 25 years of experience she began a Master’s in Medical Education working in clinical, pharmaceutical, and at the University of Dundee, which she administrative research. Prior to joining completed in 2017. The focus of her Master’s the Network, Ms. Harris‑McAllister was thesis was Feedback and Debriefing in the Director of Health Sciences Research Simulation Based Medical Education, (2017‑2020) and Manager of Health Sciences specifically in CPR training. Since becoming Research (2008‑2017) at the Kingston a staff physician at KHSC she has continued General Health Research Institute and research in novel approaches to CPR and Kingston Health Sciences Centre. She has resuscitation training. Her work has also worked in the Respiratory incorporated principles of deliberate Investigation Unit at Queen’s University practice and spaced repetition using (2004‑2008) and at the University of real‑time feedback, near‑peer teaching, Ottawa Heart Institute in the Prevention and autonomous training models. and Rehabilitation Centre (2001‑2004). Ms. Harris‑McAllister is a graduate of She currently holds a PSI New Investigators Queen’s University (BSc, Biochemistry), grant to implement and evaluate a University of New Brunswick (BPHE, Sports responsive and personalized CPR training Science), and East Stroudsburg University program for nursing staff working in (MSc, Cardiac Rehabilitation & Exercise critical care areas of Kingston Health Sciences). Sciences Centre. She is also working on adapting an automated CPR training program for medical students at Queen’s.

30 | Annual Report 2019 Departmental Life SOCIAL EVENTS

TMTL (There's More to Life…)

Drs. Karen Graham and Louise Rang created this event six years ago, to try and find a way to make November a little brighter. All ED attending and residents are invited to give a talk of their choosing, with only 2 conditions:

• It has to be 15 min or less, and

• It must have nothing to do with medicine itself.

The goal of the afternoon is to provide some time for us to connect without talking about the latest shoulder As part of the day, we always ask the we always gently shape each other’s reduction technique, or an obscure group to submit some thoughts on what lives. We are a united, stalwart constant ECG finding from last week. It gives us a they love about working here, and these amongst the ever changing, wondrous, chance to learn about one another and are some of the submissions: controlled chaos we have all chosen to our (often slightly obscure) and always call a home away from home.” “A group that snacks together stays interesting side passions. together” We are more than just coworkers. We are The theme this year was inspiration. As colleagues and friends partners in the “Walking through the double doors of usual we had a wide‑ranging array of adversities of the ED standing strong the ED feels like walking home. There topics from an encounter with a Syrian and unified. We take care of each other, are familiar sounds and smells, but most refugee, the South African concept “now” and lean on each other, because we are of all there are familiar faces that look vs “Just now”, awesome sea creatures, all vulnerable and imperfect, but trying forward to seeing. While we sometimes why cross fit is not a cult, family secrets, to do our best for our patients and the save and often affect patients’ lives all the way to travel pictures of Italy. community.

Resident Retreat

In the spring of each year and to celebrate the end of the academic year, the program holds its annual Resident Retreat. The retreat is a getaway full of camaraderie and fun. The morning session consists of group discussions, residents work on team‑building, teaching skills, and ways to maximize educational opportunities. The afternoon is spent in the great outdoors!

32 | Annual Report 2019 SOCIAL EVENTS

BMC We left our bikes outside and had a round of supersized BigMac Meals outside. We The Big Mac Challenge has been one of were voraciously hungry and literally the major social/team building events inhaled the meals. Needless to say we in our Department/Residency program were getting a bit chilly sitting outside since 2001(we think). The BMC originated in the 9C temperature and Bob piped by accident and the legend shall remain up – “I’m getting cold, lets go.” Mas said in the folklore of our department until he didn’t feel to well but we headed out. eternity. Bob took of like a scalded cat as he was so cold and we decided to let him go back Many years ago in the year 2001 before alone as Max wasn’t feeling great. I was computers or ED Ultrasound were freezing as well but Max was cold, very invented, Bob Mcgraw, Max Montalvo weak and had gut issues. I pulled Max and Terry O’Brien embarked on an epic back to Kingston into a big headwind and bike ride to Gananoque on a cold, gray, Bob arrived back close to an hour before blustery day in early November. Max had we did and had a warm shower and a nap been in peak cycling shape that year and by the time we arrived. was dressed in his signature Zebra Bike riding outfit (white zebra shorts, Jersey, This story enthralled all of our residents arm warmers and helmet… seriously and so much that the BMC gradually evolved little wonder people tried to run us off over the years to the extravaganza it is the road so often back then). Bob and I today. The challenge took many forms were in basic functional bike gear. in the early years and there were some major brave painful rides by many in our Max had been in great cycling shape group – namely Dave Messenger, Heather during the summer but had been resting White, Evan Russell and Jim Landine. since August. Bob and I had still been Some of the suffering has involved keeping up a bit of training leading up to major life threatening chafing, Rhabdo, the ride. vomiting, crashes and some arrhythmias. The wind was at our back (35k per hour The race gone through multiple phases to Gananoque) and as we arrived feeling and refinements to its current form. great. In Gananoque Bob said “guys let’s We are proud to use this event as a stop at MacDonald’s – I need a burger”. fundraiser for UHKF, in support of ED.

Summer Party

The summer party is a time to celebrate with family and friends, welcome our incoming residents and congratulate the BMC winners.

Department of Emergency Medicine | 33 RESEARCH GRANTS AND PUBLICATIONS

Department of Emergency Medicine’s Research Grants 13. Resident Progress Decisions: Evaluating the Fidelity and Integrity of Competence Commitee Implementation in Funded Canadian Residency Training Programs, $ 18,846.00, 1. Innovation for Defence Excellence and Security (IDEaS) Grant: Operating, RCPSC Education Grant, 2‑2019. Warren Cheung, Intelligent, Dynamically Adaptive Simulation and Operational Andrew Hall, Anna Oswald, Lisa Gorman, Alex Skutovich, support to Enhance Medical Trauma Response, $ 189,050.00, Elaine Van Melle, Jason Frank. Operating, Department of National Defence, 1‑2019 / 6‑2019. 14. Perspectives, Attitudes and Beliefs about Simulation for Paul Hungler, Daniel Howes, Adam Szulewski, James McLellan, Assessment, $ 4,300.00, Operating, Queen’s University Center Ali Etemad, Dirk Rodenburg. for Teaching and Learning Grant, 3‑2019. Andrew Hall, 2. Gender‑based inequalities in adolescent mental health in Melanie Walker, James Ahlin, Kyla Caners, Mike O’Brien. Canada, $ 497,250.00, Operating, Canadian Institutes of 15. Rapid Evaluation of the Competence By Design Health Research, 4‑2019 / 3‑2023. Pickett W, Michaelson V, Implementation, $ 19,920.00, Operating, RCPSC Intramural Phillips S, McIsaac M, Davison V, Steeves V. Grant, 7‑2019. Andrew Hall, Cheung W.J., Cooke L.J., Frank J.R., 3. Investigating food insecurity, poverty, and adolescent mental Van Melle E. and physical health in high‑ and low‑income countries, 16. National Simulation Innovation Network Project, $ 250,000.00, $ 100,000.00, Operating, Canadian Institutes of Health Operating, Canadian Medical Association – Joule Innovation Research, 4‑2019 / 3‑2020. Elgar F, Pickett W, et al. Grant, 12‑2019. Dan Howes, Adam Szulewski, Paul Hungler, 4. Implementation and Evaluation of an In Situ Personalized CPR Ali Etemad, Dirk Rodenburg. Training Program for Critical Care Nurses, $ 340,000.00, 17. AED on the Fly: A Drone Delivery Feasibility Study, $ 50,000.00, Operating, Physician Service Incorporated, 2‑2019 / 3‑2022. Operating, Zoll Medical Corporation, 5‑2019 / 4‑2021. Sheldon Erin Brennan, Rylan Egan, Melanie Walker. Cheskes, Snobelen Paul, Nolan, Michael, Collaciti Greg, Reece 5. Traumatic arrest in Ontario, Canada: A population‑based Philip, Vaillancourt Christian, Dainty Katie, Brooks Steven, analysis, $ 19,293.00, Operating, Kingston Resuscitation Chan Tim. Institute (KRI), 8‑2019 / 7‑2020. Chris Evans. 18. AED on the Fly: A Drone Delivery Feasibility Program, 6. Mastering Debriefing: Simulating the Experience of $ 149,787.00, Operating, CANnet – Commercialization Grant, Competency‑based Medical Education Academic Advising, 1‑2019 / 12‑2021. Sheldon Cheskes, Michael Nolan, Paul Preceptorship, and Competence Committee Decision Making, Snobelen, Greg Colacitti, Philip Reece, Christian Vaillancourt, $ 10,000.00, Operating, Royal College of Physician and Tim Chan, Katie Dainty, Shelley McLeod and Steven Brooks. Surgeons of Canada, 11‑2019 / 10‑2020. Richard van Wylick, 19. Optimization of the Deployment of Automatic External Ingrid Harle, Adam Szulewski, Boris Zevin, Eleftherios Soleas, Defibrillators in Public Places in England, $ 811.00, Operating, Marian Luctkar‑Flude, Heather Braund, Nancy Dalgarno, Heart of England NHS Foundation Trust, 1‑2019 / 12‑2021. Mikaila, De. Sousa, Allison Bright. Gavin Perkins, Steven Brooks, Terry Brown, Theadooros 7. Video/Audio Recording Quality Improvement Infrastructure Arvanitis, Lazaros Andronis, Ranjit Lall, John Long, Christopher in the Emergency Department at KGH, $ 22,261.63, Operating, Smith, Niroshan Siriwardena, Charles Deakin, Gareth Clegg, Kingston Resuscitation Institute, 10‑2019 / 9‑2020. and James Mapstone. Adam Szulewski. 20. Age‑adjusted D‑dimer cutoff levels to rule out deep vein 8. Neighbours Saving Neighbours: Planning a Community thrombosis (The Adjust DVT study), $ 188,628.00, Operating, Volunteer Resuscitation Program For Victims of Out‑of‑Hospital Heart and Stroke Foundation Canada, 4‑2019 / 3‑2021. Cardiac Arrest in Canada. Planning and Dissemination Grant Colin Bell. – Institute Community Support, $ 14,992.00, Operating, 21. POCUMON study, $ 5,000.00, Operating, Thomas M. and Canadian Institutes of Health Research (CIHR). Louise A. Brown Research Studentship Fund, 5‑2019 / 9‑2019. 9. Queen’s University, Royal College of Physicians and Surgeons Colin Bell. of Canada, Haramaya University Partnership, $ 20,000.00, 22. Centre for the Future of Simulation, $ 220,000.00, Operating, Operating, Queen’s International Fund, 3‑2019. Susan Bartels Joule, 12‑2019 / 12‑2020, Daniel Howes. and Amanda Collier. 23. CBME Program Evaluation in Postgraduate Medical Education, 10. Last Mile Research Methods, $ 26,500.00, Operating, Matariki $ 40,000.00, Operating, PGME Special Bursary Grant (Winter), Network, 1‑2019. Colleen Davison. 10‑2019. Dagnone JD, McEwen L, Hall A, Acker A, 11. QR Policy Funding at the University of Birmingham: Chamberlain S, Smith C, Dalgarno N, Braund H, Stockley D. Addressing Sexual Exploitation and Abuse by UN Peacekeepers 24. CBME Program Evaluation in Postgraduate Medical Education, in DRC, $ 51,483.00, Operating, QR Policy Funding University $ 50,000.00, Operating, PGME Special Bursary Grant (Fall), of Birmingham, 11‑2019. Sabine Lee, Susan Bartels, et al. 8‑2019. Dagnone JD, McEwen L, Hall A, Acker A, 12. Queen Elizabeth Scholars: Advancing Health of Last Mile Chamberlain S, Smith C, Dalgarno N, Braund H, Stockley D. Populations: QE Scholars in Research and Practice, 25. CBME Program Evaluation in the Department of Surgery, $ 300,000.00, Operating, Universities Canada, 11‑2019. Susan $ 15,000.00, Operating, SEAMO Innovation Grant, 6‑2019. Bartels, Colleen Davison, Heather Aldersey, Eva Purkey. Payne D, Dagnone JD, McEwen L, Bardana D, Jalink D.

34 | Annual Report 2019 RESEARCH GRANTS AND PUBLICATIONS

26. Creating a Coaching Culture in Postgraduate Medicine, Peer‑Reviewed Abstracts $ 11,585.00, Operating, Royal College of Physicians & 1. Lee S, Bartels SA, Luissa Vahedi. Sexual relations between Surgeons of Canada, 4‑2019. Jessica Trier, Jennifer Turnnidge, UN peacekeepers and local women / girls in Haiti. Accepted Dagnone JD, Cote J. for oral presentation at the Sexual Violence Research Initiative 27. Age‑adjusted D‑dimer cutoff levels to rule out deep vein Forum, Cape Town, South Africa. October 2019. thrombosis, $ 188,628.00, Operating, HSFC, 3‑2019 / 2‑2021. 2. Bartels SA, Collier A, Davison C, Geara P, Kelly J, Michael S, Le Gal G, Marco Sivilotti, et al. Parmar P, Scott J, Vahedi, L. SenseMaker® as a monitoring and 28. Needs Assessment for new Emergency Medicine Program evaluation tool to provide new insights on sexual and in Ethiopia, $ 10,000.00, Operating, Queen’s, 7‑2019. gender‑based violence programs and services in Lebanon. Amanda Collier and Susan Bartels. Accepted for oral presentation at the Sexual Violence Research 29. ast Mile Research Collaboration, $ 30,000.00, Operating, Initiative Forum, Cape Town, South Africa. October 2019. Queen’s‑Dartmouth / Matariki, 7‑2019. Collen Davison, 3. Roupetz S, Bergquist B, Garbern S, Bartels SA, Michael S. Lisa Adams, Eva Purkey, Heather Aldersey, Karen Yeates. Sexual and gender‑based violence among Syrian refugee girls 30. A National Research Network on Lyme Disease, $ 3,990,966.00, in Lebanon. Accepted for oral presentation at the Sexual Operating, Canadian Institutes of Health Research (CIHR), Violence Research Initiative Forum, Cape Town, South Africa. 9‑2019. Moore KM. October 2019. 4. Blouin D. Quality Assurance and Organizational Culture of Publications Medical Schools. WFME World Conference, Seoul, Korea. 2019. Chapters 5. Blouin D. Accreditation as Quality Assurance: Measures of 1. M.L.A. Sivilotti, Aspirin, 6‑2018, Goldfrank’s Toxicologic Effectiveness. WFME World Conference, Seoul, Korea. 2019. Emergencies, Vol. 8, 115 6. Blouin D. Accreditation et Assurance de la Qualite: Indicateurs 2. M.L.A. Sivilotti, Hematologic Principles, 6‑2018, Goldfrank’s de success. RIFRESS, Rabat, Morocco. 2019. Toxicologic Emergencies, Vol. 11, 20 7. Blouin D. Les facultes de medecine accreditees ont‑elles 3. M.L.A. Sivilotti and C.H. Linden, Salicylate and other developpe une culture d’amelioration continue de la qualite? Nonsteroidal Anti‑inflammatory Drug Poisoning, 5‑2018, RIFRESS, Rabat, Morocco. 2019. Irwin & Rippe’s Intensive Care Medicine, Vol. 122(8):1111‑18 8. Blouin D. Impact de l’accreditation sur les processus des 4. Michaelson V, Trothen TJ, Davison CM, Pickett W, Bodies and facultes de medicine. RIFRESS. 2019. Behaviours: A study of body image in adolescent girls and 9. Flynn L, Blouin D, Hastings Truelove A. Perceptions of the Canadian churches, 10‑2018, Practical Theology in Progress: medical education development fund. ICRE, Ottawa. 2019. Showcasing an Emerging Discipline, Vol. 11, 10 10. Blouin D. Accreditation as Quality Assurance. AMEE, Vienna, 5. Roelofs S, Edwards N, Davison CM, MacLean L, Life and Your Austria. Program of Research: Finding the work‑life balance that works 11. Venance SL, McKay DM, Blouin D. Canadian medical schools for you, 11‑2018, Developing a Program of Research: An and their curricula: Accreditation and the winds of change. essential process for a successful research career, Vol. 3, 10 CCME, Niagara Falls. 2019. 6. Murray M and Davison CM, Navigating the post‑PhD transition 12. Roy M, Wood TJ, Blouin D, Eva K. A national look at the influence to Independent Researcher, 11‑2018, Developing a Program of accreditation on Medical Council of Canada Qualifying of Research: An essential process for a successful research Examination (MCCQE) scores. CCME, Niagara Falls. 2019. career, Vol. 2, 10 13. Johri A, Grubic N, Kuljic N, O’Connor M, Graham K, Bennett R, Complete Books Moulson N. Translation of the Canadian Cardiovascular 1. Szulewski, Adam. Through The Eyes of the Physician: Expertise Society/Canadian Heart Rhythm Society Cardiovascular Development In Resuscitation Medicine. PHD Thesis, Vol. 1. Screening in care of athletes program into practice. Canadian Journal of Cardiology. 35(7):935‑939. 2019. Editorials 14. Wood T, Roy M, Eva K, Blouin D. A national look at the 1. Murray H. Quality Standards for early pregnancy loss, 2‑2019, influence of accreditation on Medical Council of Canada Health Quality Ontario Qualifying Examination (MCCQE Part I) scores. Canadian 2. David Messenger. Working Towards Inclusion: Listening to Medical Education Journal. 2019. LGBTQI2S+ Student Voices in Medicine. Queen’s Gazette. 15. Venance S, Blouin D. Accreditation and Canadian medical Non‑Peer‑Reviewed Articles schools: Harnessing the power of affinity mapping for CQ. Canadian Medical Education Journal. 2019. 1. Walker, Simpson, Drummond, Sinclair. Multiple health policy 16. Purkey, E, Bartels SA, Davison, C. Parenting in Adversity: blogs, co‑authored, 1‑2019, https://www.queensu.ca/connect/ An international comparative study. Accepted for poster policyblog/ presentation at the North American Primary Care Research Group annual conference. Toronto. November 2019.

Department of Emergency Medicine | 35 RESEARCH GRANTS AND PUBLICATIONS

17. C.R. Bell, A. Szulewski, M. Walker and J Kendall. Eye fixation 32. Weersink K, Hall J, Dagnone JD. Resident Leadership in the as a measure of competency assessment. Oral Presentation Co‑Production of CBME. CCME. Niagara Falls, ON. 2019. AIUM. Orlando, FL. 2019. 33. Dagnone JD, Chan M‑K, Meschino D, McEwen L. Managing 18. Cormier, A., Brennan, E. Quick Refresher Sessions: Improving Change in Medical Education. CCME. Niagara Falls, ON. 2019. Chest Compression Training for Medical Students. 2019. 34. Collings LJ, Szulewski A, Hopman WJ, Hall AK. The correlation 19. Carpenter J, Sheeham G, Soleas T, DeSousa M, Matzinger E, of workplace‑based assessments with periodic performance Baumhoer J. Realistic Preparation For Going Global: assessment of emergency medicine residents. [abstract]. Simulation‑Based Pre‑Departure Training. Presented by ICRE Abstract Book. 2019. J. Carpenter at: CCME, Niagara Falls. April 2019. 35. Hall AK, Rich JV, Dagnone D, Weersink K, Caudle J, Van Melle E. 20. Jomaa D, Chaplin T. The development of a resuscitation record Rapid Evaluation of CBME to Facilitate System Change. at an academic hospital: a survey and focus group of Code [abstract]. ICRE Abstract Book. 2019. Blue team members. European Society for Emergency 36. Vella K, Szulewski A, Hopman W, Van Merrienboer JJG, Hall AK. Medicine Congress, Prague. October 2019. Measuring cognitive load on shift: Application of cognitive 21. Rusiecki D, Hoffe S, Walker M, Reid J, Rocca N, White H, load theory during clinical work in the emergency Chaplin T. In situ simulation: A team sport? Canadian department. CAEP. 2019. Association of Emergency Physicians, Halifax. May 2019. 37. Collings L, Szulewski A, Hopman W, Hall AK. The correlation of 22. Hall A, Forristal C, Chaplin T, Russell E, Szulewski A, workplace‑based assessments with periodic performance Petrosoniak A, Mastoras G, Caners K, Thoma B, Huffman J, assessment of emergency medicine residents. [abstract] CAEP. Woolfrey K, McColl T, Dakin C. Simulation in the continuing 2019. professional development of Canadian academic emergency 38. Kester‑Greene N, Hall AK, Walsh C. Simulation curricular physicians – a national survey. Canadian Association of content in postgraduate emergency medicine: a multicenter Emergency Physicians, Halifax. May 2019. delphi study. CAEP. 2019. 23. Cofie N, Chaplin T, Rylan E, McColl T, Gu J, Thoma B. Improving 39. McKaigney C, Hall AK, Bell C. Development of a competency residents’ confdence and accuracy in making clinical based assessment tool for emergency department point of judgement: Evidence from a multi‑institutional simulation- care ultrasound. Nominated for best educational abstract. based study. Canadian Conference on Medical Education, 2019. CAEP. 2019. Niagara Falls. April 2019. 40. Chaplin T, Thoma B, Petrosoniak A, Caners K, McColl T, Forristal 24. Railer J, Stockley D, Walker R, Dagnone JD, McEwen L, Egan R, C, Dakin C, Deshaies JF, Raymond‑Dufresne E, Fotheringham van Wylick R, Hall J. A Systems Approach to Curricular Reform: M, Ha D, Holm N, Huffman J, Lonergan AM, Mastoras G, Breaking Down Silos. ISSOTL Atlanta, GA. 2019. O’Brien M, Paradis MR, Sowers N, Stern E, Hall AK. 25. Hall A, van Melle E, Dagnone JD, Weersink K. Program Simulation‑based research in emergency medicine in Canada: Evaluation on the Frontline of CBME. ICRE, Ottawa, ON. 2019. priorities and perspectives. CAEP. 2019. 26. Trier J, Turnnidge J, Dagnone JD, Cote J. Implementing 41. M. Gilley, M. Sivilotti, D. Juurlink, E. Macdonald, Z. Yao, Effective Coaching Behaviours in the Learning Environment. Y. Finkelstein. Trends of intentional drug overdose among ICRE. Ottawa, ON. 2019. youth: a population‑based cohort study. Clin Toxicol 2019; 27. Dagnone JD, Hussain A, Flynn L, Stockley D. Building 57: 948 (lightning oral, North American Congress of Clinical relationships and fostering community – The Transition to Toxicology, Nashville TN. September 2019. Competency Based Medical Education: Results from a 3 Year 42. S. Tung, M.L.A. Sivilotti, B. Linder, C. Lynch, D. Loricchio, Longitudinal Study. ICRE. Ottawa, ON. 2019. A. Szulewski. Impact of High Emergency Department 28. Dos‑Santos A, Bouchard M, McEwen L, Dagnone JD. Occupancy on Time to Physician Initial Assessment: a Traffic Leveraging Elentra’s assessment plan builder to visualize and Theory Analysis. Clin Exp Emerg Med 2019; ICEM 2019 special track resident performance. ICRE 2019 Ottawa, ON. edition:6. oral presentation, International Conference on 29. Soleas EK, van Wylick R, Dagnone JD, Harle I, Stockley D. Emergency Medicine, Soeul SK. 2019. Developing competencies for academic advisors and 43. A. Wong, M.C. Yarema, G.K. Isbister, M.L.A. Sivilotti, R. McNulty, competence committee members: A grassroots community A. Chiew, C. Page, S.L. Greene, N. Gunja, N.A. Buckley, approach for faculty development. ICRE Ottawa, ON. 2019. A. Graudins. Comparison of adverse reactions to a two‑bag 30. Dagnone JD, Stockley D, Flynn L, Hussain A. Hastings Truelove versus three‑bag intravenous acetylcysteine regimen during A. Implementing Competency‑Based Medical Education in treatment of paracetamol overdose. Clin Toxicol 2019; PGME: A Three Year Longitudinal Study. CCME. Niagara Falls, 57(6):569‑570. European Association of Poison Centres and ON. 2019. Clinical Toxicologists Congress, Napoli, IT. May 2019. 31. Van Wylick R, Dagnone JD, Stockley D. Developing academic advisors and competence committee member competencies: A grassroots community approach to Faculty Development. CCME. Niagara Falls, ON. 2019.

36 | Annual Report 2019 RESEARCH GRANTS AND PUBLICATIONS

44. J.J. Perry, M.L.A. Sivilotti, M. Emond, A. Worster, J. Lee, J. Morris, 52. Chaplin T., Thoma B., Szulewski A., Braund, H., Dalgarno N., G. Stotts, G.A. Wells, I.G. Stiell, K. W. Cheung, N. Chagnon, Egan R. Multi‑source feedback during simulated resuscitation H. Murray, M. Sharma. Prospective Multicenter Validation of scenarios: a qualitative analysis. Canadian Conference on the Canadian TIA Score for Predicting Subsequent Stroke Medical Education (CCME), Vancouver, CA. (Oral Abstract). 2019. within Seven Days. Can J Emerg Med 2019; 21(supp1):S5. 53. Chaplin T, Thoma B, Szulewski A, Braund H, Dalgano N, Egan R. Opening Plenary, Grant Innes Best Research Paper Award, Multi‑source feedback during simulated resuscitation Canadian Association of Emergency Physicians Annual scenarios: a qualitative analysis. Simulation Summit Organized Scientific Meeting, Halifax NS. May 2019. by the Royal College of Physicians and Surgeons of Canada. 45. I. Stiell, J. Perry, D. Birnie, L. Macle, A. Vadeboncoeur, Winnipeg, MB. (Oral Abstract). 2019. V. Thiruganasambandamoorthy, B. Borgundvaag, R. Brison, 54. Szulewski A. Cognitive Load Theory in Health Professions C. Hohl, A. McRae, B. Rowe, M. Sivilotti, J. Morris, E. Mercier, Education. International Cognitive Load Theory Conference C. Clement, J. Brinkhurst, M. Taljaard, G. Wells. A randomized (ICLTC). Masstricht, Netherlands, Invited Opening Plenary. 2019. controlled comparison of electrical versus pharmacological cardioversion for emergency department patients with Peer‑Reviewed Articles recent‑onset atrial fibrillation. Can J Emerg Med 2019; 1. Bielska IA, Brison R, Brouwer B, Janssen I, Johnson AP, Day AG, 21(supp1):S5. Opening Plenary, Canadian Association of Pickett W. Is recovery from ankle sprains negatively affected Emergency Physicians Annual Scientific Meeting, Halifax NS. by obesity? Annals of physical and rehabilitation medicine, May 2019. Vol. 62(1):8‑13. 46. S. Tung, M. Sivilotti, B. Linder, C. Lynch, D. Loricchio, A. Szulewski. 2. Phillips SP, King N, Michaelson V, Pickett W. Sex, drugs, risk and Impact of High Emergency Department Occupancy on Time resilience: analysis of data from the Canadian Health to Physician Initial Assessment Using Traffic Theory. Can J Behaviour in School‑aged Children (HBSC) study. European Emerg Med 2019; 21(supp1):S35. Oral presentation, Canadian Journal Of Public Health. 29(1):38‑43. Association of Emergency Physicians Annual Scientific 3. Blouin D. Accreditation of Canadian Undergraduate Medical Meeting, Halifax NS. May 2019. Education Programs: A Study of Measures of Effectiveness. 47. J.J. Perry, M.L.A. Sivilotti, M. Emond, A. Worster, J. Lee, J. Morris, Acad Med. 2020 Jun;95(6):931‑937. G. Stotts, G.A. Wells, I.G. Stiell, K. W. Cheung, N. Chagnon, 4. Lefebvre D, Dong KA, Dance E, Rosychuk RJ, Yarema M, H. Murray, M. Sharma. Prospective Multicenter Validation of Blouin D, Williams J, Rowe BH. Resident Physician Wellness the Canadian Transient Ischemic Attack Score for Predicting Curriculum: A Study of Efficacy and Satisfaction. Cureus. Subsequent Stroke within Seven Days. Acad Emerg Med 2019; 11(8):e5314 26(S1):S9. Opening Plenary, Society for Academic Emergency 5. Boelen C, Blouin D, Gibbs T, Woollard. Accrediting excellence Medicine Annual Conference, Las Vegas NV. May 2019. for a medical school’s impact on population health. Education 48. I.G. Stiell, J.J. Perry, D. Birnie, L. Macle, A. Vadeboncoeur, for Health (Abingdon, England). 32(1):41‑48. V. Thiruganasambandamoorthy, B. Borgundvaag, R.J. Brison, 6. Blouin D. Quality improvement in medical schools: vision C. Hohl, A.D. McRae, B.H. Rowe, M.L.A. Sivilotti, J. Morris, meets culture. Medical Education. 53(11):1100‑1110. E. Mercier, C. Clement, J. Brinkhurst, M. Taljaard, G.A. Wells. 7. Blouin D, Tekian A, Harris IB. Do organizational cultures of A randomized controlled comparison of electrical versus Canadian medical schools promote a quality culture? Medical pharmacological cardioversion for emergency department Teacher. 41(6):662‑667. patients with recent‑onset atrial fibrillation. Acad Emerg Med 2019; 26(S1):S22 Oral presentation, Society for Academic 8. Thomasson RR, Yazer MH, Gorham JD, Dunbar NM, MTP Use Emergency Medicine Annual Conference, Las Vegas NV. Study Investigators, on behalf of the Biomedical Excellence May 2019. for Safer Transfusion (BEST) Collaborative. International assessment of massive transfusion protocol contents and 49. S. Tung, M.L.A. Sivilotti, B. Linder, C. Lynch, D. Loricchio, indications for activation. Transfusion.59(5):1637‑1643. A. Szulewski. Impact of High Emergency Department Occupancy on Time to Physician Initial Assessment Using 9. Egan R, Chaplin T, Szulewski A, Braund H, Cofie N, McColl T, Traffic Theory. Acad Emerg Med 2019; 26(S1):S129‑130. Hall A, Dagnone D, Kelley L, Thoma B., A case for feedback and Oral presentation, Society for Academic Emergency Medicine monitoring assessment in competency‑based medical Annual Conference, Las Vegas NV. May 2019. education. Journal of Evaluation in Clinical Practice. Dec. 2019. Epub ahead of print. 50. Johannessen E, Szulewski A, Radulovic N, White M, Howes D, Braund H, Rodenburg D, Davies, C. Psycho‑physiologic 10. Brunet M, Chaplin T. Does point‑of‑care ultrasonography Measures of Cognitive Load in Trauma Physicians During improve clinical outcomes in emergency department patients Resuscitation Response. International cognitive load theory with undifferentiated hypotension? CJEM. 21(5):593‑59. conference. Maastricht, Netherlands. (Oral Abstract). 2019. 11. Chaplin T, Thoma B, Petrosoniak A, Caners K, McColl T, Forristal 51. Chaplin T, Thoma B, Szulewski A, Braund H, Dalgarno N, C, Dakin C, Deshaies JF, Raymond‑Dufresne E, Fotheringham Egan R. Multi‑source feedback during simulated resuscitation M, Ha D, Holm N, Huffman J, Lonergan AM, Mastoras G, scenarios: a qualitative analysis. International Conference on O’Brien M, Paradis MR, Sowers N, Stern E, Hall AK. Residency Education, Ottawa, ON. September, 2019. Simulation‑based research in emergency medicine in Canada: Priorities and perspectives. CJEM. 22(1):103‑111.

Department of Emergency Medicine | 37 RESEARCH GRANTS AND PUBLICATIONS

12. Weersink K, Hall AK, Rich J, Szulewski A, Dagnone JD. 24. Lee S, Bartels SA. Self‑interpreted narrative capture: A research Simulation versus real‑world performance: a direct project to examine life courses of Amerasians in Vietnam and comparison of emergency medicine resident resuscitation the United States. Methodological Innovations. entrustment scoring. Advances in Simulation (London, 12(2):2059799119863280. England). 1;4:9. 25. Ho B, Weber C, Lee S, and Bartels S. Life Courses of Amerasians 13. Szulewski A, Braund H, Egan R, Gegenfurtner A, Hall AK, in Vietnam: A Qualitative Analysis of Emotional Well‑Being. Howes D, Dagnone D, van Merrienboer JJG. Starting to Think Vietnam Journal of Social Sciences and Humanities. Like an Expert: An Analysis of Resident Cognitive Processes 26. Paluku JL, Carter TE, Lee M, Bartels SA. Massive single visit during Simulation‑Based Resuscitation Examinations. Annals cervical pre‑cancer and cancer screening in eastern of Emergency Medicine. 74(5):647‑659. Democratic Republic of Congo. BMC Women’s Health. 19(1):43. 14. Szulewski A. A Doctor in the Headlights. AEM Education and 27. Subedi S, Bartels S, Davison C. Emotional and Physical Child Training. 3(2):200‑20. Abuse in the Context of Natural Disasters: A Focus on Haiti. 15. Szulewski A, Egan R, Gegenfurtner A, Howes D, Dashi G, Disaster Medicine and Public Health Preparedness. McGraw NCJ, Hall AK, Dagnone D, van Merrienboer JJG. 13(5‑6): 927‑935. A new way to look at simulation‑based assessment: the 28. Dube A, Bartels S, Michael S, and Michaelson V. Positive Worry relationship between gaze‑tracking and exam performance. and Negative Hope: Paradoxical Perceptions of the CJEM. 21(1): 129‑137. Experiences of Syrian Refugee Girls in Lebanon. International 16. Ross K, Sarkar P, Rodenburg D, Ruberto A, Hungler P, Journal of Humanitarian Action. Szulewski A, Howes D, Etemad A. Toward Dynamically 29. McGraw R, Chaplin T, Rocca N, Rang L, Jaeger M, Holden M, Adaptive Simulation: Multimodal Classification of User Keri Z, Fichtinger G. Cognitive load theory as a framework for Expertise Using Wearable Devices. Sensors (Basel, Switzerland). simulation‑based, ultrasound‑guided internal jugular 19(19):E4270. catheterization training: Once is not enough, but we must 17. Vahedi L, Bartels SA, Lee S. Even Peacekeepers Expect measure it first. CJEM. 21(5):E4. Something in Return: A Qualitative Analysis of Sexual 30. Hall AK, Rich J, Dagnone JD, Weersink K, Caudle J, Sherbino J, Interactions between UN Peacekeepers and Female Haitians. Frank JR, Bandiera G, Van Melle E. It’s a Marathon, Not a Sprint: Global Public Health. Dec. 2019. Epub ahead of print. Rapid Evaluation of CBME Program Implementation. 18. McKenna C, Bartels SA, Pablo LA, Walker M. Women’s Academic Medicine. 95(5):786‑793. decision‑making power and malnutrition in their children 31. Hall AK, Woods R, Frank JR. Changing the culture of residency under age five in the Democratic Republic of the Congo: training through faculty development – ERRATUM. CJEM. A cross‑sectional study. PLOS One. 14(12):e0226041. 21(6):E4. 19. Jain R, Davison C, Michael S, Durand MA, Bartels SA. 32. Kester‑Greene N, Hall AK, Walsh CM. Simulation curricular A Qualitative Analysis of Knowledge, Attitudes, and content in postgraduate emergency medicine: A multicentre Perceptions of Family Planning Among Syrian Refugees in Delphi study. CJEM. 21(5):667‑675. Lebanon. Current Opinions in Gynecology and Obstetrics. 33. Thoma B, Turnquist A, Zaver F, Hall AK, Chan TM. 2(1):346‑53. Communication, learning and assessment: Exploring the 20. Bartels SA, Michael S, Vahedi L, Collier A, Kelly J, Davison C, dimensions of the digital learning environment. Medical Scott J, Parmar P, Geara P. SenseMaker as a monitoring and Teacher. 41(4):385‑390. evaluation tool to provide new insights on gender‑based 34. Rich JV, Young SF, Donnelly C, Hall AK, Dagnone JD, Weersink K, violence programs and services in Lebanon. Evaluation and Caudle J, Van Melle E, Klinger D. Competency‑based education program planning. 77:101715. calls for programmatic assessment but what does this look 21. Dutton S, Davison CM, Malla M, Bartels SA, Collier K, like in practice? Journal of Evaluation in Clinical Practice. Plamondon K, Purkey E. Biographical Collage as a Tool in Inuit Dec. 2019. Epub ahead of print. Community‑Based Participatory Research and Capacity 35. Ahlin J, Hall AK. Great Evidence in Medical Education. CAEP Development. International Journal for Qualitative Methods. (GEMeS). https://caep.ca/em-community/academic-section/ 18:1‑10. education-committee/gemes/ 22. Collier A, Marton G, Chun S, Nijssen‑Jordan C, Bartels SA, Pulfrey S, Lang E, Schull M, Landes M, Johnson K. CAEP 2018 Academic Symposium: Recommendations for developing and supporting Global Emergency Medicine in Canadian academic emergency departments and divisions. CJEM. 21(5):600‑606. 23. Han A, Michal S, Helal S, Bunting A, Davison C, and Bartels SA. Perspectives on Family Planning Among Syrian Child Brides in Lebanon. Current Opinions in Gynecology and Obstetrics. 2(1):209‑15.

38 | Annual Report 2019 RESEARCH GRANTS AND PUBLICATIONS

36. Nolan JP, Berg RA, Andersen LW, Bhanji F, Chan PS, Donnino 47. Maranda S, Halliday S, Murray H. Comparison of Peer Tutor MW, Lim SH, Ma MH, Nadkarni VM, Starks MA, Perkins GD, and Librarian Feedback for the Literature Search Component Morley PT, Soar J, Utstein Collaborators. Cardiac Arrest and of a Medical School Research course. Journal of the Canadian Cardiopulmonary Resuscitation Outcome Reports: Update of Health Libraries Association. the Utstein Resuscitation Registry Template for In‑Hospital 48. Dzara K, Chen D, Haidet P, Murray H. The Effective Use of Cardiac Arrest: A Consensus Report From a Task Force of the videos in Medical Education. Academic Medicine. 95(6):970. International Liaison Committee on Resuscitation (American 49. Rajaram A, Hickey Z, Patel N, Newbigging J, Wolfrom B. Heart Association, European Resuscitation Council, Australian Training medical students and residents in the use of and New Zealand Council on Resuscitation, Heart and Stroke electronic health records: a systematic review of the literature. Foundation of Canada, InterAmerican Heart Foundation, Journal of the American Medical Informatics Association. Resuscitation Council of Southern Africa, Resuscitation 27(1):175‑180. Council of Asia). Resuscitation. 144:166‑177. 50. Yao G, Hong TP, Lee P, Newbigging J, Wolfrom B. Point‑of‑Care 37. Wang P, Brooks S. Cochrane corner: Are mechanical Ultrasound Training for Family Medicine Residents: Examining compressions better than manual compressions in cardiac the outcomes and feasibility of a pilot ultrasound curriculum. arrest? Heart. 106(8):559‑561. POCUS Journal. 4(2):22‑26 38. Christopher L. F. Sun, Lena Karlsson, Christian Torp‑Pedersen, 51. Lewis D, Rang L, Kim D, Robichaud L, Kwan C, Pham C, Shefrin Laurie J. Morrison, Steven C. Brooks, Fredrik Folke, Timothy C. A, Ritcey B, Atkinson P, Woo M, Jelic T, Dallaire G, Henneberry R, Y. Chan. In silico trial of artificial intelligence‑optimized versus Turner J, Andani R, Demsey R, Olszynski P. Recommendations real public defibrillator locations. JACC. 74(12):1557‑1567. for the use of point‑of‑care ultrasound (POCUS) by emergency 39. Shuvy M, Koh M, Qiu F, Brooks SC, Chan TCY, Cheskes S, Dorian physicians in Canada. CJEM. 21(6):721‑726. P, Geri G, Lin S, Scales DC, Ko DT. Health care utilization prior 52. J. Sherbino, G Bandiera, K Doyle, J Frank, B Holroyd, G Jones, to out‑of‑hospital cardiac arrest: A population‑based study. J Norum, C Snider, K Magee. The competency based medical Resuscitation. 141:158‑165. education evolution of Canadian emergency medicine 40. Nikolaou N, Dainty KN, Couper K, Morley P, Tijssen J, specialist training. Canadian Journal of Emergency Medicine. Vaillancourt C, International Liaison Committee on 22(1)95‑102. Resuscitations (ILCOR) Basic Life Support and Pediatric Task 53. Krzyzaniak SM, Gottlieb M, Parsons M, Rocca N, Chan TM. Forces. A systematic review and meta‑analysis of the effect of What Emergency Medicine Rewards: Is There Implicit Gender dispatcher‑assisted CPR on outcomes from sudden cardiac Bias in National Awards? Annals of Emergency Medicine. arrest in adults and children. Resuscitation. 138:82‑105. 74(6):753‑758. 41. Hanuschak TA, Peng Y, Day A, Morrison LJ, Zhan CC, Brooks SC, 54. Grunau B, Kawano T, Scheuermeyer F, Tallon J, Reynolds J, Rescu Investigators. Patient and hospital factors predict use Besserer F, Barbic D, Brooks S, Christenson J. Early advanced of coronary angiography in out‑of‑hospital cardiac arrest life support attendance is associated with improved survival patients. Resuscitation. 138:182‑189. and neurologic outcomes after non‑traumatic out‑of‑hospital 42. Bell, C. R., & Holden, M. S. Wanted: automated objective cardiac arrest in a tiered prehospital response system. proficiency assessment metrics for the FAST exam (and other Resuscitation. 135:137‑144. POCUS studies).European Journal of Trauma and Emergency 55. Leung AK, Loricchio D, Brison RJ, Graham K. Perspectives of Surgery. 45(4):763‑764. ambulatory patients visiting the emergency department 43. Holden MS, Xia S, Lia H, Keri Z, Bell C, Patterson L, Ungi T, during the Christmas and New Year holiday period: Fichtinger G. Machine learning methods for automated Descriptive survey. Canadian family physician Medecin de technical skills assessment with instructional feedback in famille canadien. 65(7):e305‑e310. ultrasound‑guided interventions. International journal of 56. Cote, Yu H, Shearer HM, Randhawa K, Wong JJ, Mior S, Ameis A, computer assisted radiology and surgery. 14(11):1993‑2003. Carroll LJ, Nordin M, Varatharajan S, Sutton D, Southerst D, 44. Sinclair D, Toth P, Chochinov A, Foote J, Johnson K, McEwen J, Jacobs C, Stupar M, Taylor‑Vaisey A, Gross DP, Brison RJ, Messenger D, Morris J, Pageau P, Petrie D, Snider C. Health Paulden M, Ammendolia C, Cassidy JD, Loisel P, Marshall S, human resources for emergency medicine: a framework for Bohay RN, Stapleton J, Lacerte M. Non‑pharmacological the future. CJEM. 22(1):40‑44. management of persistent headaches associated with neck 45. Vij S, Burton A, Murray H, Walker M. Can we safely use a wait pain: A clinical practice guideline from the Ontario protocol and see approach for patients with recent onset atrial for traffic injury management (OPTIMa) collaboration. fibrillation? CJEM. 21(6):715‑716. European journal of pain (London, England). 23(6):1051‑1070. 46. Lee P, Murray H. Midazolam or Haloperidol Premedication 57. Veldhoen RA, Howes D, Maslove DM. Is Mortality a Useful Reduced Ketamine‑Induced Recovery Agitation and Increased Primary End Point for Critical Care Trials? Chest. ED Recovery Time. Annals of Emergency Medicine. S0012‑3692(19)34369‑7. 170(10):JC57.

Department of Emergency Medicine | 39 RESEARCH GRANTS AND PUBLICATIONS

58. Van Melle E, Frank JR, Holmboe ES, Dagnone D, Stockley D, 69. Wong A, McNulty R, Taylor D, Sivilotti M, Greene S, Gunja N, Sherbino J, International Competency‑based Medical Koutsogiannis Z, Graudins A. The NACSTOP Trial: A Multicenter, Education Collaborators. A Core Components Framework for Cluster‑Controlled Trial of Early Cessation of Acetylcysteine in Evaluating Implementation of Competency‑Based Medical Acetaminophen Overdose. Hepatology (Baltimore, Md.). Education PrograMs. Academic medicine: Journal of the 69(2):774‑784. Association of American Medical Colleges. 94(7):1002‑1009. 70. Yau L, Mukarram MA, Kim SM, Arcot K, Thavorn K, Stiell IG, 59. Dagnone JD, Stockley D, Flynn L, Healey J, Reznick R. Taljaard M, Rowe BH, Sivilotti MLA, Re‑Imagining Medical Training – A Near Future Vision of Thiruganasambandamoorthy V. Outcomes and emergency Competency‑Based Medical Education. ICE Blog. https:// medical services resource utilization among patients with icenetblog.royalcollege.ca/2019/08/20/reimagining-medical- syncope arriving to the emergency department by training-a-near-future-vision-of-competency-based-medical- ambulance. CJEM. 21(4):499‑504. education-the-story-of-jane-miller-md-articulating-cbme- 71. Innes GD, Sivilotti MLA, Ovens H, McLelland K, Dukelow A, through-narrative-story-telling/ Kwok E, Chopra A, Cheng I, Kalla D, Mackinnon D, Kim Sing C, 60. Pero R, Pero E, Marcotte L, Dagnone JD. Educational Barclay N, Ross T, Chochinov A. Emergency overcrowding and consultants: fostering an innovative implementation of access block: A smaller problem than we think. CJEM. competency‑based medical education. Medical education. 21(2):177‑185. 53(5):524‑525. 72. Villa‑Roel C, Borgundvaag B, Majumdar SR, Emond M, 61. Dagnone D, Stockley D, Flynn L, Egan R, van Wylick R, Campbell S, Sivilotti M, Abu‑Laban RB, Stiell IG, Aaron SD, McEwan L, Walker R, Reznick R. Delivering on the promise of Senthilselvan A, Rowe BH, AIR Investigators. Reasons and competency based medical education – an institutional outcomes for patients receiving ICS/LABA agents prior to, and approach. Canadian Medical Education Journal.10(1):e28‑e38. one month after, emergency department presentations for 62. Dibajnia P, Sivilotti MLA, Juurlink D, Shurrab M. ST‑elevation in acute asthma. The Journal of asthma: official journal of the ethylene glycol toxicity mimicking myocardial infarction. Association for the Care of Asthma. 56(9):985‑994. Journal of Electrocardiology. 58:128‑131. 73. Mullins ME, Yarema MC, Sivilotti MLA, Thompson M, Beuhler 63. Gilley M, Sivilotti MLA, Juurlink DN, Macdonald E, Yao Z, MC, Algren DA, Holstege CP. Comment on: Transition to Finkelstein Y. Trends of intentional drug overdose among Two‑Bag Intravenous Acetylcysteine for Acetaminophen youth: a population‑based cohort study. Clinical toxicology. Overdose., Clinical toxicology (Philadelphia, Pa.). 58(5):433‑435. 58(7):711‑715. 74. Mutsaers A, Sivilotti MLA, Yarema MC, Green JP, Johnson DW, 64. Perry JJ, Sivilotti MLA, Emond M, Hohl CM, Khan M, Lesiuk H, Rumack BH. Letter in response to the Letter to the Editor by Abdulaziz K, Wells GA, Stiell IG. Prospective Implementation Harmouche. Clinical toxicology (Philadelphia, Pa.). 58(3):221‑222. of the Ottawa Subarachnoid Hemorrhage Rule and 6‑Hour 75. Thiruganasambandamoorthy V, Rowe BH, Sivilotti MLA, Computed Tomography Rule. Stroke. 51(2):424‑430. McRae AD, Arcot K, Nemnom MJ, Huang L, Mukarram M, 65. Thiruganasambandamoorthy V, Rowe BH, Sivilotti MLA, Krahn AD, Wells GA, Taljaard M. Response by McRae AD, Arcot K, Nemnom MJ, Huang L, Mukarram M, Thiruganasambandamoorthy et al to Letters Regarding Article. Krahn AD, Wells GA, Taljaard M. Duration of Circulation. 140(12):e655‑e656. Electrocardiographic Monitoring of Emergency Department 76. Wong A, Graudins A, Heard K, Dalhoff K, Sivilotti MLA. Patients With Syncope. Circulation. 139(11):1396‑1406. Improving the management of the paracetamol poisoned 66. Albert K, Sivilotti MLA, Gareri J, Day A, Ruberto AJ, Hookey LC. patient. EClinicalMedicine. 12:10. Hair cannabinoid concentrations in emergency patients with 77. M.E. Mullins, M.C. Yarema, M.L.A. Sivilotti, M. Thompson, cannabis hyperemesis syndrome. CJEM. 21(4):477‑481. D.A. Algren, M.C. Beuhler, C.P. Holstege. Comment on: 67. Thiruganasambandamoorthy V, Sivilotti MLA, Rowe BH, Acetylcysteine in paracetamol poisoning: a perspective of McRae AD, Mukarram M, Malveau S, Yagapen AN, Sun BC, 45 years of use. Toxicol Res. North American Syncope Consortium. Prevalence of 78. Papadomanolakis‑Pakis N, Moore K, Lew J, Boulet M, Review Pulmonary Embolism Among Emergency Department of Coroner Inquest Recommendations into Opioid Prescribing Patients With Syncope: A Multicenter Prospective Cohort Practices in Ontario: Ongoing Health Policy Gaps. Healthcare Study. Annals of Emergency Medicine. 73(5):500‑510. policy. 15(1):20‑28. 68. Mutsaers A, Green JP, Sivilotti MLA, Yarema MC, Tucker D, 79. Dawson E, Lew J, Mauer‑Vakil D, Van Dijk A, Belanger P, Moore Johnson DW, Spyker DA, Rumack BH. Changing nomogram KM. A longitudinal analysis of temporal and spatial incidence risk zone classification with serial testing after acute of neonatal abstinence syndrome in Ontario: 2003‑2016. acetaminophen overdose: a retrospective database analysis. Journal of opioid management. 15(3):205‑212. Clinical toxicology (Philadelphia, Pa.). 57(6):380‑386. 80. Rajaram A, Moore KM, Mamdani M. Preparing family medicine trainees for the information revolution: Pearls, potential, promise, and pitfalls. Can Fam Physician. 65(6):390‑392.

40 | Annual Report 2019 Department of Urology

Department of Surgery

Department of Psychiatry CARE PROVIDENCE Department of Public Health Sciences

Department of Physical Medicine & Rehabilitation

Department of Pathology & Molecular Medicine

Department of Pediatrics

Department of Otolaryngology HOSPITAL Department of Ophthalmology HOTEL DIEU

Department of Oncology GENERAL

Department of Obstetrics & Gynaecology HOSPITAL KINGSTON

Department of Medicine

Department of Family Medicine

Department of Diagnostic Radiology QUEEN’S

UNIVERSITY Department of Critical Care Medicine SEAMO

Department of Biomedical and Molecular Sciences Department of Emergency Medicine

Department of Anesthesiology and Perioperative Medicine Department of Emergency Medicine Queen's University 76 Stuart Street, Kingston, ON, K7L 2V7