{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:02:16Z","timestamp":1790233336114,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["AEM Education and Training"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The current numerical standards for procedural competency in Emergency Medicine (EM) lack strong evidentiary support. In the absence of more validated competency standards, self\u2010reported confidence has been used as a learner\u2010centered measure of perceived procedural readiness. Characterizing procedural confidence, patterns across procedures, and factors associated with confidence may help inform improvements in residency curricula and assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize self\u2010reported confidence in key emergency medicine procedures, identify patterns across procedures, and examine associated residency program factors among graduating EM residents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional survey of graduating EM residents was conducted in June 2025, from 20 programs recruited to be intentionally diverse. The survey underwent content and response\u2010process validity assessment and pilot testing before distribution. Residents rated their confidence in 17 essential EM procedures using a 5\u2010point Likert\u2010based scale; program contacts provided program\u2010level characteristics through a separate questionnaire. Survey data was analyzed to determine procedure\u2010specific confidence levels and examine associations between overall procedural confidence and select program characteristics. Additionally, hierarchical clustering was used to identify patterns of confidence across procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 103 residents (41%) from 20 programs completed the survey. Confidence was highest for intubation (100%) and central line placement (98.1%), and lowest for pericardiocentesis (33.0%). Program\u2010level variables, including program length and emergency department volume, were not significantly associated with confidence. Hierarchical clustering identified three broad domains of procedural confidence: critical invasive procedures, core procedural skills, and resuscitation procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Graduating residents reported near universal confidence in performance of select skills, but meaningful confidence gaps remained for rare procedures and some core procedures. Procedural confidence clustered into clinically recognizable domains, while examined program characteristics were not consistently associated with confidence. These findings identify potential targets for curricular and assessment efforts while reinforcing that self\u2010reported confidence should complement, rather than replace, objective measures of procedural competence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/aet2.70256","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:37:22Z","timestamp":1790231842000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Procedural Confidence Among Graduating Emergency Medicine Residents: Implications for Training and Assessment of Clinical Readiness"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-4127","authenticated-orcid":false,"given":"Shaila","family":"Quazi","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Tower Health  West Reading Pennsylvania USA"},{"name":"Drexel University College of Medicine  West Reading Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1906-7523","authenticated-orcid":false,"given":"Patrick","family":"Olivieri","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Envision Physician Services, Valley Health System  Las Vegas Nevada USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0796-1213","authenticated-orcid":false,"given":"Andrew","family":"Mittelman","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8661-2053","authenticated-orcid":false,"given":"Ryan","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Stankewicz","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine St. Luke's University Health Network  Bethlehem Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6096-2856","authenticated-orcid":false,"given":"Joshua","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Vituity and University of Kansas School of Medicine  Wichita Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3924-8924","authenticated-orcid":false,"given":"Michela","family":"Stephens","sequence":"additional","affiliation":[{"name":"American College of Emergency Physicians  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moira","family":"Davenport","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Allegheny General Hospital\/Drexel University College of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4801-6314","authenticated-orcid":false,"given":"Martin P.","family":"Wegman","sequence":"additional","affiliation":[{"name":"American College of Emergency Physicians  Chicago Illinois USA"},{"name":"Department of Emergency Medicine HCA Florida Orange Park Hospital  Orange Park Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3276-8375","authenticated-orcid":false,"given":"Michael","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"issue":"3","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.ajic.2011.04.005","article-title":"Overview of Adverse Events Related to Invasive Procedures in the Intensive Care Unit","volume":"40","author":"Pottier V.","year":"2012","journal-title":"American Journal of Infection Control"},{"key":"e_1_2_12_3_1","volume-title":"Emergency Medicine Defined: Key Index Procedure Minimums","author":"Review Committee for Emergency Medicine","year":"2017"},{"issue":"7","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1111\/j.1553-2712.1999.tb00444.x","article-title":"Procedural Competency in Emergency Medicine: The Current Range of Resident Experience","volume":"6","author":"Hayden S. 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