Sheryl Heron
Emory University, Emergency Medicine, Faculty Member
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The US population is becoming more diverse. Despite changing demographics, health disparities and inequities in the numbers of ethnically/racially diverse health care providers perpetuate. Numbers of underrepresented minorities (URM’s)... more
The US population is becoming more diverse. Despite changing demographics, health disparities and inequities in the numbers of ethnically/racially diverse health care providers perpetuate. Numbers of underrepresented minorities (URM’s) graduating from medical schools continue to be far less than percentages in the population. Quality health care and outcomes for minorities continue to lag behind white counterparts. Successful methods and strategies to address these concerns should be sought and utilized. These disparities and inequities must be addressed aggressively and continuously through training, research, recruitment, and retention of health care providers and researchers from underrepresented minority groups. We present historical perspectives on racial/ethnic health care disparities and inequities.
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Equity in the promotion of women and underrepresented minorities (URiM) is essential for the advancement of academic emergency medicine and the specialty as a whole. Forward‐thinking healthcare organizations can best position themselves... more
Equity in the promotion of women and underrepresented minorities (URiM) is essential for the advancement of academic emergency medicine and the specialty as a whole. Forward‐thinking healthcare organizations can best position themselves to optimally care for an increasingly diverse patient population and mentor trainees by championing increased diversity in senior faculty ranks, leadership, and governance roles. This article explores several potential solutions to addressing inequities that hinder the advancement of women and URiM faculty. It is intended to complement the recently approved American College of Emergency Physicians (ACEP) policy statement aimed at overcoming barriers to promotion of women and URiM faculty in academic emergency medicine. This policy statement was jointly released and supported by the Society for Academic Emergency Medicine (SAEM), American Academy of Emergency Medicine (AAEM), and the Association of Academic Chairs of Emergency Medicine (AACEM).
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Objective: To use 360-degree evaluations within an Observed Structured Clinical Examination (OSCE) to assess medical student comfort level and communication skills with intimate partner violence (IPV) patients. Methods: We assessed a... more
Objective: To use 360-degree evaluations within an Observed Structured Clinical Examination (OSCE) to assess medical student comfort level and communication skills with intimate partner violence (IPV) patients. Methods: We assessed a cohort of fourth year medical students' performance using an IPV standardized patient (SP) encounter in an OSCE. Blinded pre-and post-tests determined the students' knowledge and comfort level with core IPV assessment. Students, SPs and investigators completed a 360-degree evaluation that focused on each student's communication and competency skills. We computed frequencies, means and correlations. Results: Forty-one students participated in the SP exercise during three separate evaluation periods. Results noted insignificant increase in students' comfort level pre-test (2.7) and post-test (2.9). Although 88% of students screened for IPV and 98% asked about the injury, only 39% asked about verbal abuse, 17% asked if the patient had a saf...
Discrimination based on race is a known source of stress in individuals and is a contributor to poor health outcomes in patients. However, less is known about how the experiences of racism impact the stress levels of emergency health care... more
Discrimination based on race is a known source of stress in individuals and is a contributor to poor health outcomes in patients. However, less is known about how the experiences of racism impact the stress levels of emergency health care workers (EHCWs).
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Targeted interventions have improved physical activity and wellness of medical residents. However, no exercise interventions have focused on emergency medicine residents. This study aimed to measure the effectiveness of a wearable device... more
Targeted interventions have improved physical activity and wellness of medical residents. However, no exercise interventions have focused on emergency medicine residents. This study aimed to measure the effectiveness of a wearable device for tracking physical activity on the exercise habits and wellness of this population, while also measuring barriers to adoption and continued use. This pre-post cohort study enrolled 30 emergency medicine residents. Study duration was 6 months. Statistical comparisons were conducted for the primary end point and secondary exercise end points with nonparametric tests. Descriptive statistics were provided for subjective responses. The physical activity tracker did not increase the overall self-reported median number of days of physical activity per week within this population: baseline 2.5 days (interquartile range, IQR, 1.9) versus 2.8 days (IQR 1.5) at 1 month (P=.36). There was a significant increase in physical activity from baseline to 1 month a...
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Study objectives: We determine the differences between households with and without children at the scene of intimate partner violence (IPV) 911 telephone calls in regard to arrests, presence of a weapon, alcohol use, and injury severity.... more
Study objectives: We determine the differences between households with and without children at the scene of intimate partner violence (IPV) 911 telephone calls in regard to arrests, presence of a weapon, alcohol use, and injury severity. Methods: 911 telephone calls for IPV in metropolitan Atlanta, Georgia, placed in 2002 were linked with cases of police-documented IPV incident reports. These incident reports were reviewed for relationship of offender and victim, sociodemographic information, weapon and substance use, previous incidents, and injury severity (measured by the Conflict Tactics Scale [CTS]). Results: Incident reports (1,677) were characterized as IPV and linked with 911 calls. Of these, 1,505 came from unique addresses. Children were present at 45.7% of IPV incidents (n=664/1,453). IPV victims were less likely to be arrested (5.7% versus 11.2%; P P =.004) if a child was present at the scene. There were no differences in regard to weapon use (13.8% versus 13.2%; P =.78) or increased severity of violence/CTS score greater than 13 (87.7% versus 86.4%; P =.45) and presence of children at the scene. However, IPV victims (4.7% versus 16.6%; P P Conclusion: Households with children that called 911 for IPV were arrested less frequently and were less likely to be intoxicated at the incident. There are no differences in weapon use or severity of violence between households with and without children that call 911 for IPV.
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Research Interests: Domestic Violence, Ethnicity, Medicine, Georgia, Intimate Partner Violence, and 13 moreEmergency Medical Services, Humans, Female, Male, African Americans, Recurrence, Clinical Sciences, Public health systems and services research, Retrospective Studies, Hotlines, Academic, Cohort Studies, and Family Characteristics
Emergency medicine's (EM's) development as a specialty has spanned the last 25 years, with the first certifying examination administered by the American Board of Emergency Medicine in 1980. National census data project... more
Emergency medicine's (EM's) development as a specialty has spanned the last 25 years, with the first certifying examination administered by the American Board of Emergency Medicine in 1980. National census data project that the new millennium will bring a U.S. population that will be 40% minority. In the year 2000, the U.S. population had a projected minority population of 28%. The diversity of the patients we treat demonstrates the need for EM programs to diversify their faculty and residency staff. Strategies include expanding recruitment and supporting retention of underrepresented students, faculty, and trainees, addressing barriers that may exist for promotion of underrepresented women and minorities, mentoring underrepresented minority (URM) faculty in research and education, providing opportunities for URMs to advance in the field, and mentoring URMs at the junior high and high school levels in the sciences to expand the applicant pool in the field. The authors describe an academic EM program that is a model program for diversity within our specialty.
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Emergency medicine's (EM's) development as a specialty has spanned the last 25 years, with the first certifying examination administered by the American Board of Emergency Medicine in 1980. National census data project... more
Emergency medicine's (EM's) development as a specialty has spanned the last 25 years, with the first certifying examination administered by the American Board of Emergency Medicine in 1980. National census data project that the new millennium will bring a U.S. population that will be 40% minority. In the year 2000, the U.S. population had a projected minority population of 28%. The diversity of the patients we treat demonstrates the need for EM programs to diversify their faculty and residency staff. Strategies include expanding recruitment and supporting retention of underrepresented students, faculty, and trainees, addressing barriers that may exist for promotion of underrepresented women and minorities, mentoring underrepresented minority (URM) faculty in research and education, providing opportunities for URMs to advance in the field, and mentoring URMs at the junior high and high school levels in the sciences to expand the applicant pool in the field. The authors describe an academic EM program that is a model program for diversity within our specialty.
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Introduction: Although national guidelines have been published for the management of critically injured traumatic cardiopulmonary arrest (TCPA) patients, many hospital systems have not implemented in-hospital triage guidelines. The... more
Introduction: Although national guidelines have been published for the management of critically injured traumatic cardiopulmonary arrest (TCPA) patients, many hospital systems have not implemented in-hospital triage guidelines. The objective of this study was to determine if hospital resources could be preserved by implementation of an in-hospital tiered triage system for patients in TCPA with prolonged resuscitation who would likely be declared dead on arrival (DOA).Method: We conducted a retrospective analysis of 4,618 severely injured patients, admitted to our Level I trauma center from December 2000 to December 2008 for evaluation. All of the identified patients had sustained life-threatening penetrating and blunt injuries with pre-hospital TCPA. Patients who received cardiopulmonary resuscitation (CPR) for 10 minutes were assessed for survival rate, neurologic outcome, and charge-for-activation (COA) for our hospital trauma system.Results: We evaluated 4,618 charts, which consi...
Research Interests: Psychology and Medicine
institutions and using them for learner-driven educational activities. One such opportunity exists for departments that have a summer hiatus in their grand rounds (GR) schedules. What was tried? In 2010, faculty staff collaborated with... more
institutions and using them for learner-driven educational activities. One such opportunity exists for departments that have a summer hiatus in their grand rounds (GR) schedules. What was tried? In 2010, faculty staff collaborated with trainees to develop a 6-week resident grand rounds (RGR) series. The RGR series takes place in the summer at the same time each week and in the same physical space as the department’s GR series. The goal of the series is to allow residents to identify topics of interest that may be under-represented in the central curriculum and are unlikely to be incorporated within the traditional GR schedule. The series is organised by the chief residents for medical education, with oversight by the associate programme director. The senior residents are responsible for all aspects of the series, including the soliciting of feedback from other residents about desired topics and speakers, the issuing of invitations, and scheduling, advertising and so on. What lessons were learned? The RGR series was surprisingly simple to implement. Using the time already protected for GR ensured that there were few conflicts. We also benefited from a sense of institutional inertia: residents and faculty staff were already accustomed to attending educational activities in this slot and were pleased to continue to do so. The series has also been remarkably effective. Residents have recruited an extraordinary array of speakers representing a diverse range of topics. Qualitative feedback from both residents and faculty members has been resoundingly positive and attendance excellent. The most significant obstacles we faced related to financing. The series was initially conducted without any budget. This limited us to local speakers, resident-led sessions, and those guests willing to come out of their own goodwill. Nonetheless, even when the sessions themselves were well received, participants complained about the lack of typical GR amenities (including snacks and video-recordings). We therefore lobbied the department chair for support and he graciously provided resources sufficient to cover these expenses plus a small amount for travel and accommodation for out-of-state speakers. We imagine that budgetary concerns may be a limiting – although not necessarily prohibitive – factor for smaller institutions. To the best of our knowledge, this is the first instance of a trainee-organised and implemented GR series. We believe this is a creative and effective approach to involving learners in meeting their own self-identified educational gaps and also to enhancing the diversity of educational opportunities.
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The Research to Practice column presents an analysis of current and controversial research findings with implications for practice change relevant to emergency care settings. This review critiques Johnson et al.'s (2016)... more
The Research to Practice column presents an analysis of current and controversial research findings with implications for practice change relevant to emergency care settings. This review critiques Johnson et al.'s (2016) investigation, titled “The Impact of Cognitive Stressors in the Emergency Department on Physician Implicit Racial Bias,” that examined emergency department characteristics and stressors and their effects on physician racial bias and decision making. Their findings suggest that unconscious biases can affect clinical decisions when providers experience increased cognitive stress. The implications are significant for emergency providers as resources are especially strained during the COVID-19 pandemic and as the adverse effects of unconscious bias on health disparities and patient outcomes have become clearly apparent. Implicit bias training (IBT) is recommended for emergency providers and has significant implications for medical and nurse educators in executing and evaluating IBT outcomes.
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According to the National Center for Educational Statistics, underrepresented minorities (URMs) are more likely to leave science, technology, engineering and mathematics (STEM) fields at higher rates than their peers during undergraduate... more
According to the National Center for Educational Statistics, underrepresented minorities (URMs) are more likely to leave science, technology, engineering and mathematics (STEM) fields at higher rates than their peers during undergraduate studies. Many institutions of higher learning have implemented pipeline programs aimed at preparing and inspiring high school and college aged students in select careers in health sciences with varying levels of success. Research has shown that a health care workforce that mirrors the community they serve is more effective in reducing health disparities and increasing positive health outcomes. We hypothesize that a hospital-based, multidisciplinary youth mentoring and medical exposure program will enhance the decision of URM high school students to choose healthcare careers. A retrospective analysis of the Reach One Each One Program (ROEO) was performed. ROEO is a hospital based, 11-week multidisciplinary youth mentoring and medical exposure program...
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Physician burnout has received considerable attention in the literature and impacts a large number of emergency medicine physicians, but there is no standardized curriculum for wellness in resident education. A culture change is needed to... more
Physician burnout has received considerable attention in the literature and impacts a large number of emergency medicine physicians, but there is no standardized curriculum for wellness in resident education. A culture change is needed to educate about wellness, adopt a preventative and proactive approach, and focus on resiliency. We describe a novel approach to wellness education by focusing on resiliency rather than the unintended endpoint of physician burnout. One barrier to adoption of wellness education has been establishing legitimacy among emergency medicine (EM) residents and educators. We discuss a change in the language of wellness education and provide several specific topics to facilitate the incorporation of these topics in resident education. Wellness education and a culture of training that promotes well-being will benefit EM residents. Demonstrating the impact of several factors that positively affect emergency physicians may help to facilitate alert residents to the importance of practicing activities that will result in wellness. A change in culture and focus on resiliency is needed to adequately address and optimize physician self-care.
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Compartment syndrome of the foot is a rare but life- and limb-threatening condition that is often difficult to diagnose. The common signs and symptoms of compartment syndrome are pain out of proportion to the injury, pain with passive... more
Compartment syndrome of the foot is a rare but life- and limb-threatening condition that is often difficult to diagnose. The common signs and symptoms of compartment syndrome are pain out of proportion to the injury, pain with passive stretch of the compartment, paresis, paresthesias, and often, intact pulses. Foot compartment syndrome is often caused by traumatic injuries, and the clinical presentation may be confusing in this setting. The foot contains nine compartments, which should all be assessed for elevated compartment pressures. Definitive management is fasciotomy. Prompt recognition, diagnosis, and treatment are essential to prevent devastating complications. This article discusses the key components of presentation, diagnosis, and management of foot compartment syndrome. A patient presented to the Emergency Department (ED) with a crush injury of his foot. He had significant swelling and pain in his foot, but no fractures were identified on X-ray study. Given the severity of his injury and pain, foot compartment pressures were measured to accurately diagnose foot compartment syndrome. The patient underwent fasciotomies of the foot within 3 h of presentation to the ED and suffered no sequelae at the time of follow-up in clinic. Foot compartment syndrome is a surgical emergency that can be difficult to diagnose. Early diagnosis with compartment pressure measurements is crucial, as definitive management with fasciotomies can prevent long-term sequelae.
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Background: Although injuries affect all populations, certain groups children under age five, older adults, racial and ethnic minority populations, and people of low socioeconomic status are more vulnerable to its effects. Methods: The... more
Background: Although injuries affect all populations, certain groups children under age five, older adults, racial and ethnic minority populations, and people of low socioeconomic status are more vulnerable to its effects. Methods: The Emory Center for Injury Control (ECIC) established a consortium that includes leaders from nine public and private universities, including historically black colleges, several community-based organizations and two state agencies to reduce the burden of injury among highly vulnerable populations. ECIC's diverse faculty hold leadership positions within the ECIC Core, chair and serve on committees that guide the ECIC's mission and activities, and provide scientific input and content expertise in their respective disciplines. In order to demonstrate the true impact of this approach, the ECIC has developed a comprehensive evaluation plan that includes both process and outcome measures. Results/Outcomes: Examples of successful interdisciplinary acti...