Abstract
To the Editor:
We thank Dr Hill for his letter to the editor 1 regarding our recent publication, “A National Survey of Wilderness Medicine Curricula in the United States Emergency Medicine Residencies” 2 and appreciate the opportunity to comment.
Indeed, a study evaluating wilderness medicine (WM) education was published in 2015, 3 3 y prior to our data collection. We reference that paper here not to draw it into any critique, but as a foundation for our work. Although the 2015 study does not specify the timing of actual data collection, the listing of 187 residencies used was based on a Society for Academic Emergency Medicine directory accessed in March of 2014. In the interim, emergency medicine residency program numbers grew by almost 30%. We believe this rapid growth in residencies, rather than a specific timeframe, should be the indicator for reappraisal.
Although we too would have preferred a higher response rate, our response rate of 57% is comparable to that of the 2015 paper (56%). No analysis of nonresponding programs was given in that study, so we cannot compare these points. Similarly, neither paper specifically defined WM educational content, and the model of the clinical practice of emergency medicine has not changed significantly between the 2013 and 2016 versions.4,5 Although indeed “every program should be teaching WM to a degree,” 1 both papers reported that programs indicated that they did not teach any WM, so the interpretation of the terminology by respondents may have been similarly limited. As such, although our approaches did differ, we believe that our paper can be viewed as complementary to the 2015 study.
Lastly, we concur in our paper that categorizing programs by geography could have yielded additional insights, and we encourage the inclusion of these data in future studies.
We appreciate Dr Hill’s statement that our study poses “more questions than answers” as an opportunity for further inquiry and look forward to contributing to the effort to cement excellent WM education in our residencies on a national level.