Dr. Al'ai Alvarez FACEP FAAEM is a clinical assistant professor of Emergency Medicine (EM) and an assistant residency program director (APD) at the Stanford Emergency Medicine Residency Program. He is the APD for Residency Process Improvement (Quality and Clinical Operations), Recruitment (Diversity), and Well-being (Inclusion). He is the second year class APD, and the Austere Medicine and Population Health Line Director for the Stanford Emergency Medicine ACCEL Program (https://emed.stanford.edu/residency/ACCEL.html).
Dr. Alvarez serves as the co-chair of WellMD's Physician Wellness Forum and is one of the peer supporters for WellMD's Physician Resource Network (PRN) Support.
Dr. Alvarez works on recruitment efforts for faculty, graduate, and undergraduate medical education with a passion for increasing diversity and inclusion at Stanford University. He serves on various diversity and inclusion leadership roles within Stanford University including the EM Faculty Search Committee, steering committee member for the Leadership Education in Advancing Diversity (LEAD) at the Stanford School of Medicine, the EM director for the Stanford Clinical Opportunity for Residency Experience (SCORE) Program, and faculty for the Diversity Advisory Panel at the Stanford MD Admissions.
Nationally, Dr. Alvarez serves on committees on physician wellbeing and diversity and inclusion in medical education. He is the co-chair of the Council of EM Residency Directors (CORD) Wellness Leadership Mini-Fellowship, and also serves as a mentor at the Academic Life in Emergency Medicine (ALiEM) Faculty Incubator.
Dr. Alvarez has given numerous grand rounds as well as national and international conference lectures and workshops on relevant topics in gratitude and compassion, physician wellbeing, burnout, the imposter syndrome, as well as increasing leadership capacity and mentorship to enhance diversity and inclusion in medicine.
Dr. Alvarez is the recipient of the 2019 American College of Emergency Physician (ACEP) Diversity, Inclusion and Health Equity Distance and Impact Award. He is also the recipient of the 2020 Society for Academic Emergency Medicine (SAEM) Academy for Diversity and Inclusion in Emergency Medicine (ADIEM) Outstanding Academician Award. Dr. Alvarez has already received the 2020 CORD Academy for Scholarship in Education in Emergency Medicine Academy Member Award on Teaching and Evaluation.
- Emergency Medicine
- Physician Wellbeing
- Diversity and Inclusion
- Self Compassion
- Patient Safety and Quality Improvement
- Patient Experience and Clinical Operations
Clinical Assistant Professor, Emergency Medicine
Co-Chair, Stanford WellMD Physician Wellness Forum (2019 - Present)
Assistant Residency Program Director, Department of Emergency Medicine (2016 - Present)
Interim Assistant Clerkship Director, Department of Emergency Medicine (2017 - 2019)
Honors & Awards
Distance and Impact Award, Diversity, Inclusion & Health Equity Section. American College of Emergency Physicians (ACEP) (2019)
National Organizational/Institutional Award, Building Next Generation of Academic Physicians (BNGAP) (2020)
Outstanding Academician Award, Society for Academic EM (SAEM) -- Academy for Diversity & Inclusion in EM (ADIEM) (2020)
Scholarship in Education in Emergency Medicine Academy Member Award on Teaching and Evaluation, Council of Residency Director (CORD) (2020)
Boards, Advisory Committees, Professional Organizations
Diplomate, American Board of Emergency Medicine (2012 - Present)
Fellow, American College of Emergency Physicians (2016 - Present)
Fellow, American Academy of Emergency Medicine (2016 - Present)
Residency: Albert Einstein College of Medicine (2011) NY
Internship: Albert Einstein College of Medicine (2008) NY
Board Certification: American Board of Emergency Medicine, Emergency Medicine (2012)
Residency, Jacobi/Montefiore Residency Program at the Albert Einstein College of Medicine, Bronx, NY, Emergency Medicine (2011)
Medical Education: University at Buffalo School of Medicine (2007) NY
BS, SUNY at Buffalo (University at Buffalo, Biological Sciences (2002)
BS, SUNY at Buffalo (University at Buffalo), Biophysics (2002)
BA, SUNY at Buffalo (University at Buffalo), English (2002)
Community and International Work
Systems Improvement at District Hospitals and Regional Training of Emergency Care (sidHARTe) Program, Kintampo, Ghana
Mass Casualty training of staff
Opportunities for Student Involvement
Post 2010 Earthquake Relief, Port-au-prince, Haiti
Disaster Emergency Medicine in austere environments
MediShare, University of Miami
Opportunities for Student Involvement
The Impact of Due Process and Disruptions on Emergency Medicine Education in the United States.
The western journal of emergency medicine
INTRODUCTION: Academic Emergency Medicine (EM) departments are not immune to natural disasters, economic or political forces that disrupt a training program's operations and educational mission. Due process concerns are closely intertwined with the challenges that program disruption brings. Due process is a protection whereby an individual will not lose rights without access to a fair procedural process. Effects of natural disasters similarly create disruptions in the physical structure of training programs that at times have led to the displacement of faculty and trainees. Variation exists in the implementation of transitions amongst training sites across the country, and its impact on residency programs, faculty, residents and medical students.METHODS: We reviewed the available literature regarding due process in emergency medicine. We also reviewed recent examples of training programs that underwent disruptions. We used this data to create a set of best practices regarding the handling of disruptions and due process in academic EM.RESULTS: Despite recommendations from organized medicine, there is currently no standard to protect due process rights for faculty in emergency medicine training programs. Especially at times of disruption, the due process rights of the faculty become relevant, as the multiple parties involved in a transition work together to protect the best interests of the faculty, program, residents and students. Amongst training sites across the country, there exist variations in the scope and impact of due process on residency programs, faculty, residents and medical students.CONCLUSION: We report on the current climate of due process for training programs, individual faculty, residents and medical students that may be affected by disruptions in management. We outline recommendations that hospitals, training programs, institutions and academic societies can implement to enhance due process and ensure the educational mission of a residency program is given due consideration during times of transition.
View details for DOI 10.5811/westjem.2019.10.42800
View details for PubMedID 31999245
Emergency Medicine Gender in Resident Leadership Study (EM GIRLS): The Gender Distribution Among Chief Residents
AEM Education and Training
View details for DOI 10.1002/aet2.10436
Patient feedback in the emergency department: A feasibility study of the Resident Communication Assessment Program (ReCAP).
Journal of the American College of Emergency Physicians open
2020; 1 (6): 1194–98
Resident physicians must develop competence in interpersonal and communication skills, but workplace-based assessment of these skills remains challenging. We explored the feasibility of the Resident Communication Assessment Program (ReCAP) for eliciting patient feedback about resident physician communication in the emergency department (ED).This study is a prospective, observational study conducted in the ED of a university-based hospital from December 2018 through April 2019. ReCAP is a program that interviews patients prior to discharge from the ED using the Communication Assessment Tool (CAT). CAT consists of 14 Likert style questions and 3 open-ended questions for patient feedback about residents' communication. Open-text, narrative responses from patients were coded using a modified version of the Completed Clinical Evaluation Report Rating tool.We collected data from 42 subjects who completed the CAT, and provided 32 open-text, narrative responses about 20 resident physicians. Patient responses were overwhelmingly positive with 551/588 (94%) CAT responses scoring "Very Good," the highest category. Open-text, narrative comments analyzed using CCERR were unbalanced, favoring residents' strengths rather than areas for improvement. Patient comments offered more examples of strengths than weaknesses, and few subjects provided recommendations to improve resident performance.ReCAP represents a feasible method for eliciting patient feedback about resident communication skills in the ED. The CAT can be used to structure brief patient interviews by trained staff but generally elicits only positive feedback. Further studies are needed to identify more discriminatory assessment tools.
View details for DOI 10.1002/emp2.12272
View details for PubMedID 33392522
View details for PubMedCentralID PMC7771786
Physically Distant, Educationally Connected: Interactive Conferencing in the Era of COVID-19.
During the coronavirus outbreak, physical distancing restrictions led to the cancellation of live, large-group events worldwide. This included weekly educational conferences required of Emergency Medicine (EM) residency programs in the United States. Specifically, the Residency Review Committee in EM under the Accreditation Council for Graduate Medical Education has mandated that there be at least four hours per week of synchronous conference didactics.
View details for DOI 10.1111/medu.14192
View details for PubMedID 32324933
Mastery Learning Ensures Correct Personal Protective Equipment Use in Simulated Clinical Encounters of COVID-19.
The western journal of emergency medicine
2020; 21 (5): 1089–94
The correct use of personal protective equipment (PPE) limits transmission of serious communicable diseases to healthcare workers, which is critically important in the era of coronavirus disease 2019 (COVID-19). However, prior studies illustrated that healthcare workers frequently err during application and removal of PPE. The goal of this study was to determine whether a simulation-based, mastery learning intervention with deliberate practice improves correct use of PPE by physicians during a simulated clinical encounter with a COVID-19 patient.This was a pretest-posttest study performed in the emergency department at a large, academic tertiary care hospital between March 31-April 8, 2020. A total of 117 subjects participated, including 56 faculty members and 61 resident physicians. Prior to the intervention, all participants received institution-mandated education on PPE use via an online video and supplemental materials. Participants completed a pretest skills assessment using a 21-item checklist of steps to correctly don and doff PPE. Participants were expected to meet a minimum passing score (MPS) of 100%, determined by an expert panel using the Mastery Angoff and Patient Safety standard-setting techniques. Participants that met the MPS on pretest were exempt from the educational intervention. Testing occurred before and after an in-person demonstration of proper donning and doffing techniques and 20 minutes of deliberate practice. The primary outcome was a change in assessment scores of correct PPE use following our educational intervention. Secondary outcomes included differences in performance scores between faculty members and resident physicians, and differences in performance during donning vs doffing sequences.All participants had a mean pretest score of 73.1% (95% confidence interval [CI], 70.9-75.3%). Faculty member and resident pretest scores were similar (75.1% vs 71.3%, p = 0.082). Mean pretest doffing scores were lower than donning scores across all participants (65.8% vs 82.8%, p<0.001). Participant scores increased 26.9% (95% CI of the difference 24.7-29.1%, p<0.001) following our educational intervention resulting in all participants meeting the MPS of 100%.A mastery learning intervention with deliberate practice ensured the correct use of PPE by physician subjects in a simulated clinical encounter of a COVID-19 patient. Further study of translational outcomes is needed.
View details for DOI 10.5811/westjem.2020.6.48132
View details for PubMedID 32970559
Detection of Type B Aortic Dissection in the Emergency Department with Point-of-Care Ultrasound.
Clinical practice and cases in emergency medicine
2019; 3 (3): 202–7
Aortic dissection (AD) is a rare, time-sensitive, and potentially fatal condition that can present with subtle signs requiring timely diagnosis and intervention. Although definitive diagnosis is most accurately made through computed tomography angiography, this can be a time-consuming study and the patient may be unstable, thus preventing the study's completion. Chest radiography (CXR) signs of AD are classically taught yet have poor diagnostic reliability. Point-of-care ultrasound (POCUS) is increasingly used by emergency physicians for the rapid diagnosis of emergent conditions, with multiple case reports illustrating the sonographic signs of AD. We present a case of Stanford type B AD diagnosed by POCUS in the emergency department in a patient with vague symptoms, normal CXR, and without aorta dilation. A subsequent review of CXR versus sonographic signs of AD is described.
View details for DOI 10.5811/cpcem.2019.5.42928
View details for PubMedID 31404375
- ROUGH DAY? BE GRATEFUL. International Clinical Educators (ICE) blog. 2019
IDEA Series: A Low-fidelity Simulation Workshop for Teaching Cricothyroidotomy.
Academic Life in Emergency Medicine.
An Interactive Session to Help Faculty Manage Difficult Learner Behaviors in the Didactic Setting.
MedEdPORTAL : the journal of teaching and learning resources
2018; 14: 10774
The transition to more active learning during residency didactics has made the skill of managing difficult learner behaviors essential: Just one learner exhibiting difficult behavior can derail the educational experience for the room. Many educators feel uncomfortable handling these learners in real time and after the session.We created an interactive session for a mixed group of educators at a medical education boot camp. After learning about a framework for addressing difficult learner behaviors, participants were paired and presented with the case of a withdrawn learner. For each pair, the cause of the behavior was different. With one of the pair role-playing the learner, they were asked to identify the problem and solutions together. Multiple etiologies for the identical behavior reinforced the need to address underlying causes to create an effective plan for behavior change. Strategies to address difficult behaviors in real time were also discussed in large-group format.Participants gave the session a mean score of 4.5 out of 5, indicating a high likelihood of changing their teaching practice. Free-response comments remarked on the role-play's educational value and the enjoyability of the session overall.This session was effective in giving participants a framework for dealing with difficult learner behaviors, as well as hands-on practice with these skills. While this was a short (30-minute), single session, its success with participants with a wide variety of experience levels suggests it would be highly adaptable to other settings and may benefit from future expansion into the clinical setting.
View details for PubMedID 30800974
- Rough day? Be grateful. A talk on positive psychology in Emergency Medicine Stanford BeWell. 2018