scholarly journals P015: Staff skills: a procedural skills curriculum for emergency medicine attending physicians in Calgary

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S62-S62
Author(s):  
A.F. Chad ◽  
L. Baker ◽  
A. Johnston ◽  
I.M. Wishart
Keyword(s):  
Emergency Medicine ◽  
Chest Tube ◽  
Surgical Skills ◽  
Emergency Department Physician ◽  
Ultrasound Guided ◽  
Skills Laboratory ◽  
Surgical Airway ◽  
Support Fund ◽  
Pacemaker Insertion ◽  
Attending Physicians

Introduction: Emergency medicine attending physicians perform many essential procedures but some infrequently. Skill proficiency and familiarity declines over time. We intended to identify skills where colleagues felt deficient and create an opportunity to demonstrate and practice in a safe environment. Methods: Sessions began from a review of ultrasound guided central line and pacemaker insertion. Other procedures have been added as a result of critical incidents, needs assessments by attending physicians, acquisition of new technology/equipment and expert consensus. An evaluation and needs assessment is performed after each session to adjust curricula. Results: Since 2011, we have held 2-3 skill sessions per year at the Advanced Trauma Surgical Skills Laboratory at the University of Calgary. Sessions are taught by attending emergency physicians, employ task trainers, simulators, animal and human cadaveric models, ultrasound, and procedural equipment stocked in our local hospitals. We are able to accommodate ~30 participants per session for 3 hours of rotating 7-8 participants through various stations. Every session has been fully attended with a wait list. Physicians register by email with preference given to new participants and those identified during clinical practice review of requiring remediation. Costs of sessions are covered by voluntary contribution to an emergency department physician support fund. Procedures practiced have included airway (basic, adjuncts, bronchoscopy, video laryngoscopy, surgical airway, chest tube), vascular access (ultrasound guided central venous insertion, transvenous pacemaker insertion, nerve blocks, IO insertion), surgical skills (thoracotomy, chest tube, canthotomy, surgical airway) and other percutaneous procedures (paracentesis, thoracentesis, nerve block, lumbar puncture). High fidelity skills videos were created to augment the sessions, available on the department website. Four point scale evaluations from our most recent session yielded 100% excellent rating for overall workshop and relevance to practice. The 6 facilitators performance received 100% excellent or good ratings. Conclusion: We have developed a fun, nonthreatening opportunity for attending physicians to practice infrequent but important ED procedures. The sessions are well received, well attended, foster collegiality, confidence and competence in performance of infrequent ED skills. Our model could be generalized to other centres.

scholarly journals Establishing a surgical skills laboratory and dissection curriculum for neurosurgical residency training

2015 ◽  
Vol 123 (5) ◽  
pp. 1331-1338 ◽  
Author(s):  
James K. C. Liu ◽  
Varun R. Kshettry ◽  
Pablo F. Recinos ◽  
Kambiz Kamian ◽  
Richard P. Schlenk ◽  
...  
Keyword(s):  
Surgical Training ◽  
Training Programs ◽  
Core Competencies ◽  
Technical Skills ◽  
Surgical Skills ◽  
Training Experience ◽  
Surgical Trainees ◽  
Modern Health Care ◽  
External Pressures ◽  
Skills Laboratory

Surgical education has been forced to evolve from the principles of its initial inception, in part due to external pressures brought about through changes in modern health care. Despite these pressures that can limit the surgical training experience, training programs are being held to higher standards of education to demonstrate and document trainee competency through core competencies and milestones. One of the methods used to augment the surgical training experience and to demonstrate trainee proficiency in technical skills is through a surgical skills laboratory. The authors have established a surgical skills laboratory by acquiring equipment and funding from nondepartmental resources, through institutional and private educational grants, along with product donations from industry. A separate educational curriculum for junior- and senior-level residents was devised and incorporated into the neurosurgical residency curriculum. The initial dissection curriculum focused on cranial approaches, with spine and peripheral nerve approaches added in subsequent years. The dissections were scheduled to maximize the use of cadaveric specimens, experimenting with techniques to best preserve the tissue for repeated uses. A survey of residents who participated in at least 1 year of the curriculum indicated that participation in the surgical skills laboratory translated into improved understanding of anatomical relationships and the development of technical skills that can be applied in the operating room. In addition to supplementing the technical training of surgical residents, a surgical skills laboratory with a dissection curriculum may be able to help provide uniformity of education across different neurosurgical training programs, as well as provide a tool to assess the progression of skills in surgical trainees.

scholarly journals An Ultrasound-Guided Regional Anesthesia Elective for Emergency Medicine Residents

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Ryan Tucker ◽  
Robert Huang ◽  
William Peterson ◽  
Brendan Munzer ◽  
Molly Thiessen
Keyword(s):  
Emergency Medicine ◽  
Regional Anesthesia ◽  
Ultrasound Guided

scholarly journals 268 A Simulation-Based Mastery Learning Ultrasound Guided IV Insertion Curriculum for Emergency Medicine Trainees

2018 ◽  
Vol 72 (4) ◽  
pp. S106 ◽  
Author(s):  
A.E. Amick ◽  
P. Trinquero ◽  
E. Davis ◽  
A. Moore ◽  
V. Gappmaier ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Mastery Learning ◽  
Ultrasound Guided ◽  
Simulation Based

scholarly journals Benzodiazepine resistant alcohol withdrawal: What is the clinician's preferred definition?

CJEM ◽  
2019 ◽  
Vol 22 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Hugo Langlois ◽  
Monique Cormier ◽  
Eric Villeneuve ◽  
Robert S. Hoffman ◽  
Cristina Longo ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Alcohol Withdrawal ◽  
Future Research ◽  
Full Time ◽  
Consensus Guidelines ◽  
Median Dose ◽  
Cross Sectional ◽  
Web Based ◽  
Definition Of ◽  
Attending Physicians

ABSTRACTObjectivesAlthough alcohol withdrawal is common, the recognition of benzodiazepine-resistant alcohol withdrawal is a relatively new concept. To provide a framework for both literature review and future research, we assessed clinicians’ personal definition of resistant alcohol withdrawal.MethodWe developed a cross-sectional web-based survey. Administrators from collaborating toxicology and emergency medicine associations deployed the survey directly to their respective memberships. Only physicians, pharmacists, and other clinicians routinely treating alcohol withdrawal were eligible to participate. Respondents selected their preferred definition among the three most common author sources – JB Hack, NJ Benedict, D Hughes – or provided their own. Additional criteria to define resistant alcohol withdrawal were explored.Results384 individuals answered the survey. Respondents were mostly attending physicians (79%), in full-time practice (90%), in emergency medicine (70%), and from North America (90%). The majority (64%) described resistant alcohol withdrawal as a high benzodiazepine dosage. Seizures (26%) and persistent tachycardia (16%) were also main characteristics. The median dose to describe high benzodiazepine dose (n = 146) was 40 mg per hour of diazepam equivalents (IQR 20–50). Available definitions were ranked equally as the preferred one: Hack (27%); Benedict (28%); Hughes (28%).ConclusionOur results did not identify one single preferred definition for resistant alcohol withdrawal even though a high total dose of benzodiazepine is a major component. Hourly requirements of 40 mg of diazepam equivalents or more emerged as a possible threshold. These findings serve as a base to explore consensus guidelines or future research.

scholarly journals Use and Effectiveness of the Cadaver-Lab in Orthopaedic and Traumatology Education: An Italian Survey

Joints ◽  
2017 ◽  
Vol 05 (04) ◽  
pp. 197-201 ◽  
Author(s):  
Michele Losco ◽  
Filippo Familiari ◽  
Francesco Giron ◽  
Rocco Papalia
Keyword(s):  
Skills Training ◽  
Surgical Anatomy ◽  
Surgical Skills ◽  
Surgical Instruments ◽  
Survey Study ◽  
Level Of Evidence ◽  
Surgical Skills Training ◽  
Upper Limb Surgery ◽  
Skills Laboratory ◽  
Lower Limb Surgery

Purpose The purpose of this study is to provide basic information on the availability and current use of cadaver laboratories in the education of orthopaedic residents and trainees and to determine the interest for the implementation of this type of training. Methods All Orthopaedic residents and trainees who attended a cadaver laboratory organized by SIGASCOT (Italian Society of the Knee, Arthroscopy, Sports Traumatology, Cartilage and Orthopaedic Technology) between 2013 and 2016 were asked to complete a survey on the availability and current use of cadaver laboratories in the education of Orthopaedic residents and trainees. The survey was sent via e-mail to 102 Orthopaedic residents and trainees. All data were analyzed and all responses are presented as counts, percentages, or means. Results Thirty-eight (37.2%) Orthopaedics and traumatology residents and trainees completed the survey and were included in this analysis. Eighteen trainees (18/38; 44.3%) attended a cadaver laboratory focused on lower limb surgery, whereas 20 (20/38; 52.7%) on upper limb surgery. Twenty participants (55.7%) perceived skills laboratory sessions as extremely beneficial to the understanding and becoming familiar with the normal surgical anatomy; moreover, 16 (45.7%) participants considered the cadaver laboratory extremely beneficial to the understanding of a specific surgical technique and very beneficial (44.4%) to become confident with arthroscopic or other specific surgical instruments. Over 60% of participants perceived cadaver laboratory to be very to extremely beneficial to increase confidence and speed in the operating room (OR), and more than a half of them considered skills laboratory sessions to be extremely beneficial to increase participation and decrease the occurrence of damages in the real surgical activity. Conclusion Orthopaedic residents and trainees found the addition of a cadaver laboratory for teaching surgical skills a significant benefit to both their overall education and surgical skills training. Level of Evidence Level IV, survey study.

scholarly journals Training the trainers: a survey of simulation fellowship graduates

2017 ◽  
Vol 8 (3) ◽  
pp. e81-89 ◽  
Author(s):  
Patrick Hughes ◽  
Jose Cepeda Brito ◽  
Rami Ahmed
Keyword(s):  
Emergency Medicine ◽  
North America ◽  
Research Design ◽  
Multiple Choice ◽  
Medical Simulation ◽  
Multiple Choice Questions ◽  
Web Based ◽  
One Year ◽  
Attending Physicians ◽  
Standardized Curriculum

Background: Coupled with the expansion of simulation has been the development and growth of medical simulation fellowships. These non-accredited fellowships do not have a standardized curriculum and there are currently no studies investigating the simulation fellowship experience. The purpose of this study was to explore the simulation fellowship experience of graduates throughout North America and how it prepared them for their post-fellowship career.Methods: A web-based survey was developed by Emergency Medicine attending physicians both of whom completed one-year fellowships in medical simulation. Prior to distribution, the survey was reviewed and tested by three simulation fellowship graduates and a PhD researcher. Feedback was integrated into the survey prior to distribution. The survey consisted of a maximum of 29 multiple choice questions including two step-logic questions and two open response questions. The survey was distributed to simulation fellowship directors in multiple disciplines and the directors were asked to forward the survey to graduates. Additionally, the Society for Academic Emergency Medicine Simulation Academy list-serve was utilized for distribution of the survey.Results: The survey had 35 responses. The majority of respondents completed fellowship within the last two years (66%, 23/35). Fellowship graduates strongly agreed or agreed that their fellowship adequately prepared them for their post-fellowship simulation career (88%). Graduates report that research design/reporting (53%) and administration (18%) were areas of their fellowship curriculum that needed the most improvement.Conclusion: The majority of simulation fellowship graduates agreed that their fellowship experience adequately prepared them for their post-fellowship simulation career. Graduates also felt that training in research and administration are areas that could be improved.

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