P033: Procedural skills training in emergency medicine physicians within the Edmonton zone: a needs assessment

Introduction: Procedural skills are a key component of an emergency physician's practice. The Edmonton Zone is a health region that comprises twelve tertiary, urban community and rural community emergency departments (EDs) and represents over three hundred emergency physicians. This study describes the current attitudes toward procedural skill competency, current procedural skill practices, and the role for educational skills training sessions among emergency medicine physicians within a geographical health region. Methods: Multicenter descriptive cross-sectional survey of all emergency medicine physicians working at 12 emergency departments within the Edmonton Zone in 2019 (n = 274). The survey underwent several phases of systematic review; including item generation and reduction, pilot testing, and clinical sensibility testing. Survey items addressed current procedural skill performance frequency, perceived importance and confidence, current methods to maintain competence, barriers and facilitating factors to participation in a curriculum, preferred teaching methods, and desired frequency of practice for each procedural skill. Results: Survey response rate was 53.6%. Variability in frequency of performed procedures was apparent across the type of hospital sites. For majority of skills, there was a significantly positive correlation between the frequency at which a skill was performed and the perceived confidence performing said skill. There was inconsistency and no significant correlation with perceived importance, perceived confidence, or frequency performing a given skill and the desired frequency of training for that skill. Course availability (76.2%) and time (72.8%) are the most common identified barriers to participation in procedural skills training. Conclusion: This study summarized the current emergency department procedural skill practices and attitudes toward procedural skill competency and an educational curriculum among emergency medicine physicians in Edmonton. This represents a step towards targeted continuing professional development in the growing realm of competency-based medical education.

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P117: Procedural skills training in emergency medicine physicians within the Edmonton zone: a needs assessment

CJEM ◽

10.1017/cem.2019.308 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S106

Author(s):

R. Schonnop ◽

B. Stauffer ◽

A. Gauri ◽

D. Ha

Keyword(s):

Emergency Medicine ◽

Needs Assessment ◽

Rural Community ◽

Tendon Repair ◽

Extensor Tendon ◽

Skills Training ◽

Ultrasound Guided ◽

Procedural Skills ◽

Central Lines ◽

Health Region

Introduction: Procedural skills are a key component of an emergency physician's practice. The Edmonton Zone is a health region that comprises eleven tertiary, urban community and rural community emergency departments (EDs) that represents over three hundred emergency physicians. We report the initial stakeholder and site leadership needs assessment used to inform the development of a comprehensive continuing professional development (CPD) procedural skills curriculum for the Edmonton Zone. Methods: A list of procedural skills was distributed to the two Edmonton Zone Clinical Department Heads of Emergency Medicine (EM). This list was based on a previous Canadian study that utilized procedures from the Objectives of Training in EM. Based on perceived needs, twenty-five procedures were chosen by consensus from zone leadership and study authors as the initial focus for a skills curriculum. This list was sent via survey to the physician site leads of all EDs in the zone. Each site lead was asked to indicate the fifteen procedure curriculum they felt would most benefit their respective physician groups. Responses were collated to look at all departments as a group and stratified by the type of ED (tertiary, urban and rural community). Results: Every site chief of Edmonton Zone EDs completed the survey (100% response rate). Cricothyrotomy and pediatric intubation were the two procedures prioritized by every site. One procedure (ultrasound guided central lines) was prioritized by 10/11 sites while three procedures (ultrasound guided central lines, adult intubation and chest tube insertion) were specified by 9/11 sites as needs. Two procedures (pericardiocentesis and thoracotomy) were named as priorities only by tertiary centers. Conversely, three procedures (extensor tendon repair, anterior and posterior nasal packing) were highlighted by all rural sites, but not consistently by any urban sites. Conclusion: Over the next few years, competency-based CPD will emerge for physicians in practice. Our preliminary needs assessment showed that while a common zone-wide curriculum will be possible, targeted curricula tailored to the unique needs of the various types of EDs will also be necessary. This has implications for the resources and teaching requirements needed to deliver effective and recurring CPD courses to an entire health region. A targeted needs assessment to all Edmonton Zone physicians will be the next step to verify and further elaborate on these preliminary results.

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Needs Assessment of Emergency Department Residents in Examining and Managing Patients with Ophthalmologic Complaints

Journal of Academic Ophthalmology ◽

10.1055/s-0039-1692194 ◽

2019 ◽

Vol 11 (01) ◽

pp. e50-e56

Author(s):

Kaidi Wang ◽

Sarah R. Williams ◽

Ian Chong ◽

Douglas R. Fredrick

Keyword(s):

Emergency Medicine ◽

Needs Assessment ◽

Tertiary Care ◽

Skills Training ◽

Educational Interventions ◽

Comfort Level ◽

Care Hospital ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Presenting Symptoms

Purpose Emergency medicine residents are trained to deal with a variety of emergency conditions; eye emergencies represent only a small portion of their clinical experience. This study was a targeted needs assessment of the comfort level of emergency medicine residents in diagnosing and managing patients who present with an ophthalmic chief complaint, with the goal of targeting future educational interventions. Methods This was a cross sectional survey conducted at a large tertiary-care hospital between June 2016 and August 2016. Participants were 1st, 2nd, or 3rd year emergency medicine residents in an Accreditation Council for Graduate Medical Education (ACGME)-approved emergency medicine residency. Results The total response rate was 67.4% (29/43). The majority of residents did not expect equivalent availability of ophthalmology consultation services post-graduation. They generally believed ophthalmology and examination skills to be important to their future career and became more comfortable with the slit lamp exam through residency, although the average level of comfort was only 6.9 on a 1 to 10 scale for 3rd year residents (standard deviation [SD] = 2.6). A majority of residents were not confident with their diagnostic, examination, or management skills when queried about specific ophthalmic conditions or presenting symptoms. They indicated a variety of reasons why their comfort with ophthalmologic patients was limited. Conclusion There is both need and desire for increased ophthalmic skills training for emergency medicine residents. Given time constraints in residency training, possible solutions will need to be innovative and multifaceted in order to target this goal.

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Portrait of rural emergency departments in Québec and utilization of the provincial emergency department management Guide: cross sectional survey

BMC Health Services Research ◽

10.1186/s12913-015-1242-0 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 4

Author(s):

Richard Fleet ◽

Julien Poitras ◽

Patrick Archambault ◽

Fatoumata Korika Tounkara ◽

Jean-Marc Chauny ◽

...

Keyword(s):

Emergency Department ◽

Emergency Departments ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Emergency Department Management ◽

Department Management

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Workplace violence against nurses in the emergency departments of three hospitals in Riyadh, Saudi Arabia: A cross-sectional survey

NursingPlus Open ◽

10.1016/j.npls.2016.09.001 ◽

2016 ◽

Vol 2 ◽

pp. 35-41 ◽

Cited By ~ 9

Author(s):

Asmaa Alyaemni ◽

Hana Alhudaithi

Keyword(s):

Saudi Arabia ◽

Workplace Violence ◽

Emergency Departments ◽

Cross Sectional Survey ◽

Cross Sectional

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Emergency medicine registrar training in Africa: overview of programmes, faculty and sustainability

Emergency Medicine Journal ◽

10.1136/emermed-2019-208668 ◽

2020 ◽

pp. emermed-2019-208668

Author(s):

Abena Obenewaa Akomeah ◽

Hendry Robert Sawe ◽

Juma A Mfinanga ◽

Michael S Runyon ◽

Erin Elizabeth Noste

Keyword(s):

Emergency Medicine ◽

Training Programme ◽

Descriptive Statistics ◽

African Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Career Options ◽

Survey Responses ◽

Collaborative Efforts ◽

Registrar Training

BackgroundThe specialty of emergency medicine (EM) is new in most African countries, where emergency medicine registrar (residency) programmes (EMRPs) are at different stages of evolution and little is known about the programmes. Identifying and describing these EMRPs will facilitate planning for sustainability, collaborative efforts and curriculum development for existing and future programmes. Our objective was to identify and provide an overview of existing EMRPs in Africa and their applicant requirements, faculty characteristics and plans for sustainability.MethodsWe conducted a descriptive cross-sectional survey of Africa’s EMRPs between January and December 2017, identifying programmes through an online search supplemented by discussions with African EM leaders. Leaders of all identified African EMRPs were invited to participate. Data were collected prospectively using a structured survey and are summarised with descriptive statistics.ResultsWe identified 15 programmes in 12 countries and received survey responses from 11 programmes in 10 countries. Eight of the responding EMRPs began in 2010 or later. Only 36% of the EMRPs offer a 3-year programme. Women make up an average of 33% of faculty. Only 40% of EMRPs require faculty to be EM specialists. In smaller samples that reported the relevant data, 67% (4/6) of EMRPs have EM specialists who trained in that EMRP programme making up more than half of their faculty; 57% of Africa’s 288 EMRP graduates to date are men; and an average of 39% of EMRP graduates stay on as faculty for 78% (7/9) of EMRPs.ConclusionEMRPs currently produce most of their own EM faculty. Almost equal proportions of men and women have graduated from a predominantly >3-year training programme. Graduates have a variety of opportunities in academia and private practice. Future assessments may wish to focus on the evolution of these programme’ curricula, faculty composition and graduates’ career options.

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Does facility type and location impact upon patient experiences in emergency departments? Secondary analysis of a state‐wide, cross‐sectional survey

Emergency Medicine Australasia ◽

10.1111/1742-6723.13466 ◽

2020 ◽

Vol 32 (4) ◽

pp. 562-569

Author(s):

Claudia Bull ◽

Julia Crilly ◽

Wendy Chaboyer ◽

David Spain ◽

Brendan Mulhern ◽

...

Keyword(s):

Emergency Departments ◽

Secondary Analysis ◽

Patient Experiences ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Wide Cross ◽

Facility Type

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P078: Handover education in Canadian adult and pediatric emergency medicine residencies: a national survey and needs assessment

CJEM ◽

10.1017/cem.2016.254 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S104-S105

Author(s):

P. Lee ◽

I. Rigby ◽

S.J. McPherson

Keyword(s):

Emergency Department ◽

Emergency Medicine ◽

Patient Care ◽

Pediatric Emergency ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Risk Period ◽

Hand Off ◽

Pediatric Inpatient ◽

Didactic Lecture

Introduction: Emergency department handover is a high-risk period for patient safety. A recent study showed a decreased rate of preventable adverse events and errors after implementation of a resident hand-off bundle on pediatric inpatient wards. In a 2013 survey by the Canadian Associations of Internes and Residents, only 11% of residents in any discipline stated they received a formal teaching session on handover. Recently, the CanMEDS 2015 Physician Competency Framework has added safe and skillful transfer of patient care as a new proficiency within the collaborator role. We hypothesize that significant variation exists in the current delivery and evaluation of handover education in Canadian EM residencies. Methods: We conducted a descriptive, cross-sectional survey of Canadian residents enrolled in the three main training streams of Emergency Medicine (FRCP CCFP-EM, PEM). The primary outcome was to determine which educational modalities are used to teach and assess handover proficiency. Secondarily, we described current sign-over practices and perceived competency at patient handover. Results: 130 residents completed the survey (73% FRCP, 19% CCFP-EM, 8% PEM). 6% of residents were aware of handover proficiency objectives within their curriculum, while 15% acknowledged formal evaluation in this area. 98% of respondents were taught handover by observation of staff or residents on shift, while 55% had direct teaching on the job. Less than 10% of respondents received formal sessions in didactic lecture, small group or simulation formats. Evaluation of handover skills occurred primarily by on shift observation (100% of respondents), while 3% of residents had received assessment through simulation. Local centre handover practices were variable; less than half of residents used mnemonic tools, written or electronic adjuncts. Conclusion: Canadian EM residents receive variable and sparse formal training and assessment on emergency department handover. The majority of training occurs by on shift observation and few trainees receive instruction on objective tools or explicit patient care standards. There exists potential for further development of standardized objectives, utilization of other educational modalities and formal assessments to better prepare residents to conduct safer patient handoffs.

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