scholarly journals Realism of procedural task trainers in a pediatric emergency medicine procedures course

2015 ◽  
Vol 6 (1) ◽  
pp. e68-e73
Author(s):  
Allan Shefrin ◽  
Afshin Khazei ◽  
Adam Cheng
Keyword(s):  
Emergency Medicine ◽  
Chest Tube ◽  
Central Line ◽  
Pediatric Emergency ◽  
Chest Drain ◽  
Pediatric Emergency Medicine ◽  
Training Models ◽  
Central Line Insertion ◽  
Line Insertion ◽  
Procedural Task

Background: Pediatric emergency medicine (PEM) physicians have minimal experience in life saving procedures and have turned to task trainers to learn these skills. Realism of these models is an important consideration that has received little study.Method: PEM physicians and trainees participated in a day long procedural training course that utilized commercially available and homemade task trainers to teach pericardiocentesis, chest tube insertion, cricothyroidotomy and central line insertion. Participants rated the realism of the task trainers as part of a post-course survey.Results: The homemade task trainers received variable realism ratings, with 91% of participants rating the pork rib chest tube model as realistic, 82% rating the gelatin pericardiocentesis mold as realistic and 36% rating the ventilator tubing cricothyroidotomy model as realistic. Commercial trainers also received variable ratings, with 45% rating the chest drain and pericardiocentesis simulator as realistic, 74% rating the crichotracheotomy trainer as realistic and 80% rating the central line insertion trainer as realistic.Conclusions: Task training models utilized in our course received variable realism ratings. When deciding what type of task trainer to use future courses should carefully consider the desired aspect of realism, and how it aligns with the procedural skill, balanced with cost considerations.

scholarly journals MP09: Critical care skills training day for emergency medicine residents: A curriculum in evolution

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S45
Author(s):  
J. Riggs ◽  
S. Gray ◽  
M. McGowan ◽  
A. Petrosoniak
Keyword(s):  
Emergency Medicine ◽  
Critical Care ◽  
Deliberate Practice ◽  
Skills Training ◽  
Central Line ◽  
Free Text ◽  
Fibre Optic ◽  
Training Models ◽  
Central Line Insertion ◽  
Line Insertion

Introduction: Emergency medicine (EM) residents are expected become proficient in a number of rarely performed, high risk procedures. We developed Critical Care Skills Training Day for senior FRCP and CCFP EM residents at a single university program to fill a gap in resident confidence with these procedures. The day applies principles of deliberate practice with focused feedback using simulation-based training for several rarely performed procedures including thoracotomy, fibre-optic intubation, pericardiocentesis, resuscitative hysterotomy and central line insertion. The objectives of this work was to improve the residents’ scores of self-perceived comfort independently performing these procedures by completion of the training day. Methods: Clinician educators, residency program directors and simulation specialists designed and taught the curriculum. We used pre- and post-training day surveys blending Likert, multiple choice and free text comments to measure comfort performing each procedure, overall satisfaction and usefulness of this training. Descriptive statistics were used to analyze results. Pre-post differences were assessed using paired sample T-tests. Comments and themes from course evaluations were used to make yearly iterative changes. Results: A total of 95 residents completed the curriculum between 2016-2018. 89 completed evaluations (93%). Residents reported significant (p < 0.05) improvement in comfort independently performing fibre optic intubation, thoracotomy and central line insertion. The day was rated very highly, 9.4/10 (SD, 0.72), over 3 years. Feedback was positive with participants identifying opportunities for repeated practice, feedback from instructors and practical tips to improve performance as valuable aspects. Iterative changes were made yearly in response to resident feedback including introduction of new procedures, incorporating skills into sim-based cases, and different training models for skill training. Conclusion: Critical Care Skills Training Day for EM residents was created using the principle of deliberate practice to fill a perceived gap in resident training. Residents who completed the annual curriculum showed a marked increase in comfort independently performing several of the procedures. Ongoing challenges include the length of the day, economies of scale, and training models available for the rare procedures. Future directions include the integration of longitudinal objective performance evaluations to align with the competency by design curriculum.

Practical procedures

2019 ◽  
pp. 783-862
Author(s):  
Punit S. Ramrakha ◽  
Kevin P. Moore ◽  
Amir H. Sam
Keyword(s):  
Liver Biopsy ◽  
Cardiac Pacing ◽  
Central Line ◽  
Positive Pressure ◽  
Chest Drain ◽  
Central Line Insertion ◽  
Vein Cannulation ◽  
Line Insertion ◽  
Dc Cardioversion ◽  
Intra Aortic Balloon Counterpulsation

This chapter discusses practical procedures in acute medicine, including arterial blood sampling, arterial line insertion, central line insertion, internal jugular vein cannulation, subclavian vein cannulation, ultrasound (US)-guided central venous catheterization, pulmonary artery catheterization, temporary cardiac pacing (ventricular pacing, atrial pacing, complications), pericardial aspiration, DC cardioversion, intra-aortic balloon counterpulsation, principles of respiratory support, mechanical ventilation, nasal ventilation, positive pressure ventilation, percutaneous cricothyrotomy, endotracheal intubation, aspiration of a pneumothorax, aspiration of a pleural effusion, insertion of a chest drain, ascitic tap (paracentesis), total paracentesis, insertion of a Sengstaken–Blakemore tube, percutaneous liver biopsy, transjugular liver biopsy, transjugular intrahepatic portosystemic shunt (TIPS), peritoneal dialysis, intermittent haemodialysis, plasmapheresis, renal biopsy, pH determination, joint aspiration, lumbar puncture, and needle-stick injuries.

YouTube to Teach Central Lines, The Expert vs Learner Perspective

2021 ◽  
pp. 088506662199997
Author(s):  
Daniel King ◽  
Danielle Davison ◽  
Ivy Benjenk ◽  
Eric Heinz ◽  
Khashayar Vaziri ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Subgroup Analysis ◽  
Gold Standard ◽  
Central Line ◽  
Medical Procedures ◽  
Central Line Insertion ◽  
Line Insertion ◽  
Care Surgery ◽  
Better Than

Purpose: Instructional videos of medical procedures can be a useful guide for learners, demonstrating proper and safe technique. Open publishing sites such as YouTube are readily accessible, however the content is not peer reviewed and quality of videos vary greatly. Our aim was to evaluate a learner’s ability to interpret the quality of openly published content by comparing their rating of the most popular central line insertion videos on YouTube to expert evaluations. Method: YouTube search results for “central line placement” sorted by views or relevance compiled a list of the four most common videos. A fifth gold standard video, published by the New England Journal, was included, however was not found in the top results. Eleven expert practitioners from varying medical specialties (Critical Care, Surgery, Anesthesia, & Emergency Medicine) evaluated the 5 videos, utilizing a 22-item Likert scaled questionnaire emphasizing: preparation, sterility, anatomy, technique, & complications. Videos were compared as a composite average of the individual items on the survey. The highest, lowest, and 3rd ranked videos were evaluated by 45 residents (“learners”) in varying specialties (Internal Medicine, Emergency Medicine, Surgery, Anesthesia) and post graduate year (PGY). Learners assessed the videos using the same scale. A Welch T-test assessed statistical significance between the two groups. Subgroup analysis compared experts against different PGY and specialty cohorts. Results: The lowest scored video among the experts and learners was the most popular on YouTube, with 858,933 views at the time of inclusion. Though lowest in rank, this video was judged higher by learners than the experts (2.63/5 vs 2.18/5, P = 0.0029). The 3rd ranked video by experts with 249,746 views on YouTube, was also rated higher by learners (3.77/5 vs 3.45/5, P = 0.0084). The gold standard video by NEJM had 320,580 views and was rated highest by both the experts and learners (4.37/5 vs 4.28/5, P = 0.518). Subgroup analysis showed similar results with learners rating the videos overall better than experts, this was particularly true in the PGY-1 subgroup. Conclusion: The most popular central line insertion video was the worst rated by both experts and learners. Learners rated all the videos better than the expert. YouTube videos demonstrating medical procedures including central line insertion should come from peer reviewed sources if they are to be incorporated into educational curriculum.

Milestones Comparisons from Residency to Pediatric Emergency Medicine Fellowship: Resetting Expectations

2021 ◽  
Author(s):  
Tien T. Vu ◽  
Jerri A. Rose ◽  
Veronika Shabanova ◽  
Maybelle Kou ◽  
Noel S. Zuckerbraun ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Pediatric Emergency ◽  
Pediatric Emergency Medicine

Pediatric Emergency Medicine Fellows’ Milestone Evaluations: Do they all meet the targets for graduation?

2021 ◽  
Author(s):  
Cindy G. Roskind ◽  
Kathryn Leonard ◽  
Aline Baghdassarian ◽  
Maybelle Kou ◽  
Kelly Levasseur ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Pediatric Emergency ◽  
Pediatric Emergency Medicine

Essentials of Pediatric Emergency Medicine Fellowship

2016 ◽  
Vol 32 (10) ◽  
pp. 726-730 ◽  
Author(s):  
In K. Kim ◽  
Noel Zuckerbraun ◽  
Maybelle Kou ◽  
Tien Vu ◽  
Kelly Levasseur ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Pediatric Emergency ◽  
Pediatric Emergency Medicine

scholarly journals Pediatric Emergency Medicine Training

1995 ◽  
Vol 2 (7) ◽  
pp. 665-665 ◽  
Author(s):  
R. W. Schafermeyer ◽  
Stephen Ludwig
Keyword(s):  
Emergency Medicine ◽  
Pediatric Emergency ◽  
Pediatric Emergency Medicine
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