Procedural Skills Training in Emergency Medicine Physicians Within the Edmonton Zone: A Needs Assessment

Schonnop, Rebecca; Stauffer, Brandy; Gauri, Aliyah; Ha, D.

doi:10.1002/aet2.10495

Cited by 4 publications

(5 citation statements)

References 31 publications

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“…11 Although it is unknown how many thoracenteses a physician should perform to be competent, studies have shown a positive association between the number of thoracenteses performed and the perceived competence, actual competence, and the complication rate. 1,[12][13][14] Importantly, it may be very difficult to achieve thoracentesis competencies using ad hoc bedside supervision without formalized training when the number of consultants being competent to perform thoracentesis is limited. Therefore, it is likely that a substantial amount of the Danish physicians in emergency medicine specialist training will have difficulties obtaining thoracentesis competencies given the current training efforts.…”

Section: Discussionmentioning

confidence: 99%

Lack of Thoracentesis Competencies and Training in Danish Emergency Departments: A Danish Nationwide Study

Langsted¹,

Lauridsen²,

Weile³

et al. 2022

OAEM

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Background Dyspnea caused by pleural effusion is a common reason for admission to the emergency department (ED). In such cases, thoracentesis performed in the ED may allow for swift symptom relief, diagnostics, and early patient discharge. However, the competence level of thoracentesis and training in the ED are currently unclear. This study aimed to describe the current competencies and training in thoracentesis in Danish EDs. Methods We performed a nationwide cross-sectional study in Denmark. A questionnaire was distributed to all EDs in March 2022 including questions on competencies and thoracentesis training methods. Descriptive statistics were used. Results In total, 21 EDs replied (response rate 100%) between March and May 2022. Overall, 50% of consultant and 77% of physicians in emergency medicine specialist training were unable to perform thoracentesis independently. Only 2 of 21 EDs (10%) had a formalized training program. In these 2 EDs, there were no requirements of maintaining these competences. Informal training was reported by 14 out 21 (66%) EDs and consisted of ad-hoc bedside procedural demonstration and/or guidance. Among the 19 EDs without formalized training, 9 (47%) had no intention of establishing a formalized training program. Conclusion We found a major lack of thoracentesis competencies in Danish EDs among both consultant and physicians in emergency medicine specialist training. Moreover, the vast majority of EDs had no formalized thoracentesis training program.

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Section: Discussionmentioning

confidence: 99%

Lack of Thoracentesis Competencies and Training in Danish Emergency Departments: A Danish Nationwide Study

Langsted¹,

Lauridsen²,

Weile³

et al. 2022

OAEM

View full text Add to dashboard Cite

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“…Very few studies have looked at the level of training, and/or frequency or quantity of performed procedures by the operator with procedural complications completed in the emergency room. One such study, conducted in Canada, surveyed Emergency Medicine physicians about procedural skills competency and found that confidence levels increased when more procedures were performed [ 11 ]. Further research is indicated to determine the best structure to utilize to maintain the procedural skills of veteran emergency medicine physicians, and how this system would be structured.…”

Section: Discussionmentioning

confidence: 99%

Procedural Competency in Academic Emergency Medicine Attending Physicians: How Is Competency Maintained and Evaluated by Academic Institutions in the US?

Bell

Fischer

Sinatro

2021

Cureus

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IntroductionThere have been numerous studies examining the minimum graduation requirements for resident training of procedural skills within Emergency Medicine programs; however, how academic medical centers in the United States maintain Emergency Medicine attending procedural skill competency has not been explored. ObjectivesThe aim of this study was to examine the processes in place to evaluate and track the procedural skills practices of Emergency Medicine attending physicians at academic institutions in the US. MethodsAn exploratory cross-sectional survey was sent to all 39 ACGME-accredited Emergency Medicine programs in the US through a REDCap survey in 2020. Survey items inquired about the current methods in place to maintain competence on 13 procedural skills performed by Emergency Medicine providers. ResultsThe survey response rate was 26.9%. The majority of programs did not have a process in place to evaluate procedural skills at the time of initial appointment (74.3%), and almost half of participating programs reported no formalized process during employment (51.3%). Institutions reported no minimum required number for the following procedures: dislocation reduction, intraosseous placement, lateral canthotomy, lumbar puncture, paracentesis, pericardiocentesis, thoracentesis, transvenous cardiac pacing, and tube thoracostomy. For central venous access, cricothyrotomy, endotracheal intubation, and procedural sedation, 25.6% or less of institutions had minimum annual requirements. ConclusionThis study summarized the current methods in place to assess Emergency Medicine attending procedural skills at US academic institutions and demonstrated that the majority of programs lack a formalized method to assess attending procedural competency. Further research is needed to determine the value and benefit of different methods available for procedural skill competency assessment. It is believed that preventing procedural skill decay in attending physicians by a standardized process has the potential to improve patient outcomes, reduce costs and complication rates, and improve physician self-esteem, well-being, and confidence.

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“…3 Furthermore, there is correlation between frequency of skill performance and perceived confidence at performing the skill. 4 While some EM education and training needs could be met through structured online video conferencing, procedural skills training was identified as a significant challenge. We sought to fill this gap by designing and conducting a real-time procedure-based hands-on workshop, facilitated remotely by a team of instructors, with the goal of giving the trainees an added opportunity to practice suturing under supervision of field experts.…”

Section: Objec Tive Of Innovationmentioning

confidence: 99%

“…Procedural skills, such as suturing, are an essential component of EM training 3 . Furthermore, there is correlation between frequency of skill performance and perceived confidence at performing the skill 4 . While some EM education and training needs could be met through structured online video conferencing, procedural skills training was identified as a significant challenge.…”

Section: Objective Of Innovationmentioning

confidence: 99%

Sustaining capacity building and practical skills training during the COVID‐19 pandemic: Lessons from India

Owens

Ahluwalia

Douglass

et al. 2022

AEM Education and Training

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Background:The scale and duration of the COVID-19 pandemic posed a threat to provide the required support needed by emergency medicine (EM) trainees in India participating in the masters in EM program, a global partnership between the Ronald Reagan Institute for Emergency Medicine at the George Washington University and 14 institutions in India. While some of this support has been filled by remote education through thrice-weekly online video conferencing and webinars, the gap in procedural teaching posed a different challenge. Methods:We developed a two-part innovation to teach suture skills, a required procedure for EM trainees. The innovation consisted of a hands-on procedure lab with the opportunity for live feedback followed by an independent competitive skill demonstration. Trainees were notified in advance of materials needed for the procedure lab to encourage attendance and participation.Results: A total of 160 trainees attended the virtual suture skills lab; 74 trainees (46% of attendees) submitted feedback back of whom 94% were able to practice skills in real time. Written feedback was overwhelmingly positive and included requests to implement this method for other procedural skills. Twenty-one residents participated in the Innovative Suture Challenge, with the top three submissions receiving accolades in the following grand rounds-style session. Conclusions:The combination of virtual teaching with the opportunity for real-time feedback and an integrated project to independently showcase skills learned is a way to continue procedural skills teaching in a remote environment. The aim of this innovation was to test the feasibility, acceptability, and level of engagement of conducting virtual, live supervised suturing remotely across multiple geographical locations. Our next step would be to gather pre and post data to measure the impact. Additionally, we believe this provides a proof-of-concept model to further explore sustainable, cost-effective, and scalable models for remote procedure-based teaching.

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Procedural Skills Training in Emergency Medicine Physicians Within the Edmonton Zone: A Needs Assessment

Cited by 4 publications

References 31 publications

Lack of Thoracentesis Competencies and Training in Danish Emergency Departments: A Danish Nationwide Study

Lack of Thoracentesis Competencies and Training in Danish Emergency Departments: A Danish Nationwide Study

Procedural Competency in Academic Emergency Medicine Attending Physicians: How Is Competency Maintained and Evaluated by Academic Institutions in the US?

Sustaining capacity building and practical skills training during the COVID‐19 pandemic: Lessons from India

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