Journal of education & teaching in emergency medicine最新文献

{"title":"A Cold Case: Myxedema Coma.","authors":"Andrew M Namespetra, Matthew J Petruso, Andrew M Bazakis","doi":"10.21980/J8VM0J","DOIUrl":"10.21980/J8VM0J","url":null,"abstract":"<p><strong>Audience: </strong>This case was designed and developed to train emergency medicine residents through high-fidelity simulation and experiential learning in the management of a hemodynamically unstable patient presenting with myxedema coma.</p><p><strong>Introduction: </strong>Myxedema coma refers to decompensated hypothyroidism manifesting as altered mental status and multisystem organ dysfunction. Myxedema coma is a life-threatening endocrine emergency that requires prompt recognition and treatment. Mortality associated with this condition is high, approaching 30% with optimized treatment, and nearly 100% if untreated.1 Whilst myxedema coma is a cannot-miss diagnosis, it is a relatively uncommon presentation to the emergency department (ED); incidence of myxedema coma is as low as 1.08 per million people per year.2 The clinical triad of myxedema coma is altered mental status, hypothermia and the presence of a precipitating factor.3 Typically, the patient will be over age 60 years, female, and with clinical features associated with hypothyroidism including dry skin, coarse hair, non-pitting edema.4 Myxedema coma has a temporal association with most cases occurring in the winter months.5 Despite knowledge of the disease process, recognition can be challenging, thus delaying treatment. Therefore, clinicians must have a high degree of suspicion to make the diagnosis in the ED. These characteristics of infrequency and lethality suggest medical simulation as an ideal medium to educate learners on recognition, diagnosis and management of myxedema coma in the ED in a realistic and safe setting.</p><p><strong>Educational objectives: </strong>The primary educational goals are to elicit the differential diagnoses for a patient with altered mental status, order an appropriate workup, and initiate life-saving interventions for a patient with decompensated hypothyroidism. At the conclusion of the simulation, the learner is expected to: 1) Recognize the key features on history and examination of a patient presenting in myxedema coma and initiate the appropriate workup and treatment, 2) Describe clinical features and management for a patient with myxedema coma, 3) Develop a differential diagnosis for a critically ill patient with altered mental status, 4) Discuss the management of myxedema coma in the ED, including treatments, appropriate consultation, and disposition.</p><p><strong>Educational methods: </strong>This case was delivered as a high-fidelity simulation employing a computerized manikin as the patient, and a confederate actor in the role of the registered nurse (RN). A post-scenario debriefing session was facilitated by the instructor as a four-step formative process described by Rudolph, <i>et al.</i>6 Other aspects of the debriefing included discussion about the pathophysiology, presentation, management, and disposition of patients with myxedema coma.</p><p><strong>Research methods: </strong>Learners were asked to submit anonymous feedba","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"S1-S42"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Advantage of Using Video Laryngoscope in Puncture and Incisional Drainage of Peritonsillar Abscess: A Case Report.","authors":"Daisuke Goto, Jin Takahashi, Hiraku Funakoshi","doi":"10.21980/J8G935","DOIUrl":"10.21980/J8G935","url":null,"abstract":"<p><p>This case report demonstrates the use of a video laryngoscope to aid in the incision and drainage of a peritonsillar abscess in a 30-year-old male. This technique, which has not been widely discussed in the literature, provided enhanced visualization, overcoming challenges like poor access due to trismus and poor lighting. The video laryngoscope improved safety, offered clearer guidance, and provided valuable teaching opportunities, particularly for less experienced physicians and residents. This case contributes to the literature by illustrating how the video laryngoscope can function as both a therapeutic tool and an educational resource, improving the management of peritonsillar abscesses and potentially reducing complications.</p><p><strong>Topics: </strong>Peritonsillar abscess, peritonsillar aspiration, peritonsillar incision, video laryngoscope.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"V22-V24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drowning Complicated by Hypothermia.","authors":"Alexander Close, Jennifer Yee","doi":"10.21980/J8QS7P","DOIUrl":"10.21980/J8QS7P","url":null,"abstract":"<p><strong>Audience: </strong>This scenario was developed to educate emergency medicine residents on the diagnosis and management of two concurrent conditions: drowning and hypothermia.</p><p><strong>Introduction: </strong>Patients who present after drowning may have delayed respiratory compromise without immediate radiographic pathological findings, highlighting the need for continued observation. The presentation and management of patients with hypothermia depends on multiple factors, including core temperature. Emergency physicians should be aware of hypothermia's underlying pathophysiology, associated dysrhythmias, and different warming methods.</p><p><strong>Educational objectives: </strong>At the conclusion of the simulation session, learners will be able to:Obtain a relevant focused history, including circumstances of drowning and/or cold exposure.Outline different clinical presentations of hypothermia, loosely correlated with core temperature readings.Discuss management of hypothermia, including passive external rewarming, active external rewarming, active internal rewarming, and extracorporeal blood rewarming.Discuss pathophysiology of drowning.Identify appropriate disposition of patients who present after drowning.Identify appropriate disposition of hypothermic patients.</p><p><strong>Educational methods: </strong>This session was conducted using high-fidelity simulation, followed by a debriefing session and discussion about the diagnosis, differential, and management of both drowning and hypothermia. Debriefing methods may be left to the discretion of participants, but the authors have utilized advocacy-inquiry techniques. In this technique, the facilitators describe something they observed in the case, outline their reasoning as a facilitator why this observation was important or why they had questions, and then ask the learners to share their frame of reference at the time. An example: \"I heard someone say that both chest tubes should be placed on the left, but then another resident said 'I disagree.' No one paused to come to a consensus. I'm wondering why this wasn't explored further in real time. Tell me more.\" This scenario may also be run as a structured interview case.</p><p><strong>Research methods: </strong>Our residents were provided a survey at the completion of the debriefing session so they might rate different aspects of the simulation, as well as provide qualitative feedback on the scenario. The local institution's simulation center's electronic feedback form is based on the Center of Medical Simulation's Debriefing Assessment for Simulation in Healthcare (DASH) Student Version Short Form1 with the inclusion of required qualitative feedback if an element was scored less than a 6 or 7.</p><p><strong>Results: </strong>Seventeen learners filled out a feedback form. This session received a majority of 6 and 7 scores (consistently effective/very good, and extremely effective/outstanding, respectively) other than four 5 scores","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"S43-S74"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Simulation Anywhere and Anytime: Simulation in a Backpack.","authors":"Janice Shin-Kim, Adam Blumenberg","doi":"10.21980/J8Z94W","DOIUrl":"10.21980/J8Z94W","url":null,"abstract":"<p><strong>Audience: </strong><i>Simulation in a Backpack</i> is designed to offer immersive simulation experiences to medical professionals, including emergency medicine and pediatrics residents, medical students, pharmacists, and pharmacy students. It particularly targets those in environments where traditional simulation equipment is not readily accessible.</p><p><strong>Introduction: </strong>Simulation education plays a crucial role in emergency medicine training, offering hands-on experiences in managing critical resuscitations. <i>Simulation in a Backpack</i> was developed to provide portable and quickly set-up simulation sessions, offering a solution for environments lacking simulation laboratories.</p><p><strong>Educational objectives: </strong>By the end of this simulation experience learners will be able to:Recognize and manage emergencies through immersive simulation experiences with an inflatable manikin and pre-programmed free software system.Demonstrate knowledge and skills to resuscitate patients with medical emergencies.Enhance confidence and competence in responding to medical emergencies using portable, low-tech resources.Foster interdisciplinary collaboration and effective communication during scenarios.</p><p><strong>Educational methods: </strong><i>Simulation in a Backpack</i> utilizes an inflatable manikin and free simulation software, Med Sim Studio, with easy portability and speedy setup, facilitating hands-on learning in realistic scenarios and optional electronic modulators to augment fidelity. The curriculum employs experiential learning theory, engaging learners in reflective experiences and practical application.</p><p><strong>Research methods: </strong>The efficacy of <i>Simulation a Backpack</i> was evaluated through learner (resident physicians, medical students, pharmacists) feedback. The Net Promoter Score (NPS) and focused qualitative analysis of written feedback were used to assess satisfaction and learning experiences.</p><p><strong>Results: </strong>Out of 191 learners, <i>Simulation in a Backpack</i> received a commendable NPS of +81.33, indicating high satisfaction. Focused qualitative analysis showed positive feedback, with learners valuing the educational experience despite the low-fidelity of the manikin.</p><p><strong>Discussion: </strong><i>Simulation in a Backpack</i> effectively provided meaningful educational experiences, as evidenced by high NPS and positive written feedback. Modifications were made based on practical experience and learner feedback, emphasizing efficient and immersive experiences and managing expectations regarding fidelity.This innovation addresses the growing need for portable simulation solutions, offering a cost-effective and flexible approach to simulation in medical training.</p><p><strong>Topics: </strong>Portable simulation, innovative simulation, interdisciplinary collaboration.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"I1-I9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acetaminophen Toxicity.","authors":"Rachel Whittaker, Navneet Cheema","doi":"10.21980/J8435R","DOIUrl":"10.21980/J8435R","url":null,"abstract":"<p><strong>Audience: </strong>This is a practice structured interview case which is appropriate for emergency medicine residents at all levels of training.</p><p><strong>Introduction: </strong>Acetaminophen (APAP) is an over-the-counter medication commonly used by adult and pediatric populations. While acetaminophen has demonstrated to be reasonably safe and well-tolerated at therapeutic doses, it can cause severe hepatic toxicity if taken in excess. Acetaminophen toxicity is the most common cause of acute hepatic failure in the United States, accounting for approximately 50 percent of all reported cases and 20 percent of liver transplants.1 In 2021, poison control received more than 80,000 cases involving acetaminophen-containing products, and acetaminophen toxicity is responsible for 56,000 - 75,000 emergency department visits annually.2,3 Acetaminophen toxicity is compounded by introduction of acetaminophen combination products, with unintentional and chronic overdose accounting for over 50 percent of cases of acetaminophen-related acute hepatic failure in the United States and United Kingdom.4 Given the prevalence of acetaminophen toxicity and oftentimes vague presentation of symptoms, it is imperative that emergency medicine physicians promptly identify and manage acetaminophen toxicity.</p><p><strong>Educational objectives: </strong>At the end of this practice oral board session, examinees will be able to: 1) demonstrate an ability to obtain a complete medical history in an oral boards structured interview format, 2) review appropriate laboratory tests and imaging to evaluate abdominal pain, 3) investigate a broad differential diagnosis for right upper quadrant abdominal pain, 4) recognize chronic acetaminophen toxicity, 5) initiate the appropriate treatment for chronic acetaminophen toxicity, 6) demonstrate effective communication with the patient, consultants, and the admitting team.</p><p><strong>Educational methods: </strong>This is a structured interview case intended to evaluate learner thought processes throughout the evaluation, workup, and diagnosis of a patient with acetaminophen toxicity.</p><p><strong>Research methods: </strong>The practice structured interview case was developed and then tested in a small group environment with emergency medicine residents at different levels of training. After the case was completed, learners and instructors were given the opportunity to assess its strengths and weaknesses by providing electronic feedback during a residency conference. The format of oral boards' assessing the strengths and weaknesses of a case was mimicked through having one instructor to one to two residents per case administration. Subsequent modifications were made to remove ambiguity based on the feedback provided.</p><p><strong>Results: </strong>This case was administered as part of our residency oral boards didactics series. Thirty-one EM residents PGY1-PGY3 were administered in the case. Ten learners completed an evalua","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"SI1-SI19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed Tomography Findings in Non-Obstetric Vulvar Hematoma: A Case Report.","authors":"Eleanor M Birch, Theodore McClean, Scott Szymanski","doi":"10.21980/J8194H","DOIUrl":"10.21980/J8194H","url":null,"abstract":"<p><p>Non-obstetric vulvar hematoma is a rare but clinically important diagnosis in the emergency department for which there is no consensus on optimal diagnosis or management. We present a case of non-obstetric vulvar hematoma that occurred after minimal trauma in a young, otherwise healthy woman who presented with labial swelling after consensual digital penetration, initially managed conservatively but ultimately requiring surgical drainage. Although a rare presentation in the emergency department, prompt identification, diagnosis, and management of vulvar hematoma is crucial to appropriately treat complications including pain, hemodynamically significant hemorrhage, urinary obstruction, and soft tissue necrosis.</p><p><strong>Topics: </strong>Vulvar hematoma, pelvic trauma, women's health, CT (computed tomography) angiography.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 4","pages":"V6-V9"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Whodunit Gamified Flipped Classroom For High Yield Bite Injuries And Envenomation.","authors":"Mary G McGoldrick, Laryssa Patti, Meigra Chin, Tiffany Murano","doi":"10.21980/J88S81","DOIUrl":"10.21980/J88S81","url":null,"abstract":"<p><strong>Audience: </strong>Clerkship-level medical students, sub-interns, junior and senior residents, attending physicians.</p><p><strong>Introduction: </strong>Bite injuries and envenomation are core content found in the model of the clinical practice of emergency medicine.1 However, depending on the geographic location of training or clinical practice, physicians may or may not be exposed to these pathologies. For example, a qualitative analysis conducted in 2022 discovered a significant range in emergency medicine (EM) physician perception of snake antivenom use and level of comfort, noting that experiences with its use ranged from hundreds of cases treated to purely didactic understanding.2 Such discrepancies necessitate supplemental education and activities to bridge the knowledge gap. Ideally, these activities would utilize tenets of experiential learning to allow learner processing comparable to that of clinical experience.3 Flipped classroom and audience participation promote engagement and active learning when compared to the passive learning of lectures.4 In that vein, there is a growing body of gamified resources in medical education which utilize pattern recognition and problem solving skills that can be analogous to clinical practice.5,6.</p><p><strong>Educational objectives: </strong>By the end of this activity, learners will be able to: 1) identify and name species responsible for bite/sting/envenomation injuries, 2) recognize associated signs, symptoms, physical exam findings and complications associated with bites/stings/envenomations by certain species, 3) discuss management such as antibiotics, antivenom, and supportive care.</p><p><strong>Educational methods: </strong>We designed a small group activity asking residents to identify, research, and present the \"culprits\" implicated in environmental exposures to animals and insects, and match them to corresponding clinical scenarios.</p><p><strong>Research methods: </strong>Participants anonymously answered electronic multiple-choice quizzes before and after completing the activity to gauge its effectiveness in conveying the material. They also completed an additional anonymous, electronic survey regarding their attitudes towards this activity and the possibility of other gamified didactics within the curriculum.</p><p><strong>Results: </strong>Each resident class showed an upward trend in their average multiple-choice score, the greatest of which was seen in the post-graduate year (PGY) 1 class. The residency demonstrated a statistically significant improvement in their ability to answer multiple choice questions (MCQs), with an average pre-activity score of 67.14%, and post-activity score of 87.14%. Participants showed determination and enthusiasm to engage with the material when presented in a gamified format, and 100% of post-activity survey respondents wanted to participate in further gamified activities.</p><p><strong>Discussion: </strong>Gamified small group activities ","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 4","pages":"SG13-SG23"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Going in Blind: A Common Scenario in an Uncommon Situation.","authors":"Ethan Hartman, Kimberly Sokol","doi":"10.21980/J8RS8C","DOIUrl":"10.21980/J8RS8C","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;Medical students, interns, junior resident physicians, senior resident physicians.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Power outages have been increasing in frequency in the past few years, therefore becoming an increased threat to healthcare delivery.1 While most studies related to the effects of power outages are focused on outpatient care, such as acute exacerbations of chronic lung conditions and the lack of chargeable equipment, with the increasing number of power outages, hospitals must be prepared for this situation as well.2,3 Although agencies such as the Federal Emergency Management Agency (FEMA) and the US Department of Health and Human Services (HHS) have provided guidelines for the response of hospitals to temporary loss of power,12,13 hospitals generally rely on institutional policies in response to the event of a power outage. Given the relative rarity but increasing frequency of power outages in hospital settings, this medical simulation was created to present a common occurrence in the emergency department (eg, cardiac arrest) in an uncommon setting of a power outage. Simulation has been shown to improve learner self-efficacy, confidence, and leadership skills among resuscitation teams.4,5 The role of simulation also helps learners identify latent safety threats, in this case a power outage.6 The goal of this simulation is to improve the skills of healthcare professionals with regards to managing cardiac arrest and to encourage these practitioners to consider their own hospital guidelines in response to a power outage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this simulation, learners will be able to (1) evaluate and treat a patient experiencing myocardial infarction and subsequent cardiac arrest during a power outage, (2) describe the local protocols for managing patient care during a power outage, (3) demonstrate the ability to coordinate a medical team during a simulated power outage in an emergency department with limited resources, (4) manage a cardiac arrest patient by following Advanced Cardiac Life Support (ACLS) protocols for bradycardia and ventricular fibrillation, and (5) justify the urgency of transfer to a certified ST segment elevation myocardial infarction center/cardiac intensive care unit, referencing the recommended 120-minute door-to-balloon time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;This simulation was conducted with a high-fidelity mannequin. A total of six residents of various post-graduate year (PGY) levels participated in the simulated patient encounter as part of the simulation competition at the Western Regional meeting of the Society for Academic Emergency Medicine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;This case was assessed for educational content and piloted by emergency medicine attendings from several institutions prior to running the case for the Western Regional meeting. The efficacy of the content was assessed by oral feedback.&lt;/p&gt;&lt;p&gt;&lt;s","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 4","pages":"S50-S72"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Painful Visual Loss - Managing Orbital Compartment Syndrome in the Emergency Department.","authors":"Jessica Pelletier, Alexander Croft, Michael Pajor, Matthew Santos, Douglas Char, Marc Mendelsohn, Ernesto Romo","doi":"10.21980/J8N35D","DOIUrl":"10.21980/J8N35D","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;Emergency medicine (EM) residents. This simulation curriculum may also be utilized for senior medical students conducting EM rotations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Ophthalmologic education represents only a small portion of medical school curriculums and continues to decrease over time, leaving physicians poorly equipped to diagnose and manage eye complaints.1 Of emergency physicians (EPs) surveyed, 72.5% felt that they could diagnose orbital compartment syndrome (OCS), yet only 40.3% felt comfortable performing a necessary lateral canthotomy and cantholysis (LCC).2 These survey results demonstrate the urgent need for improved ophthalmology education in EM residency to help us diagnose and manage potentially vision-threatening pathology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this simulation, learners will be able to: 1) demonstrate the major components and a systematic approach to the emergency ophthalmologic examination, 2) develop a differential diagnosis of sight-threatening etiologies that could cause eye pain or vision loss, 3) demonstrate proficiency in performing potentially vision-saving procedures within the scope of EM practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;Low-fidelity simulation was conducted using a novel model adapted from that used by Phillips et al. during their ophthalmology day in the Department of Emergency Medicine at Vanderbilt University.3 The simulation case was developed by an interdepartmental team of ophthalmologists and EPs at our institution.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research objectives: &lt;/strong&gt;To evaluate for statistically significant changes in self-efficacy, knowledge, and performance after an educational intervention. Our primary outcome was defined as a checklist-based performance on a simulated case of orbital compartment syndrome necessitating LCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;We conducted a single-center prospective pre- and post-interventional study evaluating the impact of an educational intervention on EM resident management of a simulated case of OCS. Our two-part study intervention consisted of a lecture on OCS followed by a four and a half hour ophthalmology education day (OED). Residents were evaluated using self-efficacy scales (SES), multiple-choice questions (MCQ), and a performance checklist (developed via a modified Delphi process) at three timepoints: Pre-intervention, immediate post-intervention, and three months post-intervention. Post-graduate year (PGY)-1 through PGY-4 EM residents at an Urban Level 1 Trauma Center participated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Initial recruitment consisted of 18 residents (PGY-1 through PGY-4), and 16 residents (PGY-1 through PGY-3) completed the study. Nine residents participated in the OED and seven residents did not. There were no pre-existing differences in median checklist-based performance, MCQ, or SES scores prior to the intervention. At three months post-OED, the OED attendees","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 4","pages":"S1-S50"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Simulation and Small-Group Pediatric Emergency Medicine Course for Generalist Healthcare Providers: Gastrointestinal and Nutrition Emergencies.","authors":"Adeola Adekunbi Kosoko, Alicia E Genisca, Nicholas A Peoples, Connor Tompkins, Ryan Sorensen, Joy Mackey","doi":"10.21980/J8WH2K","DOIUrl":"10.21980/J8WH2K","url":null,"abstract":"<p><strong>Audience and type of curriculum: </strong>This is a review curriculum utilizing multiple methods of education to enhance the skills of generalist healthcare providers in low- and middle-income countries (LMICs) in the identification and stabilization of pediatric respiratory emergencies. Our audience of implementation was Belizean generalist providers (nurses and physicians).</p><p><strong>Length of curriculum: </strong>8-10 hours.</p><p><strong>Introduction: </strong>Early recognition and stabilization of critical pediatric patients can improve outcomes. Compared with resource-rich systems, many low-resource settings (i.e., LMICs) rely on generalists to provide most pediatric acute care. We created a curriculum for general practitioners comprising multiple educational modules focused on identifying and stabilizing pediatric emergencies. Our aim was to develop an educational framework to update and teach generalists on the recommendations and techniques of optimally evaluating and managing pediatric nutritional and gastrointestinal emergencies: bowel obstructions, gastroenteritis, and malnutrition.</p><p><strong>Educational goals: </strong>The aim of this curriculum is to increase learners' proficiency in identifying and stabilizing acutely ill pediatric patients with gastrointestinal medical or surgical disease or complications of malnutrition. This module focuses on the diagnosis and management of gastroenteritis, acute bowel obstruction, and deficiencies of feeding and nutrition. The target audience for this curriculum is generalist physicians and nurses in limited-resource settings.</p><p><strong>Educational methods: </strong>The educational strategies used in this curriculum include didactic lectures, medical simulation, and small-group sessions.</p><p><strong>Research methods: </strong>We evaluated written pretests before and posttests after intervention and retested participants four months later to evaluate for knowledge retention. Participants provided qualitative feedback on the module.</p><p><strong>Results: </strong>We taught 21 providers. Eleven providers completed the pretest/posttest and eight completed the retest. The mean test scores improved from 8.3 ± 1.7 in the pretest to 12.2 ± 2.6 in the posttest (mean difference: 1.4, <i>P</i>=0.027). The mean test score at pretest was 8.3 ± 2.3, which increased to 10.8 ± 3.0 at retest (mean difference: 2.5, <i>P</i>=0.060). Seven (71.4%) and four (28.5%) participants found the course \"extremely useful\" and \"very useful,\" respectively (n=11).</p><p><strong>Discussion: </strong>This curriculum may be an effective and welcome training tool for Belizean generalist providers. There was a statistically significant improvement in the test performance but not in retesting, possibly due to our small sample size and high attrition rate. Evaluation of other modules in this curriculum, application of this curriculum in other locations, and measuring clinical practice interventions will be i","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"9 4","pages":"C1-C120"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}