Quantification of Procedures and Resuscitations in an Emergency Medicine Residency

Langdorf, Mark I.; Montague, Brian J.; Bearie, Brian; Sobel, Craig S

doi:10.1016/s0736-4679(97)00252-7

Cited by 36 publications

(34 citation statements)

References 14 publications

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“…13 Furthermore, the literature is limited regarding the procedural experience of EM residents. 14,15 The most comprehensive study to address procedural experience among EM residents evaluated procedural logging systems from 92 US residency programs. 16 More recently, the procedural experience of Canadian pediatric EM fellows has been published.…”

Section: Ré Sumémentioning

confidence: 99%

Emergency medicine procedural skills: what are residents missing?

Petrosoniak¹,

Herold²,

Woolfrey³

2013

CJEM

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Objective: This study sought to establish the current state of procedural skills training in Canadian Royal College emergency medicine (EM) residencies. Methods: A national Web-based survey was administered to residents and program directors of all 13 Canadian-accredited Royal College EM residency programs. Program directors rated the importance and experience required for competence of 45 EM procedural skills. EM residents reported their experience and comfort in performing the same procedural skills. Results: Thirteen program directors and 86 residents responded to the survey (response rate of 100% and 37%, respectively). Thirty-two (70%) procedures were considered important by . 70% of program directors, including all resuscitation and lifesaving airway procedures. Four procedures deemed important by program directors, including cricothyroidotomy, pericardiocentesis, posterior nasal pack for epistaxis, and paraphimosis reduction, had never been performed by the majority of senior residents. Program director opinion was used to categorize each procedure based on performance frequency to achieve competence. Overall, procedural experience correlated positively with comfort levels as indicated by residents. Conclusions: We established an updated needs assessment of procedural skills training for Canadian Royal College EM residency programs. This included program director opinion of important procedures and the performance frequency needed to achieve competence. However, we identified several important procedures that were never performed by most senior residents despite program director opinion regarding the experience needed for competence. Further study is required to better define objective measures for resident competence in procedural skills.

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Section: Ré Sumémentioning

confidence: 99%

Emergency medicine procedural skills: what are residents missing?

Petrosoniak¹,

Herold²,

Woolfrey³

2013

CJEM

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“…While several authors have reported computerized tracking of resident procedures, [2][3][4][5][6] this study represents the first compilation of EM resident procedure tracking using hand-held PDAs. Documentation via these devices offers several advantages over traditional procedural logbooks.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown procedural and resuscitation documentation capture rates of 27-84%. [6][7][8] While this study was not intended to address the issue of procedural capture, it has been our experience that those residents who are fastidious with manual documentation are generally better with computerized documentation as well. Those residents who are poorly compliant with documentation will continue to be so, regardless of the method offered to them.…”

Section: Discussionmentioning

confidence: 99%

Emergency Medicine Resident Patient Care Documentation Using a Hand‐held Computerized Device

Bird

Zarum

Renzi

2001

Academic Emergency Medicine

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Abstract. Objective: To determine whether emergency medicine (EM) resident documentation of procedures, patient encounters, and patient follow-ups improved after implementation of a personal digital assistant (PDA) hand-held recording system. Methods: All first-year EM residents were provided a PalmV (Palm, Inc., Santa Clara, CA) PDA. A customized patient procedure and encounter program was constructed using Pendragon Forms (Pendragon Software Corporation, Libertyville, IL) and loaded into each PDA. Residents were instructed to enter information on patients who had any of 21 procedures performed or were considered to be clinically unstable. These data were downloaded to the residency coordinator's desktop computer. The mean number of procedures, encounters, and follow-ups performed per resident were then compared with those of a group of 36 historical controls from the three previous first-year resident classes who recorded the same information using a handwritten card system. Data from the historical controls were combined and the means of each group were compared by Student's t-test. Results: Mean documentation of three procedures was significantly increased in the PDA group versus the index card system: conscious sedation 5.8 vs. 0.03 (p < 0.000005), thoracentesis 2.2 vs. 0.0 (p = 0.002), ultrasound 6.3 vs. 0.0 (p = 0.002). The mean numbers of pericardiocenteses and unstable pediatric surgical patient evaluations were significantly decreased in the hand-held group [from 1.2 to 0.4 (p = 0.03) and from 9.1 to 2.2 (p = 0.02), respectively]. Patient follow-up documentations were not statistically different between the two groups. Conclusions: Use of a hand-held PDA was associated with an increase in first-year EM resident documentation in three of 20 procedures and a decrease in one procedure and the number of unstable surgical pediatric patient resuscitations. The overall time savings in constructing a resident procedure database, as well as the other uses of the PDAs, may make transition to a hand-held computer-based procedure log an attractive option for EM residencies.

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“…[3][4][5] However, most residents fi nish training with inadequate knowledge and profi ciency with critical care skills. [5][6][7][8][9][10][11] Surveys of pediatric residents reveal that large percentages have never led a resuscitation event, and program directors perceive that many fail to achieve procedural competence. 6,11,12 The PALS course is insuffi cient in ensuring a resident's prolonged mastery of resuscitation skills.…”

Section: Introductionmentioning

confidence: 99%

High-Fidelity Simulation Enhances Pediatric Residents’ Retention, Knowledge, Procedural Proficiency, Group Resuscitation Performance, and Experience in Pediatric Resuscitation

Mills

Williams

et al. 2013

Hospital Pediatrics

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OBJECTIVE: The goal of this study was to assess the effect of high-fi delity simulation (HFS) pediatric resuscitation training on resident performance and self-reported experience compared with historical controls. METHODS:In this case-control study, pediatric residents at a tertiary academic children's hospital participated in a 16-hour HFS resuscitation curriculum. Primary outcome measures included cognitive knowledge, procedural profi ciency, retention, and self-reported comfort and procedural experience. The intervention group was compared with matched-pair historical controls. RESULTS:Forty-one residents participated in HFS training with 32 matched controls. The HFS group displayed signifi cant initial and overall improvement in knowledge (P < .01), procedural profi ciency (P < .05), and group resuscitation performance (P < .01). Signifi cant skill decay occurred in all performance measures (P < .01) with the exception of endotracheal intubation. Compared with controls, the HFS group reported not only greater comfort with most procedures but also performed more than twice the number of successful reallife pediatric intubations (median: 6 vs 3; P = .03). CONCLUSIONS:Despite signifi cant skill decay, HFS pediatric resuscitation training improved pediatric resident cognitive knowledge, procedural profi ciency, and comfort. Residents who completed the course were not only more profi cient than historical controls but also reported increased real-life resuscitation experiences and related procedures.

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Quantification of Procedures and Resuscitations in an Emergency Medicine Residency

Cited by 36 publications

References 14 publications

Emergency medicine procedural skills: what are residents missing?

Emergency medicine procedural skills: what are residents missing?

Emergency Medicine Resident Patient Care Documentation Using a Hand‐held Computerized Device

High-Fidelity Simulation Enhances Pediatric Residents’ Retention, Knowledge, Procedural Proficiency, Group Resuscitation Performance, and Experience in Pediatric Resuscitation

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