Resuscitation Rotation: A Novel Emergency Medicine Rotation to Augment Resuscitative Training
Correspondence should be addressed to Michael J Burla at burlamic@gmail.com
DOI: https://doi.org/10.21980/J85P9F
ABSTRACT:
Audience:
This resuscitation curriculum is designed for second year emergency medicine residents who have completed their intensive care unit rotations during their first year of residency.
Introduction:
Resuscitation of critically ill patients is an integral part of emergency medicine (EM). While EM residents provide resuscitation during clinical training, dedicated educational time associated with resuscitations can vary. At our institution, we developed a new emergency department (ED) curriculum focused on improving and supplementing resident resuscitation training.
Educational Goals:
Our goal is to augment resuscitative education in the ED in order to improve resident skill, confidence, and knowledge of resuscitative treatments.
Educational Methods:
The educational strategies used in this curriculum include: case-based didactic sessions, resuscitation literature review, and focused clinical shifts with the ability to follow patients longer during the course of critical illness.
Research Methods:
This curriculum was implemented at the Beaumont Hospital Emergency Medicine Residency Program, associated with Oakland University William Beaumont School of Medicine. Survey questionnaire responses and encounter logs were collected from 10 residents during a one-year pilot period in 2015. Likert scales from 1 (least) to 5 (most) were utilized to evaluate a variety of experiences including how confident a resident feels in certain clinical scenarios, how much anxiety a resident feels during resuscitations, and other various experiences. Knowledge-based questions were included on the pre- and post-surveys as well, and residents were instructed to log encounters and procedures during the month.
Results:
Statistical significance was demonstrated in several parameters comparing pre- and post-scores. Mean Likert scores of perceptions of self-efficacy increased by 0.70 (pre = 3.40, post = 4.10; p = 0.001). Mean score for confidence in leading a resuscitation increased by 0.60 (pre = 2.50, post = 3.10; p = 0.005). Mean score for involvement in resuscitation of septic patients increased by 0.80 (pre = 4.20, post = 5.00; p = 0.003). Both mean scores for anxiety level when performing a thoracentesis and recognizing different cardiac arrhythmias decreased, by values of 0.90 (pre = 2.50, post = 1.60; p = 0.004) and 0.40 (pre = 2.00, post = 1.60; p = 0.037) respectively. There was no statistical difference between the pre- and post-percentage of knowledge-based questions on the survey (pre = 54.67%, post = 66.67%, p = 0.074), or any of the other survey questions.
Discussion:
Based on survey results and resident feedback from the pilot period, we concluded that this resuscitation curriculum was of benefit to our residents and incorporated it as a permanent rotation.
Length of curriculum:
The curriculum is a one-month rotation.
Topics:
Resuscitation training and management: Trauma and medical codes, post-cardiac arrest care, targeted temperature management, sepsis, pulmonary embolism, unstable arrhythmias, cerebral vascular accident.
