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Emergency medicine procedural skills: what are residents missing?

Published online by Cambridge University Press:  04 March 2015

Andrew Petrosoniak ,
Jodi Herold  and
Karen Woolfrey
Andrew Petrosoniak
Affiliation:
Royal College Emergency Medicine Residency Training Program, Toronto, ON
Jodi Herold
Affiliation:
Wilson Centre for Research in Education, University Health Network, Faculty of Medicine, Toronto, ON
Karen Woolfrey*
Affiliation:
Royal College Emergency Medicine Residency Training Program, Toronto, ON Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON
*
Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, C7-53, Toronto, ON M4N 3M5; [email protected]

Abstract

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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. Programdirectors 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.

Keywords

clinical competenceemergency medicinemedical education
Type
Education • Enseignement
Information
Canadian Journal of Emergency Medicine , Volume 15 , Issue 4 , July 2013 , pp. 241 - 248
Copyright
Copyright © Canadian Association of Emergency Physicians 2013

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