Introduction: Competence in procedural skills is vital within the emergency department. Challenging procedures such as cricothyroidotomy are difficult to master as they are rare and hard to train for. Additionally, common procedures such as chest tube insertions require practice to become sufficiently competent. Opportunities to hone these skills are essential in residency training. This project aimed to create instructional video modules for specific emergency medicine (EM) procedures and gauge their utility as adjunctive resources for procedural learning in the EM residency curriculum. Methods: Tutorial videos for clamshell thoracotomy, cricothyroidotomy, and chest tube insertion were filmed within a cadaver lab with step-by-step instructions. The footage was edited and overlaid with a pre-prepared audio narration using Camtasia®/Apple® Video Editing software. These videos were embedded within modules that included foundational knowledge relevant to the procedures, including anatomy, physiology and pathophysiology. The modules were peer-edited by licensed EM staff physicians and distributed to EM residents and staff physicians for analysis. Qualitative and quantitative analysis relied upon participants’ answers to questions and a Modified Task Value Scale, respectively. Results: Ten participants were included in the analysis, including EM residents (n = 6) and staff emergency physicians (n = 4). Qualitative feedback suggested that positive aspects of the modules included visuals, content, narration, and review of anatomy. Negative aspects included the lack of indications for procedures, technical details, real patient examples, and a speed up function. Quantitative feedback resulted in scores of 4 and above out of 5 on the Motivated Task Value Scale across all aspects for all the modules. Furthermore, analysis revealed an average score of 3.9 for inclination to access more modules such as these, and a score of 4.4 for overall perception of the modules. Conclusion: Participants found the video modules valuable to their learning, both qualitatively and quantitatively. This study was limited by a small sample size of modules and a low number of participants. Furthermore, a more detailed analysis with further measures, including self-efficacy and self-confidence, would yield more comprehensive conclusions. However, video-based modules provide an effective and easily accessible adjunctive tool to acquire skill and confidence with EM procedures, for medical learners and staff physicians.

Introduction: Maintaining competence in high-acuity low-occurrence (HALO) procedures is often difficult due to their infrequent occurrence. While simulation is a valuable tool to hone skills, providing effective simulation-based education (SBE) to learners outside academic centers can be challenging. Utilizing a mobile tele-simulation unit (MTU) with expert instruction from a geographically separated mentor could prove a valuable approach to overcoming barriers in this setting. However, to maximize benefit and buy-in, the training modules developed for this unique delivery method must align with the needs of those practicing in rural settings. Objectives: - To evaluate the procedural skills training needs of emergency medicine (EM) physicians in rural Newfoundland and Labrador (NL) - To inform the development of simulation modules designed for use in a MTU Methods: A web-based needs assessment was distributed to physicians registered with the NL Medical Association, working in rural locations, and having EM listed as their primary specialty. Participants evaluated their comfort, performance frequency and desire to have further training for 12 HALO procedures. Two EM physicians selected these from a broader list of core procedural skill competencies for CCFP-EM residents at Memorial University. Participants were also able to suggest other procedures that might benefit from SBE. Results: The data collection occurred for 8 weeks with a 68% response rate (N = 22). No respondents had formal EM training outside of exposure in family medicine residency. 60% had 10+ years practicing EM. Chest tube insertion (100%), difficult intubation (92.3%) and surgical airway (92.3%) were the procedures that most respondents felt required more SBE. In practice, they most often performed bag-valve ventilation, splint application and procedural sedation (>10 per year). Additional procedures felt to require SBE were central venous line placement and trauma assessment. Opportunities to participate in SBE were limited (66.7%-less than annually). Despite this, most participants agreed SBE would be a significant benefit if accessible (93.3%). The greatest barriers to SBE included lack of equipment, rural location, and time necessary for travel to larger centres. Conclusion: The provision of medical care in rural settings can be particularly challenging when HALO procedures must be performed. Unique delivery methods of SBE targeted to the needs of rural practitioners may help bridge gaps in knowledge and technical skills.