(architecture, health systems, human-computer interac- tion, computer science, and systems engineering) par- ticipated in this class. The course included a ...
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consideration of the effect of polypharmacy and comorbidity on the presenting complaint. This module will be available to residency programs as an ‘‘asynchronous educational session’’ via the Council of Emergency Medicine Residency Directors (CORD) website as well as to practicing emergency physicians via the SAEM and American College of Emergency Physicians (ACEP) websites.
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The Emergency Informatics Transition Course: A Flexible, Online Course in Health Informatics for Emergency Medicine Clinicians and Trainees Michael Wadman, William Hersh, Jeffrey Nielson, James McClay University of Nebraska, Oregon Health & Science University, Akron City Hospital
Increasing emphasis on health information technology (HIT) as a mechanism to control costs and increase quality in health care is accelerating the diffusion of more advanced health information systems into emergency medicine. This has created an increased demand for informatics-trained emergency physicians to provide clinical input. In response to this need we partnered with the American College of Emergency Physicians (ACEP) to adapt an existing informatics educational program to emergency medicine. The American Medical Informatics Association (AMIA) 10X10 program is an effort to provide formal informatics training to 10,000 clinicians by 2010. Our first AMIAACEP 10X10 Emergency Informatics Transition Course matriculated 37 emergency physicians this fall. This 12 week online course is an adaption of the Oregon Health & Science University (OHSU) introductory informatics 10X10 course where students complete weekly assignments and participate in online discussions. At the end of the course they meet face-to-face at the ACEP Scientific Assembly where they present their projects and discuss common themes. The online design of the course proved adaptable for a widely varied enrollment. The first class contained students from the United States and four other countries, both large urban and small rural hospitals, and both new and experienced clinicians. Extensive input from the students will assist us in further refining this annual course to better meet the needs of emergency clinicians. We will demonstrate the design of this course, which we believe offers interested residents and fellows in emergency medicine a flexible opportunity to advance their informatics training.
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The ED of the Future: an Interdisciplinary Graduate Course in Healthcare Design David Cowan, Ellen Yi-Luen Do, Marilyn Margolis, Craig Zimring, Jeremy Ackerman Georgia Institute of Technology, Emory University, Perkins + Will Architects
Six faculty members from Georgia Institute of Technology, Emory University School of Medicine, Emory
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Healthcare, and Perkins + Will created and taught a one-semester course titled ‘‘The Emergency Department of the Future’’. The goals of the course were to provide an environment for students to be exposed to the unique challenges of healthcare design, to experience and learn techniques for successful interdisciplinary design, and to create innovations with impact. Twenty graduate students representing five disciplines (architecture, health systems, human-computer interaction, computer science, and systems engineering) participated in this class. The course included a series of didactic lectures covering a wide range of issues including architectural design of hospitals and emergency departments, observation techniques for working environments, electronic medical records, and patient-centered care. Lecturers included emergency physicians, nurses, architects, human-computer interaction researchers, and design specialists. Students developed problem statements along with prototype design solutions through these lectures, direct observation, and interaction with course faculty. The resulting projects include a mobile triage chair that takes vital signs, equipment sliders for easy functional transformation, an integrated lighting design, as well as patient assistants for self registration, communication, environmental control, and discharge support. The developed projects have generated ideas to improve emergency care that may be implementable commercial products as well as fundable projects for future research. The final presentation open house attracted over a hundred visitors from local and national healthcare facilities and industry. This presentation will highlight the structure and organization of the course as well as the resulting projects.
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Teamwork Training for Interdisciplinary Applications Bev Foster, Carol Durham, Susan Sawning, Karen Frush, Gwen Sherwood, Cherri Hobgood, Susan Promes, Donald Woodyard, David Hollar University of North Carolina School of Nursing, University of North Carolina School of Medicine, Duke University
Safe healthcare delivery in the emergency department is a team sport. Medical educators seek efficient and effective methods to teach and practice teamwork skills to all levels of interdisciplinary learners with the goal of enhancing communication, insuring smooth clinical operations, and improving patient safety. We present a new interdisciplinary, health professions teamwork curriculum, modified from TeamSTEPPS, that is efficient, effective, and can be delivered using multiple teaching modalities. This flexible curriculum structure begins with a brief didactic core designed to orient the learners to team concepts and invest them in the rationale for focusing on teamwork skills. This is followed by one of four additional instructional modalities: traditional didactic, interactive audience response didactic, lowfidelity simulation (role play), and high-fidelity patient simulation. Each of these additional modalities can be utilized singly or in combination to enhance the
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2009 SAEM ANNUAL MEETING ABSTRACTS
learners’ attitudes, knowledge, and skills in team-based behaviors. Interdisciplinary cases have been defined, piloted, modified, and deployed at two major universities across more than 400 learners. Interdisciplinary simulation scenarios range from team-based role play to high-fidelity human patient simulation. Assessment cases using standardized patients are designed for interdisciplinary applications and focus on observable team-based behaviors rather than clinical knowledge. All of these cases have accompanying assessment instruments for attitudes, knowledge, and skills. These instruments may be used for formative assessment to provide feedback to the learners and standardize the faculty’s information delivery. If used in a summative manner they provide data for course completion criteria, remediation, or competency assessment.
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Skin Abscess Model for Incision and Drainage Myto Duong, Jennifer Bartlett, Regina Kovach Southen Illinois University
Background: Skin and soft tissue infection diagnosis is increasing dramatically across the nation. All healthcare providers need to be trained in adequate incision and drainage of these lesions. The only descriptions of skin and soft tissue models in the literature involve the use of cadavers or chickens. We devised an inexpensive and easily assembled skin abscess model that will be invaluable for the training of this procedure for all healthcare providers. This relatively realistic skin abscess model can be assembled within minutes using materials that can be purchased in your local grocery or home improvement store. The steps required in the creation of this abscess model will be depicted in the exhibit. Supplies for assembly of the model will be available during the exhibition for participants to build their own abscess and practice incising and draining their abscess. Materials: • Lotion (white) mixed with food coloring (red, blue, yellow) • Baby oil gel • 1’’ Urethane Foam sheeting • Heavy cardboard or poster board • Food handler gloves (Textra Cast Poly) • Glue gun (low temp) • Low temp glue gun sticks • ‘‘Smooth Top Easy Liner’’ shelf liner • Abscess incision and drainage kit. Conclusion: This exhibit will provide a detailed description of how to assemble a quick and easy skin abscess model for incision and drainage. This model can be used in the skills lab to demonstrate and practice this basic procedure.
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Model for Ultrasound-Assisted Lumbar Puncture Training Melissa Bollinger, Joel Schofer, Michael Bauman, Paul Sierzenski, Jason Nomura Christiana Care Health System
Lumbar puncture is an important diagnostic procedure in emergency medicine. Data have been published showing improved success rate with ultrasound assistance and the ability of emergency medicine physicians to recognize sonographic lumbar spinous anatomy.
However, with educational models and the push for improved patient safety, procedural skills should be practiced on phantoms rather than the ‘‘see one, do one, teach one’’ of the past. There are no currently available phantoms for ultrasound-assisted lumbar puncture training. We have produced a phantom that can be used to train physicians on ultrasound-assisted lumbar puncture with respect to both imaging and procedural competency. A plastic fluid-filled bladder was immersed in gelled opacified mineral oil, a safe and easily used tissue mimic that obscures direct visualization of structures. Spinous anatomy is replicated with the use of wooden struts supporting wooden disks that mimic lumbar spinous processes. The spine analog was mounted over the plastic bladder and surrounded with gelled mineral oil. The phantom produces images similar to human lumbar anatomy. The phantom allows insertion of spinal needles into the ‘‘interspinous spaces’’ with inability to pass the needle outside of those locations. Fluid collection and repeated punctures can be performed on the phantom. Appearance and performance of the phantom were evaluated by physicians with expertise in ultrasound-assisted lumbar puncture. The only limitation is that external appearance is not realistic. This model performs well, is made from readily available materials, and can be used to train physicians in ultrasound-assisted lumbar puncture.
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Geriatric Emergency Medicine with Integrated Simulation Curriculum Chris Doty, Stephan Rinnert, Joel Gernshiemer, Brian Gillett, Jessica Stetz State University of New York Downstate
Our initiative is a replicable model curriculum that teaches emergency geriatric care principles utilizing didactics and immersive simulation. Simulated scenarios encompass principles specific to geriatric care. Major curricular principles include: 1) respect for patients’ autonomy, 2) accommodating patients’ physical and cognitive limitations, 3) appropriate resource utilization, and 4) accurate symptom recognition and clinical decision-making. These four basic principles are incorporated throughout the curriculum and specifically during three simulated scenarios: 1) a patient with respiratory distress in the setting of end-stage cancer and end-oflife teaches topics pertaining to living wills, health care proxies and DNR orders; 2) a fallen patient requiring a trauma evaluation and safe discharge teaches resource utilization, complex evaluation of home environment, social support principles, access to medical care concepts, and utilization of institutional social services; 3) a patient with altered mental status caused by polypharmacy and sepsis teaches geriatric diagnostic and intervention challenges. Faculty teach specific clinical tactics such as minimizing distractions, frequent reorientation, minimal use of urinary catheters and ‘‘tethering’’ devices, prompt triage and medical screening exams, and coordinating disposition with family, nursing, and clerical staff. The curriculum also includes large classroom didactics incorporating active learning via live
