Design and Implementation of a Low-Cost Priapism Reduction Task Trainer.

Abstract

This low-cost priapism reduction task trainer is designed to instruct emergency medicine (EM) resident physicians. Priapism is a true urologic emergency that EM physicians must be able to diagnose and treat in order to prevent significant tissue damage and loss of erectile function. Given the nature of the condition, priapism treatment is often both physically invasive and psychologically upsetting. Simulation allows learners to practice invasive or rare procedures in a safe and educational environment. At present, there are few inexpensive and easily created task trainers for priapism reduction. Our goal was to create an inexpensive, reusable task trainer that allows learners to practice the skills needed for priapism reduction. By the end of this educational session, learners should be able to 1) Verbalize the difference between low-flow and high-flow priapism 2) Describe the landmarks for a penile ring block and cavernosal aspiration/injection 3) Demonstrate the appropriate technique for performing a penile ring block, cavernosal aspiration, and cavernosal injection. Using inexpensive and commonly found materials, we were able to successfully create a partial task trainer for teaching priapism reduction techniques including administering local anesthesia, medication injection, and realistic cavernosal aspiration with simulated blood return. As part of a standard EM residency didactics curriculum, this task trainer has been used to teach post graduate year (PGY) 1-4 resident learners. After an introductory didactic session, participants were given the opportunity for hands-on skills-based practice using the simulated task trainer. Learners were asked to complete a post-session survey to assess the educational value of the station and the task trainer. We were able to successfully create a low cost, easy to build partial task trainer for priapism reduction that allowed learners to perform local anesthesia, medication injections, and corporal aspiration. Twenty-five residents (ten PGY-1, five PGY-2, five PGY-3, five PGY-4) participated in a single didactic session and completed a post-session survey. The majority (68%, N=17) of participants had never previously treated a patient with priapism. On average, participants rated their comfort managing a patient with priapism before the session to be 1.76 on a 5-point Likert-scale (where 1=not at all comfortable and 5=extremely comfortable). Following the session, participants' comfort increased to 3.76 on the same scale. Participants rated the usefulness of the priapism model for teaching priapism reduction techniques to be 4.64 on a 5- point scale (where 1=not at all useful and 5=extremely useful). Using inexpensive and commonly found materials, we were able to successfully create a partial task trainer for teaching priapism reduction techniques including local anesthesia, medication injection, and cavernosal aspiration. Learners reported that the educational session greatly increased their confidence in caring for patients presenting with priapism. Additionally, they found the priapism model to be extremely helpful for teaching reduction techniques. Our model was successful in teaching a procedure that providers may encounter in clinical practice yet most resident learners had not yet had the opportunity to perform in training. Penile anesthesia, priapism reduction, urologic emergencies.