TF1 “From Head To Toe!” Developing Competency in Adult Trauma Resuscitations

Abstract

At our institution, trauma is run through a combined cooperative of the emergency medicine (EM) and surgical residency programs. A formal curriculum is currently lacking for the PGY1 EM residents rotating on this service, who are then expected to become proficient team leaders in combined resuscitations. Competency is defined as the ability to do something successfully or efficiently. ACGME currently requires that residents demonstrate “competency in adult trauma resuscitations” as a key index procedure prior to graduation. Therefore, the primary learners are first year residents rotating through the trauma service to these introduce concepts early. The curriculum will also be available to surgical residents as secondary learners if desired. The primary goal is for the learner to achieve competency in adult trauma resuscitations: by identifying injuries, perceiving when life-saving interventions are required and acting upon it. The secondary objective is to evaluate if initiating this curriculum will have an impact on in-training exam (ITE) scores in the trauma subcategory. This curriculum is designed as a self-guided, self-paced instructional system based in a modular asynchronous format. The entire curriculum will be available using Google Classroom. Each learner will perform a pre-test assessment prior to initiating the curriculum; administration will have the ability to review. This will allow our program to monitor the learner’s progress. The modules use interactive power point presentations using a visual diagnosis theme. The educational content is derived from both written emergency medicine and trauma texts as well as published on-line FOAM Ed (Free Open Access Medical Education). These FOAM Ed resources encompass evidence-based Web sites, emergency medicine specific training Web sites, and You Tube videos produced specifically for education. Each module will include self-assessment questions with answers provided and at the end of the rotation, each resident will receive a direct clinical skills evaluation using a provided checklist during a live trauma resuscitation. Using multiple assessment techniques will provide the resident with a well-rounded evaluation of their performance early in residency. To evaluate the impact of the curriculum, ITE scores before and after initiation will be compared. It is essential for emergency medicine residents to have competency in adult trauma resuscitations for daily use as a well-rounded physician. As junior residents, they are placed on a designated trauma service for 4 weeks and therefore, a self-guided modular curriculum allowing them to work at their own pace while participating in resuscitations on a daily basis will not only introduce the material, but also aid in retention and hopefully in reproduction as senior residents.