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• W112969522 abstract "I nternational P erspective International Perspective from Saudi Arabia on “Procedural Skills Training During Emergency Medicine Residency: Are We Teaching the Right Things?” Nadeem Qureshi, MD King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia Supervising Section Editor: Mark I. Langdorf, MD, MHPE Submission history: Submitted July 07, 2009; Revision Received June 20, 2009; Accepted July 22, 2009 Reprints available through open access at www.westjem.org [WestJEM. 2009;10:157-158.] Commentary This article illustrates the use of an essential post-residency survey to identify specific topic deficiencies in the emergency medicine (EM) residency curriculum. This method has been effectively used in other specialties. Lieberman et al. 1 used a post-residency survey in Canada to record opinions of 239 pediatricians for their preparedness for practice. Results showed trainees need more community and ambulatory pediatrics and less tertiary care exposure, and these were later incorporated in the curriculum. Khairy et al. 2 did a similar study to evaluate surgical residency training in Saudi Arabia. Ninety-six surgeons from different practice settings participated in the survey, which identified technical skills as the biggest training deficit. A structured skills training center for both junior and senior residents, especially outside the operating theater, was proposed. Aksay et al. 3 describes a 14-year experience in Turkey using a similar survey to guide developing their EM programs. They used three different surveys for residents, trainers, and department heads of 20 EDs and 261 physicians. One hundred eighty-five residents, 56 trainers and 20 department heads participated in the study. Comparison of resident and trainer views regarding various aspect of EM training program was presented. Resident views differed significantly from trainer views (expressed as sufficiency percentages) in the number of practical skills (29.6% vs. 67.3%), competency in practical skills (60% vs. 78.2%), literature update (21% vs 37%), and quality of education (44.3%.vs 76.8%). Similar observations were made when theoretical knowledge and practical skills were evaluated. The residents’ sufficiency level for different core content compared to trainer were as follows: cardiovascular, 74% vs. 91%; neurology, 68% vs. 86%; Western Journal of Emergency Medicine resuscitation, 83% vs. 98%; trauma, 76% vs. 87%; orthopedics 56% vs. 75%; pediatrics, 16% vs. 27%; and toxicology, 63% vs. 82% respectively. Resident and trainer views on practical skills were significantly different in all procedures except endotracheal intubation. For all other procedures the resident felt more under-prepared than the trainers reported. The authors concluded that while most of the departments have developed the basic components for residency training, significant gaps were identified in the curriculum taught and practical skills acquired. This important observation reminds educators of the need for post-training feedback to guide future training. The present study used a similar survey to address preparation for “twelve common procedures taught during EM training and their importance in practice.” Investigators used procedures considered important but not emergent, with the assumption that emergent procedures are routinely performed and well taught. The responses were classified in three groups: over or under-prepared and concordant. Slit lamp usage, computed tomography interpretation, transvenous pacing and procedural sedation were areas reported as under-prepared. The study limitations included small sample size, single residency program and lack of information on methods of instruction and intensity of training. The authors did not compare these results with emergent procedures preparation, which would have allowed better understanding of the cause of this perceived under-preparation. The significant message from this study is that this evaluation can help identify program-specific deficiencies and modify the residency accordingly. This study looks at the micro level of actual educational delivery to each resident rather than the macro view of curricular plan. Practice environments differ across the country. What may be important in one environment may not be in another setting. In the U.S., rural and community ED practices customarily have fewer on-call specialists than urban, academic ones. This, in turn, requires emergency Volume X, no . 3 : August 2009" @default.
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• W112969522 date "2009-08-01" @default.
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• W112969522 title "International perspective from saudi arabia on procedural skills training during emergency medicine residency: are we teaching the right things?." @default.
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