Third-Year Resident, Department of Emergency Medicine, Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas.
Acting Instructor, Department of Emergency Medicine, University of Washington School of Medicine.
MedEdPORTAL. 2024 Jul 9;20:11421. doi: 10.15766/mep_2374-8265.11421. eCollection 2024.
Critical care, emergency medicine, and surgical trainees frequently perform surgical and Seldinger-technique tube thoracostomy, thoracentesis, and thoracic ultrasound. However, approaches to teaching these skills are highly heterogeneous. Over 10 years, we have developed a standardized, multidisciplinary curriculum to teach these procedures.
Emergency medicine residents, surgical residents, and critical care fellows, all in the first year of their respective programs, underwent training in surgical and Seldinger chest tube placement and securement, thoracentesis, and thoracic ultrasound. The curriculum included preworkshop instructional videos and 45-minute in-person practice stations (3.5 hours total). Sessions were co-led by faculty from emergency medicine, thoracic surgery, and pulmonary/critical care who performed real-time formative assessment with standardized procedural steps. Postcourse surveys assessed learners' confidence before versus after the workshop in each procedure, learners' evaluations of faculty by station and specialty, and the workshop overall.
One hundred twenty-three trainees completed course evaluations, demonstrating stable and positive responses from learners of different backgrounds taught by a multidisciplinary group of instructors, as well as statistically significant improvement in learner confidence in each procedure. Over time, we have made incremental changes to our curriculum based on feedback from instructors and learners.
We have developed a unique curriculum designed, revised, and taught by a multidisciplinary faculty over many years to teach a unified approach to the performance of common chest procedures to surgical, emergency medicine, and critical care trainees. Our curriculum can be readily adapted to the needs of institutions that desire a standardized, multidisciplinary approach to thoracic procedural education.
重症监护、急诊医学和外科培训生经常进行外科和 Seldinger 技术的胸腔引流管置管术、胸腔穿刺术和胸部超声检查。然而，这些技能的教学方法差异很大。在过去的 10 年中，我们开发了一种标准化的多学科课程来教授这些程序。
急诊医学住院医师、外科住院医师和重症监护研究员，均处于各自项目的第一年，接受了外科和 Seldinger 胸腔引流管放置和固定、胸腔穿刺术和胸部超声检查的培训。该课程包括课前教学视频和 45 分钟的现场实践站（总共 3.5 小时）。课程由来自急诊医学、胸外科和肺/重症监护的教员共同领导，他们使用标准化的程序步骤进行实时形成性评估。课程结束后，通过调查评估学习者在每个程序中的术前和术后信心、学习者对每个实践站和专业教员的评价以及对整个课程的评价。
123 名学员完成了课程评估，结果表明，来自不同背景的学员对由多学科教员教授的课程反应稳定且积极，并且在每个程序中的学习信心都有显著提高。随着时间的推移，我们根据教员和学员的反馈对课程进行了逐步修改。
我们开发了一种独特的课程，由多学科教员设计、修订和教授多年，旨在为外科、急诊医学和重症监护培训生提供一种统一的方法来执行常见的胸部程序。我们的课程可以根据希望采用标准化多学科方法进行胸部程序教育的机构的需求进行调整。
