Pediatric lumbar puncture trainers are less available than adult trainers; most are the newborn size and quite expensive. Due to age-based practice patterns for fever diagnostic testing, most pediatric lumbar punctures are performed on young infants, and residents have fewer opportunities to perform lumbar punctures on older children.1 Adult lumbar puncture trainers have been created using a 3D-printed spine and ballistics gel, which allows for ultrasound guidance.2 No previous model has been described for pediatric lumbar puncture.
During medical simulation, the inherent unpredictability of learners’ performances and decisions can make it challenging to consistently achieve desired learning objectives. The amount learned and the errors made can vary wildly between groups. Paradoxically, a stellar student can minimize the learning for the other providers if he or she takes over and effortlessly completes the case. Likewise, the visceral impact of seeing a case go horribly wrong can have tremendous teaching value.1
In addition to these challenges, the COVID-19 pandemic has introduced additional barriers to medical simulation training; physical distancing measures have resulted in limited or canceled simulation activities for most emergency medicine residency programs.
Bedside ultrasound (US) often plays a crucial role in medical and trauma resuscitations in the emergency department (ED) . Performing and interpreting bedside US studies such as the Extended Focused Assessment with Sonography for Trauma (E-FAST) during traumas or echocardiography during medical resuscitations are key skills for emergency medicine residents to learn during their training and adopt into clinical practice . During trauma resuscitations timely and efficient dissemination of critical information is paramount. Information obtained via bedside US can be critical in determining further clinical actions (need for urgent thoracostomy for a pneumothorax, need for urgent exploratory laparotomy in a hypotensive patient with free fluid in the abdomen, etc.) through shared decision making between ED and trauma teams . Information obtained via bedside US, however, is often difficult to convey during resuscitations given crowded rooms, simultaneous interventions, and limited viewing of the US screen. For ED and trauma providers wishing to better understand the utility of bedside US during resuscitations and how this powerful tool can change clinical management, a clearly visualized representation of what is displayed on the US screen could provide an ideal learning opportunity.
In order to enhance emergency medicine (EM) residents’ knowledge of toxicology core content, we previously created an immersive escape room experience complete with team-based puzzle solving in a geographical maze to find an antidote. The subsequent COVID-19 pandemic and physical distancing guidelines resulted in canceled in-person EM conferences, thereby requiring a rapid adaptation to virtual formats [1-4]. Our toxicology division sought a novel method of engaging learners with toxicology core content remotely.
Although escharotomy is rarely performed by emergency physicians during the initial management of burns, it is a life and limb-sparing skill important to know as a trainee and provider in emergency medicine [1,2]. There are few models made to accommodate procedural training, and the ones available are often cost-prohibitive. It is critical to have a method for learning and practicing this important procedure [3,4].
The novel coronavirus pandemic (COVID-19) resulted in the cancellation of educational experiences for emergency medicine (EM) residents at many institutions, including emergency medical services (EMS) ambulance ride alongs. The Accreditation for the Council of Graduate Medical Education (ACGME) requires that residents have educational experiences related to EMS, emergency preparedness, and disaster medicine. EMS experiences must include ground unit runs, direct medical oversight, and participation in multi-casualty incident drills . There are few dedicated EMS curricula published in the literature, and those in existence incorporate physical ride-alongs .
Emergency Medicine (EM) physicians care for anyone, with anything, at any time. This includes pediatric patients as well as adults. For those without advanced pediatric training, “sick kids” can be quite intimidating. Rashes in the pediatric population are often benign, but in rare cases they portend significant illness. Rashes are also frequent chief complaints; In 2015, there were 1,452,300 pediatric ED visits for “skin and subcutaneous tissue disorders” . We sought to improve the teaching of pediatric rashes in our residency curriculum.