Advanced Ultrasound Workshops for Emergency Medicine Residents

Abstract

Background: Ultrasound has become a standard component of Emergency Medicine training. Most residency programs fulfill this requirement with a dedicated rotation. [i] At our institution this occurs in the intern year and focuses primarily on the ACEP core applications.[ii] This focused time allows intensive exposure, but for many residents, scanning declines after competency in the basic applications is achieved. Educational Objectives: We sought to renew interest in ultrasound by presenting two advanced workshops on nontraditional content. Sessions covered ways ultrasound could augment or replace aspects of the physical exam. and ultrasound guided nerve blocks. Curricular Design: Two workshops were implemented during a Post-Graduate Year (PGY) 2 resident class session. Each workshop was divided into brief modules which included a brief case-based didactics immediately followed by 10-15 minutes of hands-on practice scanning. This back-andforth approach allowed the residents to immediately practice the presented content. The physical exam workshop covered splenomegaly, acute mitral regurgitation, aortic dissection, hepatomegaly, jugular venous distension, patellar tendon rupture, and shoulder dislocation. The nerve block workshop covered posterior tibial, ulnar, radial, femoral, sciatic, interscalene brachial plexus, and supraclavicular brachial plexus nerve blocks. Ideally every 3-4 learners in a workshop require: 1 instructor, 1 ultrasound machine, 1 standardized patient. Impact/Effectiveness: Residents were given an anonymous self-assessment survey after the workshops. For the Physical Exam workshop, the residents all reported an increased level of comfort using ultrasound, and many of them reported they were using ultrasound more frequently after the session. For the Nerve Block session, the residents reported increased comfort performing these procedures, however there was not a significant difference in self-reported nerve block procedure numbers pre and post workshop. The main challenges reported with attempting ultrasound guided nerve blocks were difficulty identifying the nerve and lack of attending comfort level in supervising the procedure. These sessions could be easily replicated in other residency programs. (Table Presented).