Technical Skills
Technical skills learning will be based on the psychomotor skills learning process described in the ATLS instructor's manual. This process is based on educational theory in the psychomotor domain by Simpson (1966) and Dave (1970) and is reviewed in this article:
Davis Ann Emerg Med 2017 Educational Theory for Learning Technical Skills.pdfThe steps are:
Conceptualization
Visualization
Verbalization
Guided Practice
Feedback
Skill Mastery
Autonomy
Technical skills learning should be prepared for by completing steps 1-3 at home prior to the skills sessions. Some resources for this will be provided below. Steps 4 and 5 will occur in the simulation center during skills labs. Steps 6 and 7 occur throughout a career in EM and are not the objective of the skills labs.
The 2-year repeating curriculum is as follows:
July 2022: Airway lab
Conceptualization: Pediatric Airway Screencast
Visualization: Pediatric Intubation POV LMA Insertion
Verbalization: BVM PEMOSATS, LMA PEMOSATS
Aug 2022: Direct Laryngoscopy/Bougie PEMOSATS
Preparation for Intubation PEMOSATS
Sep 2022: Video Laryngoscopy: Glidescope and CMAC/fiberoptic PEMOSATS
Conceptualization: Roberts and Hedges VL Chapter
Visualization:
Dr. Gallagher's Fiberoptic Intubation Youtube Video
Fiberoptic intubation with split screen
ETT position check with fiberoptic
Verbalization: Glidescope PEMOSATS
Oct 2022: IO PEMOSATS
Conceptualization: Roberts and Hedges "Intraosseous Infusion" Chapter
Visualization: Pediatric IO Placement POV Video
Verbalization: IO Placement PEMOSATS
Nov 2022: Emergency Umbilical Catheter
Conceptualization:
Visualization: Pocket Procedures
Verbalization: PEMOSATS
Ultrasound #1 (Cardiac, Lung and eFAST, bladder)
Conceptualization/Visualization:
Sonosite M-Turbo Knobology Videos (4 videos totaling 20 minutes that review how to use our Sonosite machine)
Pulmonary, Cardiac, and eFAST videos from 5minsono.com
TTE Standard Views from University of Toronto (3-D Animation to help you visualize views - focus on parasternal long axis, parasternal short axis at LV mid level, apical four-chamber, and subcostal four chamber)
Dec 2022: Faculty House, Suture Skills lab
Conceptualization: Duke Suture Skills Video
Visualization: ALiEM Wound Closure Video Series
Verbalization:
Jan 2023: Ultrasound-guided LP
Later Month: CVL microskills lab, Central Line PEMOSATS
Conceptualization: emcrit.org CVL Microskills
Visualization:
Microskills POV Video
emcrit.org Full Sterile Preparation video
Verbalization: CVL Microskills Checklist
Feb 2023: Ophtho skills lab
(Slit Lamp, panoptic, FB removal, Morgan lens irrigation, ph check, fluorescein stain)
Conceptualization:
Roberts and Hedges Ophthalmologic procedures chapter
Visualization:
Removing an ocular foreign body: Video 1 and Video 2
Verbalization:
Mar 2023: In-situ sim in Peds ED
April 2023: Foreign bodies
Team leadership (TEAMSTEPPS and CRM) animated lecture
Conceptualization:
Visualization:
Verbalization:
May 2023: Inter-disciplinary Simulation cases
Conceptualization:
Visualization: Youtube video: The Ideal Pediatric Resuscitation
Verbalization:
June 2023: Faculty House, Ortho reductions, compartment check with stryker and splinting
Conceptualization:
Visualization:
ERcast Splint Like a Pro videos
Verbalization:
July 2023: None
Airway Lab,Direct Laryngoscopy/Bougie PEMOSATS
Conceptualization: Pediatric Airway Screencast
Visualization: Pediatric Intubation POV LMA Insertion
Verbalization: BVM PEMOSATS, LMA PEMOSATS Preparation for Intubation PEMOSATS Direct Laryngoscopy PEMOSATS
Aug 2023: CVL microskills lab and Central Line PEMOSATS
Pericardiocentesis PEMOSATS
Conceptualization: Roberts and Hedges Chapter
Visualization: NEJM video Ultrasound Podcast
Verbalization:
Sep 2023: Team leadership (TEAMSTEPPS and CRM)
Conceptualization:
Visualization: The Ideal Paediatric Resuscitation
Verbalization: Team Leadership PEMOSATS
Oct 2023: Immersive Sim cases with nursing
Nov 2023: None
Dec 2023: Faculty House, Suture skills lab
Feb 2024: iCare and Lateral Canthotomy
Mar 2024: Umbilical Lines
April 2024: Traditional Chest Tube/Seldinger Chest Tube/needle thoracostomy
Conceptualization: Roberts and Hedges Chapter
Visualization: Trauma Professional's Blog EM:RAP HD
Verbalization: PEMOSATS
May 2024: APE
June 2024: Sim Cases in Sim Center?
Emergency vaginal delivery
Conceptualization/Visualization:
Roberts and Hedges Emergency Childbirth Chapter
https://first10em.com/2015/03/07/precipitous-delivery-in-the-ed/
https://first10em.com/2015/03/07/the-difficult-delivery-shoulder-dystocia/
https://first10em.com/2015/03/07/the-difficult-delivery-breech-presentation/
https://first10em.com/2015/03/07/the-difficult-delivery-umbilical-cord-prolapse/
http://emcrit.org/wee/peri-mortem-c-section/
Verbalization: PEMOSATS
Ultrasound #2
Procedural:MSK [tendon, reduction]/soft tissue [abscess, nec fasc, water bath]/LP
Team Leadership
Inter-disciplinary Sim
Medication Administration
Later Month: CVL microskills lab, Central Line PEMOSATS
Conceptualization: emcrit.org CVL Microskills
Visualization:
Microskills POV Video
emcrit.org Full Sterile Preparation video
Verbalization: CVL Microskills Checklist
Other: emergency/complicated delivery, respiratory therapy, medication administration, airway drills
Games for first Wed: Dental Bowl (Dental splinting and PTA drainage), Cardiac Bowl, Ortho Bowl, Ophtho Bowl