Trauma to the Eye -A Low Fidelity Resident Teaching Module for Identifying and Treating a Retrobulbar Hematoma.

Introduction: A retrobulbar hematoma (RH) is a serious time-dependent diagnosis due to its potential for permanent damage of the optic nerve, resulting in blindness. Emergency medicine (EM) physicians face the challenge of recognizing this time-sensitive injury and treating it before irreversible damage occurs. Due to its relative infrequency in the emergency department, residents may not have adequate experience in recognizing and treating RH. Methods: This educational intervention outlined a simulated scenario that we developed to educate EM residents to diagnose RH and perform an emergent lateral canthotomy and cantholysis (LCC). Participating residents were asked to obtain a history and perform a physical examination that was consistent with a 34-year-old patient presenting with pushing behind the eye suggesting RH. Once residents made a diagnosis, they practiced performing an emergent LCC on a low-fidelity task trainer supplemented with a novel checklist. The residents completed an assessment questionnaire before and after the teaching module to measure the educational intervention\u27s effectiveness. Results: Learners\u27 scores significantly improved in the ability to recognize and treat RH (12%, Discussion: This educational intervention is a successful resource that can decrease cases of preventable blindness by improving EM residents\u27 ability to recognize and treat RHs

“Trauma to the Eye” – A Low Fidelity Module for Identifying Retrobulbar Hematoma and Practicing Lateral Canthotomy & Cantholysis

Purpose: A retrobulbar hematoma (RH) can cause preventable blindness due to damage of the optic nerve. Due to its relative infrequency in the emergency department, Emergency Medecine (EM) residents have limited experience in recognizing and treating a RH. This paper outlines a simulated scenario that was developed to improve EM residents knowledge in diagnosing a RH and performing an emergent lateral canthotomy and cantholysis (LCC). Methods: This module used a low fidelity task trainer and case vignette created for EM residents to practice recognizing a RH and perfroming a LCC. Participants took an assessment questionnaire before and after the teaching module, which included questions in the knowledge and affective domain. The study measured scores for recognition and treatment of a RH, stress levels (higher scores=less stress), and confidence levels using a paired t-test, and asked participants to indicate their feelings of comparative preparedness after the module. Results and Conclusions: Participants’ scores improved on the assessment questionnaire in the knowledge (12.30%, p=0.00005) and affective (confidence: 17.61%, p=0.0002; stress: 9.64%, p=0.058) domain. All participants indicated that they felt more prepared to treat a RH after the module. The results suggest that this teaching module significantly improved their ability to recognize and treat a RH, their confidence in performing the procedure, and their feelings of relative preparedness, but did not significantly decrease their stress. This module is a successful educational resource that can decrease cases of preventable blindless by improving EM residents ability to recognize and treat RHs

The Utility of Surgical Simulation in Student Education

The use of simulation in the field of surgery has become a heavily researched topic over the last few decades, but it is by no means a new concept. The first recorded use of surgical simulation dates back 2,500 years with evidence of nasal models for flap reconstruction made of leaf and clay.1 But simulation as we know it today did not take shape until the 1980s with the invention of the Comprehensive Anesthesia Simulation Environment (CASE) mannequins. The use of nonorganic simulation tools revolutionized the field and continues to play a large role in medical education. These modalities have become particularly helpful in the field of surgery because they allow for repeated practice of skills without sacrificing patient safety. Current surgical simulation has many forms that include, but are not limited to, live animal surgery, cadavers, benchtop simulators, virtual reality (VR) simulators, and robot assisted surgery (RAS) simulators.2 Each of these simulation techniques offer unique opportunities to learn, practice, and improve surgical technique in a high fidelity, minimal stress environment

Overcoming the Learning Curve: A Single Institution Review of HoLEP Complications and How to Manage Them

We performed a comprehensive retrospective chart review of patients who underwent HoLEP, primarily by a single surgeon, between 2013 and 2020 at our institution. We assessed for 16 complications related to HoLEP and Clavien-Dindo classification grade II and above.https://jdc.jefferson.edu/urologyfposters/1002/thumbnail.jp