Body Packing with Cocaine: A Simulation Exercise

Pedagogically sound simulation-based medical education (SBME) produces effective learning. We present a simulation scenario for "body packing", which is the concealment of an illicit drug in packets (usually condoms) inside the body by swallowing or recto-vaginal insertion, usually for transportation across borders. This scenario will train Emergency Medicine residents to suspect body packing under appropriate circumstances, and to treat the potential alimentary pathologies and drug toxicities which body packing with cocaine can cause

Pregnancy and Privacy in an Emergency Department: A Simulated Session

The practice of emergency medicine requires that physicians make critical decisions under the pressures of both time and socially challenging situations. Ectopic pregnancy is one such scenario in which physicians must think and act quickly, while keeping in mind the complexities of discussing reproductive health issues in an environment where confidentiality is difficult to achieve. The following describes a simulation session in which learners are tasked with the integration of clinical decision-making and the maintenance of privacy and confidentiality

Deteriorating Patient Scenario for Simulation-Based Training of Difficult Patient Encounters in the Emergency Room

The use of standardized patients [SP] in a deteriorating patient scenario [DPS] is a low-fidelity simulation technique, used to enhance conflict resolution skills in the emergency room [ER]. In this report, we describe a DPS simulation session in which SPs act as "difficult patients" in the setting of a busy ER. The purpose is to teach junior trainees how to recognize and learn to manage conflict so that they are better able to deal with future encounters with difficult patients

A: Pregnancy and privacy in an emergency department: A simulated session.

Abstract The practice of emergency medicine requires that physicians make critical decisions under the pressures of both time and socially challenging situations. Ectopic pregnancy is one such scenario in which physicians must think and act quickly, while keeping in mind the complexities of discussing reproductive health issues in an environment where confidentiality is difficult to achieve. The following describes a simulation session in which learners are tasked with the integration of clinical decision-making and the maintenance of privacy and confidentiality

Rural family physician perspectives on communication with urban specialists: a qualitative study

Objective Communication is a key competency for medical education and comprehensive patient care. In rural environments, communication between rural family physicians and urban specialists is an essential pathway for clinical decision making. The aim of this study was to explore rural physicians’ perspectives on communication with urban specialists during consultations and referrals.Setting Newfoundland and Labrador, Canada.Participants This qualitative study involved semistructured, one-on-one interviews with rural family physicians (n=11) with varied career stages, geographical regions, and community sizes.Results Four themes specific to communication in rural practice were identified. The themes included: (1) understanding the contexts of rural care; (2) geographical isolation and patient transfer; and (3) respectful discourse; and (4) overcoming communication challenges in referrals and consultations.Conclusions Communication between rural family physicians and urban specialists is a critical task in providing care for rural patients. Rural physicians see value in conveying unique aspects of rural clinical practice during communication with urban specialists, including context and the complexities of patient transfers

A mixed-methods evaluation of a multidisciplinary point of care ultrasound program

<p><b>Background:</b> Point of Care Ultrasound (PoCUS) is well established within emergency medicine, however, the availability of formal training for other clinical disciplines is limited. Memorial University has established a cost-efficient, multidisciplinary PoCUS training program focusing on training residents’ discipline-specific ultrasound skills. This study evaluates the skills, knowledge, and attitudes of residents who participated in the program.</p> <p><b>Methods:</b> Analysis was conducted using a mixed-methods, sequential exploratory approach. Initially, a focus group of seven first year residents was conducted to generate themes that were used to guide development of a survey administered to residents over a two-year period.</p> <p><b>Results:</b> Thirty residents responded to the survey (response rate 63.8%) with 53.3% meeting the training requirements for focused assessment using sonography in trauma, 43.3% for pleural effusion, 40.0% for aortic aneurysms, and 40.0% for cardiac scans. Early pregnancy assessment was the skill of least interest with 46.6% not interested. Over half the residents (53.6%) agreed or strongly agreed that a multidisciplinary program met their needs while 21.4% disagreed. The focus group found the multidisciplinary approach adequate.</p> <p><b>Conclusions:</b> A single PoCUS curriculum has been shown to meet the needs and expectations of a majority of residents from multiple disciplines. It can enhance collaboration and bridge gaps between increasingly compartmentalized practices of medicine.</p

The importance of personal protective equipment design and donning and doffing technique in mitigating infectious disease spread: A technical report

During the current coronavirus pandemic, significant emphasis has been placed on the importance of mitigating nosocomial spread of coronavirus disease 2019 (COVID-19). One important consideration involves the appropriate use of effective personal protective equipment (PPE), which may reduce a healthcare provider's likelihood of becoming infected while simultaneously minimizing exposure to other patients that they care for. This may reduce demands placed on the healthcare system and help to preserve the workforce. First, the importance of PPE design cannot be underestimated, as the manufacturing process must strive to maximize protection of the user while ensuring adequate comfort. Second, it has been demonstrated that inadequate education and training can significantly impact compliance with PPE recommendations. Technique regarding donning and doffing of PPE is crucial to the protection of those who don it. The purpose of this technical report is two-fold: first, to describe some important considerations in the manufacturing and design process of face shields to maximize protection for healthcare providers, and second, to describe a simulation scenario that may be used to train healthcare workers in the appropriate donning and doffing of PPE

Prehospital trauma care: A simulation scenario for rural-based healthcare providers

Trauma is a major cause of premature death and disability worldwide, with a disproportionate number of deaths occurring in rural and remote areas. Prehospital care is a key link in the chain of trauma survival and its role may be currently underestimated. Therefore, addressing deficiencies in prehospital trauma care may help to improve outcomes. Several potential solutions have been proposed to address the disparities that exist in rural prehospital trauma care, some of which focus on educational endeavors. Simulation-based medical education (SBME) is one cost-effective strategy to train healthcare providers in high-acuity, lowopportunity (HALO) scenarios, such as those encountered during major trauma. The aim of this technical report is to present a mass casualty simulation scenario that is intended for healthcare providers in rural and remote locations to refine their skills and comfort level with such cases. It emphasizes prehospital trauma management and effective communication skills among healthcare teams, which are two key elements in improving trauma outcome