Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Academic Emergency Medicine

Abstract

Intro/Background: Critical Access Hospitals (CAHs) have staffing shortages as most recent graduates of emergency medicine (EM) recidency programs pursue jobs in urban environments. It is presumed that this is due to limited exposure to rural EM scenarios throughout training, leading to hesitancy to practice in these situations as a new graduates with minimal single provider experience. Review of MedEd Portal demonstrates no curriculum filling this deficit in EM training, leading to the development of this curriculum. Purpose/Objective: The goal of the curriculum was to inspire further interest and preparedness to work in rural/critical access hospitals (CAHs). The hope was that by completing this curriculum, residents would feel more comfortable with applying for careers at more rural sites. Through the various aspects of the curriculum, the secondary goal was to build upon foundations of medical knowledge and direct the application of this knowledge into a rural environment with limited support staff/consult services. Methods: A multi-part curriculum spanning 6 months was performed to address topics within critical access hospitals (CAHs) that may commonly be encountered. Topics included: Foundations of CAHs, Transfer Services/EMTALA, Bedside Pharmacology. This information was further supplemented via simulation cases as well as a hands-on procedure lab. This lab addressed performing stabilization procedures with limited resources, such as practicing a Burr Hole on a 3D model skull, lateral canthotomy, and performing a precipitous delivery. Summary: This novel curriculum utilized a multimodal approach to enhance the education of current residents in an area of curriculum that is less commonly addressed in urban settings. After a literature review was performed, there were indications of limited curricular development that have been previously established in the field of critical access and rural medicine. We felt this would be an important area of focus as most graduating residents will be entering the workforce in centers that may require shifts in rural settings. Thus, we sought out a novel approach to provide residents with a handson learning experience to increase their knowledge, familiarity, and comfort level with managing critical conditions in a rural setting. The curriculum involved an initial lecture series that established fundamentals of rural hospital management and afterwards, this was supplemented simulation and a procedure lab. The simulation established a focus of triaging and management of multiple critical patients in a single coverage environment, while addressing rural environment health disparities and transfer requirements; The skills lab allowed for hands on management of these procedures utilizing both high and low fidelity models. After initial implementation of this curriculum within our single center, there has been an overwhelmingly positive outlook on this curriculum, with most residents requesting further education on this topic. Currently, we are focusing on additional approaches to further grow the curriculum, such as the creation of further low fidelity models, increasing the number of simulation cases residents are exposed to in this setting, integrating further health disparities to the curriculum, with an ultimate goal of extending the curriculum to become a longitudinal 3 year model,

Volume

31

Issue

S1

First Page

381

Comments

Society for Academic Emergency Medicine, SAEM Annual Meeting, May 14-17, 2024, Phoenix, AZ

Last Page

382

DOI

10.1111/acem.14533

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