The Thanksgiving Turkey Tap: A New and Simple Model for Teaching Ultrasound-guided Thoracentesis

entertaining and successful learning experience forboth residents and faculty. Like the Clinical PathologicalCases (CPC) competitions, ‘‘Sim Wars’’ provides ashowcase for residencies to demonstrate practice phi-losophies while providing a unique emphasis on team-work and communication skills. The ability to expandthis program to include regional competitions that leadto a national contest could be the framework for futureexciting and educational events.

5 Use of Simulation Technology in ForensicMedical EducationHeather Rozzi, Michael Bohrn, Andrew KepnerYork Hospital

Although the emergency department often provides thefirst and only opportunity to collect forensic evidence,very few emergency medicine residencies have a foren-sic medicine curriculum in place. Most of the existingcurricula are composed only of traditional didactics.However, as with any lecture-based education, theremay be a significant delay between the didactic sessionand clinical application. In addition, traditional curriculalack the opportunity for residents to practice skillsincluding evidence collection, documentation, and useof a colposcope. At York Hospital, we have developed aforensic curriculum which consists of both traditionallectures and practical experience in our Medical Simu-lation Center. As part of their educational conferenceseries, residents receive presentations on domestic vio-lence, child abuse, elder abuse, evidence collection, sex-ual assault, ballistics, pattern injuries, documentation,forensic photography, and court testimony. Followingthese presentations, residents have the opportunity toapply their knowledge of forensic medicine in the Simu-lation Center. First, they interview a standardizedpatient. They then utilize the mannequins in the Simula-tion Center to practice evidence collection, photo docu-mentation, and use of our specialized forensic medicinecharts. After evidence collection and documentation,the residents provide safety planning for the standard-ized patients. Each portion is videotaped, and each resi-dent is debriefed by victim advocates, experiencedsexual assault nurse examiners, and emergency depart-ment faculty. The use of simulation technology in resi-dent education provides the opportunity to practice theskills of forensic medicine, ultimately benefitingpatients, residents, and law enforcement, and permit-ting teaching and evaluation in all six core competencyareas.

6 The Thanksgiving Turkey Tap: A New andSimple Model for Teaching Ultrasound-guided ThoracentesisDerek Richardson, Dean StraffNew York Presbyterian

Thoracentesis is a critical procedure that every emer-gency physician must be able to perform comfortably.By introducing ultrasound technology to the procedure,

we have the potential to redefine the standard of carefor emergency department thoracentesis by effectivelydecreasing complication rates of this procedure. Ultra-sound-guided thoracentesis has been shown to lead tofewer incidents of pneumothorax than the traditionaltechnique; however, due to the complicated anatomy ofthe chest wall, this skill is difficult to teach withoutusing living patient models. The NewYork-PresbyterianEmergency Medicine Residency Program has devel-oped an effective model for teaching and practicingultrasound-guided thoracentesis. The Presbyterianmodel uses a whole turkey with the cavity lined with awater-retaining plastic sheet, containing water and anair-filled balloon. Ultrasound can then be used to visual-ize the ribs, the underlying fluid, and the balloon repre-senting lung space. By using a standard thoracentesiskit with our model, the complete procedure can be per-formed and techniques of positioning, entry point, andfluid collection can be demonstrated and practiced. Thiswas performed for 50 medical students, residents, andattending physicians in late November 2008 for under$100. This simple model may be used to introduce newpractitioners to thoracentesis, or to update experiencedphysicians on new techniques to decrease complicationrates during procedures with an effective and inexpen-sive model.

7 Geriatric Emergency Medicine EducationalModule: Abdominal Pain in the Older AdultLowell Gerson, Eve LosmanNortheastern Ohio Universities, University ofMichigan

The Society for Emergency Medicine (SAEM) Geriat-rics Task Force has created an instructional tool toaddress the complaint of abdominal pain in olderadults presenting to the emergency department (ED).This is the first module in a comprehensive, web-basedgeriatric emergency medicine curriculum that willaddress common syndromes in older adults presentingto the ED. There is no formal, residency-based curric-ulum in geriatric emergency medicine and there is apaucity of geriatric Continuing Medical Education(CME) opportunities for practicing emergency physi-cians. The amount, quality, and convenience of geriat-rics training available to emergency physicians isinsufficient. This educational gap is particularly con-cerning given the ever-growing volume of older adultemergency patients. The Task Force chose to focusfirst on geriatric abdominal pain because a survey ofemergency physicians in the mid 1990s found that it isone of the most difficult complaints to evaluate andmanage. The module comprises of six clinical caseswith a pre- and post-test. Together, these casesencompass the broad differential diagnosis for geriat-ric abdominal pain and the core medical knowledgepertaining to the subject. The modules will expose thelearner, through either content or modeling, to the sixAccreditation Council for Graduate Medical Education(ACGME) core competencies and to the Principles ofGeriatric Emergency Medicine including rapid evalua-tion of functional status, communication skills, and

S276 2009 SAEM ANNUAL MEETING ABSTRACTS