1
Methods: Researchers watched a total of 53 non-news, non reality-TV totalling 53 programs across 10 weeks of Spring 2011 primetime (8-11 PM EST) from the following networks: ABC, CBS, NBC, FOX and CW. Commercials were excluded. All instances of seat belt usage (driver and passenger), helmets (bikes and motorcycle) and miscellaneous pedestrian and vehicular traffic infractions were also recorded. Results: Total of 273 of prime time TV was viewed with an overall rate for proper seat belt usage in 37.6% (95% CI: 32.4-42.9) of drivers, 22.3% (95% CI: 18.5-26.0) passengers. Proper seating and childseat usage not noted in original 1998 study was only 14%. Helmet were used by 15.9% of bicyclists, 70.3% of motorcyclists. There was 17% rate of pedestrian and 22% vehicular traffic violations, also. Overall proper 2011 restraint use was 30.1% (95%CI: 25.4- 34.6). This figure represent only a 4.2% rise and no significant increase since the prior study. Portrayal of primetime TV seatbelt usage rose a 4.8% (p 0.11) from 1998 to 2011 while actual US seatbelt use increased a significant 20%.(p 0.03). Helmet use did increase for both bike by 32% to 15.9% and motorcycle by 20% to 70.3%. Conclusion: Recent studies have found traffic safety behaviors continue to increase in US population; however, major TV network programs have not incorporated such simple safety changes into current programming despite prior study into these deficiencies. A poor example continues to be set. TF-1 Self Instructional Module for Simulation Elective in Emergency Medicine Anderson BB/University of Colorado School of Medicine, Aurora, CO Introduction: High-fidelity simulation (SIM) is a rapidly expanding area in medical education and has increasing use in emergency medicine training. Research supports the efficacy and impact simulation has on medical training, skills acquisition, learned communication styles and improvement in patient safety measures. Many emergency medicine residents in this country are being trained utilizing SIM, yet most of them have never been trained how to create and run a medical SIM case themselves or to facilitate small group (SG) debriefing sessions following scenarios. Many residency graduates will soon become educators and will be called upon to help teach using SIM. The goal of this 1-week elective is to instruct senior emergency medicine residents how to create their own SIM scenarios, run them for secondary learners (junior emergency medicine residents and 3rd year medical students on emergency medicine clerkship) and debrief the participants in a SG learning format in an effective manner. Study Objectives: During this elective, the learner will be expected to: 1) Develop an understanding of what is appropriate for an emergency medicine simulation case; 2) Create an emergency medicine SIM scenario utilizing realistic technical support, scripts and ancillary studies 3) Create teaching points using evidence based resources to help guide a SG session 4) Review pertinent literature regarding skills for facilitation of a SG 5) Practice facilitating a SG using 3 features, specific objectives, active participation, and reflection. Methods: The learner will read the “Guidelines for Creating a Simulation Scenario” (Appendix 1), then will analyze medical scenarios from online portal databases to create their own novel case and discuss with their mentor. Examples of SIM cases are provided in template form as well as H&P form (Appendix 2,3) with learning objectives, critical actions, and SG facilitation plans to review. Learners then create an emergency medicine SIM scenario based on the format of these examples. Example documents of teaching points written for previous cases (Appendix 4) are reviewed and learners create their own scenario specific teaching points, which are utilized to guide the SG session. During and following draft completion the learner sends versions to the faculty mentor for feedback and further suggestions. Learners then acquire skills to facilitate a SG by studying assigned references and by answering study questions (Appendix 5) based on provided references. Lastly, they run their case and facilitate the debriefing session. The faculty member evaluates SG facilitation skills and verbal feedback is given to the learner following the session. Conclusion: After completion of this 1-week elective in emergency medicine residency, residents will be able to successfully create and run a SIM scenario and facilitate a SG debriefing session. This elective provides residents the tools as educators to effectively use this teaching modality in educating future generations of learners in emergency medicine. TF-2 Disaster Management and Complex Humanitarian Emergencies Elective Irvin CB, Bills C/University of Chicago Medical Center, Chicago, IL Introduction: Currently, the University of Chicago (UC) lacks a formal curriculum dedicated to disaster management and complex humanitarian crisis, important components of global health. This elective builds upon the UC’s post- earthquake humanitarian work in Haiti and experience in teaching Haitian national staff the components of disaster management and complex humanitarian emergencies. This elective will introduce fourth year medical students and emergency medicine residents enrolled in the Global Health Scholars Track to the basic principles of this discipline and provide opportunities for practical application both in the classroom and the field. Study Objectives: Upon completion of the elective participants will: 1) Demonstrate knowledge of the basic principles of disaster response; 2) Correctly apply basic principles to case-based scenarios; 3) Integrate basic principles in field simulation Methods (curricular and evaluative): This elective is structured as an 8 session seminar series (24 total hours) followed by a 1-week in-country practicum in Fond Parisien, Haiti. Core concepts from a robust reading list will be reinforced with lectures and small group activities during the formal didactic sessions. Content will focus on the basic principles of disaster management and complex humanitarian crisis with specific focus on public health surveillance, needs assessments, water and sanitation management, food and nutrition, shelter and the ethics of providing assistance. UC faculty with formal training and field experience in disaster management and humanitarian emergencies will teach the seminar series. Knowledge of basic principles will be evaluated by multiple-choice questions at the completion of the seminar series. Application of these principles will be evaluated by accuracy of case-based scenarios during both the seminar and in-country practicum. Participant results from case-based scenarios will be compared to results obtained by the University of Chicago and Haitian instructors. Integration of basic principles in the in-country field simulation will be evaluated by direct observation and summarized in an evaluation form completed by University of Chicago and Haitian instructors. Conclusion: To our knowledge, no other course offers an in-country practicum focused on application and integration of the basic concepts of disaster management and complex humanitarian emergencies to junior trainees. This course also serves to empower Haitian staff, strengthen international partnerships, and create a sustainable and engaging educational experience with practical implications. We intend to use this course to stimulate ongoing scholarly collaboration and research between the University of Chicago community and the Haitian medical education system. TF-3 Ten-Minute Teaching Boysen MM/University of California, Irvine, Placentia, CA Introduction: The Accreditation Council on Graduate Medical Education (ACGME) annual survey assesses the balance between service obligations and teaching in question 33, formerly question 19. Approximately 30% of emergency medicine residency programs have a significant proportion of their residents answering this question unfavorably, implying that service obligations often overshadow the educational experience for residents. To enrich the educational experience for residents, a residency program director may improve the ratio of educational experiences to service obligations, or possibly the perception of this ratio. A creative solution may be to better unite service obligations and educational experiences, resulting in an actual and perceived increase in educational experience without sacrificing service obligations. Chitnis demonstrated that 30% of emergency department rounds resulted in an educational experience for residents. However, only 42% of faculty and residents participate in a formalized sign-out inclusive of both faculty and residents. Whereas 72% of program directors agree that a standardized sign-out system in the ED would improve communication and reduce medical error. “10-minute teaching” is designed to integrate faculty teaching into morning sign- out, in an effort to improve resident satisfaction with faculty teaching. Study Objectives: Primary: To improve resident satisfaction with faculty teaching. Secondary: Individual learning objectives from each teaching session. Methods: The UC Irvine Emergency Medicine Residency Program participates in 1 formalized sign-out process per 24-hour period, occurring at 7:00 AM each morning, with the primary goal as transfer of care. This morning sign-out typically includes 1 post graduate year (PGY)-3 resident, 1 PGY-2, 2 to 3 PGY-1s, and up to 6 medical students. In the first phase of this project, the Program Director, Clerkship Director, Associate Program Director, and other interested faculty will create 10-minute teaching experiences in the form of lecture, small group discussion, visual diagnosis, bedside teaching, and low-fidelity simulation. When these faculty members are Research Forum Abstracts Volume , . : October Annals of Emergency Medicine S331

TF-1 Self Instructional Module for Simulation Elective in Emergency Medicine

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Methods: Researchers watched a total of 53 non-news, non reality-TV totalling53 programs across 10 weeks of Spring 2011 primetime (8-11 PM EST) from thefollowing networks: ABC, CBS, NBC, FOX and CW. Commercials were excluded.All instances of seat belt usage (driver and passenger), helmets (bikes and motorcycle)and miscellaneous pedestrian and vehicular traffic infractions were also recorded.

Results: Total of 273 of prime time TV was viewed with an overall rate forproper seat belt usage in 37.6% (95% CI: 32.4-42.9) of drivers, 22.3% (95% CI:18.5-26.0) passengers. Proper seating and childseat usage not noted in original 1998study was only 14%. Helmet were used by 15.9% of bicyclists, 70.3% ofmotorcyclists. There was 17% rate of pedestrian and 22% vehicular traffic violations,also. Overall proper 2011 restraint use was 30.1% (95%CI: 25.4- 34.6). This figurerepresent only a 4.2% rise and no significant increase since the prior study. Portrayalof primetime TV seatbelt usage rose a 4.8% (p � 0.11) from 1998 to 2011 whileactual US seatbelt use increased a significant 20%.(p � 0.03). Helmet use didincrease for both bike by 32% to 15.9% and motorcycle by 20% to 70.3%.

Conclusion: Recent studies have found traffic safety behaviors continue toincrease in US population; however, major TV network programs have notincorporated such simple safety changes into current programming despite priorstudy into these deficiencies. A poor example continues to be set.

TF-1 Self Instructional Module for Simulation Elective inEmergency Medicine

Anderson BB/University of Colorado School of Medicine, Aurora, CO

Introduction: High-fidelity simulation (SIM) is a rapidly expanding area inmedical education and has increasing use in emergency medicine training. Researchsupports the efficacy and impact simulation has on medical training, skillsacquisition, learned communication styles and improvement in patient safetymeasures. Many emergency medicine residents in this country are being trainedutilizing SIM, yet most of them have never been trained how to create and run amedical SIM case themselves or to facilitate small group (SG) debriefing sessionsfollowing scenarios. Many residency graduates will soon become educators and will becalled upon to help teach using SIM. The goal of this 1-week elective is to instructsenior emergency medicine residents how to create their own SIM scenarios, runthem for secondary learners (junior emergency medicine residents and 3rd yearmedical students on emergency medicine clerkship) and debrief the participants in aSG learning format in an effective manner.

Study Objectives: During this elective, the learner will be expected to: 1) Developan understanding of what is appropriate for an emergency medicine simulation case;2) Create an emergency medicine SIM scenario utilizing realistic technical support,scripts and ancillary studies 3) Create teaching points using evidence based resourcesto help guide a SG session 4) Review pertinent literature regarding skills forfacilitation of a SG 5) Practice facilitating a SG using 3 features, specific objectives,active participation, and reflection.

Methods: The learner will read the “Guidelines for Creating a SimulationScenario” (Appendix 1), then will analyze medical scenarios from online portaldatabases to create their own novel case and discuss with their mentor. Examples ofSIM cases are provided in template form as well as H&P form (Appendix 2,3) withlearning objectives, critical actions, and SG facilitation plans to review. Learners thencreate an emergency medicine SIM scenario based on the format of these examples.Example documents of teaching points written for previous cases (Appendix 4) arereviewed and learners create their own scenario specific teaching points, which areutilized to guide the SG session. During and following draft completion the learnersends versions to the faculty mentor for feedback and further suggestions. Learnersthen acquire skills to facilitate a SG by studying assigned references and by answeringstudy questions (Appendix 5) based on provided references. Lastly, they run their caseand facilitate the debriefing session. The faculty member evaluates SG facilitationskills and verbal feedback is given to the learner following the session.

Conclusion: After completion of this 1-week elective in emergency medicineresidency, residents will be able to successfully create and run a SIM scenario andfacilitate a SG debriefing session. This elective provides residents the tools aseducators to effectively use this teaching modality in educating future generations oflearners in emergency medicine.

TF-2 Disaster Management and Complex HumanitarianEmergencies Elective

Irvin CB, Bills C/University of Chicago Medical Center, Chicago, IL

Introduction: Currently, the University of Chicago (UC) lacks a formalcurriculum dedicated to disaster management and complex humanitarian crisis,important components of global health. This elective builds upon the UC’s post-earthquake humanitarian work in Haiti and experience in teaching Haitian nationalstaff the components of disaster management and complex humanitarianemergencies. This elective will introduce fourth year medical students and emergencymedicine residents enrolled in the Global Health Scholars Track to the basicprinciples of this discipline and provide opportunities for practical application both inthe classroom and the field.

Study Objectives: Upon completion of the elective participants will: 1)Demonstrate knowledge of the basic principles of disaster response; 2) Correctlyapply basic principles to case-based scenarios; 3) Integrate basic principles in fieldsimulation

Methods (curricular and evaluative): This elective is structured as an 8 sessionseminar series (24 total hours) followed by a 1-week in-country practicum in FondParisien, Haiti. Core concepts from a robust reading list will be reinforced withlectures and small group activities during the formal didactic sessions. Content willfocus on the basic principles of disaster management and complex humanitarian crisiswith specific focus on public health surveillance, needs assessments, water andsanitation management, food and nutrition, shelter and the ethics of providingassistance. UC faculty with formal training and field experience in disastermanagement and humanitarian emergencies will teach the seminar series. Knowledgeof basic principles will be evaluated by multiple-choice questions at the completion ofthe seminar series. Application of these principles will be evaluated by accuracy ofcase-based scenarios during both the seminar and in-country practicum. Participantresults from case-based scenarios will be compared to results obtained by theUniversity of Chicago and Haitian instructors. Integration of basic principles in thein-country field simulation will be evaluated by direct observation and summarized inan evaluation form completed by University of Chicago and Haitian instructors.

Conclusion: To our knowledge, no other course offers an in-country practicumfocused on application and integration of the basic concepts of disaster managementand complex humanitarian emergencies to junior trainees. This course also serves toempower Haitian staff, strengthen international partnerships, and create a sustainableand engaging educational experience with practical implications. We intend to usethis course to stimulate ongoing scholarly collaboration and research between theUniversity of Chicago community and the Haitian medical education system.

TF-3 Ten-Minute TeachingBoysen MM/University of California, Irvine, Placentia, CA

Introduction: The Accreditation Council on Graduate Medical Education(ACGME) annual survey assesses the balance between service obligations andteaching in question 33, formerly question 19. Approximately 30% of emergencymedicine residency programs have a significant proportion of their residentsanswering this question unfavorably, implying that service obligations oftenovershadow the educational experience for residents.

To enrich the educational experience for residents, a residency program directormay improve the ratio of educational experiences to service obligations, or possiblythe perception of this ratio. A creative solution may be to better unite serviceobligations and educational experiences, resulting in an actual and perceived increasein educational experience without sacrificing service obligations.

Chitnis demonstrated that 30% of emergency department rounds resulted in aneducational experience for residents. However, only 42% of faculty and residentsparticipate in a formalized sign-out inclusive of both faculty and residents. Whereas72% of program directors agree that a standardized sign-out system in the ED wouldimprove communication and reduce medical error.

“10-minute teaching” is designed to integrate faculty teaching into morning sign-out, in an effort to improve resident satisfaction with faculty teaching.

Study Objectives: Primary: To improve resident satisfaction with facultyteaching. Secondary: Individual learning objectives from each teaching session.

Methods: The UC Irvine Emergency Medicine Residency Program participates in1 formalized sign-out process per 24-hour period, occurring at 7:00 AM eachmorning, with the primary goal as transfer of care. This morning sign-out typicallyincludes 1 post graduate year (PGY)-3 resident, 1 PGY-2, 2 to 3 PGY-1s, and up to 6medical students.

In the first phase of this project, the Program Director, Clerkship Director,Associate Program Director, and other interested faculty will create 10-minuteteaching experiences in the form of lecture, small group discussion, visual diagnosis,bedside teaching, and low-fidelity simulation. When these faculty members are

Research Forum Abstracts

Volume , . : October Annals of Emergency Medicine S331