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entertaining and successful learning experience for both residents and faculty. Like the Clinical Pathological Cases (CPC) competitions, ‘‘Sim Wars’’ provides a showcase for residencies to demonstrate practice phi- losophies while providing a unique emphasis on team- work and communication skills. The ability to expand this program to include regional competitions that lead to a national contest could be the framework for future exciting and educational events. 5 Use of Simulation Technology in Forensic Medical Education Heather Rozzi, Michael Bohrn, Andrew Kepner York Hospital Although the emergency department often provides the first and only opportunity to collect forensic evidence, very few emergency medicine residencies have a foren- sic medicine curriculum in place. Most of the existing curricula are composed only of traditional didactics. However, as with any lecture-based education, there may be a significant delay between the didactic session and clinical application. In addition, traditional curricula lack the opportunity for residents to practice skills including evidence collection, documentation, and use of a colposcope. At York Hospital, we have developed a forensic curriculum which consists of both traditional lectures and practical experience in our Medical Simu- lation Center. As part of their educational conference series, 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. Following these presentations, residents have the opportunity to apply their knowledge of forensic medicine in the Simu- lation Center. First, they interview a standardized patient. They then utilize the mannequins in the Simula- tion Center to practice evidence collection, photo docu- mentation, and use of our specialized forensic medicine charts. 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, experienced sexual assault nurse examiners, and emergency depart- ment faculty. The use of simulation technology in resi- dent education provides the opportunity to practice the skills of forensic medicine, ultimately benefiting patients, residents, and law enforcement, and permit- ting teaching and evaluation in all six core competency areas. 6 The Thanksgiving Turkey Tap: A New and Simple Model for Teaching Ultrasound- guided Thoracentesis Derek Richardson, Dean Straff New 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 care for emergency department thoracentesis by effectively decreasing complication rates of this procedure. Ultra- sound-guided thoracentesis has been shown to lead to fewer incidents of pneumothorax than the traditional technique; however, due to the complicated anatomy of the chest wall, this skill is difficult to teach without using living patient models. The NewYork-Presbyterian Emergency Medicine Residency Program has devel- oped an effective model for teaching and practicing ultrasound-guided thoracentesis. The Presbyterian model uses a whole turkey with the cavity lined with a water-retaining plastic sheet, containing water and an air-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 thoracentesis kit with our model, the complete procedure can be per- formed and techniques of positioning, entry point, and fluid collection can be demonstrated and practiced. This was performed for 50 medical students, residents, and attending physicians in late November 2008 for under $100. This simple model may be used to introduce new practitioners to thoracentesis, or to update experienced physicians on new techniques to decrease complication rates during procedures with an effective and inexpen- sive model. 7 Geriatric Emergency Medicine Educational Module: Abdominal Pain in the Older Adult Lowell Gerson, Eve Losman Northeastern Ohio Universities, University of Michigan The Society for Emergency Medicine (SAEM) Geriat- rics Task Force has created an instructional tool to address the complaint of abdominal pain in older adults presenting to the emergency department (ED). This is the first module in a comprehensive, web-based geriatric emergency medicine curriculum that will address common syndromes in older adults presenting to the ED. There is no formal, residency-based curric- ulum in geriatric emergency medicine and there is a paucity 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 is insufficient. This educational gap is particularly con- cerning given the ever-growing volume of older adult emergency patients. The Task Force chose to focus first on geriatric abdominal pain because a survey of emergency physicians in the mid 1990s found that it is one of the most difficult complaints to evaluate and manage. The module comprises of six clinical cases with a pre- and post-test. Together, these cases encompass the broad differential diagnosis for geriat- ric abdominal pain and the core medical knowledge pertaining to the subject. The modules will expose the learner, through either content or modeling, to the six Accreditation Council for Graduate Medical Education (ACGME) core competencies and to the Principles of Geriatric Emergency Medicine including rapid evalua- tion of functional status, communication skills, and S276 2009 SAEM ANNUAL MEETING ABSTRACTS

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

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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