title: Emergency department resuscitative procedures: animal laboratory training improves procedural competency and speed.
abstract: Certain resuscitative procedures can be lifesaving, but are performed infrequently by emergency medicine (EM) residents on human subjects. Alternative training methods for gaining procedural proficiency must be explored and tested.
  
  
  OBJECTIVE
  To test whether animal laboratory training (ALT) is associated with sustained improvement in procedural competency and speed.
  
  
  METHODS
  After watching an educational videotape of saphenous cutdown (SAPH), thoracotomy (THOR), and cricothyroidotomy (CRIC), EM residents were randomized to receive either a tutored ALT session on live anesthetized pigs (Group A) or no ALT session (Group B). Residents were tested six months later by performing procedures on live anesthetized pigs. Videotaped procedures were evaluated by blinded examiners for the number of critical steps, complications, and procedure times.
  
  
  RESULTS
  Group A (n = 10) achieved a higher number of critical steps compared with Group B (n = 8) for SAPH (15.4 +/- 0.7 vs. 9.0 +/- 1.8, p = 0.03) and THOR (17.4 +/- 0.6 vs. 12.3 +/- 1.6, p = 0.009), but not CRIC (18.1 +/- 0.4 vs. 16.2 +/- 1.0, p = 0.1). Group A completed procedures in less time than Group B for SAPH (Wilcoxon chi(2) = 4.0, p = 0.04) and THOR (chi(2) = 4.4, p = 0.04), but not CRIC (chi(2) = 0.9, p = 0.3). There was no difference in the number of complications for any of the procedures.
  
  
  CONCLUSIONS
  Residents with animal laboratory training six months prior to testing demonstrated improved procedural competency and speed in the performance of resuscitative procedures.
authors.affiliation: Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, USA. cbc3d@virginia.edu
authors.forename: Catherine B
authors.initials: CB
authors.lastname: Custalow
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kline
authors.forename: John A
authors.initials: JA
authors.lastname: Marx
authors.forename: Michael R
authors.initials: MR
authors.lastname: Baylor
mesh_terms: D000328:Adult; D000818:Animals; D002983:Clinical Competence / Q000592:standards; D003413:Cricoid Cartilage / Q000601:surgery; D004635:Emergency Medicine / Q000193:education* / Q000592:standards; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards; D008297:Male; D023421:Models, Animal; D009657:North Carolina; D012151:Resuscitation / Q000379:methods*; D012501:Saphenous Vein / Q000601:surgery; D013552:Swine; D013663:Teaching / Q000379:methods*; D013908:Thoracotomy / Q000379:methods; D013957:Thyroid Cartilage / Q000601:surgery; D013995:Time; D014139:Tracheostomy / Q000379:methods; D016748:Venous Cutdown / Q000379:methods