title: Procedure lab used to improve confidence in the performance of rarely performed procedures.
abstract: OBJECTIVE
  The objective of this study is to assess the efficacy of an animal procedure lab in improving the level of comfort in performing important emergency medicine procedures. The procedures included central venous line, chest tube, cricothyrotomy, pericardiocentesis, venous cutdown, and thoracotomy.
  
  
  METHODS
  The students were physicians participating in the Tuscan Emergency Medicine Initiative as part of a certificate program in emergency medicine. They attended a 1-h lecture discussing the procedures to be performed. Participants filled out a questionnaire before and after the lab, which asked how many times they had performed each procedure, how comfortable they felt, on a five-point scale, performing each procedure, and whether they felt comfortable performing it by themselves, with assistance or whether they would not feel comfortable performing the procedure. Differences in rated numerical values for each procedure before and after the lab were analyzed using a two-tailed t-test. Alpha was set at 0.95.
  
  
  RESULTS
  In all, there were 20 participants with a wide range of experience. A statistical improvement was observed in comfort level and willingness to perform the procedures independently (P<0.01). The only non-significant change was in willingness to perform central lines.
  
  
  CONCLUSIONS
  The use of an animal lab improves the comfort level of practitioners in performing procedures. Although procedures are best learned on patients with supervision, this is not always feasible. This lab is a useful adjunct to teaching in emergency medicine and allows participants exposure to critical procedures.
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. leon_sanchez@bidmc.harvard.edu
authors.forename: Leon D
authors.initials: LD
authors.lastname: Sanchez
authors.forename: Jennifer
authors.initials: J
authors.lastname: Delapena
authors.forename: Sean P
authors.initials: SP
authors.lastname: Kelly
authors.forename: Kevin
authors.initials: K
authors.lastname: Ban
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pini
authors.forename: Avio M
authors.initials: AM
authors.lastname: Perna
mesh_terms: D002983:Clinical Competence; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D023421:Models, Animal