title: Assessing the accreditation council for graduate medical education requirement for temporary cardiac pacing procedural competency through simulation.
abstract: OBJECTIVE
  The Accreditation Council for Graduate Medical Education (ACGME) guidelines recommend that residents perform 6 cardiac pacing attempts during residency training, while making no distinction between transcutaneous pacing (TCP) or transvenous pacing (TVP). This study seeks to enhance and validate emergency medicine residency curricula by assessing and measuring the minimum number of performances for TCP and TVP through simulation for procedural competency.
  
  
  METHODS
  In 2009-2010, 36 residents were invited to the simulation laboratory to participate in individual procedural training sessions. The residents each rotated through the 2 following partial-task training stations staffed by faculty members: (1) TVP and (2) TCP. Using the process of deliberate practice, the procedures were repeated until the faculty members had determined procedural competency defined as 2 completions without error via a preset checklist.
  
  
  RESULTS
  Residents required a mean (SD) of 3.11 (0.56) attempts and a median of 3 attempts to successfully perform TCP and a mean (SD) of 5.25 (0.94) attempts and a median of 6 attempts to successfully perform TVP. Learners required a mean (SD) total number of 8.39 (1.09) attempts and a median of 9 attempts to achieve competency at cardiac pacing. No resident required more than 5 attempts to achieve competency in TCP; no resident required more than 6 attempts to achieve competency in TVP.
  
  
  CONCLUSIONS
  When measuring TVP alone, the number of attempts to achieve competency are comparable with that of the ACGME guidelines. When accounting for both TCP and TVP, the number of attempts required to achieve competency is greater than those delineated by the ACGME guidelines. The results of this trial warrant continuation and reproduction on a larger scale to revisit the ACGME guidelines.
authors: Section of Emergency Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, IL 60637, USA. jamesahn@uchicago.edu
authors: James
authors: J
authors: Ahn
authors: Morris
authors: M
authors: Kharasch
authors: Richard
authors: R
authors: Aronwald
authors: Shekhar
authors: S
authors: Menon
authors: Hogyan
authors: H
authors: Du
authors: Nicole
authors: N
authors: Calabrese
authors: Mary
authors: M
authors: Gitelis
authors: Pamela
authors: P
authors: Aitchson
authors: Ernest
authors: E
authors: Wang
mesh_terms: D000068:Accreditation; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002983:Clinical Competence; D003198:Computer Simulation; D004521:Educational Measurement; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency / Q000379:methods*