Learning Objectives: Help resident physicians become experts on procedural competency by developing a peer-reviewed procedure guide.

Introduction: Emergency medicine physicians (EPs) need to perform a broad range of procedures quickly and effectively. While some procedures are common, others are rarely encountered. However, an EP must be ready to perform all these procedures, often with minimal time to prepare. While there are numerous procedural references, not all are reliable or easily accessible on shift. Developing a procedure guide repository would result in a useful clinical and teaching tool. Creating the guide itself will aid in mastery of the procedure.

Objective: Help resident physicians become experts on procedural competency by developing a peer-reviewed procedure guide.

Curricular Design: 73 procedures were chosen for this project. Residents and attendings worked together to create a guide for each procedure. Each pair was given a standardized template to follow which included indications, contraindications, supplies, preparation, technique, aftercare, complications, follow-up, return precautions, video examples, and references. These guides will be published on an application with Apple and Android which will allow for greater accessibility while on shift. Residents and attendings were also asked to complete a survey about the project.

Impact/Effectiveness: By creating their respective guides, the residents and attendings should gain mastery at performing and teaching their assigned procedure. So far, we have received 6 completed procedure guides. The remainder are still in development with goal of completion by June 2022. An example guide is shown in Figure 1. So far, 21 participants have completed the survey, and results are shown in Table 1. Comparing columns 4 and 5, preliminary results suggest that developing these guides help physicians become more confident with their procedure. We plan to implement the procedure guide application in 2022 and look forward to collecting more data to determine the effect on clinical confidence, competency, and bedside instruction.

Learning Objectives: Create a checklist that is expert reviewed to teach BVM to 4th year medical students. Implement a curriculum to teach using the checklist and then assess performance with high-fidelity simulation.

Introduction: Bag-valve-mask ventilation (BMV) is an essential skill to master when teaching medical students basic airway management. Standardized checklists help teach and assess learners. A validated checklist for teaching BMV to medical students does not exist in the literature. Current standards typically involve teaching learners BMV skills on mannequins in static situations.

Educational Objective: Create a checklist that is expert reviewed to teach BVM to 4th year medical students. Implement a curriculum to teach using the checklist and then assess performance with high-fidelity simulation.

Curricular Design: A previously published checklist was improved upon using expert consensus of 10 EM and 10 anesthesia faculty. A 2-handed technique using an oropharyngeal airway was emphasized to maximize a novice’s success. Senior anesthesiology and EM residents taught 200 4th year medical students using rapid sequence deliberate practice methods and the checklist. After achieving proficiency, they participated in a SIM case that required BMV. Video review was used to assess the students’ skills with the checklist.

Impact/Effectiveness: We now have a standardized, expert reviewed checklist to teach BMV skills to 4th year medical students. While all students achieved proficiency using a static mannequin, many of the students’ skills deteriorated in the high-fidelity simulation. For example, in the simulation, only 65% of students connected the oxygen to the wall correctly, 24% of students did not use the two-handed technique, and 81% of students did not correctly size and insert the oropharyngeal airway. Since our goal is to teach students BVM for use in the hospital environment, by collecting the high-fidelity simulation data we know that our method was inadequate for skill retention in the complex environment. This enables us to continue curriculum development this year incorporating more repetition in a complex environment.