Just In Time Learning: EM Resident Search Strategies in Preparation for Performing a Simulated Dental Block
Abstract
Learning Objective: To describe on-line resources and strategy used by EM residents prior to performing a simulated dental nerve block including search terms, sources, and time.
Background: EM physicians are called to perform infrequently done procedures, often using on-line resources to prepare.
Objectives: To describe on-line resources used by EM residents prior to performing a simulated nerve block.
Methods: Prospective, observational study of EM residents during a simulation workshop. Subjects were provided a visual prompt of an abscess and given 15 minutes to use on-line resources, then demonstrated the dental nerve block on a skull model. Video screen shots were recorded and data collected including search time, strategy, type and number of resources used. Subjects were observed performing the block and given credit if performed correctly. Residents answered a survey about previous experience, preferred resources and confidence in performing the procedure.
Results: 26 residents participated. The median search time was 4 minutes, 5 seconds. 57.7 % of subjects used a general search term as opposed to a specific procedure. Sites included You-Tube 69%, Google Images 53.8%, WikiEM 42%, EMRA 15%, and UpToDate 11.5%. 61.5% used 2 links. 50% used a combination of written and video material whereas 23% used video material alone. 81.8% performed the block correctly. Survey results: 42% of residents reported having done a dental block on a patient with 3.8% reporting previous training. 50% reviewed both written and video sources with 76% of respondents finding video sources more helpful. 96.2% residents felt they had adequate time to review the procedure. Confidence in ability to perform the procedure after review varied: 3.8% very confident; 46% confident; 23% neutral and 27% somewhat confident.
Conclusions: YouTube was the most frequently used resource in researching how to perform a dental nerve block. The majority of residents applied previous experience and just in time learning to correctly identify injection landmarks on a simulated model. Having a centralized video bank may decrease prep time for infrequently performed procedure.