Journal of Education and Teaching in Emergency Medicine

Audience: This rectal foreign body removal model is designed to instruct emergency medicine residents. However, the innovation is appropriate for medical students, advanced practice providers (APPs), attending physicians, and clinicians in other medical specialties.

Introduction: Rectal foreign bodies are relatively uncommon emergency department presentations but are associated with significant morbidity and mortality.¹ These foreign bodies require prompt recognition and skilled management, which can be challenging due to stigma, patient discomfort, and procedural complexity. Learners often have limited opportunities for hands-on experience with rectal foreign body removal, and to our knowledge, no established simulation tool currently exists for training in this procedure. This task trainer was designed as an easily assembled, cost-effective simulation tool to support procedural practice and promote safe, effective performance when applied in the emergency department setting.

Educational Objectives: This task trainer is intended to facilitate hands-on training in rectal foreign body removal. By the end of this training session, learners should be able to: 1) describe the indications and contraindications for rectal foreign body removal in the emergency department, and 2) demonstrate the ability to remove rectal foreign bodies of varying sizes, shapes, and depths of insertion using multiple techniques.

Educational Methods: This innovation consists of a task trainer for the simulated removal of rectal foreign bodies. The tool was constructed using readily available, inexpensive materials to accommodate the removal of foreign bodies of varying sizes and depths, allowing for customizable scenarios of variable difficulty. The session began with a brief didactic overview covering anatomy, tools, procedural steps, and complications of rectal foreign body removal, followed by supervised hands-on practice using the model. Faculty provided individualized feedback to help learners refine their techniques.

Research Methods: A pre- and post-activity survey was administered to participants to assess comfort with rectal foreign body removal and gather feedback on the educational session and task trainer. The pre-activity survey asked learners to report the number of rectal foreign body removals they had performed and to rate their comfort with the procedure on a 7-point Likert scale (1 = totally comfortable, 7 = totally uncomfortable). The post-activity survey included the same comfort scale to allow for comparison, along with additional items evaluating the model and session. Learners rated the model’s realism (1 = extremely realistic, 5 = not at all realistic), the degree to which the session increased their confidence performing the procedure (1 = extremely, 5 = not at all), and the overall usefulness of the model for teaching rectal foreign body removal (1 = extremely useful, 5 = not useful at all). This evaluation approach addressed the reaction and learning levels of the Kirkpatrick model.

Results: Thirty-nine learners completed the pre-activity survey and 37 completed the post-activity survey. Most learners (79%) had never previously performed a rectal foreign body removal. Following the session, learners reported significant improvements in comfort with the procedure. The task trainer received favorable ratings for realism, educational usefulness, and its ability to build confidence in performing the procedure on real patients.

Discussion: This educational session was both effective and well-received. Learners began with limited experience performing rectal foreign body removal, a procedure that may be infrequently encountered but carries significant risk. Providing a structured opportunity for supervised practice in a low-risk environment likely contributed to the observed improvements in reported comfort and confidence.

Beyond numerical gains, this session highlighted an important educational gap: most learners have limited exposure to this procedure that they are likely to encounter in their careers, underscoring the need for accessible methods of training in rare procedures. The favorable feedback regarding realism, confidence, and usefulness suggests that even a simple model can provide meaningful educational value.

The main takeaway is that this rectal foreign body removal task trainer offers a practical, reproducible approach to improving learner preparedness in managing a sensitive and technically challenging procedure in the emergency department setting.

Topics: Rectal foreign bodies, medical simulation, hands-on training, emergency medicine education, rare procedures.