Background: Emergency medicine (EM) requires proficiency in high-acuity, low-occurrence (HALO) procedures. Opportunities to perform these procedures often decline after training, potentially leading to skills attrition that can affect patient safety. There is currently no standard mechanism for maintenance of procedural skills for EM faculty. Based on a previously published needs assessment, we designed and implemented a skills maintenance curriculum for EM faculty: Methods: We invited EM faculty to participate in part or all of an optional two-year skills curriculum consisting of three modules: (1) airway, (2) cardiopulmonary procedures, and (3) obstetrics/pediatrics. Participants received pre-learning materials to maximize in-session, hands-on practice. Learners divided into small peer groups and practiced skills on simulation-based models under direct observation of instructors who were EM and non-EM faculty with content expertise (e.g., pediatric EM, ultrasound, obstetrics, neonatology). Participants completed pre-, post-, and 6-month surveys via REDCap to assess: frequency of performing or supervising procedures, curriculum effectiveness, confidence, attitudes pertaining to skills attrition, and opportunities for program improvement. Results: Overall faculty participation across all three modules was 39.5%. Faculty performed or supervised about half of the HALO procedures at least once in the prior year, with supervision more common than performance. For nearly all procedures, there was an increase in self-reported confidence immediately post-training which declined at 6 months but remained above baseline. All faculty agreed that skills maintenance was important, and 83.6% reported experiencing skills attrition personally. Conclusions: A faculty-targeted, simulation-based curriculum produced sustained rates of confidence in performing HALO procedures. This study demonstrates the impact of a structured program and its association with increased self-reported confidence in HALO procedures among EM faculty. Future work will seek to refine, scale, and disseminate the curriculum and ultimately study its impact on clinical care.
Trembley et al. (Wed,) studied this question.