• Jeffrey A Tabas, Jon Rosenson, Daniel D Price, Dana Rohde, Carina H Baird, and Nripendra Dhillon.
• Department of Medicine, University of California, San Francisco, CA, USA. jtabas@sfghed.ucsf.edu
• Acad Emerg Med. 2005 Aug 1;12(8):782-5.

BackgroundPreparing medical students for residency in emergency medicine involves education in many areas of knowledge and skill, including instruction in advanced emergency procedures.ObjectivesTo outline the logistics involved in running a training course in advanced emergency procedures for fourth-year medical students and to report students' perceptions of the impact of the course.MethodsThe course is a cadaver-based training laboratory that utilizes several teaching modalities, including a Web-based syllabus and online streaming video, didactic lecture, hands-on practice with models and ultrasound, and hands-on practice with unembalmed (fresh) cadavers. The course focuses on seven emergent procedural skills, including deep venous access via the subclavian, internal jugular, and femoral veins; tube thoracostomy; saphenous vein cutdown; intraosseous line placement; and emergency cricothyrotomy. The course is taught by attending emergency physicians and anatomy department faculty. After completion of the course, students reported their self-assessments on a five-point Likert scale. Data were evaluated using a paired t-test (two-tailed).ResultsThirty-three students completed the evaluation. The students reported a mean (+/- standard deviation [SD]) increase in their understanding of the indications for all procedures from 3.3 (+/- 1.1) before to 4.8 (+/- 0.4) after the course (p = 0.004, 95% CI = 0.7 to 2.0). The students reported a mean increase in their understanding of how to perform all procedures from 2.1 (+/- 0.9) before to 4.6 (+/- 0.6) after the course (p = 0.003, 95% CI = 1.9 to 3.0). The students reported a mean increase in their comfort level performing all procedures from 1.6 (+/- 0.8) before to 4.2 (+/- 0.7) after the course (p < 0.001, 95% CI = 2.0 to 2.9).ConclusionsThese findings support the value of an advanced emergency procedural training course using an unembalmed cadaver-based laboratory and incorporating several teaching modalities.

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