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A procedural skills training needs assessment of rural EM physicians in NL and perceptions on the use of remote tele-simulation to bridge the gap.


Presented at MESC 2017, St. John's, NL

Purpose: Regular clinical exposure to uncommon or high-risk procedures during training is often quite limited. Compounded with degradation of procedure specific skills and knowledge over time, later encounters are more challenging and have higher likelihood of error. A low-risk simulation-based environment to practice and review key information can be valuable to maintenance of a wide array of skills. The delivery of simulation-based training to trainees outside central academic centers can be costly and challenging with respect to time and resources. Effective delivery of expert instruction and guidance by a geographically separated mentor via tele-simulation could prove to be a valuable approach in this setting.

Methods: A web-based needs assessment targeting physicians in rural emergency departments (EDs) was developed. The survey was distributed via a contact list through the Newfoundland and Labrador Medical Association (NLMA). The survey collects information on demographics and opinions about simulation-based instruction. Participants are asked to rank their comfort performing a number of selected procedures, their desire to have further training and to make suggestions on refining the list of topics that modules should cover.

Results: The results of the survey will be compiled and undergo quantitative as well as thematic analysis. These results will be used to inform the development of a series of modules focused on core procedural skills relevant to the target audience. Modules designed to cover core information will include pre-session distribution of information such as relevant reading and audio-visual materials to cover key points. During mentor-guided instruction sessions, procedure-specific indications, contraindications, complications and equipment will be reviewed in the context of case-based scenarios. Challenges of delivering effective mentor guided tele-simulation will be addressed.

Conclusion: The provision of medical care in rural and remote settings can be particularly challenging when low-frequency high-stakes procedures must be performed. Delivery of simulation-based teaching facilitated by a geographically separated mentor using effective tele-simulation may help bridge gaps in knowledge and technical skills.


A procedural skills training needs assessment of rural EM physicians in NL and perceptions on the use of remote tele-simulation to bridge the gap.

Author Information

Cody Dunne Corresponding Author

Faculty of Medicine, Memorial University of Newfoundland, St. John's, CAN

Megan Pollard

Emergency Medicine, Memorial University of Newfoundland

Michael H. Parsons

Emergency Medicine, Memorial University, St. John's, NL, CAN

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