TITLE:
Physician-Rated Utility of Procedure Videos for Teaching Procedures in the Emergency Department, Overall and during Emergency Department Crowding
AUTHORS:
Clare L. Atzema, R. Alexandra Stefan, Refik Saskin, Greg Michlik, Peter C. Austin
KEYWORDS:
Teaching; Education; Procedures; Emergency Department; Video
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.3 No.7A,
January
2,
2013
ABSTRACT:
Background: Real-time use of procedure videos as educational tools has not been
studied. We sought to determine whether viewing a video of a medical procedure
prior to procedure performance in the emergency department improves the quality
of teaching of procedures, and whether videos are particularly beneficial
during periods of emergency department
crowding. Methods: In this
single-centre, prospective, before and after study standardized data collection
forms were completed by both trainees and supervising emergency physicians
(EPs) at the end of each emergency department shift
in the before (August 2008-March 2009) and
after (August 2009-March 2010) phase. Online procedure videos were introduced on emergency
department computers in the after phase. The primary outcome measure was EP
rating of the quality of teaching provided (5-point Likert scale). The
interaction between crowding and videos was also assessed, to determine whether
videos provide a specific additional benefit during periods of emergency department
crowding. Results: There were 1159
procedures performed by 192 trainees. Median procedures performed per shift was
1.0 (IQR 0 - 2.0). Mean EP
rating of teaching provided was significantly higher in the group that viewed
videos, at 4.2 versus 3.7 (p 0.001). In the adjusted analysis, EP ratings increased
by 0.5 with a video (p 0.001), while the odds of a score of 5.0 were 2.2 times
greater if a video was viewed (p = 0.03). The interaction of crowding and procedure videos
was not significant (the use of videos increased the average score by 0.24 in times of crowding compared to
times of non-crowding, p = 0.19). Conclusions: Use of
procedural videos was associated with EP perception of improved quality of teaching provided around procedures. While EPs
rated the quality of their teaching as improved overall, the effect of videos
on teaching quality was the same in crowded settings as it was in non-crowded
setting.