Tag Archives: Training

CREM to run an interprofessional learning course for rural paramedics, doctors, and nurses

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The CREM team has received funds from the Australasian College for Emergency Medicine to develop an inter-professional short course focussed on the management of trauma patients in rural areas.  Although rural and metropolitan clinicians may be required to manage similar patient presentations, rural practice presents unique challenges related to resourcing and clinical exposure not often encountered by medical professionals working in larger towns and cities.  In rural areas, there is a higher likelihood of nurses, GPs or paramedics working in isolation and being required to manage critical patients with fewer resources.  With this in mind, we think there is a great advantage in bringing together clinicians from different backgrounds and providing them with the opportunity to learn from, with and about each other.  Often, the difference between a case that is managed well and one where multiple errors occur is the way in which the team interacts.  The way in which a team interacts is often dependent on the background, experience and attitude of each person in that team.  By developing a short course based on the principles of inter-professional education, our aim is provide rural clinicians with the tools to adapt to, contribute to, and lead within multi-disciplinary teams.

We aim to run a pilot course in November 2016 in order to refine the facilitation and debriefing skills of the CREM teaching staff, and to run the first course in January 2017.  The course format will include an online component and 2 day workshop utilising team training activities and patient scenarios using high-fidelity simulation.  Scenarios will include pre-hospital and in-hospital cases providing participants with the opportunity to develop patient management skills in an environment they may be unfamiliar with.

Emergency Medicine may not be what you think it is

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Welcome to your medical student Emergency Medicine rotation. You may feel very familiar with emergency medicine. It is a staple of prime-time television drama, and you will have almost certainly visited the emergency department during your previous rotations. Other specialists may have given you their opinion, not always flattering, of the emergency department. We hope that while you are with us, we will deepen your understanding of emergency medicine, and help you learn skills that will help you throughout your medical career.

There will certainly be emergencies. On any shift, you could suddenly be a practical part of a team that is striving to save a patient’s life. You will learn the basics of keeping a patient alive. But you will also find that critical care is not the only part of emergency medicine. It is not even the most difficult part.

Emergency medicine deals with undifferentiated illness. By the time a patient reaches the inpatient ward, they often have a label of pneumonia, angina or appendicitis. In the emergency department they had shortness of breath or abdominal pain. Emergency medicine is a diagnostic specialty. Most of our time is spent trying work out who is really sick, without taking too much time or ordering unnecessary tests. The most stressful aspect of emergency medicine can be deciding whether to send home a patient with a headache that is probably a migraine, but just might be a cerebral haemorrhage.

The emergency department is also where the hospital meets the community. On a single day you may speak to general practitioners, specialty units, community teams, health administrators, paramedics and the police. The stresses on the health system are often most obvious here. You will see how people move between various areas of health care. You will see how they can end up in the emergency department when they fall through the cracks. You may also see how the stresses of shift work and time pressures affect you.

In these few weeks, you will perform many practical skills for the first time. Minor procedures are common in the emergency department. You should have practiced these tasks in the skills lab, but performing procedures on real people is different; they feel pain, they move, their anatomy is unique, and they may ask you to stop. Practicing procedures on patients will make you feel uncomfortable. To become a practical doctor you must become comfortable with being uncomfortable. We will be here to help. You are part of the team, and performing procedures, if consent is given, that the patient needs. It gets easier. You need to become comfortable with the basic skills, so that when you are an intern you can become uncomfortable again with even more advanced tasks.

So welcome again to your emergency rotation. It might not be what you expect, but it may be what you need.

South West Healthcare Upskilling Emergency Department Doctors Under the Emergency Medicine Programme

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South West Healthcare has employed three trainee doctors undertaking their specialist emergency medicine training thanks to funding under the Emergency Medicine Programme (EMP) from the Commonwealth Government.

EMP funds Specialist Training Posts to enable trainee emergency doctors to experience the lifestyle and work environment of rural and regional settings.

Director of South West Healthcare Emergency Department and the Centre for Rural Emergency Medicine, Dr Tim Baker said ‘our aim is to help recruit rural medical students, train them locally at Deakin University and provide as much of their specialist training as possible, here in the country. This is the best way to have doctors build country lives and, therefore, stay in the country.’

In addition, the Emergency Education and Training (EMET) program provides surrounding small hospitals, including Portland, Camperdown, Terang and Hamilton with visits, assistance, and training from the emergency specialist doctors based at Warrnambool.

South West Healthcare is one of 43 EMET hubs across Australia. In the past 30 months, the EMET program has been responsible for delivering more than 3,000 training sessions to 25,000+ doctors and nurses in more than 200 regional, rural and remote hospitals.

The EMET programme seeks to improve care for patients requiring urgent and emergency medical services in rural and remote areas by providing education, training and support to the large number of doctors and nurses working in the smaller hospitals and emergency care services who are not specifically trained in emergency medical care.

Dan Tehan, Member for Wannon said “that programs such as the EMP and EMET help to encourage health professionals who are committed to rural and regional areas at the completion of their training.”

 

Small rural emergency services can electronically collect accurate episode-level data: A cross-sectional study

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Small rural emergency services (SRES), unlike larger emergency departments, seldom collect clinical and administrative data about every patient they manage.

Samantha Dawson, Tim Baker, and Scott Salzman studied six SRES that collected this type of detailed data for 12 months.

The SRES were able to collect accurate and mostly complete electronic episode-level data for 12-months with four hours per week of support. This study provides starting data accuracy benchmarks for specific fields collected in SRES and could be used to inform decisions about widespread electronic data collection across these services.

Access article on publisher’s site

Dawson SL, Baker T, Salzman S. Small rural emergency services can electronically collect accurate episode-level data: A cross-sectional study. Aust J Rural Health. 2015, Apr;23(2):107-11.