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Boot camps are designed to deliver highly specific education in a short amount of time. Educational boot camps are known to improve confidence in clinical capabilities and medical knowledge and promote teamwork skills. We created an emergency medicine (EM) boot camp with targeted learning objectives based on expected mastery of post-graduate year (PGY)-level educational objectives based on the Accreditation Council for Graduate Medical Education (ACGME) EM milestones. This boot camp included a qualitative assessment, survey-based feedback, and quantitative assessment, which included the team's performance utilizing a validated code team checklist (Cardiac Code Management Assessment Tool). After attending the conference, EM residents felt more confident in achieving the EM ACGME milestones including the ability to provide immediate interventions to a critical patient, effective use of team communication, the ability to switch tasks efficiently, and to provide real-time feedback to their team. Eighty-six percent of residents preferred this teaching modality over other conference-based didactics and would like to see greater incorporation of similar interventions in future conferences.
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INTRODUCTION: A peritonsillar abscess (PTA) is a frequent reason for a visit to the emergency department. As there are no current published guidelines for medical versus surgical management, attending physicians vary among management tendencies, generating uncertainty among resident physicians. This project established a standard of care for managing patients with PTA and provided clear management guidelines to the emergency department, in collaboration with the otolaryngology department, at a community academic hospital. METHODS: Pre- and post-interventional, anonymous surveys were given to assess resident physician confidence in the management of PTA. A proposed management protocol was developed based on existing literature and approved by both the emergency medicine (EM) and otolaryngology (ENT) departments. The protocol was then disseminated during in-person didactic sessions to EM residents and ENT residents for use over a four-month interventional period. RESULTS: The mean confidence level for all residents increased significantly after the implementation of the protocol (p<0.001). The increase in confidence level for "antibiotic selection for PTA" (p=0.72) and "inpatient PTA management" (p=0.20) was not statistically significant for the post-graduate year (PGY) 3 and 4 residents. The increase in confidence level was higher overall for PGY 1 and 2 residents (95% CI 2.25 ± 1.09, p<0.001) than for PGY 3 and 4 residents (95% CI 1.73 ± 1.09, p=0.003). CONCLUSION: The implementation of a standardized protocol for the management of PTA proved to be an effective tool in assisting residents and improving their confidence. This study highlights the importance of establishing guidelines in clinical practice to promote consistent and evidence-based management strategies for PTA. By providing clear guidelines, this protocol enhances communication among healthcare providers and contributes to the delivery of high-quality care to patients with PTA.
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BACKGROUND: The video laryngoscope (VL) has been widely used for intubation in the emergency department (ED). However, their effectiveness remains controversial, particularly among airway management performed by residents in the ED. METHODS: We aimed to examine whether the use of VL, compared to a direct laryngoscope (DL), was associated with higher first-attempt intubation success among intubations performed by residents in the ED. This is a secondary analysis of the data from a prospective, observational, multicentre study of 15 Japanese EDs from April 2012 through March 2020. We included all adult patients who underwent intubation with VL or DL by residents (postgraduate years ≤5) in the ED. The outcome measures were first-pass success and intubation-related adverse events (overall, major, and minor adverse events). To determine the association of VL use with each of the outcomes, we constructed logistic regression models with generalized estimating equations to account for patients clustering within the ED, adjusting for patient demographics, primary indications, intubation difficulty, and intubation methods. RESULTS: Of 5,261 eligible patients who underwent an initial intubation attempt by residents, 1,858 (35%) patients were attempted with VL. Intubations performed with VL had a non-significantly higher first-pass success rate than those with DL (77% vs. 64%; unadjusted odds ratio (OR)=1.20; 95% CI=0.87-1.65; P=0.27). This association was significant after adjustment for potential confounders (adjusted OR, 1.33; 95% CI, 1.06-1.67; P=0.01). As for adverse events, the use of VL was associated with a lower rate of any (adjusted OR=0.67; 95% CI=0.51-0.86; P=0.002) and minor (adjusted OR=0.69; 95% CI=0.55-0.87; P=0.002) adverse events. CONCLUSION: The use of VL was associated with a higher first-attempt success rate and a lower rate of any adverse events compared to that with DL among intubations performed by residents in the EDs.
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Background Residents from diverse specialties perform clinical rotations in the emergency department (ED). There is little research about the value of the ED rotation for them. Objectives We sought to determine the learning objectives of non-EM residents (NEMRs) in the ED, the effectiveness of the rotation, and the highest-yield components of their experience. Methods From 2017-2019, we surveyed NEMR on their pre-rotation learning objectives and their comfort level with 15 common ED presentations/procedures before and after the rotation. We assessed how well their objectives were met, the highest-yield components of their rotation, and opportunities for improvement. Results We collected responses from 56 (47%) pre-rotation and 61 (51%) post-rotation residents over a two-year period. The five most commonly cited learning goals were: management of acutely ill patients, triage skills, procedural competence, and ultrasound. Seventy-eight percent (78%) of residents reported their learning goals were moderately to very well met during their rotation. NEMRs' level of comfort improved in all the commonly encountered clinical experiences in the ED in a statistically significant manner. They cited on-shift teaching by attending physicians and senior EM residents as the most valuable learning resource. Conclusion NEMR from diverse medical and surgical specialties could identify specific learning objectives for their EM rotation with common themes, and the majority felt their educational goals were met. They gained comfort with the management and triage of all the assessed common ED conditions. By collecting and defining their specific needs and goals, we are better equipped to improve the quality and value of the rotation.
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Background and objective Emergency medical services (EMS) are often assumed to only involve bringing patients to physicians for treatment in the emergency department. However, EMS staff are also responsible for responding to physicians in the primary care setting when medical emergencies arise. While emergency medicine (EM) residents are exposed to EMS as part of their curriculum, little is known about the knowledge of other resident physicians who may interact with EMS. In light of this, we conducted this study to address the scarcity of data related to this topic. Methods A quantitative cross-sectional knowledge assessment was conducted among resident physicians in emergency medicine, internal medicine, family medicine, pediatric, and combined medicine and pediatric residencies at the Penn State Milton S. Hershey Medical Center. Results Eighteen EM residents and 26 non-EM residents completed the assessment. The EM residents had a higher average score when compared to non-emergency medicine residents (69.2% vs. 53.8%, p=0.0012). Conclusion Variations in scores between EM and other specialties that interact with EMS highlight the need for further training and familiarization related to EMS for residents in non-EM specialties.
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Introduction Musculoskeletal (MSK) complaints and injuries account for a large percentage of presenting chief complaints to the emergency department in the United States (US). Despite the prevalence and economic impact on the US healthcare system, there is a documented deficiency in MSK education at all training and practicing levels in the US medical system. The purpose of this needs assessment is to better determine the state of MSK education in Emergency Medicine residency programs. Methods An online needs assessment form was sent to Emergency Medicine program directors in the US. Summary statistics were performed followed by an exploratory analysis. Results Data from 43 of 272 Emergency Medicine program directors that responded to this needs assessment were analyzed. Respondents ranked the importance of MSK education in Emergency Medicine on a Likert scale of 1-5 (very unimportant to very important) at a mean of 4.2. Additionally, 97.6% of respondents believe that their MSK curriculum could be improved. Seventy-nine percent of respondents were somewhat likely or highly likely to use a standardized method or tool to assess MSK knowledge. Of the top three barriers to MSK education implementation, 94.9% cited time, 56.4% cited interdepartmental relations, and 46.2% cited funding. Conclusion MSK knowledge is taught and assessed in highly variable methods across Emergency Medicine residency programs. Although efforts are being made to address the known deficiency in MSK knowledge, further research is needed to perform a larger needs assessment, study innovative MSK education modalities, and develop a standardized MSK assessment for Emergency Medicine residency training.
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Objective Gender bias against female physicians has been frequently demonstrated and associated with negative feelings toward their careers. Gender bias has also been demonstrated in prehospital clinical care. However, potential gender bias during paramedic-physician handoffs has not been studied. This study aimed to identify gender bias during interactions between prehospital personnel and emergency physicians at the time of patient handoff. Methods An observational study was conducted at an urban academic emergency department. Observers were trained to record information from paramedic-physician handoffs but were blind to the nature of the study. The primary outcome was to whom paramedics initially directed the focus of their handoff report based on physician gender, with secondary outcomes of to whom paramedics directed most of their report and whether they asked about further questions based on physician gender. Results There were 784 observed handoffs. There was no significant association between the gender of the physician and which physician received first attention (χ2 {1, N = 782} = 0.9736, p = 0.3238) or majority attention (χ2 {1, N = 780} = 1.9414, p = 0.1635). Paramedics were more likely to ask questions to male attendings than female attendings (χ2 {1, N = 784} = 4.4319, p = 0.0353). Conclusion We identified limited differences in communication based on gender between paramedics and physicians during emergency department patient handoffs.
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Over 1.5 million U.S. adolescents rely on emergency services for the majority of their healthcare, with increasing presentations (particularly for mental health complaints) during the coronavirus disease 2019 (COVID-19) pandemic. However, a majority of physicians practicing emergency medicine report feeling unprepared to care for adolescent patients. In turn, adolescent patients often report feeling uncomfortable or unsafe when attempting to access emergency care. Despite this deficiency, the extent to which adolescent medicine is addressed during emergency residency medical training remains unclear. Our objective in this systematic review was to identify any existing, publicly available curriculum targeted to teach adolescent emergency care during emergency medicine residency. We conducted a keyword search within the Medline Ovid, Embase, Web of Science, and Cochrane databases to identify relevant literature published between the years of 1968 and 2021; publications meeting inclusion criteria were then analyzed for content. Despite an extensive review of the existing literature, we identified no systematized curriculum and only seven individual papers describing educational efforts to promote competency in adolescent care among emergency medicine residents. Of the resources available, none provide instruction on the management of multiple adolescent presentations, nor common conditions that should be included in a more comprehensive general emergency residency curriculum. No standardized curricula exist for the instruction of relevant adolescent care in an emergency medicine residency. We conclude that the available education for emergency medicine residents is lacking in the area of adolescent care and future work is needed to identify specific competencies to target with further intervention.
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Recognizing and treating reversible causes of lethargy and altered mental status is crucial for emergency department physicians. One such tool that can quickly help guide resuscitation and a patient's workup is a point-of-care glucose reading. This simple test is performed routinely; however, how much thought is given to the accuracy of these tests? What factors can alter these results? Here, we present a patient who was reported to be hyperglycemic in the field by emergency medical services (EMS) but was profoundly hypoglycemic during his workup in the emergency department. This case report highlights factors that can cause false hyper- and hypoglycemic readings on point-of-care glucose meters.
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Introduction Emergency medicine (EM) postgraduate medical education in Canada has transitioned from traditional time-based training to competency-based medical education (CBME). In order to promote residents through stages of training, simulated assessments are needed to evaluate residents in high-stakes but low-frequency medical emergencies. There remains a gap in the literature pertaining to the use of evaluative tools in simulation, such as the Resuscitation Assessment Tool (RAT) in the new CBME curriculum design. Methods We completed a pilot study of resident physicians in one Canadian EM training program to evaluate the effectiveness and reliability of a simulation-based RAT for pediatric resuscitation. We recorded 10 EM trainees completing simulated scenarios and had nine EM physicians use the RAT tool to evaluate their performances. Generalizability theory was used to evaluate the reliability of the RAT tool. Results The mean RAT score for the management of pediatric myocarditis, cardiac arrest, and septic shock (appendicitis) across raters was 3.70, 3.73, and 4.50, respectively. The overall generalizability coefficient for testing simulated pediatric performance competency was 0.77 for internal consistency and 0.75 for absolute agreement. The performance of senior participants was superior to that of junior participants in the management of pediatric myocarditis (p = 0.01) but not statistically significant in the management of pediatric septic shock (p=0.77) or cardiac arrest (p =0.61). Conclusion Overall, our findings suggest that with an appropriately chosen simulated scenario, the RAT tool can be used effectively for the simulation of high-stakes and low-frequency scenarios for practice to enhance the new CBME curriculum in emergency medicine training programs.
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(1) Background: The early screening strategy for type A acute aortic syndrome (A-AAS) patients has always been challenging. (2) Methods: From September 2020-31 March 2022, 179 consecutive patients with suspected A-AAS were retrospectively reviewed. We assessed the diagnostic value of the use of handheld echocardiographic devices (PHHEs) by emergency medicine (EM) residents either alone or in combination with serum acidic calponin in this patient group. (3) Results: The direct sign of PHHE had a specificity (SP) of 97.7%. The sign of ascending aortic dilatation showed SE = 77.6%, SP = 68.5%, PPV = 48.1% and NPV = 89%. SE, SP, PPV and NPV of a positive PHHE direct sign were 55.6%, 100%, 100% and 71.4% in 19 hypotension/shock patients with suspected A-AAS, respectively. The area under curve (AUC) of acidic calponin combined with an ascending aorta diameter >40 mm was 0.927, with an SE and SP of 83.7% and 89.2%, respectively. These two combined indicators significantly improved the diagnostic efficiency of A-AAS compared with either of them alone (p = 0.017; standard error 0.016, Z value 2.39; p = 0.001, standard error 0.028, Z value 3.29). (4) Conclusion: EM resident-performed PHHE was highly indicative of A-AAS in patients presenting with shock or hypotension. An ascending aorta diameter > 40 mm combined with acidic calponin demonstrated acceptable diagnostic accuracy as a rapid first-line triage tool to identify patients with suspected A-AAS.
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Background The Accreditation Council for Graduate Medical Education defines Level 1 as "the resident demonstrates milestones expected of an incoming resident," yet a previous study of emergency medicine (EM) interns showed most were not meeting Level 1 milestones. In addition, previous research indicates that residents often provide more favorable self-assessments when compared to faculty assessments. Our study, performed in July 2022, aims to determine whether incoming EM residents remain behind on Level 1 care-based milestones and if resident self-assessments are consistent with faculty assessments. Methodology This is an observational study involving five distinct EM residency programs. Incoming interns were directly assessed by faculty for behaviors associated with the care-based milestones for EM using a standardized survey. Interns were asked to complete this same survey regarding their own performance. Results Faculty completed a total of 101 assessments on 49 residents. Of the 49 residents, 39 completed self-evaluations (80%). Achievement of Level 1 ranged from 25% to 82%. Residents had significantly higher self-assessments than faculty assessments on PC-1, PC-5a, and PC-6a. Faculty assessments were significantly higher than resident self-assessments on PC-6b. Conclusions Greater than 75% of incoming interns were able to meet Level 1 milestones in three of seven care-based milestones. However, there is a generalized trend toward overall improvement when compared to previous studies. Residents continue to demonstrate higher self-assessments than faculty in three separate care-based milestones and faculty rated residents significantly higher in one care-based milestone. This is consistent with previous studies.
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Introduction Burnout rates for emergency medicine residents are high. One intervention and initiative to enhance wellness and address burnout is the resident retreat. Retreats have multiple formats and are often designed with an emphasis on social events. This longitudinal retreat curriculum for a three-year residency training program was designed emphasizing rest, a step away from what is familiar, and reflection. Methods Individual resident retreats were designed for each year of postgraduate training. The agenda for each is organized and intentional. Activities focused on personal well-being, self-reflection, team building, professional development, and physical activities are coupled with topics unique to class year roles and responsibilities. Retreats are held away from the hospital establishing a separation from the workplace. Results The retreat program has been sustainable for almost decades with trainees evaluating it highly. Faculty and residents enthusiastically participate in the program and consider it a fundamental part of the residency; 93.75% of residents surveyed strongly agreed that the retreats benefit their training while 94.2% strongly agreed that retreats increased their enthusiasm for training. Conclusions An emergency medicine resident retreat program focusing on unique elements for each post-graduate year is achievable and sustainable in an emergency medicine residency program. Over time, the retreat has become an integral part of the residency experience with positive experiences for both faculty and trainees.
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Background Fractures are common in the emergency department, and fracture management training poses certain challenges. Recent emergency medicine (EM) residency graduates feel only somewhat prepared to manage fractures. In this study, our objectives were to determine the effect of introducing a wrist fracture simulator (Sawbones®) to traditional EM fracture management education and to assess resident attitudes, comfort with fracture management, and perceptions of the simulator. Methodology This six-month prospective study involved postgraduate year one residents at two academic EM programs. For convenience, each residency was considered as one test group. One residency group was deemed the traditional group (n = 10), while the other was the intervention simulator group (n = 16). Identical traditional lectures and buddy splinting workshops were provided. The simulator group received supplemental training with the Sawbones® simulator. Groups were filmed using this simulator for fracture management before the teaching sessions and at six months. Grading utilized a 27-point scale, with a subscale covering reduction. Data were collected regarding attitudes, comfort with fracture management, and perceptions of the simulator. Results In total, 26 residents participated in the study. There was no significant difference between groups at six months in overall fracture management scores (traditional group: 15.8 ± 3.1; simulator group: 15.4 ± 3.9; p = 0.92). On the subscale of fracture reduction skills, the simulator group showed significant improvement (p = 0.0078), while the traditional training group did not (p = 0.065). Both groups reported satisfaction with the simulator, improved comfort, and knowledge of fracture management. Conclusions Fracture management is an essential competency, and prior research has shown that most graduating EM residents do not feel comfortable with these skills. All participating residents in this study struggled with adequate fracture management, even after the teaching session. Our study suggests that there is a benefit to supplementing traditional training with a fracture simulator.
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BACKGROUND: Podcasting has become a primary delivery model for medical content among various specialties. Although this model is still growing, it has become an essential tool for many learners, educators, and institutions. Because of this rapid growth, there is an unknown availability of podcasts for each specialty. OBJECTIVES: This paper aimed to evaluate the podcasts currently available in the subspecialty of pediatric emergency medicine (PEM). METHODS: The investigators sought to evaluate the prevalence of PEM podcasts from the end-user's (medical students, residents, etc.) perspective. This was completed by performing a simple internet search using the term "podcasts in pediatric emergency medicine." Using Google Search, the first 50 results were analyzed. RESULTS: For PEM, there were only eight podcasts found, five of which were active. CONCLUSION: PEM podcasts in comparison to other specialties are currently underrepresented and lacking in this important resource. The authors call on PEM physicians, educators, and organizations to consider creating content in this educational space.
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Introduction The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) is a three-part series of examinations similar to the United States Medical Licensing Examination (USMLE) that osteopathic medical students must pass for medical licensure. Osteopathic students are not required to take the USMLE, but during the residency admission process, many emergency medicine (EM) residency programs will not consider osteopathic applicants who only take the COMLEX-USA. Therefore, we examined program-level characteristics between programs that accept the COMLEX-USA alone for osteopathic applicants and those that prefer the USMLE using free, publicly available online databases and residency program websites. Methods Emergency Medicine Residents' Association (EMRA) Match was the primary database used; however, missing exam preferences were supplemented from Fellowship and Residency Electronic Interactive Database Access (FREIDA) and individual program websites. Program characteristics were compared between EM residencies that accept the COMLEX-USA and those that prefer the USMLE using the Chi-square test for categorical variables and the Mann-Whitney test for interval variables. Results Two hundred sixty of the 278 EM programs in the dataset were included in the analyses. One hundred and seven programs reported preferring the USMLE, while 151 reported accepting the COMLEX-USA alone. Programs differed by the educational environment of the primary training site (p <0.001), number of Standardized Letter(s) of Evaluation (SLOE) needed for an interview (p = 0.042), emergency department (ED) shift length (p = 0.021), former American Osteopathic Association accreditation (p <0.001), percentage of osteopathic residents (p <0.001), annual ED volume (p = 0.001), number of intern positions (p <0.001), and number of elective weeks (p = 0.028). Conclusion EM residency programs that reported accepting the COMLEX-USA alone for osteopathic applicants differed from those that prefer the USMLE. Therefore, osteopathic medical students interested in EM should consider these differences when deciding whether to take the USMLE.
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BACKGROUND: Rural rotations can be a valuable experience for emergency medicine (EM) residents. To date, there has not been a retrospective cohort study comparing procedures performed at urban versus rural emergency departments (EDs). OBJECTIVES: The purpose of this study was to compare procedures performed by EM residents in urban versus rural EDs, with the hypothesis that there will be no significant difference in the procedures performed. METHODS: A retrospective cohort study was conducted comparing procedures performed by second- and third-year EM residents based on medical chart review. The procedures were counted at three locations in West Virginia, including a small rural ED, a large rural ED, and a tertiary care ED. Procedure notes were collected from September 2018 to September 2019. The final analysis included nine months, as three months did not have residents at all locations. Eight procedures were standardized based on the number of procedures performed per 100 hours worked by residents. A comparison of total procedures and complex versus simple procedures was performed. A Kruskal-Wallis H test was performed to compare resident hours for procedures between each of the three locations. To compare each of the hospitals to one another separately, Mann-Whitney U tests were performed. RESULTS: The total resident hours worked included 1,800 at the small rural ED, 13,725.5 at the tertiary care ED, and 5,319 at the large rural ED. A p-value of 0.0311 for the Kruskal-Wallis H Test indicated a difference between at least two of the ED sites. A statistically significant difference exists (p-value = 0.0135) between the urban ED (95% CI: 0.15-0.62) and the large rural ED (95% CI: 0.54-1.53). There was no significant difference in complex versus simple procedures among the three locations (p-value = 0.4159). CONCLUSIONS: When compared with the tertiary care ED, residents performed more total procedures at the large rural ED and similar total procedure numbers at the small rural ED when standardized for hours worked. There was no significant difference when comparing complex and simple procedures among the three locations.
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OBJECTIVES: Many health care providers experience physical and verbal abuse from patients and their visitors. This abuse is a form of workplace violence and likely has negative implications for the providers well-being. The objective of our study was to determine the rates of nonphysical workplace violence against emergency medicine (EM) trainees with a focus on prevalence by provider gender. METHODS: This was a single-center prospective cohort study using tally counters to track occurrences of nonphysical workplace violence perpetrated by patients and their visitors against EM trainees in the adult emergency department. RESULTS: There were a total of 39 completed responses submitted by 22 respondents. Of the 22 respondents, 14 identified as women and eight identified as men. On average, both men and women experienced near daily occurrences of nonphysical workplace violence. However, women experienced higher rates compared to their colleagues who are men with a mean of three occurrences per day versus 0.9, respectively. CONCLUSION: We found that women trainees were more likely to experience nonphysical workplace violence from patients and their visitors.
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INTRODUCTION: At present, there exists no standard orthopedic training for emergency medicine (EM) residency programs. Varying residency environments including but not limited to volume, acuity, and competing residency programs will dictate the number of orthopedic procedures a resident is exposed to, ultimately dictating a graduate's comfort level with orthopedic procedures. Our study set out to investigate further whether training alongside an orthopedic residency affects an attending physician's perceived procedural comfort. METHODS: This is a cohort study utilizing a 14-question survey distributed to an online community of EM physicians to examine the relationship between training at a residence program alongside orthopedic residents, the utility of an elective orthopedic rotation, and the overall confidence in managing closed reductions. RESULTS: EM physicians trained at a program that also hosted an orthopedic residency were more likely to train at large academic tertiary care centers (78%). Forty-two percent of these respondents felt that the presence of an orthopedic residency had a negative impact on their overall orthopedic training. The remaining 58% felt that the orthopedic residency had a positive impact on their procedural skills. In our study, the overall mean comfort level was statistically significant (p-value = 0.0024) higher in those who trained without orthopedic residents (8.78) compared to those who trained alongside an orthopedic residency (7.61). Those who had an elective orthopedic rotation found it to be more beneficial if they did the rotation with an orthopedic residency (p-value = 0.0329). Those who reported a beneficial orthopedic rotation also reported a higher level of confidence in the management of non-fracture reductions (p < 0.011, ρ = .25). CONCLUSION: Seeing as though both training and practice environments for emergency physicians vary greatly across the country, every effort should be taken to ensure graduating residents are prepared to perform orthopedic procedures without the assistance of orthopedic surgeons. Irrespective of whether a program has in-house orthopedic residents or not, EM residents should take it upon themselves to maximize their time during residency to focus on these core competencies. Graduates at the greatest risk of having low confidence are trained at academic centers that also host orthopedic programs. One should be cognizant of this while going through their EM residency.
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INTRODUCTION: Ischemic priapism is an emergent condition requiring immediate intervention. However, the incidence is estimated to be very low. Given the low incidence of this pathology, some emergency medicine residents do not have the opportunity to perform needle aspiration, the critical procedure to achieve detumescence. We sought to fill this void by creating low-cost, high-fidelity trainers for emergency medicine resident procedural competency. METHODS: Using items obtained online and through our hospital's simulation department, we created a low-cost priapism trainer from previously described literature. Residents completed a lecture, lab, and short post-course survey regarding helpfulness, realism, prior procedure experience, and future applicability of our training device. Descriptive data were calculated using the median with interquartile range. RESULTS: The trainer cost roughly $25 to create per unit. All participants rated the trainer a 5 for helpfulness. When asked if the lab appeared realistic, there were overly positive responses with a median of 5 (interquartile range [IQR] 4-5), with every respondent selecting either realistic (4 on the Likert scale) or very realistic (5 on the Likert scale). All participants (100%) agreed that they would recommend the use of this trainer for future medical students and residents. CONCLUSION: Priapism, specifically ischemic priapism, is truly an emergent condition requiring immediate intervention. The incidence of this condition is low, and some emergency medicine residents may not have the opportunity to perform the procedure during training. Given the need for simulated experiences, we developed a low-cost, high-fidelity trainer that was found to be helpful and realistic to emergency medicine residents. While other models exist, our model minimizes cost while maximizing realism.