Experiential Curricula

Learning is accomplished through both knowledge acquisition and skills practice. These lead to abilities necessary to the practice of emergency medicine. To that end, the faculty have drawn on existing courses and created a variety of novel experiences to enable residents to achieve excellence in all these areas. Most focus on procedural skills, but some also demonstrate how emergency medicine integrates into a system of care for the benefit of the community and the populations at risk.

R1 Year

During the six weeks of R1 orientation, residents are prepared to work in emergency departments and inpatient rotations throughout the area. Additional experiences are interspersed throughout the remainder of the first year.

Basic Disaster Life Support (BDLS)

This is the American Medical Association and National Disaster Life Support Foundation one-day course of didactics introducing an all-hazards approach to disaster response. It is taught exclusively by the Department of Emergency Medicine; however, BDLS is offered to all new residents in all residency programs affiliated with the Dayton Area Graduate Medical Education Consortium, because the Dayton area takes an integrated response to potential disasters very seriously. Triage; responses to natural and manmade events such as chemical, biological, radiological, nuclear, and high-yield explosives; and the psychological impacts of disasters are the primary topics.

BDLS Instructor Course

All emergency medicine residents will become BDLS instructors in either their R1 or R2 year.

Basic Life Support (BLS)

This is the American Heart Association short-course that includes two days of class work, hands-on practice stations, and case-based performance examinations. The focus is on the first steps in the chain of survival for emergency cardiac care. It is offered to all new residents in all residency programs affiliated with the Dayton Area Graduate Medical Education Consortium. Initial victim assessment, activation of the emergency response system, basic airway management, rapid defibrillation, and cardiopulmonary resuscitation are the primary topics.

Advanced Cardiac Life Support (ACLS)

This is the American Heart Association short-course that includes two days of class work, hands-on practice stations, and case-based performance examinations. It is offered to all new residents in all residency programs affiliated with the Dayton Area Graduate Medical Education Consortium, but is taught primarily by faculty from the Department of Emergency Medicine. Advanced airway management, ventilatory support, monitor interpretation, cardioversion, defibrillation, and pharmacological therapies are the primary topics.

ACLS Instructor Course

This course is offered to residents generally in October of the R1 year. It is a one-day course conducted by the Department of Emergency Medicine. Opportunities to teach ACLS in a variety of venues exist throughout the Dayton area.

Advanced Trauma Life Support (ATLS)

This is the American College of Surgeons short-course that includes two days of class work, hands-on practice stations, and case-based performance examinations. It is taught by faculty from the Departments of Emergency Medicine and Surgery, and is offered to all new residents in both programs. Initial victim resuscitation and stabilization prior to surgical intervention is the primary focus.

Pediatric Advanced Life Support (PALS)

This is the American Academy of Pediatrics and American Heart Association short-course that includes two days of class work, hands-on practice stations, and case-based performance examinations. It is taught by faculty from the Departments of Emergency Medicine and Pediatrics, and is offered to all new residents in both programs. Unique pediatric resuscitation situations, airway management, ventilatory support, monitor interpretation, and pharmacological therapies are the primary topics.

Cadaver Lab

This lab occurs up to bimonthly, and involves all resident levels, though the emphasis is on R1 and R2s, and is offered in conjunction with the Department of Neuroscience, Cell Biology, and Physiology. Procedures which are infrequently practiced in the emergency setting are practiced on a fresh human-cadaver model.

Intravenous-Access Lab

All emergency physicians must be skilled in central and peripheral intravenous access. This lab allows R1s to practice cannulation of peripheral veins on simulators, and on each other as human models. Simulators are also used for central venous access using a variety of methods. Ultrasound-assisted access is taught for facilitating both central and peripheral cannulation. Intraosseous access is taught in the procedure lab.

Wound-Care Lab

This lab follows the R1 YDC on the approach to wound management. R1s .

Bedside Ultrasonography Lab

After six hours of didactic instruction, this lab is taught by experienced emergency physicians and professional sonographers from the Kettering College of Medical Arts. Residents will be exposed to a variety of ultrasound machines. They will practice on each other and on human volunteers with real pathological findings.

Decontamination Familiarization Course

A contaminated patient could arrive for care in any emergency department at any time. Emergency physicians must be able to control the scene to prevent further contamination of the facility, properly protect the staff and bystanders, and respond to decontaminate the affected patients while managing any sequelae of that contamination. This course is taught by the staff of the Homeland Emergency Learning and Preparedness Center, which is part of the Department of Emergency Medicine. Wear and working in personal protective equipment, expedient decontamination during resuscitation, and a team approach to prefabricated decontamination systems are the primary topics.

R2 Year

The following experiences are unique to the R2 year. They help prepare residents for expanded roles in emergency departments and in community EMS systems.

Advanced Disaster Life Support (ADLS)

This is the American Medical Association and National Disaster Life Support Foundation that includes two days of class work, small-group discussions, and hands-on practice stations. It is taught by faculty from the Department of Emergency Medicine and several area EMS systems. Community resources, mass-casualty response, triage, decontamination procedures, mass immunizations are the primary topics.

ADLS Instructor Course

All emergency medicine residents will become BDLS instructors in either their R2 or R3 year.

Splinting Lab

This lab is conducted early in the R2 year. It focuses on appropriate splinting and casting techniques of the extremities. It serves as a supplement and precursor to the second year orthopedics rotation. It is scheduled for four hours and is delivered by faculty from the Department of Emergency Medicine.

EMS Extrication Course

This lab is conducted later in the R2 year. It focuses on familiarizing the resident with the various victim-extrication techniques, which they must understand to provide online medical control, and may rarely have an opportunity to observe. The course is taught by experienced rescue personnel, and generally involves the systematic destruction of a car using various extrication tools including the "jaws of life." During this lab, cadre also discuss the medical implications extrication procedures relative to time delays to definitive care of patients.

R3 Year

The following experiences are unique to the R3 year. They help prepare residents for life as a board-certified and independent practitioner of emergency medicine.

Ohio ACEP Review Course

In September of each year one of the best board-review courses in the country is sponsored by the Ohio Chapter of the American College of Emergency Physicians, and occurs an hour to the east of Dayton in Columbus. The department supports the R3 class with time off and financial assistance to attend this course. It is a formal and extremely thorough review of The Model of the Clinical Practice of Emergency Medicine. Its focus is to prepare participants for the American Board of Emergency Medicine. It is a course that is extremely well-respected nationally, and is much appreciated by each senior class prior to graduation.

EMS Base-Station Course

This four-hour course occurs early in the R3 year. It is conducted by emergency medicine faculty following a session reviewing statewide EMS protocols. Areas of focus are on radio communication skills, online medical control procedures, and the practicalities of offline medical control.

All Years

Some skills are so critical they require frequent reinforcement, so two labs are conducted twice for all R1s, and once each for all R2s and R3s. Additionally, some skills are not commonly performed in the emergency department, so they must be practiced in a laboratory setting.

Airway-Intervention Lab

Each class takes this lab annually in the winter, but R1s also receive an introduction during their orientation month. Isolated skill stations and case-based scenarios form the foundation of this educational experience. Residents rotate through various stations becoming familiar with basic and alternative airway adjuncts: lighted stylet; digital intubation; fiberoptic oral and nasal intubation; laryngeal mask airway and intubating LMA; transtracheal jet ventilation; retrograde intubation over a retrograde wire; and a variety of approaches to cricothyroidostomy. The focus is on the critical thinking and decision making necessary for excellent emergent airway management. R2s and R3s are also presented with simulated patient encounters with a greater emphasis on advanced approaches to airway management, and rescue techniques for the failed airway. R3s are expected to be able to assist in teaching techniques during simulated patient encounters.

Procedure Lab

All residents participate in a procedure lab during the month they rotate annually in the combined adult & pediatric emergency department at Wright-Patterson Medical Center. R1s also participate in this laboratory experience during their orientation in July, so they will practice in two sessions during their first year. The focus of these experiences is on resuscitation skills: intraosseous cannulation, venous cutdown, diagnostic peritoneal tap and lavage, needle and tube thoracostomy, resuscitative thoracotomy, internal cardiac defibrillation and massage, and cricothyroidostomy. Any resident may supplement their four sessions on a space-available basis. R3s are expected to be able to assist in teaching procedural techniques.

Mass-Gathering Support

All R levels participate in the emergency preparedness by rotating at the Dayton Air Show during the last weekend in July. The Dayton Air Show is the largest national air show in the country and attracts crowds well over 100,000. Residents and faculty of this department serve as on-site physician support for the mass-gathering medical system. From an educational standpoint, the experience serves as a vehicle to instruct and prepare all residents in disaster planning and response.

Additional Pediatric Intubation Experience

An arrangement exists between our department and the Pediatric Anesthesia Department at Children's Medical Center to afford our residents additional exposure to pediatric airway management. Any resident who is rotating in the CMC emergency department may take the first hour or two of any day shift and spend that time in the operating room intubating pediatric patients. Residents may also schedule additional experiences on their off-time during any rotation.

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