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Coaching as a discipline has seen significant growth in medicine over the last decade, especially in medical education, but is at the early stages of recognition in emergency medicine. The objective of this systematic review was to provide insight into the state of coaching practice and research in emergency medicine and outline a future research agenda. Based on PRISMA guidelines, a structured electronic literature search of Embase, Scopus and EBSCOhost was conducted. Studies were included if they met all three criteria for population ('clinicians'), concept ('coaching'), context ('emergency medicine') and were published in peer-reviewed empirical studies between 2004 and 2024. Data extraction was performed by one investigator and checked for accuracy by a second investigator. A quality assessment was conducted. Of the 1441 unique articles identified in the initial search, 13 studies met the inclusion criteria. Our review revealed three key findings: coaching is examined in relation to clinician well-being and resilience, non-technical skills, and clinician technical skills, however its influence upon non-technical skills is the main focus; coaching studies are predominantly outcome studies, with process studies receiving little attention and; a range of theories and models are used in studies of coaching in emergency medicine. This review revealed that coaching research in emergency medicine is in its infancy, highly fragmented and largely disconnected from the wider coaching research literature. Nevertheless, despite the early stages of the current research base of coaching in emergency medicine, this nascent field is rich with opportunities for future research., (© 2025 The Author(s). Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)

Background: Emergency medicine (EM) residents must complete both adult and paediatric entrustable professional activities (EPAs). During their paediatric emergency medicine rotation at a university paediatric hospital, EM residents struggled to receive EPA assessments because preceptors had not yet been trained due to the stepwise implementation of EPAs. This study aimed to evaluate the impact of a workshop on behaviour change by measuring the number of EPA assessments., Methods: A comparative pretraining and posttraining study involving 27 invited faculty members was conducted to assess the impact of a faculty development programme. The training was delivered via videoconference with experiential learning techniques to practise every aspect of the supervision of an EPA, including selecting the appropriate EPA according to mirroring real-world situations, giving feedback, evaluating autonomy and recording the EPA in the resident's logbook., Results/findings: In total, 20 out of 27 eligible faculty members (74%) agreed to participate in the study. Their main challenges reported were a lack of trainee initiative, preceptor training and competence in supervising EPAs. Over the 12-month analysis period, the enrolled faculty assessed 125 EPAs for 38 EM residents, including 52 pre-intervention EPAs and 73 post-intervention EPAs. Calculation of data points above the median showed a 1-point difference in the EPAs assessments to resident ratio between the pre- and post-intervention periods (3/7 vs. 4/7)., Conclusion: Our findings suggest that faculty training using multiple educational strategies may enable EM residents to receive more EPA assessments during their paediatric emergency medicine rotation., (© 2024 The Author(s). The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Objective: Radiological evaluation of cervical spine injury with computed tomography (CT) scanning is a fundamental component of the assessment of major trauma. Accurate interpretation of scans is essential for safe clearance or diagnosis of injuries. However, delays in radiologist reporting often result in prolonged spinal immobilisation. The aim of the present study was to evaluate a simple, structured reporting tool to improve assessment of CTs of the cervical spine by emergency medicine trainees., Methods: A prospective pre- and post-intervention cohort study was undertaken within a major metropolitan ED. Participants in the pre-intervention phase interpreted a set of randomly selected cervical spine CTs. The post-intervention phase presented the same task with the additional provision of a structured cervical spine CT reporting template designed in collaboration with radiologists and emergency physicians. Interpretation by trainees was evaluated for concordance with the final radiology report by two blinded assessors., Results: A total of 155 cervical spine CT scans were reported by the 46 participants. Participants in the cohorts were similar with regards to experience and country of primary medical degree. Concordance with the radiology report in the pre-intervention phase was 60% (95% CI 0.48-0.71), compared with a concordance of 54% (95% CI 0.42-0.65) in the post-intervention phase (P = 0.46)., Conclusions: Interpretation of cervical spine CT scans by trainees was inferior compared to radiologists and did not improve with a structured reporting template. Other innovative strategies towards timely reporting of CT scans by radiologists of the cervical spine are indicated for earlier definitive diagnosis., (© 2024 Australasian College for Emergency Medicine.)

Objectives: The aim of the present study was to quantify research outputs after completing a Coursework Pathway (CP)., Methods: Emergency medicine trainees who completed a CP during 2012-2022 were included. Research outputs were identified using Medline, EMBASE, Pubmed and Google Scholar., Results: Among 545 eligible candidates, 129 (23.7%) published at least one manuscript, with 319 publications over the study period. There was a significant increase in publications since course completion (IRR 1.13; 95%CI: 1.09-1.18)., Conclusions: A substantial proportion of trainees who completed the CP published subsequent research. This provides a measure for emergency clinicians undertaking research projects after completing the CP., (© 2024 Australasian College for Emergency Medicine.)

Objective: The serratus anterior plane block (SAPB) is a regional anaesthesia technique with increasing use as an analgesic adjunct in patients with rib fractures. The present study aimed to generate consensus of the requirements of education, training and credentialing for the use of a 'single shot' SAPB in the management of rib fractures., Methods: A modified Delphi process was designed using online questionnaires. Expert panellists from Australian and Aotearoa New Zealand were invited from the fields of Emergency Medicine and Anaesthesia and were asked to rate the importance of different components of SAPB education, training and credentialling on a 9-point Likert scale. Consensus was achieved if ≥70% of experts provided a score of seven or greater on this scale for any given statement., Results: Thirty specialists (60% FACEM, 40% FANZCA) representing New Zealand plus all states and territories of Australia formed the expert panel. Participant response rates were 100% (first round), 83% (second round) and 63% (final round). At the end of three survey rounds, 59 consensus statements were formed (27 for education, 5 for training and 17 for credentialing)., Conclusions: This series of expert statements provides consensus on the education, training and credentialling of the SAPB for the management of rib fractures. These serve as the minimum standard by which this procedure should be taught while providing clinicians with a syllabus for the development of training programmes., (© 2024 Australasian College for Emergency Medicine.)

Objectives: Point-of-care ultrasound (POCUS) use is widespread in EDs and throughout those practising medicine. Between institutions and specialities, there is widespread variety and training. With this comes the risk of patient harm and backlash to a clinically useful modality. Our objective is to form a statement that encompasses current published and unpublished guidance for creating and maintaining robust POCUS programs in EDs., Methods: Emergency Medicine Ultrasound Group (EMUG) identified this gap and volunteers from the group undertook a literature search of current best practice and institution guidelines relating to POCUS programs. They contacted colleagues from other specialities to find and get access to other countries and colleges' POCUS guidelines. EMUGs regularly run discussion forums (Collab-labs) and points from these were considered. Recommendations were then formed from these and recurrent unpublished obstacles the group had encountered. The result was reviewed by clinical leaders in ultrasound and POCUS users in Australasia., Results: The recommendations were organised under five pillars: Infrastructure, Governance, Administration, Education and Quality., Conclusion: These recommendations complement existing guidelines and are not intended to replace them; however, we hope to promote discussion and provide reference support for those developing POCUS programs. Implementing a comprehensive and robust ED POCUS program will ensure safe, effective and standardised high-quality POCUS use, with the aim of improving patient care across Australia and New Zealand. Patient safety will be enhanced through effective risk management and quality assurance and there will be consistency in POCUS education, training and credentialing across institutions., (© 2024 The Author(s). Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)

Objectives: Emergency medicine (EM) doctors are often required to manage a diverse set of complex challenges; navigating direct patient care, systemic issues and inter-professional interactions. Leadership is well recognised as crucial in optimising both the delivery and the quality of patient care. There is a clear need to gain greater understanding of the reality of EM leadership through exploring doctors' experience and perception of leadership in EM, yet there is a paucity of research focusing on this area. The objective of the present study was to explore the research question: 'What are the experiences and perceptions of leadership by EM doctors?', Methods: This single-site qualitative study was undertaken using semi-structured in-depth individual interviews to collect data. Interviews were audio recorded, transcribed and de-identified. Reflexive thematic analysis was performed by the research team with the aid of DelveTool software., Results: Our sample included nine participants incorporating consultants and registrars. Three major themes were identified: (i) situational tensions, (ii) relational tensions and (iii) leadership style tensions. Each of these was further explored with subthemes discussed separately., Conclusions: Leadership within the ED is complex and multifaceted, with doctors required to navigate many competing tensions. The present study highlighted key areas for future leadership development, including situational awareness, emotional intelligence and a fluid approach to leadership styles. The present study provides an important step towards enhancing the development of targeted leadership training for EM doctors., (© 2024 Australasian College for Emergency Medicine.)

Objective: To explore how clinicians understand coaching and their clinician-coach practice in emergency medicine., Methods: Participants were surveyed about the value of coaching and their beliefs about the enablers of, and barriers to, being a clinician-coach., Results: Three themes were developed for the value of coaching: empowerment and growth; enhanced interpersonal dynamics; and reflective transformation. Key enablers were supportive infrastructure, self-driven development and recognition of value. Key barriers were time constraints and scheduling conflicts, cultural challenges and financial and structural obstacles., Conclusions: Fostering a supportive environment for coaching could significantly enhance clinician competence and well-being, healthcare delivery and professional development., (© 2024 The Author(s). Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)

Objectives: Point-of-care ultrasound (POCUS) use is widespread in EDs and throughout those practising medicine. Between institutions and specialities, there is widespread variety and training. With this comes risk of patient harm and backlash to a clinically useful modality. Our objective is to form a statement that encompasses current published and unpublished guidance for creating and maintaining robust POCUS programs in EDs., Methods: Emergency Medicine Ultrasound Group (EMUG) identified this gap and volunteers from the group undertook a literature search of current best practice and institution guidelines relating to POCUS programs. They contacted colleagues from other specialities to find and get access to other countries and colleges' POCUS guidelines. EMUGs regularly run discussion forums (Collab-labs) and points from these were considered. Recommendations were then formed from these and recurrent unpublished obstacles the group had encountered. The result was reviewed by Clinical Leads in Ultrasound and POCUS users in Australasia., Results: The recommendations were organised under five pillars: Infrastructure, Governance, Administration, Education and Quality., Conclusion: These recommendations complement existing guidelines and are not intended to replace them; however, we hope to promote discussion and provide reference support for those developing POCUS programs. Implementing a comprehensive and robust ED POCUS program will ensure safe, effective, and standardised high-quality POCUS use, with the aim of improving patient care across Australia and New Zealand. Patient safety will be enhanced through effective risk management and quality assurance and there will be consistency in POCUS education, training and credentialing across institutions., (© 2024 The Author(s). Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)

Objective: Intra-articular injection of local anaesthetic provides safe and effective analgesia for patients with shoulder dislocation. We designed a three-dimensional-printed ultrasound model of the shoulder to educate ED clinicians on use of this technique. We aimed to evaluate the impact of a 1-h training session using this model on participants' knowledge, skills and clinical practice., Methods: This was a prospective study of the clinicians working at two EDs in New Zealand. Participants (n = 20) took part in a 1-h educational session. We tested participants' performance before the session, afterwards and at 3 months using a 10-point objective structured clinical examination. We reviewed clinical records to determine whether there was increased utilisation of this technique among ED patients before and after the training., Results: There was improvement in participants' OCSE performance (median pre-training score = 4.00, median 3-month post-training score = 7.00, P = 0.044) and self-reported competence and knowledge, which were sustained to the end of the study. There was increased use of intra-articular injection among ED patients with shoulder dislocation: 2 of 68 patients (3%) before and 11 of 76 patients (14.5%) after the study. Notably, most were performed by clinicians who did not take part in the study (n = 9)., Conclusion: A 1-h training session using a three-dimensional-printed model improved participants objective structured clinical examination performance in ultrasound-guided injection of the shoulder joint. Although there was minimal change in the practice of participating clinicians, overall use of the procedure increased., (© 2024 Australasian College for Emergency Medicine.)

The COVID-19 pandemic catapulted Telehealth to the forefront of Emergency Medicine (EM) as an alternative way of assessing and managing patients. This challenged the traditional idea that EM can only be practised within brick-and-mortar EDs. Many Emergency Physicians may find the idea of practising Telehealth in Emergency Medicine (TEM) confronting, particularly in the absence of training and clear practice guidelines. The purpose of the present paper is to describe the current use of TEM in Australasia, and outline the advantages and barriers in adopting this practice domain., (© 2024 Australasian College for Emergency Medicine.)

Indonesia and French Guiana share many geographic and medical concerns regarding access to care. The organisational needs in emergency management, particularly in the prehospital phase, are similar. Whereas emergency medicine (EM) is an academic and entire speciality in France, it is still under construction in Indonesia. In the framework of the French and Indonesian academic cooperation, the Medical school in Jakarta University and the French Guiana University in Cayenne signed a Memorandum of Understanding encompassing education programmes, joint research work and students' and health professionals' exchanges in EM. This partnership represented the first medical cooperation programme between the two countries. The first student class was launched in August 2022 and involved 50 Indonesian doctors who graduated in August 2023. The implementation and success of this Franco-Indonesian cooperation were supported by political and academic partners from the two sides. Given the first student class's success, we aim to continue this programme, in line with Indonesia and World Health Organization's plan to establish a multi-country training hub for health emergency operational readiness and Emergency Medical Teams., (© 2024 Australasian College for Emergency Medicine.)

Objective: To evaluate the Assistant in Medicine (AiM) programme and its impact on physician burden and productivity in the ED., Methods: Calvary Mater Newcastle ED employed eight final year medical students as part-time AiMs for a 10-week period from October to December 2021. Each student worked one 10-h shift per week. During these shifts, AiMs were assigned to a supervising doctor postgraduate year 3 or above to assist them with tasks including documentation, patient reviews, hospital consults, procedures, and discharge preparation. At the conclusion of each shift, the supervising doctor completed an online questionnaire of their experience., Results: Forty-seven responses were received. Thirty-six doctors (77%) felt they were able to see more patients in comparison to an average shift without an AiM and 40 doctors (85%) felt that having an AiM increased their overall productivity. Forty-five doctors (96%) supported the implementation of final year medical students as AiMs as a permanent addition to the medical workforce in the ED., Conclusion: The present study demonstrates the strong potential the AiM programme has to improve productivity, workflow and efficiency in the ED., (© 2023 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)

Objective: Emergency ultrasound (EUS) has become an integral part of emergency medicine, and the core pillars of governance, infrastructure, administration, education and quality assurance (QA) are vital for its quality and continued growth. We aimed to assess the status of these vital pillars among Australasian EDs., Methods: A survey among the clinical leads in ultrasound (CLUS) in Australasian EDs from November 2020 to April 2021., Results: We analysed a total of 98 responses from CLUS representing 98 EDs. Most CLUS (85%) held EUS qualifications (CCPU 57%, DDU 18%, other 9%) but 15% had none. Only 66% of CLUS had dedicated clinical support time, and a mere 5% had administrative personnel support. Up to three ultrasound machines in 62% of EDs, but only 26% of EDs had secured image archiving facilities. In-house credentialing and the Australasian College for Emergency Medicine (ACEM) trainee special skills placement were available in 50% and 32% of EDs, respectively. Only 11% of EDs had regular EUS training for FACEMs, and only 66% of EDs had regular EUS education for emergency medicine trainees. Only 20 EDs had sonographer educators. Regarding EUS QA, only 33% of EDs provided formal EUS report, 23% of EDs conducted regular image reviews and 37% of EDs audited EUS performance. Only 35% of EDs had high-level disinfection equipment, and 56% of EDs had formal transducer disinfection protocols., Conclusion: Despite ACEM recommendations for the practice of EUS, Australasian EDs still lack vital governance, administrative support, infrastructure, education and QA processes. Prompt actions such as ACEM mandating these recommendations are required to improve resource allocation by health services., (© 2021 Australasian College for Emergency Medicine.)

Objective: We sought to explore the activities, responsibilities and experience of leadership from Pacific emergency medicine (EM) doctors. Additionally, we explored knowledge, attitudes, leadership gaps and training insights for individual clinicians, and from a Pacific regional perspective., Methods: This was a qualitative study using in-depth, semi-structured interviews of invited Pacific EM doctors occupying a leadership role in their countries. Data were recorded, transcribed and triangulated with written field notes. Whole interviews and responses per topic were analysed using data-platform-based and manual methods. Inductive and deductive coding and thematic content analysis was performed in partnership with Pacific co-researchers to determine overall meaning. Monash University granted ethics approval., Results: Twelve doctors participated (11 verbal, one written response), representing six different Pacific Island countries. Four key themes were identified which reflected both the individual agency of the Pacific EM doctors and how their experience was constituted by others; professional identity and style; nurturing relationships and building solidarity; growth through experience, education and challenge; and progress and precarity. Pacific EM leaders perform clinical, management, advocacy and education tasks, and build their capacity and resilience through leadership training. They have a strong desire for regional solidarity and networking., Conclusions: Pacific EM doctors embrace leadership in their home countries and collaborate to drive positive change, build teams and gain recognition. As pioneers and advocates for EM, they bear high responsibility and risk burnout. These findings can inform future targeted leadership training and contribute to building Pacific regional networks for career sustainability and specialty advancement., (© 2021 Australasian College for Emergency Medicine.)

Background: Postgraduate training programmes rely on faculty to meet core educational needs, including simulation. Time is arguably the most valuable resource for academic physicians, which presents a challenge for recruiting faculty to provide extra-clinical teaching. To increase faculty engagement in simulation-based education (SBE), we first identified barriers to participation. Next, we sought to overcome barriers using a self-determination theory (SDT) framework to increase motivation using strategies that addressed faculty autonomy, competence and relatedness., Methods: Faculty from a single department of emergency medicine were surveyed about factors influencing participation in SBE. Responses were grouped into themes and used to develop the intervention-a faculty support bundle-to overcome common barriers and promote participation. Supports focused on course materials, organisational consistency and peer recognition. Faculty participation in SBE pre- and post-implementation of the support bundle was analysed via chi-squared analysis. Faculty who delivered SBE were resurveyed after the implementation phase to explore how the support bundle affected their experience., Results: Initial survey response was 41%. Reported barriers to participation in SBE included scheduling issues, preparation time, competing responsibilities, lack of confidence with simulation and lack of interest. Twenty-four faculty participated in SBE during the pre-implementation phase, compared to 39 post implementation (p = 0.03)., Discussion: The faculty support bundle increases faculty participation in SBE. Strategies focused on internal motivators identified using an SDT framework. In contrast to traditional external motivators, these were no cost interventions. Those seeking to increase faculty participation in SBE should consider implementing similar strategies., (© 2022 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Objective: The Australasian College for Emergency Medicine identifies five ultrasound applications which the College deem core to the practice of emergency medicine but there is scant information as to the uptake of ultrasound or the qualification of users. This study aims to determine the percentage of ED physicians in one metropolitan area who utilise ultrasound for core diagnostic and procedural applications in participating hospitals and the percentage of users who have been formally assessed in any ultrasound application., Methods: The EDs of eight major public hospitals in greater metropolitan Brisbane area participated in this audit. Data-collectors at each participating ED approached every senior house officer, registrar and senior medical officer in the department and, after obtaining informed consent, asked the participant six questions pertaining to their use of ultrasound for five core applications and about ultrasound training and recorded the answers without information as to the identity of the participant., Results: 94.4% of the physicians participated. Of those participating, 90% used ultrasound for venous access, with progressively fewer using E-FAST (69%), AAA (51%), Lung (40%) and BELS (29%) for diagnostic purposes. Ninety-eight percent of participants were in favour of enhanced departmental training. Only 33% of participants had their ultrasound skills assessed by a qualified person for even one application., Conclusion: While use of ultrasound in some applications is widespread, few users have had their skills assessed. Assessment being a routine part of structured training, it cannot be assumed that these users can competently use ultrasound for procedural or diagnostic applications., (© 2021 Australasian College for Emergency Medicine.)

Background: Victims of human trafficking (HT) are predisposed to numerous health concerns. Many encounter health care practitioners during captivity, but awareness and knowledge among front-line physicians is low. Limited data exist on attempts to address this within residency training programmes. Formal curriculum time in residency is limited and online modules may be a useful educational option., Methods: Residents in family medicine, emergency medicine and general paediatrics at the University of Alberta were invited to participate. They completed short surveys to assess knowledge both before and after completing an online learning module either individually (n = 15) or in a facilitated session (n = 17). Baseline and post-intervention changes in self-reported and tested knowledge were assessed., Results: Thirty-two residents completed the pre-intervention survey: only 6% self-identified as somewhat knowledgeable on HT and 16% knew the red flags used to identify victims. Eighty-one percent wanted this topic incorporated into residency training, but only 6% and 25% had received education previously in residency or medical school, respectively. Thirteen percent were comfortable supporting victims, and 6% reported knowing how to provide support. Twenty residents completed the post-intervention survey, with improvements in both self-reported (p < 0.001) and tested (p = 0.005) knowledge of HT. Residents also reported being more prepared to identify victims (p < 0.001), more comfortable supporting victims (p < 0.001) and more confident in knowing how to support victims (p < 0.001)., Discussion: Baseline HT knowledge in residents providing first-contact care appears limited. Residency programmes should consider providing more HT education in order to improve competency in care. Although an online module was shown to be effective, protected time might be necessary for the widespread adoption of online education delivery., (© 2020 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Background: Death notification can be challenging for emergency medicine physicians, who have no prior established relationship with the patient or their families. The GRIEV&#95;ING death notification curriculum was developed to facilitate the delivery of the bad news of a patient's death and has been shown to improve learners' confidence and competence in death notification. Rapid-cycle deliberate practice (RCDP), a facilitator-guided, within-event debriefing technique, has demonstrated an improvement in learners' skills in a safe learning environment. The aim of this study was to identify whether the use of this technique is an effective method of teaching the GRIEV&#95;ING curriculum, as demonstrated by learners' improved confidence, cognitive knowledge and performance. Rapid-cycle deliberate practice (RCDP), a facilitator-guided within-event, debriefing technique, has demonstrated an improvement in learners' skills in a safe learning environment METHODS: A 4-hour pilot curriculum was developed to educate and assess residents on the delivery of death notification. The curriculum consisted of a pre-intervention evaluation, the intervention phase, and a post-intervention evaluation. The cognitive test, critical action checklist, and self-efficacy/confidence surveys were identical for both pre- and post-intervention evaluations. A Wilcoxon rank-sum test was used to evaluate differences in scores between pre- and post-intervention groups., Results: Twenty-two emergency medicine residents participated in the study. We observed an increase in median self-efficacy scores (4.0 [4.0-5.0], p ≤ 0.0001), multiple-choice GRIEV&#95;ING scores (90.0 [80.0-90.0], p ≤ 0.0001) and performance scores for death notification (48.5 [47.0-53.0], p = 0.0303)., Discussion: The RCDP approach was found to be an effective method to train emergency medicine residents in the delivery of the GRIEV&#95;ING death notification curriculum. This approach is actionable with few resources except for content experts trained in RCDP methodology and the application of the GRIEV&#95;ING mnemonic., (© 2020 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Background: In India, and other low- and middle-income countries (LMICs), the majority of emergency care is provided by frontline providers without specialty training in emergency medicine. In order to fill this need, we developed the Indian Postgraduate Diploma in Emergency Medicine (PGDEM), a 1-year skills-focused course for practicing doctors. This article describes the curriculum development and implementation as well as the follow-up survey conducted to gauge the impact of the course., Methods: Programme graduates were surveyed via e-mail. All participation was voluntary and survey data remained anonymous., Results: A total of 98.1% of graduates reported that the skills and knowledge they gained during the programme were important to their current job; 94.7% reported using their training from the course on a regular basis. Graduates reported an improvement in confidence performing all procedures taught during the course. Respondents work in a variety of medical specialties, including emergency medicine (50.0%), cardiology (5.8%), internal medicine (11.5%) and family medicine (23.1%)., Discussion: PGDEM graduates overwhelmingly view the knowledge and skills they learned as essential training that they use on a regular basis and practice in a variety of medical specialties after completing the course. The PGDEM represents a unique model to provide training in emergency medicine and acute care to the frontline doctors who are frequently responsible for providing emergency care in LMICs. The PGDEM training model can be scaled up rapidly, with the potential to increase capacity in developing emergency care systems., (© 2020 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Objectives: The present study investigated the impact of introducing C-MAC videolaryngoscopy as the standard method of visualising glottic structures on first-pass intubation success of emergency medicine (EM) registrars in a large tertiary academic hospital in New Zealand., Methods: In this retrospective cohort study, all patients receiving attempted orotracheal intubation in Auckland City Hospital ED 1 year prior to and 1 year after the introduction of C-MAC videolaryngoscopy were compared. The primary outcome was first-pass intubation success rates by EM registrars. Secondary outcomes were first-pass success rates by all intubators, and incidence of any complication of intubation., Results: There were 163 intubations by EM registrars from June 2015 to August 2017. There was a clinically important and statistically significant improvement in first-pass success from 59.2% (95% confidence interval [CI] 44.1-68.8%) to 85.1% (95% CI 76.0-91.2%, P < 0.001) after the introduction of C-MAC. In multivariate analysis, the independent predictors of success were: Airway Not Predicted Difficult, odds ratio (OR) 2.49 (95% CI 1.06-5.85, P = 0.037); and use of videolaryngoscope, OR 4.49 (95% CI 1.85-10.91, P = 0.001). Overall, complications of intubation improved significantly after introduction of C-MAC (28.9%, 95% CI 19.9-40.0% prior to C-MAC introduction; 16.1%, 95% CI 9.7-25.3% after; P = 0.048)., Conclusion: This is the first published study specifically addressing EM registrar intubation success rates in New Zealand, adding to the existing body of data suggesting that videolaryngoscopy may improve success rates for novice intubators., (© 2019 Australasian College for Emergency Medicine.)

Objective: To describe the development and implementation of a Pacific medical mentoring programme and to evaluate the programme after the first year., Methods: The mentoring programme was adapted from Australasian College for Emergency Medicine resources and involved Australian emergency physicians mentoring Pacific Island Country doctors. Using a prospective, cross-sectional survey of all participants, researchers collected data that were analysed for content using deductive and inductive methods. Content analysis aimed to generate new concepts that could apply to different components of mentoring, and overarching themes that apply to the mentoring programme overall., Results: Nineteen doctors participated in the first year of the programme; 11 mentees from three different Pacific Island Countries and eight Australasian College for Emergency Medicine Fellow mentors. The survey was completed with a 100% response rate. Five core themes were identified from the data: vital face-to-face communication (the key to effective communication); supportive personal relationship (valued and desired by mentees); motivating professional relationship (including a regional Pacific network); substantial challenges (time, distance, remote communication); and issues around the mentoring model (goal-orientation, mentor-driven, culture)., Conclusions: The present study suggests a new model of Pacific mentoring that recognises the centrality of the mentoring relationship, and allows for flexible communication, shared responsibility of mentors and mentees as co-drivers and a broad understanding of goals and timelines. Future programmes should incorporate funding for in-person meetings and educational opportunities to enhance contextual and cultural understanding. These lessons can inform future medical mentorship programmes across the Pacific., (© 2019 Australasian College for Emergency Medicine.)

Although dedicated sections for non-acute care in the ED is recognised to improve patient flow and reduce ED congestion, there is anecdotal feedback that it detracts from work satisfaction and potentially career longevity and sustainability. Although allocation to fast track shifts reflects contemporary emergency medicine as practiced in Australasia, it may reduce registrar immersion on acute and resuscitation training., (© 2019 Australasian College for Emergency Medicine.)

Background: The Accident and Emergency Department (A&E) is a busy environment that requires time- and resource-efficient teaching. Managing cervical spine (c-spine) trauma is often an unfamiliar skill for new doctors starting work in A&E. This study investigated the efficacy of brief teaching interventions in changing clinician behaviour within A&E. The Accident and Emergency Department is a busy environment that requires time- and resource-efficient teaching METHODS: Data for 482 patients receiving c-spine computed tomography (CT) imaging in two Gloucestershire A&Es before and after multimodal departmental teaching were compared. Time taken to CT, indication for CT scan and presence of bony injury were manually recorded from patient management software., Results: Following the provision of teaching, the proportion of CT scans performed within 1 hour did not significantly change, from 31% before teaching to 37.6% after teaching (p = 0.133); however, the mean number of c-spine CT scans performed per week rose from 14.50 to 23.25 (p = 0.0001), and the mean number of CT scans performed per week within 1 hour rose from 4.50 to 8.75 (p ≤ 0.001). There was no reduction in the quality of these scans, with the proportion detecting bony injury remaining constant, and there was no increase in the proportion of scans not indicated by National Institute for Health and Care Excellence guidelines., Conclusions: This study demonstrates that brief, low-resource teaching can be associated with a positive change in clinician behaviour. This intervention was straightforward to implement and is likely to be transferable to other guideline-driven investigations. Limitations include the patient cohort being proportionately older than that found in major trauma centres, and a lack of data on patients in whom CT scans were indicated but not performed., (© 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Objective: To assess the effectiveness of an education programme that integrates web-based learning into classroom sessions., Methods: This prospective study involved a convenience sample of ED interns rotating at two study site hospitals between April 2015 and January 2017. Interns undertook weekly ED classroom-based education and were given access to a web-based learning resource with completion being voluntary. To assess change in medical knowledge multiple choice examinations were administered during week 1 and week 10 of the term. The study's primary end-point was the effect of the web-based resource on participants' knowledge. The median % of online modules completed by participants (75%) was used as a cut-off to create two groups. The % improvement between the test scores at week 1 and week 10 of each group were then compared. Intern satisfaction with the programme was also assessed using a satisfaction survey., Results: The average examination score for all participants was significantly higher at week 10 than week 1 (80% vs 68%; P < 0.001). The primary end-point, % improvement between the week 1 and week 10 scores of those that completed ≤75% of web-based modules (mean 16%; 95% CI 12-20%) and those that completed >75% of web-based modules (mean 27%; 95% CI 20-34%), showed a statistically significant difference (P = 0.03). Interns surveyed were also highly satisfied with programme., Conclusions: This blended curriculum that integrates a web-based resource into classroom learning shows promise in enhancing intern emergency medicine education., (© 2019 Australasian College for Emergency Medicine.)