323 learner perceptions of an ad-hoc versus modular didactic curriculum in emergency medicine...

treating resident physician. The patient was then asked to complete the survey oncethe resident, at a minimum, discussed the initial assessment and plan of care. Thescores of the patient survey were summed across the categories. In order to assessresident self-reported empathy, the JSPE was administered at the beginning of theyear and then compared to the patient mean scores.

Results: Of the 56 residents, ranging from PGY1 to PGY3, 52 consented toparticipate in the study and also completed the JSPE. 238 patients completed theJSPPPE for 47 residents. The number of patient JSPPPE ranged from 1 to 14 patientforms with a mean of 4.6 patients (SD 3.3) per resident. The JSPPPE contains 5statements eliciting a response from strongly agree to strongly disagree on a 7-pointscale. For each item, the patient response is in the table. For the most part, patientsfelt the residents were empathetic. (Table 1). Mean resident empathy was 108.9 onthe JSPE, which is considered to be the bottom quartile based on previous studies.Residents’ self report of empathy, as measured by the JSPE, did not correlate with thepatients’ report of their residents’ empathy (R�0.009, p�0.9). The residentsperceived themselves to be less empathetic than their patients’ perspective.

Conclusion: Self report of each resident’s empathy did not correlate with whethertheir patients felt they were empathetic. While the JSPE is considered to be the goldstandard by which physician empathy is measured, it did not correlate with ourpatients’ perception of physician empathy. Further study of measuring physicianempathy is needed.

322 Comparison of Knowledge Acquisition Between Case-Based and Simulation-Based Teaching in Third YearMedical Students

Myers JW, Sousa GE, Ellis AK/State University of New York at Buffalo, Buffalo,NY

Study Objective: Case-based teaching methodology has been compared withlecture format instruction for the health sciences demonstrating several benefits to theuse of case-based teaching. Simulation has been shown to improve knowledgeacquisition and critical thinking skills. There is a paucity of evidence comparingsimulation-based teaching (SBT) and case-based teaching (CBT). In this crossoverstudy, third year medical students were exposed to both teaching methodologies andassessed in the cognitive domain.

Methods: Third year medical students mid-way through their core rotations wererandomly divided into 2 groups (A and B). Group A had SBT cases on hypertensiveemergencies while Group B had identical CBT paper cases. For the crossover, GroupB had SBT on shock (S) while Group A had identical CBT paper cases. Pre and postmultiple choice question tests were administered. The change in test scores werecompared for each scenario using the Wilcoxon 2 Sample Test using SAS (ver 9.2)with a significance level of 0.05.

Results: A total of 69 students were enrolled in the study. One student from eachgroup was removed from the study for failure to complete the SBT, leaving 33students in Group A and 34 students in Group B. The mean difference inhypertensive emergencies score for Group A was �16.3% and for Group B was�15.2%. The mean difference in S score for Group A was �1% and for Group Bwas �4.2%. The Wilcoxon 2 Sample Test found no significant difference betweenthe 2 study groups for change in test scores (hypertensive emergencies p�0.5910; Sp�0.2461).

Conclusions: This crossover study comparing simulation to CBT found nosignificant difference in cognitive domain performance between the 2 instructionalmethodologies. Further analysis is needed to compare effect on critical thinking.

323 Learner Perceptions of an Ad-Hoc versus ModularDidactic Curriculum in Emergency MedicineResidency

Jin LA, Ahn J, Babcock C/University of Chicago, Chicago, IL

Study Objectives: Multiple studies demonstrate a modular curriculum is asuccessful educational model. Studies in the medical school setting found that withinitiation of a modular curriculum students score well on core competency testingand prefer learning in this model. Supporting evidence from obstetrics andgynecology and surgery literature corroborates this study. The purpose of our studywas to compare a modular didactic curriculum versus an ad-hoc curriculum in thesetting of an emergency medicine residency.

Methods: During 2009-2010 a modular curriculum was implemented into a 3-year emergency medicine residency program in a large urban tertiary care medicalcenter. Our program shifted didactic conferences away from an ad-hoc format to atopic-based modules format. An identical survey was distributed to all residentsduring the 08-09 and 09-10 academic years querying the learners’ perceptions ondidactic conferences. An unpaired T test was used to compare the results from 08-09(prior to initiation of the modular curriculum) to 09-10 (after initiation of themodular curriculum) with statistical significance determined at p � 0.05.

Results: Responses were collected from 63% of the residency. 56.7% of residentsthought that didactic conferences were organized under the modular curriculum vs.17.2% under the ad-hoc curriculum (p � .0001). 69.0% of residents agreed thatdidactic conferences with the modular curriculum improved in-service examinationperformance vs. 39.2% in the ad-hoc curriculum (p � .0113). 86.6% of residentsagreed that modular conferences improved clinical performance vs 69.0% that ad-hoccurriculum improved performance (p � .0001). 60.0% of trainees agree they had apositive educational experience at didactic conferences vs 31.0% in the ad-hoccurriculum (p � .0006). Learners also observed that there was greater residenceattendance rate after the modular curriculum was implemented. 79.3% agreed therewas adequate attendence vs 27.6% who agreed attendance was adequate with an ad-hoc curriculum. (p � .0001).

Conclusion: We found that emergency medicine residents at our institutionpreferred didactic conferences in a modular curriculum compared to an ad-hoccurriculum. Learners found the modular model more organized and more likely toimprove both their in-training exam and clinical performance. Residents report amore positive educational experience when they attend modular didactic conferences.Lastly, resident attendance is higher in a modular vs. ad-hoc conferences, whichargues that the modular curriculum is seen as more valuable to emergency medicineresidents. Globally, the emergency medicine residents valued and preferred thiscurriculum style and it will be the permanent model in which our emergencymedicine residency operates.

324 A Prospective Randomized Controlled TrialComparing the Impact of High Fidelity Simulationversus Standard Lecture-based Training on LongTerm Clinical Performance of Emergency AirwayManagement by Emergency Medicine Residents

Godbout B, Clark M, Egan D, Walker G, Hernandez J, Lanoix R, Bania T/St.Luke’s - Roosevelt Hospital Center, New York, NY

Study Objectives: The use of simulation is fast becoming a standard componentof emergency medicine residency training programs. Minimal data existsdemonstrating improved clinical performance in procedures and patient care aftersimulation training versus traditional lecture-based training. We hypothesize thathigh fidelity simulation training will have a beneficial measurable effect on long-termemergent airway management performance by emergency medicine residents whencompared with a traditional lecture-based format.

Methods: Prospective study of fourteen hypothesis-blinded second yearemergency medicine residents at an inner-city academic institution where allemergent airways are managed by second year residents. The study was approved bythe institutional review board and all residents consented to participation. Subjectswere randomly assigned into 2 even groups: traditional lecture-based airway trainingand high fidelity simulation airway training using a Laerdal 4G SimMan©. Trainingoccurred during the first month of the second year of residency for all subjects.Performance of emergency airway management requiring intubation in theemergency department was prospectively evaluated using a 43-item data collectioninstrument by both the supervising senior resident and attending physician from July

Research Forum Abstracts

S286 Annals of Emergency Medicine Volume , . : October