Development of a Simulation-Based Skills Maintenance Curriculum for Emergency Medicine Faculty

Emergency medicine (EM) requires proficiency in high-acuity, low-occurrence (HALO) procedures. Opportunities to perform procedures decline after training, potentially leading to skill attrition that can affect patient safety. Based on a previously published needs assessment, we designed and implemented the EM Faculty Interactive Training on Necessary Emergency Skills and Simulation (EM FITNESS) curriculum.

EM faculty were invited to participate in an optional, two-year curriculum consisting of three modules: 1) airway, 2) cardiopulmonary procedures, and 3) obstetrics/pediatrics. Participants received pre-learning materials to maximize in-session, hands-on practice. Learners were divided into small peer groups and practiced skills on simulation-based models under direct observation of instructors with content expertise (e.g. pediatric EM, ultrasound, obstetrics, neonatology). Pre-, post-, and 6-month surveys (REDCap, Likert scales) were used to assess: frequency of performing or supervising procedures, curriculum effectiveness, confidence, and opportunities for program improvement.

Overall faculty participation across all three modules was 39.5%. Faculty performed or supervised about half of the HALO procedures at least once in the prior year (except cricothyrotomy, fiberoptic intubation, and the pediatric and obstetric skills), with supervision more common than performance. For nearly all procedures, self-reported confidence increased immediately post-training, declined at 6 months, but remained above baseline. All faculty agreed that maintaining procedural skills was important, and 83.6% reported personally experiencing skill attrition.

A faculty-targeted, simulation-based EM curriculum produced sustained rates of increased confidence in performing HALO procedures. This study demonstrates the feasibility of a skills training program to mitigate procedural skills attrition among EM faculty. Future work will focus on refining, scaling, and disseminating the curriculum and studying its clinical impact.