Implementation and Evaluation of an Emergency Department-Based Procedure Task Trainer Cart: A Mixed Methods Study.

Introduction Teaching procedural skills in the emergency department (ED) can be challenging. To support on-shift procedural training in a busy adult academic ED setting, a dedicated modular cart containing simulation-based procedure task trainers and supplies was created and placed into the clinical space. Methods Uptake among ED providers was assessed via the number of logged cart accesses over time. The educational impact of increased availability of simulation equipment on shift was assessed using pre- and post-intervention surveys of cart users and semi-structured interviews with resident physician cart users. Results Use of the trainer cart was initially robust at 13 uses per month, but decreased significantly to one to two uses per month after the initial pilot phase. Pre- and post-survey data, while underpowered, indicated trends in on-shift training time and a preference for using equipment with near peers rather than for solo practice. Thematic analysis of semi-structured interviews revealed the following three themes around the perceived utility of task trainers: (1) "practice makes perfect," (2) "applications beyond the tool," and (3) "limitations, barriers, and solutions." Conclusion Making simulation-based procedure training more conveniently accessible and closer to real-world practice by placing a task trainer cart in the clinical setting was well-received by clinicians when it was used. Interviews offered rich insights into specific improvements for future iterations of the cart and added understanding of how similar interventions may fit into the longitudinal learning curve of procedural skill acquisition and maintenance among emergency medicine trainees.