A comprehensive, unembalmed cadaver-based course in advanced emergency procedures for medical students

Preparing medical students for residency in emergency medicine involves education in many areas of knowledge and skill, including instruction in advanced emergency procedures. To outline the logistics involved in running a training course in advanced emergency procedures for fourth-year medical students and to report students' perceptions of the impact of the course. The course is a cadaver-based training laboratory that utilizes several teaching modalities, including a Web-based syllabus and online streaming video, didactic lecture, hands-on practice with models and ultrasound, and hands-on practice with unembalmed (fresh) cadavers. The course focuses on seven emergent procedural skills, including deep venous access via the subclavian, internal jugular, and femoral veins; tube thoracostomy; saphenous vein cutdown; intraosseous line placement; and emergency cricothyrotomy. The course is taught by attending emergency physicians and anatomy department faculty. After completion of the course, students reported their self-assessments on a five-point Likert scale. Data were evaluated using a paired t-test (two-tailed). Thirty-three students completed the evaluation. The students reported a mean (+/- standard deviation [SD]) increase in their understanding of the indications for all procedures from 3.3 (+/- 1.1) before to 4.8 (+/- 0.4) after the course (p = 0.004, 95% CI = 0.7 to 2.0). The students reported a mean increase in their understanding of how to perform all procedures from 2.1 (+/- 0.9) before to 4.6 (+/- 0.6) after the course (p = 0.003, 95% CI = 1.9 to 3.0). The students reported a mean increase in their comfort level performing all procedures from 1.6 (+/- 0.8) before to 4.2 (+/- 0.7) after the course (p < 0.001, 95% CI = 2.0 to 2.9). These findings support the value of an advanced emergency procedural training course using an unembalmed cadaver-based laboratory and incorporating several teaching modalities.