Experiences and attitudes toward priapism education in Emergency Medicine residency CLICK TO GO BACK TO KIOSK MENU Jessica C. Dai MD, Douglas Franzen MD, Thomas J. Walsh MD, MS, Thomas S. Lendvay MD University of Washington, Seattle WA Background/Introduction: In the community, priapism is often managed primarily by Emergency Medicine (EM) providers. However, EM trainees may have limited experience with priapism due to involvement of Urology providers at training institutions. Objectives: To characterize the current state of formalized education on priapism for EM trainees at Accreditation Council for Graduate Medical Education (ACGME)-accredited programs. Methods: From October 2016 to February 2017, EM residents and residency program directors or assistant program directors were surveyed regarding their experiences with and attitudes towards priapism education. Surveys were distributed via the Council of Emergency Medicine Residency Directors (CORD). Results: 227 EM residents from 34 programs, and 91 residency program directors and assistant program directors from 73 programs responded. All national geographic divisions were represented. 90% of residents and 92% of residency leadership believe that EM physicians should be able to independently manage priapism in practice. Only 51% of residents and 75% of senior residents had primarily managed a case of priapism in training. 67% request urology consultation “most of the time” or “every time.” Among senior residents, 17% felt “not at all confident” in their ability to independently manage priapism. 78% of residents deemed education in priapism management “very important” or “essential,” but 36% deemed their current educational curricula “insufficient” to prepare them for independent priapism management. Among program directors, 81% reported a formalized curriculum for priapism education. A combination of lecture and bedside teaching was most common (32%). Curricula included formal lecture in 97% of programs and simulation in 19%. 43% of residency leadership deemed simulation the most effective singular method to teach residents about priapism management. 55% of residents also preferred educational curricula that incorporated simulation. Conclusions: Though most EM trainees and residency leadership believe EM physicians should be able to independently manage priapism, at least 25% of senior trainees have no experience with this entity and lack confidence in their ability to do so. Despite curricula at most programs, a need for more simulation-based education remains.   Abstract Introduction Methods Results Conclusion

Experiences and attitudes toward priapism education in Emergency Medicine residency CLICK TO GO BACK TO KIOSK MENU Jessica C. Dai MD, Douglas Franzen MD, Thomas J. Walsh MD, MS, Thomas S. Lendvay MD University of Washington, Seattle WA Introduction The incidence of priapism presenting to the Emergency Department is 5.34 per 100,000 males each year 13.3% of these cases result in hospitalization or admission for further management Emergency trainees have limited experience with priapism management during residency training Given the low incidence of acute ischemic priapism, trainees may not encounter this pathology clinically during training At academic training institutions, Urology providers are often primarily involved in acute management There are no commercially available simulation models for simulation of priapism management In the community, priapism is often managed primarily by Emergency Medicine (EM) providers. Abstract Introduction Methods Results Conclusion Objective To characterize the current state of formalized education on priapism for EM trainees at Accreditation Council for Graduate Medical Education (ACGME)-accredited programs. To characterize residents’ experiences with education on priapism management To assess residents’ attitudes toward their preparedness to manage this entity in independent practice Hypothesis EM trainees may have limited experience with priapism management during residency training Graduating EM trainees may feel unprepared to manage acute ischemic priapism independently in practice There is a need for simulation-based curriculum utilized in training EM residents on acute priapism management

Experiences and attitudes toward priapism education in Emergency Medicine residency CLICK TO GO BACK TO KIOSK MENU Jessica C. Dai MD, Douglas Franzen MD, Thomas J. Walsh MD, MS, Thomas S. Lendvay MD University of Washington, Seattle WA Anonymous survey distributed to Emergency Medicine residency program directors, assistant/associate program directors, and residents via Council of Emergency Medicine Residency Directors (CORD) Listserv Survey available online from October 2016 to February 2017 If multiple responses from the same program were received, only program director responses for program or curricula-specific questions were included in order to avoid duplicate representation of an individual program Abstract Introduction Methods Results Conclusion

Experiences and attitudes toward priapism education in Emergency Medicine residency CLICK TO GO BACK TO KIOSK MENU Jessica C. Dai MD, Douglas Franzen MD, Thomas J. Walsh MD, MS, Thomas S. Lendvay MD University of Washington, Seattle WA Abstract Introduction Methods Results Conclusion

Resident experiences in priapism management: Experiences and attitudes toward priapism education in Emergency Medicine residency CLICK TO GO BACK TO KIOSK MENU Jessica C. Dai MD, Douglas Franzen MD, Thomas J. Walsh MD, MS, Thomas S. Lendvay MD University of Washington, Seattle WA Respondents: 227 EM residents from 34 unique programs 91 residency program directors and assistant program directors from 73 unique programs Year Count % PGY1 67 29.5 PGY2 66 29.1 PGY3 77 33.9 PGY4 17 7.5 Abstract Introduction Methods Results Conclusion Table 1: Resident respondents, categorized by self-reported year of post-graduate training. PGY = post-graduate year Figure 1: Geographic distribution of resident respondents Figure 2: Geographic distribution of responding residency program directors and assistant program directors Resident experiences in priapism management: Only 51% of residents and 75% of senior residents had primarily managed a case of priapism in training. Among those who had encountered priapism in clinical training (n=116), 67% request urology consultation “most of the time” or “every time.” Among senior residents (PGY3 and PGY4), 17% felt “not at all confident” in their ability to independently manage priapism. Figure 3: Frequency of urologic consultation in the ER for acute priapism

Attitudes towards priapism education: Experiences and attitudes toward priapism education in Emergency Medicine residency CLICK TO GO BACK TO KIOSK MENU Jessica C. Dai MD, Douglas Franzen MD, Thomas J. Walsh MD, MS, Thomas S. Lendvay MD University of Washington, Seattle WA Attitudes towards priapism education: 78% of residents deemed education in priapism management “very important” or “essential” 36% of residents their current educational curricula “insufficient” to prepare them for independent priapism management Interest in simulation-based curriculum 43% of residency leadership deemed simulation the most effective singular method to teach residents about priapism management 55% of residents prefer educational curricula that incorporated simulation 90.3% of residents and 92.3% of residency program leadership believe that Emergency Medicine physicians should be able to independently manage acute ischemic priapism in practice without a urologic consult Abstract Introduction Methods Results Conclusion Figure 4: Perceived importance of curricula on priapism management among Emergency Medicine residents Current educational curricula, as reported by residency program leadership: 81% of programs (59/73) reported a formalized curriculum for priapism education A combination of lecture and bedside teaching was most common, used in 32% Formal lecture was included in 97% of curricula Simulation was included in only 19% of curricula

Experiences and attitudes toward priapism education in Emergency Medicine residency CLICK TO GO BACK TO KIOSK MENU Jessica C. Dai MD, Douglas Franzen MD, Thomas J. Walsh MD, MS, Thomas S. Lendvay MD University of Washington, Seattle WA Half of all Emergency Medicine residents and a quarter of senior residents have never primarily managed a case of acute ischemic priapism Nearly one in five senior residents do not feel comfortable in their ability to independently manage acute ischemic priapism. Over 1/3 of surveyed residents do not feel their current educational curricula on priapism is sufficient to prepare them for independent management of acute ischemic priapism Though the majority of residency programs have a formal curriculum for priapism, less than 20% include a simulation component. There is interest among both residents and residency program leadership in simulation-based education A need for greater simulation-based educational curricula on acute ischemic priapism management exists for Emergency Medicine residents. Abstract Introduction Methods Results Conclusion References Montague DK, Jarow J, Broderick GA, et al. “Management of Priapism.” American Urological Association Clinical Guidelines. 2010.<http://www.auanet.org/guidelines/priapism-(2003-reviewed-and-validity-confirmed-2010)#x3010.> Accessed 1/26/18. Roghmann F, et al. “Incidence of priapism in emergency departments in the United States.” J Urol. 2013 Oct; 190 (4): 1275-80. Doi: 10.1016/j.juro.2013.03.118. Rueset AS, Getto LP, Fredrette JM, Cherico A, Papas MA, Nomura JT. “A Novel Task Trainer for Penile Corpus Cavernosa Aspiration.” Simul Healthc. 2017 Dec;12(6):407-413. doi: 10.1097/SIH.0000000000000262.