1. Experiences and attitudes toward priapism education in Emergency Medicine residency
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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

2. Experiences and attitudes toward priapism education in Emergency Medicine residency
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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

3. Experiences and attitudes toward priapism education in Emergency Medicine residency
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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

4. Experiences and attitudes toward priapism education in Emergency Medicine residency
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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

5. Resident experiences in priapism management:
Experiences and attitudes toward priapism education in Emergency Medicine residency
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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

6. Attitudes towards priapism education:
Experiences and attitudes toward priapism education in Emergency Medicine residency
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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

7. Experiences and attitudes toward priapism education in Emergency Medicine residency
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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 < Accessed 1/26/18.
Roghmann F, et al. “Incidence of priapism in emergency departments in the United States.” J Urol Oct; 190 (4): Doi: /j.juro
Rueset AS, Getto LP, Fredrette JM, Cherico A, Papas MA, Nomura JT. “A Novel Task Trainer for Penile Corpus Cavernosa Aspiration.” Simul Healthc Dec;12(6): doi: /SIH