1. EDUCATION IN EMERGENCY MEDICINE: EUROPEAN CURRICULUM BASED PILOT PROJECT CROATIA-AUSTRALIA Silvija Hunyadi-Anticevic, MD, Department of Emergency and Intensive Care Medicine, Clinical Hospital Center Zagreb, Croatia Prof. Anne-Maree Kelly, MD, Prof. Joseph Epstein, MD, Department of Emergency Medicine, Western Hospital, Footscray, Victoria, Australia Prof. Stjepan Oreskovic, PhD, “Andrija Stampar” School of Public Health, Zagreb, Croatia

2. Background EM doesn’t exist as a speciality in Croatia 1.Long-term goal: establishment of EM by educating medical professionals, building EDs, improving EMS Stepwise approach in education: Short-term: ALS,PLS,ATLS,BLS-AED Interim: Education for MDs,RNs,EMTs

3. Pilot Project in Koprivnica County, Croatia Task: How to educate a core group of medical professionals from a particular hospital in the shortest time possible to achieve enough knowledge, skills and competencies to work in the ED that is being built and to further implement this process to the whole country 5 MDs and 5 RNs assigned from Koprivnica Problem oriented body of knowledge and skills according to the European Curriculum in EM identified

4. Why Australia ? EDs at Western and Sunshine Hospital, Footscray, Victoria, Australia chosen due to the possibility that Croatian medical professionals can get hands-on-patient training in the accredited tertiary ED, provided with the conditional registration by the Medical Board in the relevant region of Australia

5. EM Educational Course Clinical EM-Tutorial component in Croatia (April 22-25, 2003) Clinical placement in EM in Australia I group : April 28-August 14 & II group: Sept 1-Dec 14, 2003 EM Project (within 6 months upon return to Croatia)

6. Clinical EM-Tutorial component in Croatia 30-hour seminar based intensive course in Koprivnica covering key clinical topics (medicine, surgery, paediatrics, obstetrics and gynaecology, intensive care etc) and educational activities during attachment period in Australia Assessment: written pre-test, coupled with the skills test

7. Clinical placement in EM in Australia 14 weeks placement in II groups of 5: Adult ED Western Health Hospital (8 wks) Paediatric and Ob & Gyn ED Sunshine Hospital (4 weeks) ICU Western Health Hospital (2 wks) WADEM - 13th World Congress on Disaster and EM, May 2003 ACEM Winter Meeting, June 2003

8. Clinical placement in EM in Australia-cont. Clinical topics: Direct teaching: 2-3 days/week Three 9 hour supervised ED shifts/week PLS and Trauma Management Course Advanced airway skills practised in OR Case reports with literature search

9. Clinical placement in EM in Australia-cont. ED processes: Triage Models of education Disaster response and principles of retrieval medicine Develop. of protocols Quality msr.&mng. Evidence based medicine Management change processes

10. Clinical placement in EM in Australia-cont. BLS, ALS, PLS Triage process Basic and advanced EKG interpretation Pain management (adult and paed.) IV cannulation Advanced airway management and RSI Mech. ventilation Interpretation of ABG Arterial line insertion Competencies assessed:

11. Clinical placement in EM in Australia-cont. Assessment: 3 written case discussions Written scenario-based exam 6 station oral scenario-based exam

12. Emergency Medicine Project To be completed within 6 months at the parent hospital: 1.Improving asthma management (MD) 2.Setting up an ongoing education program for staff (MD) 3.Setting up a triage process (RN) 4.Improving resuscitation team process (RN) 5.Improving EKG interpretation skills (RN)

13. SUMMARY Pilot Project on interim education in EM (based on the European Curriculum) for health care professionals from the country without existing EM as a distinct speciality (Croatia) in the country with fully established EM (Australia) Educational approach: delivering short-term improvements with the goal of long-term sustainability Ongoing process - full evaluation upon completion (June 2004)