{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:46:34Z","timestamp":1790660794613,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,10,8]],"date-time":"2023-10-08T00:00:00Z","timestamp":1696723200000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["AEM Education and Training"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Managing acute pain is a common challenge in the emergency department (ED). Though widely used in perioperative settings, ED\u2010based ultrasound\u2010guided nerve blocks (UGNBs) have been slow to gain traction. Here, we develop a low\u2010cost, low\u2010fidelity, simulation\u2010based training curriculum in UGNBs for emergency physicians to improve procedural competence and confidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this pre\u2010\/postintervention study, ED physicians were enrolled to participate in a 2\u2010h, in\u2010person simulation training session composed of a didactic session followed by rotation through stations using handmade pork\u2010based UGNB models. Learner confidence with performing and supervising UGNBs as well as knowledge and procedural\u2010based competence were assessed pre\u2010 and posttraining via electronic survey quizzes. One\u2010way repeated\u2010measures ANOVAs and pairwise comparisons were conducted. The numbers of nerve blocks performed clinically in the department pre\u2010 and postintervention were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 36 participants enrolled in training sessions, eight participants completed surveys at all three data collection time points. Of enrolled participants, 56% were trainees, 39% were faculty, 56% were female, and 53% self\u2010identified as White. Knowledge and competency scores increased immediately postintervention (mean\u2009\u00b1\u2009SD t<jats:sub>0<\/jats:sub> score 66.9\u2009\u00b1\u20098.9 vs. t<jats:sub>1<\/jats:sub> score 90.4\u2009\u00b1\u200911.7; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and decreased 3\u2009months postintervention but remained elevated above baseline (t<jats:sub>2<\/jats:sub> scores 77.2\u2009\u00b1\u200911.5, compared to t<jats:sub>0<\/jats:sub>; <jats:italic>p<\/jats:italic>\u2009=\u20090.03). Self\u2010reported confidence in performing UGNBs increased posttraining (t<jats:sub>0<\/jats:sub> 5.0\u2009\u00b1\u20092.3 compared to t<jats:sub>1<\/jats:sub> score 7.1\u2009\u00b1\u20091.5; <jats:italic>p<\/jats:italic>\u2009=\u20090.002) but decreased to baseline levels 3\u2009months postintervention (t<jats:sub>2<\/jats:sub>\u2009=\u20096.0\u2009\u00b1\u20091.9, compared to t<jats:sub>0<\/jats:sub>; <jats:italic>p<\/jats:italic>\u2009=\u20090.30).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A low\u2010cost, low\u2010fidelity simulation curriculum can improve ED provider procedural\u2010based competence and confidence in performing UGNBs in the short term, with a trend toward sustained improvement in knowledge and confidence. Curriculum adjustments to achieve sustained improvement in confidence performing and supervising UGNBs long\u2009term are key to increased ED\u2010based UGNB use.<\/jats:p><\/jats:sec>","DOI":"10.1002\/aet2.10912","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T23:49:07Z","timestamp":1697068147000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Implementing ultrasound\u2010guided nerve blocks in the emergency department: A low\u2010cost, low\u2010fidelity training approach"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3619-7129","authenticated-orcid":false,"given":"Carrie D.","family":"Walsh","sequence":"first","affiliation":[{"name":"Harvard Affiliated Emergency Medicine Residency Program, Department of Emergency Medicine Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene W. Y.","family":"Ma","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Cumming School of Medicine University of Calgary  Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9590-1084","authenticated-orcid":false,"given":"Andrew J.","family":"Eyre","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munaa","family":"Dashti","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Stegeman","sequence":"additional","affiliation":[{"name":"Harvard Affiliated Emergency Medicine Residency Program, Department of Emergency Medicine Mass General Brigham  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger D.","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Nagdev","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Highland Hospital, Alameda Health System  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Goldsmith","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4829-4979","authenticated-orcid":false,"given":"Nicole M.","family":"Duggan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts 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