Introduction: The World Health Organization has identified the development of emergency medicine as a priority. Seven new emergency departments have been opened in major cities of Armenia, but are staffed by non-emergency trained physicians. Thirteen physicians are currently participating in the first emergency medicine training program. Implementation of emergency medicine training programs in other countries has shown a reduction in mortality, and procedural training is central to emergency medicine education. Methods: The Accreditation Council for Graduate Medical Education (ACGME) specifies core competencies for each specialty in the United States. All residents must complete a minimum of fifteen key procedures essential to the practice of emergency medicine for graduation requirements. There are many additional procedures performed by emergency physicians. A curriculum to teach these procedures to residents in Armenia, either through lecture or hands-on practice, was created. All residents were initially asked to identify how many times they had previously performed a list of 69 emergency medicine procedures. Results: Before the start of the program, most residents had very little procedural experience and relied heavily on consultant support. At this point in the curriculum, residents have had teaching in many procedures, including incision and drainage, laceration repair, intubation, and several point-of-care ultrasounds. Most reported performing these procedures initially in conjunction with consulting services, and now more independently. Conclusion: Development of procedural expertise is central to emergency medicine education. This is typically done during lectures, in simulation, and on shift. As this residency program is non-clinical, faculty have relied on a combination of lecture and simulation to support resident learning, in addition to scheduled in-person teaching several times during the program. Nearly three-quarters of the way through the curriculum, residents have incorporated procedures into their practice with the support of consulting services as they grow the scope of emergency medicine in Armenia.
Longerstaey et al. (Sun,) studied this question.