95% CI: 9.65 - 11.35; ‘‘At expected level’’: mean=7.32, 95% CI: 6.90-7.74; ‘‘Belowexpected level’’: mean=5.53, 95% CI: 5.11-5.95).

Conclusion: The FYMS does not appear to impact on senior MS ability toidentify standard rhythm and morphologic findings on the 12 lead ECG. Senior MSoften fail to identify certain critical ECG findings, and accurately perceive thisdeficiency. Additional research in this area is required to develop a validated ECGtesting set to evaluate the ECG interpretation skills of MS.

by emergency nurses was 95% (95% CI: 96-99%) and the specificity was 97%(95% CI: 97-100%).

Conclusion: Emergency room nurses can be taught to perform bedsideultrasound for detection of fetal heart tones in patients greater than 10 weeksgestation. A brief course, with strict guidelines, allows for quick and accurateultrasonography by emergency nurses. The use of portable handheld real-timeultrasound at the bedside may be an improvement from the traditional Dopplerdevices currently employed.

43 Prime Time Televison Seat Beat Usage: Still a Poor

Example

Milzman DP, O’Leary C, Sarohia M, Milton L, Kaehler C, Washington Hospital

Center, Washington, DC

Study Objectives: In 1998, a study was conducted by students at Michigan StateUniversity found that only 25% of drivers on 4 broadcast networks and 4 highlyviewed cable channels wore seat belts, when national use of seat belts was reported at58% (1994) and recently rose to 75% (2002). Each percentage-point increase insafety belt use represents 2.8 million more people buckling up, 250 more lives savedand 6,400 serious injuries prevented annually.1 The results of this survey lead to a callfor network television producers to improve use of safety restraints on prime timetelevision. This study will re-examine those findings and expand on the exact seatingand safety issues represented with vehicular safety depicted by networks onprimetime.

Methods: A prospective viewing was performed for the first 4 episodes of eachnon-live action or sporting event on the four major broadcast networks (ABC, CBS,FOX, and NBC). These programs were viewed between 8pm and 11pm (EST).Medical Students served as participants and recorded all safety actions within vehiclesincluding use of restraints by drivers and all passengers, as well as proper seatingpositions for smaller children including the use of car-safety seats. The participantswere blinded to study objectives and all agreed voluntarily to participate and IRBwaived consent. A computer log of all viewing findings was maintained andparticipants were randomly checked with study investigators with regard to accuracyof viewing logs.

Results: There were 34 shows with 18- 30 min. sitcoms accounting for a total of25.5 hours of viewing weekly or 102 hours viewed during the study period.Drivers(actors) were noted properly wearing seat belts 32% of the time. Passengerswere found to use seat belts 21% of the time and position in the vehicle varied onlywith front seat passengers noting a 29% vs. 17% increased use over rear seatpassengers: p\.03. Children were found to lack proper seat positioning for thoseunder 10 years, which includes not sitting in front seat positions. Young childrenunder 4 years were not seated in child seats more than 50% of the time. The propersafety restraints were compared with the prior study and no difference was found.(meta-analysis, t-test)

Conclusion: While recent studies suggest that usage has increased among thegeneral population and that the media is the main target to increase usage throughcampaigns such as ‘‘Click it or Ticket’’, the major networks do not appear to have

Research Forum Abstracts

41 How Do Emergency Medicine Residents Learn?

Rowden AK, Ramalanjaona G, University of Virginia, Charlottesville, VA; Seton Hall

University, South Orange, NJ

Introduction: The Kolb Learning Style Inventory (LSI) has been applied toseveral areas of medical education and medical specialty selection. Application ofthe LSI to emergency medicine residents is not described in the medical literature.We attempt to apply Kolb’s learning style model to better understand the learningstyle of emergency medicine residents. Through better understanding, we hope topositively affect the education of emergency medicine residents throughout theirtraining.

Methods: This is a prospective study using a modified Kolb’s Learning StyleInventory on emergency medicine residents. The LSI was mailed to a conveniencesample of 28 emergency medicine residencies. Participation in the study was strictlyanonymous and voluntary. Responses where recorded and compared using the Chi-squared test in regard to gender and level of training. The resident’s level of trainingwas based on junior meaning a resident in his/her first or second post graduate year oftraining and senior meaning a resident in his/her third or fourth year of training. TheIRB approved this study.

Results: The LSI were returned from 13 of 28 emergency medicine residencyprograms (46%). Overall, 45.9% of respondents identified themselves as Convergers,25.3% as Accommodators, 25.3% as Assimilators, and 3.6% as Divergers. Of males,44.6% identified as convergers, 26.8% as Accomodators, and 28.6% as Assimilators.52.2% of female respondents identified themselves as Convergers, 26.1% asAccommodators, and 21.7% as Assimilators. No significant difference in distributionwas found between males and females. Of the junior residents, 47.2% identified asConvergers, 28.3% as Accommodators, and 24.5% as Assimilators. Of the Seniorresidents, 48.2% identified as Convergers, 22.2% as Accommodators, and 29.6% asAssimilators. No significant difference was found in distribution between juniors andseniors.

Conclusion: This study shows a majority of emergency medicine residents (EMR)are Converging learners. They learn best through abstract conceptualization andactive experimentation. This observation of EMR as Converging learners remainedwhen compared across gender and level of training. Kolb’s learning style inventory isa useful tool in the understanding of adult learning. A better understanding oflearning style by both teacher and student would facilitate a better and more efficientlearning environment for the training of emergency medicine residents. Theresearchers advocate that programs determine the learning style of its residents anddevelop didactics and clinical experiences that best suit its residents.

42 Emergency Nurses’ Utilization and Accuracy of Handheld

Ultrasound Devices for Detection of Fetal Heart Tones in

Pregnant Patients

Aguilera P, De Guzman V, Tenet Healthcare, Santa Ana, CA; Tenet Healthcare,

Santa Ana, CA

Study Objectives: To evaluate the accuracy of bedside ultrasound fetal heart tonedetection by emergency nurses after a brief course.

Methods: Emergency nurses underwent a 45 minute training program specificallydesigned to enhance detection of fetal heart tones in patients less than 20 weekspregnant. Training included a brief didactic session, overview of handheld device, andproctored examinations. Patients whose last menstrual period was less than 10 weeksor those in which an intrauterine pregnancy was not visible were excluded.Ultrasound examinations of 20 nurses were examined over an 8 month periodimmediately following the course. The total number of examinations includingadequacy and accuracy of ultrasound examinations were prospectively examined.

Results: A total of 181 obstetrical examinations detecting fetal heart tones wereperformed during the study period. One hundred seventy-one (171) ultrasoundexaminations (95%) were read as adequate views and had accurate documented fetalheart tones. One hundred sixty (162) were correctly interpreted by the ED physicianas accurate (95% CI: 96-99%). The sensitivity of the bedside ultrasound performed

incorporated such simple safety changes into any changes in programming.1-[NHTSA, FY2003 Performance Plan, 2002]

44 Randomized Controlled Trial of Physical Examination

Teaching to First-Year Medical Students in the

Emergency Department

Masser BA, Woo B, Kerfoot P, Beth Israel Deaconess Medical Center, Boston,

MA; Harvard University - Brigham and Women’s Hospital, Boston, MA; Veterans

Administration Boston Healthcare System, West Roxbury, MA

Study Objectives: Utilizing a randomized controlled design, the objective of ourstudy was to determine whether early clinical teaching in the emergency department(ED) setting, in this case specifically the teaching of physical examination skills,resulted in improved student learning as measured by their performance on anobjective structured clinical exam (OSCE).

Methods: Harvard’s 170 first-year medical students were invited to participate.Volunteers were randomized into 2 groups: (1) ED physical exam teaching(intervention), in addition to standard teaching by lecture/small group, or (2)standard teaching alone (controls). Controls had 2 sessions on pulmonary andcardiac exams: a 1-hour lecture followed by a 1-hour small group skills session.The ED curriculum consisted of three monthly, two-hour sessions covering thepulmonary exam, the cardiac exam, and the combined lung-heart exam. During

S14 Annals of Emergency Medicine Volume 46, no. 3 : September 2005