Nicholas Geoffrey Ashenburg

All Publications

• 19-Year-Old with Sudden Onset Left Testicular Pain. Clinical practice and cases in emergency medicine Small, E., Ashenburg, N., Schertzer, K. 2022; 6 (4): 327-329

  Abstract

  A previously healthy 19-year-old man presented to the emergency department with severe, sudden onset of left testicular pain. Physical exam revealed a left high-riding, horizontally oriented testicle without cremasteric reflex. Point-of-care ultrasound was used to confirm the diagnosis of testicular torsion, as well as to guide manual detorsion, verifying return of blood flow after reduction.Testicular torsion is a urologic emergency in which testicular viability is time dependent. Point-of-care ultrasound can be an important and helpful tool to not only confirm suspicion but help guide adequacy of blood flow return after manual detorsion in conjunction with comprehensive ultrasound.

  View details for DOI 10.5811/cpcem.2022.7.56747

  View details for PubMedID 36427024

• A Distance-Learning Approach to Point-of-Care Ultrasound Training (ADAPT): A Multi-Institutional Educational Response During the COVID-19 Pandemic. Academic medicine : journal of the Association of American Medical Colleges Nix, K., Liu, E. L., Oh, L., Duanmu, Y., Fong, T., Ashenburg, N., Liu, R. B. 2021

  Abstract

  PROBLEM: The COVID-19 pandemic significantly disrupted point-of-care ultrasound (POCUS) education. Medical schools and residency programs placed restrictions on bedside teaching and clinical scanning as part of risk mitigation. In response, POCUS faculty nationwide from 15 institutions collaborated on an alternative model of ultrasound education, A Distance-learning Approach to POCUS Training (ADAPT).APPROACH: ADAPT was repeated monthly from April 1 through June 30, 2020. It accommodated 70 learners, who included 1- to 4-week rotators and asynchronous learners. The curriculum included assigned pre-work and learning objectives covering 20 core POCUS topics. A rotating group of 30 faculty and fellows delivered daily virtual teaching sessions that included gamification to increase learner engagement and hands-on instruction through teleguidance. After participation, faculty and learners completed anonymous surveys.OUTCOMES: Educators reported a significant decrease in preparatory time (6.2 vs. 3.1 hours per week, P < .001) dedicated to ultrasound education after implementing ADAPT. The majority of 29 learners who completed surveys felt "somewhat confident" or "very confident" in their ability to acquire (n = 25, 86.2%) and interpret (n = 27, 93.1%) ultrasound images after the intervention; the majority of 22 educators completing surveys rated the program "somewhat effective" or "very effective" at contributing to learner's ability to acquire (n = 13, 59.1%) and interpret (n = 20, 90.9%) images. Most learners (n = 28, 96.6%) and all educators (n = 22, 100%) were "satisfied" or "very satisfied" with ADAPT as a whole, and the large majority of educators were "very likely" (n = 18, 81.8%) to recommend continued use of this program.NEXT STEPS: A virtual curriculum that pools the efforts of multiple institutions nationwide was implemented rapidly and effectively while satisfying educational expectations of both learners and faculty. This collaborative framework can be replicated and may be generalizable to other educational objectives.

  View details for DOI 10.1097/ACM.0000000000004399

  View details for PubMedID 34524135

• Using a Simulated Model and Mastery Learning Approach to Teach the Ultrasound-guided Serratus Anterior Plane Block to Emergency Medicine Residents: A Pilot Study. AEM education and training Rider, A. C., Miller, D. T., Ashenburg, N., Duanmu, Y., Lobo, V., Schertzer, K., Sebok-Syer, S. S. 2021; 5 (3): e10525

  Abstract

  Background: The serratus anterior plane block (SAPB) is a safe, single-injection alternative for pain control in patients with rib fractures. This pilot study aims to teach the ultrasound-guided SAPB to emergency medicine (EM) residents using a mastery learning approach.Methods: A 19-item checklist was created and mastery was determined to be 17 of 19 items correct. This pass score was established using a Mastery Angoff standard-setting exercise with a group of EM experts. Learners participated in baseline testing on a simulated model and performance was assessed by two raters. Learners then watched an instructional video and participated in an individualized teaching session. Learners underwent deliberate practice followed by posttesting until mastery was achieved. Score differences in baseline testing and posttesting were analyzed using a paired t-test. Pre- and posttesting surveys were also completed by participants.Results: Twenty-eight PGY-1 to -4 residents volunteered to participate in the study. The range of reported SAPBs seen previously was 0 to 5. The mean (±SD) number of items correct on the checklist for initial testing was 8.5 of 19 (±2.7), while the mean (±SD) final score was 18 of 19 (±0.6; p<0.001). All participants met mastery standards after the curriculum intervention. Median self-reported procedural confidence was 2 out of 5 on a 5-point Likert scale before the session and 5 out of 5 after the session (Z=-4.681, p<0.001).Conclusions: Using a mastery learning approach and simulated model, we were able to successfully train EM residents to perform the SAPB at a level of mastery and increase their overall confidence in executing this procedure.

  View details for DOI 10.1002/aet2.10525

  View details for PubMedID 34041432

• Intra-Articular Catheter Placement: A Novel Approach for Simulating Ankle Effusions in Cadaver Models. The western journal of emergency medicine Ross, G. A., Ashenburg, N. G., Wynn, W. D., McCarthy, J. J., Clendening, A. M., Presley, B. C., Kubalak, S. W., Barnes, R. M. 2019; 20 (1): 92-93

  View details for DOI 10.5811/westjem.2018.9.39810

  View details for PubMedID 30643607

  View details for PubMedCentralID PMC6324721