Background
There is a paucity of literature determining the best technique for routine fish hook removal (FHR). A professional literature search primarily found case reports. The literature does not describe any methods for teaching or evaluating FHR with physicians or the use of simulation for teaching and evaluating FHR.
Objective
To evaluate the effectiveness of a FHR simulation workshop using investigator-developed diagrams, practice models, and a teaching video.
Methods
This is an Institutional Review Board–approved descriptive, prospective, educational study. The primary outcomes are the learner’s perception of ease of learning, performance ability, and amount of tissue damage for each technique. A 2.5-minute educational video and instructional visual diagrams were created to teach 4 techniques: simple retrograde, string pull, advance and cut, and needle cover. Learners performed each technique on a model and placed in rank order their preferences for ease of learning, performance, tissue damage, and overall choice.
Results
Of the total group of 20 learners (85% emergency medicine residents/faculty, 67% male, 40% recreational fishers), 35% had previous FHR experience. On first attempt, 90% had successful FHR using all techniques except needle cover (40%). Simple retrograde was rated easiest to learn (75%) and to perform (55%), and caused least damage (35%), whereas needle cover was ranked hardest to learn (85%) and perform (80%), and advance and cut caused the worst damage (40%). Overall preferred technique was tied between simple retrograde and string pull (35%), with needle cover least preferred (65%). Of interest, despite its perception for causing the most tissue damage, advance and cut was the preferred technique learners would use on the face (40%) or on an extremity (50%).
Conclusions
This study is the first to experimentally evaluate physician learning and preferences for FHR techniques. After a brief educational session, physicians could effectively use all techniques except needle cover. Simple retrograde and string pull were the overall preferred techniques.