Increasing Emergency Medicine Residents’ Confidence in Disaster Management: Use of an Emergency Department Simulator and an Expedited Curriculum

2012 ◽  
Vol 27 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Jeffrey Michael Franc ◽  
Darren Nichols ◽  
Sandy L. Dong
Keyword(s):  
Emergency Medicine ◽  
Disaster Management ◽  
Medical Training ◽  
Faculty Evaluation ◽  
Computer Software ◽  
Disaster Medicine ◽  
Disaster Plan ◽  
Significant Difference ◽  
Simulation Based ◽  
Post Test

AbstractIntroduction: Disaster Medicine is an increasingly important part of medicine. Emergency Medicine residency programs have very high curriculum commitments, and adding Disaster Medicine training to this busy schedule can be difficult. Development of a short Disaster Medicine curriculum that is effective and enjoyable for the participants may be a valuable addition to Emergency Medicine residency training.Methods: A simulation-based curriculum was developed. The curriculum included four group exercises in which the participants developed a disaster plan for a simulated hospital. This was followed by a disaster simulation using the Disastermed.Ca Emergency Disaster Simulator computer software Version 3.5.2 (Disastermed.Ca, Edmonton, Alberta, Canada) and the disaster plan developed by the participants. Progress was assessed by a pre- and post-test, resident evaluations, faculty evaluation of Command and Control, and markers obtained from the Disastermed.Ca software.Results: Twenty-five residents agreed to partake in the training curriculum. Seventeen completed the simulation. There was no statistically significant difference in pre- and post-test scores. Residents indicated that they felt the curriculum had been useful, and judged it to be preferable to a didactic curriculum. In addition, the residents’ confidence in their ability to manage a disaster increased on both a personal and and a departmental level.Conclusions: A simulation-based model of Disaster Medicine training, requiring approximately eight hours of classroom time, was judged by Emergency Medicine residents to be a valuable component of their medical training, and increased their confidence in personal and departmental disaster management capabilities.

scholarly journals Disaster Day: A Simulation-Based Disaster Medicine Curriculum for Novice Learners

2021 ◽  
Vol 8 ◽  
pp. 238212052110207
Author(s):  
Brad D Gable ◽  
Asit Misra ◽  
Devin M Doos ◽  
Patrick G Hughes ◽  
Lisa M Clayton ◽  
...  
Keyword(s):  
Medical Students ◽  
Disaster Management ◽  
Disaster Preparedness ◽  
Real Life ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Incident Command ◽  
Management Concepts ◽  
Simulation Based ◽  
Second Year

Background: Mass casualty and multi-victim incidents have increased in recent years due to a number of factors including natural disasters and terrorism. The Association of American Medical Colleges (AAMC) recommends that medical students be trained in disaster preparedness and response. However, a majority of United States medical students are not provided such education. Objective: The goal of this study was to evaluate the effectiveness of a 1 day, immersive, simulation-based Disaster Day curriculum. Settings and Design: Learners were first and second year medical students from a single institution. Materials and Methods: Our education provided learners with information on disaster management, allowed for application of this knowledge with hands-on skill stations, and culminated in near full-scale simulation where learners could evaluate the knowledge and skills they had acquired. Statistical analysis used: To study the effectiveness of our Disaster Day curriculum, we conducted a single-group pretest-posttest and paired analysis of self-reported confidence data. Results: A total of 40 first and second year medical students participated in Disaster Day as learners. Learners strongly agreed that this course provided new information or provided clarity on previous training, and they intended to use what they learned, 97.6% and 88.4%, respectively. Conclusions: Medical students’ self-reported confidence of key disaster management concepts including victim triage, tourniquet application, and incident command improved after a simulation-based disaster curriculum. This Disaster Day curriculum provides students the ability to apply concepts learned in the classroom and better understand the real-life difficulties experienced in a resource limited environment.

scholarly journals LO43: Simulation curricular content in postgraduate emergency medicine: a multicenter delphi study

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S23
Author(s):  
N. Kester-Greene ◽  
A. Hall ◽  
C. Walsh
Keyword(s):  
Emergency Medicine ◽  
Delphi Study ◽  
Clinical Training ◽  
Medical Training ◽  
Validity Evidence ◽  
Delphi Methodology ◽  
Curricular Content ◽  
Simulation Based ◽  
Em Simulation ◽  
National Emergency

Introduction: There is increasing evidence to support the integration of simulation into medical training; however, no national emergency medicine (EM) simulation curriculum currently exists. Using Delphi methodology, we aimed to identify and establish content validity evidence for EM curricular content best suited for simulation-based training to inform national postgraduate EM training. Methods: A national panel of experts in EM simulation-related education iteratively rated potential curricular topics, on a 4-point scale, to determine those best suited for simulation-based training. After each round, responses were analyzed and topics scoring <2/4 were removed. Remaining topics were resent to the panel for further ratings until consensus was achieved, defined as Cronbach α ≥ 0.95. At conclusion of the Delphi process, topics that were rated ≥3.5/4 were considered core curricular topics, while those rated 3.0-3.5 were considered extended curricular topics. Results: Forty-four experts from 13 Canadian centres participated. Two hundred and eighty potential curricular topics, in 29 domains, were generated from a systematic review of the literature, analysis of relevant educational documents and a survey of Delphi panelists. Three rounds of Delphi surveys were completed before consensus was achieved, with response rates ranging from 93-100%. Twenty-eight topics, in 8 domains, reached consensus as core curricular topics. An additional 35 topics, in 14 domains, reached consensus as extended curricular topics. Conclusion: Delphi methodology allowed for achievement of expert consensus and content validation of EM curricular content best suited for simulation-based training. These results provide a foundation for improved integration of simulation into postgraduate EM training and can be used to inform a national simulation curriculum to supplement clinical training and optimize learning.

scholarly journals Awareness of family physician residents of their roles in disaster health management: a cross-sectional study in Turkey

2020 ◽  
Vol 21 ◽  
Author(s):  
Tarık Eren Yılmaz ◽  
Tuğba Yılmaz ◽  
Nüket Örnek Büken ◽  
Adem Özkara ◽  
Kerim Hakan Altıntaş
Keyword(s):  
Disaster Management ◽  
Family Physician ◽  
Role Models ◽  
Health Management ◽  
Family Physicians ◽  
Disaster Medicine ◽  
Specialty Training ◽  
Disaster Plan ◽  
Cross Sectional ◽  
Important Place

Abstract Aim: Family physicians are role models for their societies in disaster management and have an important place in it. This study was carried out during the specialty training of the residents, who are currently family physicians fighting against COVID-19 in the field, and was aimed to identify the awareness levels of residents regarding the roles and duties of family physicians before, during, and after disasters and to increase their awareness of disaster medicine and management. Background: The duties and responsibilities of a family physician in disasters should be a part of their specialty training. This study has contributed to the limited literature, increased awareness, and opened a new avenue of research for studies to be conducted with family physicians by demonstrating the current situation of family physicians in disaster management. Methods: This is an observational and descriptive study. The knowledge, experience, opinions, willingness, attitudes of the residents, and the awareness levels of the residents regarding their roles and duties in a disaster were evaluated along with their sociodemographic information. The surveys were applied in the family medicine clinics of the all residents by the interview method (n = 233). Findings: Only 9.2% of the residents stated that they had received training on disaster medicine where they currently work. The knowledge level of the residents on this subject was found as ‘Unsure’. In total, 80% of the residents stated that family physicians should have a role in disasters. It was found that 83.3% of the residents had never joined a disaster drill, 94.3% had never participated in making or applying a disaster plan, and 97.7% had never worked in any disaster. Conclusion: The residents participating in the study lacked not only information on disaster management but also experience. The residents’ willingness to receive training, work voluntarily, significantly question the curriculum, and specialize in disaster medicine were a positive outcome.

scholarly journals The Effect of Disaster Management Education on Mother’s Under Five Preparedness Facing Floods In Aceh Province

2021 ◽  
Vol 9 (E) ◽  
pp. 1032-1035
Author(s):  
Rachmawati Rachmawati ◽  
Rosi Novita ◽  
Ida Fitria
Keyword(s):  
Disaster Management ◽  
Disaster Preparedness ◽  
Management Education ◽  
Statistical Tests ◽  
Mean Value ◽  
T Test ◽  
Under Five ◽  
Significant Difference ◽  
Before And After ◽  
Post Test

BACKGROUND: The flood disaster has had various impacts on the people in Aceh. One of the groups prone to flooding is mothers with toddlers. Efforts should be made to increase capacity, understanding, and knowledge through education and education for disaster preparedness to reduce the risk of occurring. AIM: Analyzing the effect of disaster management education on the Preparedness of mothers under five in Aceh. METHODS: This type of research is a quasi-experimental study using the One-Group Pretest-Posttest. The sample in this study was 51 mothers of children under five who were willing to sample and resided in two flood-affected villages. Data collection on the Preparedness of mothers under five in this study was carried out using pre-test and post-test questionnaires before and after the provision of disaster education. Data analysis using bivariate used dependent T-test and correlation analysis used Rank Spearman correlation. RESULTS: The results showed a significant difference in the mean value of knowledge, attitudes, and Preparedness of under-five mothers before and after receiving education about disasters, as evidenced by statistical tests using the dependent t-test p < 0.05. Measurement of the pre-test and post-test scores on the average increase in knowledge from before 89.45 to 94.53 after education provision. The attitude variable also increased on average from 39.43 to 48.40 after the provision of education. The preparedness variable also increased on average from 50.69 to 58.28 after the provision of education. CONCLUSION: Disaster management education has provided increased knowledge, attitudes, and Preparedness for mothers under five to flood disasters.

Operational Medicine: Specialized Emergency Medicine Training

1985 ◽  
Vol 1 (S1) ◽  
pp. 105-106
Author(s):  
Prentis B. Vaughn
Keyword(s):  
Emergency Medicine ◽  
Medical Training ◽  
Armed Forces ◽  
Disaster Medicine ◽  
Humanitarian Assistance ◽  
Medical Department ◽  
Medical Evacuation ◽  
Disaster Relief Operations ◽  
Emergency Medical ◽  
Operational Medicine

The discipline of emergency medicine includes the field of disaster medicine. Unfortunately, little actual emphasis is placed upon this vital area of training in emergency medical residency programs aside from nominal involvement in mock hospital-community disaster drills and triage exercises. In addition to these important areas of disaster medicine, physicians must be knowledgeable in field medical sanitation, environmental illnesses, ground and aero-medical evacuation, epidemiology and logistics in addition to hands on emergency medical casualty care. To better serve this important neglected area of the emergency medicine residency curriculum, we developed a one-month block of instruction.The operational medicine course is composed of separate instructional modules. The emphasis of the field medical training is obviously a military one; however, that emphasis is easily translated into a field medical environment, one that is commonly employed in military disaster relief operations. The American armed forces, particularly the US Army, frequently come to the aid of victims of both civil and natural disasters. This humanitarian assistance also serves the readiness training goals of the Army Medical Department during peacetime.

scholarly journals Methodology for quantitative assessment of combat casualty care

SIMULATION ◽  
2018 ◽  
Vol 95 (4) ◽  
pp. 289-295
Author(s):  
Michael A. Xynidis ◽  
Brian F. Goldiez ◽  
Jack E. Norfleet ◽  
Nina Rothstein
Keyword(s):  
Student Performance ◽  
Quantitative Assessment ◽  
Medical Training ◽  
Evaluation Process ◽  
Training Effectiveness ◽  
Individual Student ◽  
Psychomotor Activity ◽  
Combat Casualty ◽  
Significant Difference ◽  
Simulation Based

Evaluating proficiency in simulation-based combat casualty training includes the assessment of hands-on training with mannequins through instructor observation. The evaluation process is error-prone due to high student–instructor ratios as well as the subjective nature of the evaluation process. Other logistical inconsistencies, such as the short amount of time to observe individual student performance, can lessen training effectiveness as well. The simulation-based methodology described in this article addresses these challenges by way of quantitative assessment of training effectiveness in combat casualty training. The methodology discusses adaptation of Lempel–Ziv (LZ) complexity indexing to quantify psychomotor activity that is otherwise only subjectively estimated by an instructor. LZ indexing has been successfully used to assess proficiency in related studies of simulation-based training conducted by Bann et al. at the Imperial College of Science Technology and Medicine in London, and more recently by Watson at the University of North Carolina at Chapel Hill. This type of analysis has been applied to using simulation as a tool to assess not only mastery of a task, but as a method to assess whether a particular simulator and training approach actually works. Data have been gathered from nearly 100 military combat medic trainees at Joint Base Lewis McChord Medical Simulation Training Center. Participant hand-acceleration data from an emergency surgical cricothyrotomy reveals a statistically significant difference in ability between expertise levels. The higher the LZ scores and self-reported expertise level, the better the participant performed. The results show that when presented with demographic and video performance-based data, it is possible to gauge experience by applying LZ scoring to motion data. The methodology provides an objective measure that complements the subjective component of simulation-based cricothyrotomy training assessments. Further study is needed to determine whether this methodology would provide similar assessment advantages in other medical training in which speed and accuracy would be significant factors in determining procedural expertise.

scholarly journals Peningkatan Peran Guru Sekolah Dasar Dalam Pengobatan Darurat untuk Menghilangkan Rasa Sakit Gigi dan Mulut

2021 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Ryana Budi Purnama ◽  
Helmi Hirawan ◽  
Tirta Wardana ◽  
Mutia Rochmawati ◽  
Pratiwi Nur Widyaningsih ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Elementary School ◽  
Oral Health ◽  
Elementary School Teachers ◽  
School Environment ◽  
Emergency Treatment ◽  
Wilcoxon Test ◽  
School Teachers ◽  
Significant Difference ◽  
Post Test

Abstract - Oral and dental health is a condition that needs to be considered and maintained to improve the quality of life. One of the efforts made to maintain dental and oral health in the school environment is by conducting UKGS (Usaha Kesehatan Gigi Sekolah). In UKGS activities, teachers have a role in providing emergency treatment to relieve pain. The emergency treatment administered by teachers in schools can perform in cases such as avulsions, choking, and abscesses. This community service aims to increase the role of elementary school teachers through UKGS to maintain, improve the oral health of all students at SDN in the Karangtengah area, Baturaden District, Purwokerto. The method of implementation was basely on optimizing the potential of UKGS teacher cadres, including identification of target schools and participants, pre-test implementation, maturation, coaching, enhancement of UKGS teacher cadres. Coaching and training have been carried out for UKGS supervisors for abscess, choking and avelse conditions. Post-test activities to gain insight into emergency medicine and relieve tooth and mouth pain. Results: p data analysis using the Wilcoxon asymp test.sig.(2-tailed) of 0.001 (<0.05), this value indicates that there is an influence on the level of knowledge about emergency medicine. The analysis performed with the Wilcoxon Test; there was a significant difference (sig = 0.001, p <0.05). There was an increase in the average pre-test value of 76.92 and post-test of 97.85.Conclusion: There is increasing knowledge about emergency medicine to relieve tooth and mouth pain in elementary school teachers.

Disaster Medicine: A Multi-Modality Curriculum Designed and Implemented for Emergency Medicine Residents

2016 ◽  
Vol 10 (4) ◽  
pp. 611-614 ◽  
Author(s):  
Jessica Ngo ◽  
Kimberly Schertzer ◽  
Phillip Harter ◽  
Rebecca Smith-Coggins
Keyword(s):  
Emergency Medicine ◽  
Training Programs ◽  
Journal Club ◽  
Disaster Medicine ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Virtual Reality Simulation ◽  
Simulation Based ◽  
Large Scope ◽  
Modality Approach

AbstractObjectiveFew established curricula are available for teaching disaster medicine. We describe a comprehensive, multi-modality approach focused on simulation to teach disaster medicine to emergency medicine residents in a 3-year curriculum.MethodsResidents underwent a 3-year disaster medicine curriculum incorporating a variety of venues, personnel, and roles. The curriculum included classroom lectures, tabletop exercises, virtual reality simulation, high-fidelity simulation, hospital disaster drills, and journal club discussion. All aspects were supervised by specialty emergency medicine faculty and followed a structured debriefing. Residents rated the high-fidelity simulations by using a 10-point Likert scale.ResultsThree classes of emergency medicine residents participated in the 3-year training program. Residents found the exercise to be realistic, educational, and relevant to their practice. After participating in the program, residents felt better prepared for future disasters.ConclusionsGiven the large scope of impact that disasters potentiate, it is understandably difficult to teach these skills effectively. Training programs can utilize this simulation-based curriculum to better prepare the nation’s emergency medicine physicians for future disasters. (Disaster Med Public Health Preparedness. 2016;10:611–614)

scholarly journals LO80: Perfecting practice for rare procedures: a simulation-based, multi-centre randomized trial

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S36-S36
Author(s):  
A. Petrosoniak ◽  
C. Hicks ◽  
S. Gray ◽  
M. McGowan ◽  
J. Sherbino ◽  
...  
Keyword(s):  
Mastery Learning ◽  
Deliberate Practice ◽  
Skills Training ◽  
Secondary Outcome ◽  
Guided Practice ◽  
Practice Performance ◽  
Significant Difference ◽  
Simulation Based ◽  
Skill Performance ◽  
Post Test

Introduction: Mastery learning, which deconstructs a complex task into sequential sub-steps combined with deliberate practice to achieve each step in sequence, represents an important method to enhance simulation-based procedural skills training. However, the evidence to support the effectiveness of this theory to improve learning is lacking. This study compared mastery learning using deliberate practice with self-guided practice on skill performance of a rarely performed, life-saving procedure, a bougie-assisted cricothyroidotomy (BAC). Methods: In this multi-centre, randomized study at five North American emergency medicine (EM) residency training programs, we assigned 166 EM postgraduate trainees to either mastery learning and deliberate practice (ML + DP) or self-guided practice for BAC. Three blinded airway experts independently evaluated BAC skill performance by video review before (pre-test) and after (post-test) each training session. The primary outcome was post-test skill performance using a 5-point global rating score (GRS). A secondary outcome, defined a priori, was performance time to complete the BAC skill (chronometry). Results: There was no significant difference in post-test BAC performance after ML + DP or self-guided practice. Performance scores improved for both groups by 13% from the pre-test to post-test (F (1,138) = 43, p < 0.001). Overall, time to complete the BAC improved significantly from pre-test (87.6 seconds) to posttest (54.1 seconds), (F, 1,149) = 122, p < 0.001). At post-test, the ML + DP group performed the skill 7.4 seconds faster than the self-guided practice group (F (1,150) = 6.77, p < 0.01). Conclusion: Mastery learning coupled with deliberate practice provides systematic and focused feedback during skill acquisition. However, it is resource intensive and its efficacy is not fully defined. In this study, MP + DP did not result in improved global performance; it did result in faster performance times, a relevant finding for time-sensitive procedures. These results are important for educators who seek to optimize technical skills training in a competency-based model of medical education. Our findings suggest that time-sensitive procedures might benefit from ML + DP teaching strategies to enhance time to procedural performance.

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