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Adapting to a Pandemic: Web-Based Residency Training and Script Concordance Testing in Emergency Medicine During COVID-19

Published online by Cambridge University Press:  29 November 2023

Katarzyna Naylor Open the ORCID record for Katarzyna Naylor [Opens in a new window] ,
Maja Chrzanowska-Wąsik ,
Patrycja Okońska ,
Tomasz Kucmin ,
Ahmed M. Al-Wathinani  and
Krzysztof Goniewicz Open the ORCID record for Krzysztof Goniewicz [Opens in a new window]
Katarzyna Naylor
Affiliation:
Independent Unit of Emergency Medical Services and Specialist Emergency, Medical University of Lublin, Lublin, Poland
Maja Chrzanowska-Wąsik
Affiliation:
Department of Emergency Medicine, Medical University of Lublin, Lublin, Poland
Patrycja Okońska
Affiliation:
Department of Emergency Medicine, Medical University of Lublin, Lublin, Poland
Tomasz Kucmin
Affiliation:
Department of Didactics and Medical Simulation, Medical University of Lublin, Lublin, Poland
Ahmed M. Al-Wathinani
Affiliation:
Department of Emergency Medical Services, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Saudi Arabia
Krzysztof Goniewicz*
Affiliation:
Department of Security, Polish Air Force University, Dęblin, Poland
*
Corresponding author: Krzysztof Goniewicz; Email: k.goniewicz@law.mil.pl
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Abstract

Objective:

The coronavirus disease (COVID-19) pandemic necessitated alternative methods to ensure the continuity of medical education. Our study explores the efficacy and acceptability of a digital continuous medical education initiative for medical residents during this challenging period.

Methods:

From September to December 2020, 47 out of 60 enrolled trainee doctors participated in this innovative digital Continuous Medical Education (CME) approach. We utilized the Script Concordance Test to bolster clinical reasoning skills. Three simulation scenarios, namely Advanced Trauma Life Support (ATLS), Advanced Life Support (ALS), and European Paediatric Life Support (EPLS), were transformed into interactive online sessions via Zoom™. Participant feedback was also collected through a survey.

Results:

Consistent Script Concordance Testing (SCT) scores among participants indicated the effectiveness of the online training module. Feedback suggested a broad acceptance of this novel training approach. However, discrepancies observed between formative SCT scores, and summative Multiple-Choice Questions (MCQ) assessments highlighted areas for potential refinement.

Conclusions:

Our findings showcase the resilience and adaptability of medical education amidst challenges like the global pandemic. The success of methodologies such as SCT, endorsed by prestigious bodies like the European Resuscitation Council and the American Heart Association, suggests their potential in preparing health care professionals for emergent situations. This research offers valuable insights for shaping future online CME strategies.

Keywords

adaptive medical education emergency medicineclinical reasoning skillsContinuous Medical EducationCOVID-19health care professionals trainingmedical assessment toolsonline medical educationpandemic responseresilience in health careScript Concordance Testspecialty training
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e541
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health

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References

The World Health Organization. Key Planning Recommendations for Mass Gatherings in the Context of COVID-19: Interim Guidance (No. WHO/2019-nCoV/POE Mass Gathering/2020.2). Published 2020. Accessed August 20, 2023. https://www.who.int/publications-detail/key-planning-recommendations-for-mass-gatherings-in-the-context-of-the-current-covid-19-outbreak Google Scholar
Naylor, K, Torres, K. Approaches to stimulate clinical reasoning in continuing medical education during the COVID-19 pandemic. Kardiol Pol. 2020;78(7-8):770-772. https://doi.org/10.33963/KP.15419. https://pubmed.ncbi.nlm.nih.gov/32500994/ Google Scholar
Schulte, TL, Gröning, T, Ramsauer, B, et al. Impact of COVID-19 on continuing medical education—results of an online survey among users of a non-profit multi-specialty live online education platform. Front Med. 2021;8:2104. https://www.frontiersin.org/articles/10.3389/fmed.2021.773806/full CrossRefGoogle ScholarPubMed
COVID-19 Guidelines. European Resuscitation Council. Published 2020. Accessed June 6, 2020. https://www.erc.edu/assets/documents/ERC_covid19_spreads.pdf Google Scholar
Edelson, DP, Sasson, C, Chan, PS, et al. Interim guidance for Basic and Advanced Life Support in adults, children, and neonates with suspected or confirmed COVID-19. Circulation. 2020;141(25). https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.047463 CrossRefGoogle ScholarPubMed
COVID-19 Videos. Centre for Disease Control and Prevention. CDC. Published 2021. Accessed June 20, 2021. https://www.cdc.gov/coronavirus/2019-ncov/communication/videos.html?Sort=Date%3A%3Adesc Google Scholar
Nolan, JP, Monsieurs, KG, Bossaert, L, et al. European Resuscitation Council COVID-19 guidelines executive summary. Resuscitation. Published 2020. Accessed June 8, 2020. https://linkinghub.elsevier.com/retrieve/pii/S030095722030232X Google Scholar
Scquizzato, T, Olasveengen, TM, Ristagno, G, Semeraro, F. The other side of novel coronavirus outbreak: fear of performing cardiopulmonary resuscitation. Resuscitation. 2020;150:92-93. https://www.sciencedirect.com/science/article/pii/S0300957220301337 CrossRefGoogle ScholarPubMed
Kanneganti, A, Sia, C-H, Ashokka, B, Ooi, SBS. Continuing medical education during a pandemic: an academic institution’s experience. Postgrad Med J. 2020;96(1137):384-386. http://www.ncbi.nlm.nih.gov/pubmed/32404498 CrossRefGoogle ScholarPubMed
Daniel, M, Gordon, M, Patricio, M, et al. An update on developments in medical education in response to the COVID-19 pandemic: a BEME scoping review: BEME Guide No. 64. Med Teach. 2021;43(3):253-271. https://www.tandfonline.com/doi/full/10.1080/0142159X.2020.1864310 CrossRefGoogle Scholar
Chandra, S, Laoteppitaks, C, Mingioni, N, Papanagnou, D. Zooming-out COVID-19: virtual clinical experiences in an emergency medicine clerkship. Med Educ. 2020;54(12):1182-1183. http://www.ncbi.nlm.nih.gov/pubmed/32502282 CrossRefGoogle Scholar
Dennis, B, Highet, A, Kendrick, D, et al. Knowing your team: rapid assessment of residents and fellows for effective horizontal care delivery in emergency events. J Grad Med Educ. 2020;12(3):272-279. http://www.ncbi.nlm.nih.gov/pubmed/32595843 CrossRefGoogle ScholarPubMed
Ministry of Health. The bill concerning the specialities for medical doctors and dentistry doctors. Warsaw: The Polish Ministry of Health; 2013:1-10.Google Scholar
Lubarsky, S, Dory, V, Duggan, P, et al. Script concordance testing: from theory to practice: AMEE Guide No. 75. Med Teach. 2013;35(3):184-193. http://www.ncbi.nlm.nih.gov/pubmed/23360487 CrossRefGoogle ScholarPubMed
Fournier, JP, Demeester, A, Charlin, B. Script concordance tests: guidelines for construction. BMC Medical Inform Decis Mak. 2008;8:18. http://www.ncbi.nlm.nih.gov/pubmed/18460199 CrossRefGoogle ScholarPubMed
Torres, A, Domańska-Glonek, E, Dzikowski, W, et al. Transition to online is possible: solution for simulation-based teaching during the COVID-19 pandemic. Med Educ. 2020;54(9):858-859. https://onlinelibrary.wiley.com/doi/10.1111/medu.14245 CrossRefGoogle ScholarPubMed
Fernandez Castelao, E, Boos, M, Ringer, C, et al. Effect of CRM team leader training on team performance and leadership behavior in simulated cardiac arrest scenarios: a prospective, randomized, controlled study. BMC Med Educ. 2015;15(1):116. https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-015-0389-z CrossRefGoogle Scholar
Saiboon, IM, Apoo, FN, Jamal, SM, et al. Improving the position of resuscitation team leader with simulation (IMPORTS); a pilot cross-sectional randomized intervention study. Medicine (Baltimore). 2019;98(49):e18201 http://www.ncbi.nlm.nih.gov/pubmed/31804343 CrossRefGoogle ScholarPubMed
Bennett, CE. Not who, but rather how: the ideal resuscitation team leader. Mayo Clin Proc Innov Qual Outcomes. 2021;5(5):817-819. http://www.ncbi.nlm.nih.gov/pubmed/34458679 CrossRefGoogle ScholarPubMed
Kinney, B, Slama, R. Rapid outdoor non-compression intubation (RONCI) of cardiac arrests to mitigate COVID-19 exposure to emergency department staff. Am J Emerg Med. 2020;38(12):2760.e1-2760.e3. https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20200001566 CrossRefGoogle ScholarPubMed
Ministry of Health. [Bill on the specialities for medical doctors and dentistry doctors]. 2021;4(2):37-48. http://www.ncbi.nlm.nih.gov/pubmed/19480590 Google Scholar
Campbell, J. International trauma life support for emergency care providers. Pearson+; 2021:1689-1699, Vol 1. https://www.itrauma.org/product/itls-for-emergency-care-providers-9th-edition/ Google Scholar
Buchanan, EA, Hvizdak, EE. Online survey tools: ethical and methodological concerns of human research ethics committees. J Empir Res Hum Res Ethics. 2009;4(2):37-48. http://www.ncbi.nlm.nih.gov/pubmed/19480590 CrossRefGoogle ScholarPubMed
Ghasemi, A, Zahediasl, S. Normality tests for statistical analysis: a guide for non-statisticians. Int J Endocrinol Metab. 2012;10(2):486-489. http://www.ncbi.nlm.nih.gov/pubmed/23843808 CrossRefGoogle Scholar
Bland, JM, Altman, DG. Statistical methods for assessing agreement between two methods of clinical measurement. Int J Nurs Stud. 2010;47(8):931-936. https://www.sciencedirect.com/science/article/abs/pii/S0020748909003204 CrossRefGoogle Scholar
Goos, M, Schubach, F, Seifert, G, Boeker, M. Validation of undergraduate medical student script concordance test (SCT) scores on the clinical assessment of the acute abdomen. BMC Surg. 2016;16(1):57. http://www.ncbi.nlm.nih.gov/pubmed/27535826 CrossRefGoogle ScholarPubMed
Duggan, P, Charlin, B. Summative assessment of 5th year medical students’ clinical reasoning by script concordance test: requirements and challenges. BMC Med Educ. 2012;12(1):29. https://bmcmededuc.biomedcentral.com/articles/10.1186/1472-6920-12-29 CrossRefGoogle ScholarPubMed
Koo, TK, Li, MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155-163. http://www.ncbi.nlm.nih.gov/pubmed/27330520 CrossRefGoogle ScholarPubMed
Boulouffe, C, Doucet, B, Muschart, X, et al. Assessing clinical reasoning using a script concordance test with electrocardiogram in an emergency medicine clerkship rotation. Emerg Med J. 2014;31(4):313-316. http://www.ncbi.nlm.nih.gov/pubmed/23539495 CrossRefGoogle Scholar
Christopher, TA, Christopher, AN. Emergency medicine and COVID-19: now and next year. Emerg Crit Care Med. 2021;1(1):14-19. https://journals.lww.com/10.1097/EC9.0000000000000010 CrossRefGoogle Scholar
Andersson, U, Maurin Söderholm, H, Wireklint Sundström, B, et al. Clinical reasoning in the emergency medical services: an integrative review. Scand J Trauma Resusc Emerg Med. 2019;27(1):76. https://sjtrem.biomedcentral.com/articles/10.1186/s13049-019-0646-y CrossRefGoogle ScholarPubMed
Subra, J, Chicoulaa, B, Stillmunkès, A, et al. Reliability and validity of the script concordance test for postgraduate students of general practice. Eur J Gen Pract. 2017;23(1):209-214. https://www.tandfonline.com/doi/full/10.1080/13814788.2017.1358709 CrossRefGoogle ScholarPubMed
Drolet, P. Assessing clinical reasoning in anesthesiology: making the case for the Script Concordance Test. Anaesth Crit Care Pain Med. 2015;34(1):5-7. https://linkinghub.elsevier.com/retrieve/pii/S2352556815000090 CrossRefGoogle Scholar
Lubarsky, S, Chalk, C, Kazitani, D, et al. The Script Concordance Test: a new tool assessing clinical judgement in neurology. Can J Neurol Sci. 2009;36(3):326-331. http://www.ncbi.nlm.nih.gov/pubmed/19534333 CrossRefGoogle Scholar
Tan, K, Tan, NCK, Kandiah, N, et al. Validating a script concordance test for assessing neurological localization and emergencies. Eur J Neurol. 2014;21(11):1419-1422. http://www.ncbi.nlm.nih.gov/pubmed/24484361 CrossRefGoogle ScholarPubMed
Deschênes, M-F, Charlin, B, Phan, V, et al. Educators and practitioners’ perspectives in the development of a learning by concordance tool for medical clerkship in the context of the COVID pandemic. Can Med Educ J. 2021;12(6):43-54. http://www.ncbi.nlm.nih.gov/pubmed/35003430 Google ScholarPubMed
George, PP, Papachristou, N, Belisario, JM, et al. Online eLearning for undergraduates in health professions: a systematic review of the impact on knowledge, skills, attitudes and satisfaction. J Glob Health. 2014;4(1):010406. doi: 10.7189/jogh.04.010406 CrossRefGoogle ScholarPubMed
Roslan, NS, Yusoff, MS. Script concordance test. In: Written Assessment in Medical Education (pp. 101-109). Springer International Publishing; 2023.CrossRefGoogle Scholar
Brentnall, J, Thackray, D, Judd, B. Evaluating the clinical reasoning of student health professionals in placement and simulation settings: a systematic review. Int J Environ Res Public Health. 2022;19(2):936.CrossRefGoogle ScholarPubMed
van der Vleuten, CP, Driessen, EW. What would happen to education if we take education evidence seriously? Perspect Med Educ. 2014;3:222-232.CrossRefGoogle ScholarPubMed
Van Alten, DC, Phielix, C, Janssen, J, Kester, L. Effects of flipping the classroom on learning outcomes and satisfaction: a meta-analysis. Educ Res Rev. 2019;28:100281.CrossRefGoogle Scholar
Thorne, CJ, Kimani, PK, Hampshire, S, et al. The nationwide impact of COVID-19 on life support courses. A retrospective evaluation by Resuscitation Council UK. Resuscitation Plus. 2023;13:100366. https://doi.org/10.1016/j.resplu.2023.100366 (https://www.sciencedirect.com/science/article/pii/S2666520423000097)CrossRefGoogle Scholar
McCutcheon, K, Lohan, M, Traynor, M, Martin, D. A systematic review evaluating the impact of online or blended learning vs. face-to-face learning of clinical skills in undergraduate nurse education. J Adv Nurs. 2015;71(2):255-270.CrossRefGoogle ScholarPubMed
Deschênes, M-F, Goudreau, J, Fernandez, N. Learning strategies used by undergraduate nursing students in the context of a digitial educational strategy based on script concordance: a descriptive study. Nurse Educ Today. 2020;95:104607. http://www.ncbi.nlm.nih.gov/pubmed/33045676 CrossRefGoogle ScholarPubMed
Goniewicz, K, Burkle, FM. Redefining global disaster management strategies: lessons from COVID-19 and the call for united action. Disaster Med Public Health Prep. 2023;17:e450. doi: 10.1017/dmp.2023.111 CrossRefGoogle ScholarPubMed
Goniewicz, M, Khorram-Manesh, A, Włoszczak-Szubzda, A, et al. Influence of experience, tenure, and organisational preparedness on nurses’ readiness in responding to disasters: an exploration during the COVID-19 pandemic. J Glob Health. 2023;13:06034. doi: 10.7189/jogh.13.06034 CrossRefGoogle ScholarPubMed
Wan, S. Using the script concordance test to assess clinical reasoning skills in undergraduate and postgraduate medicine. Hong Kong Med J. Published online August 28, 2015. http://www.hkmj.org/earlyrelease/hkmj154572.htm CrossRefGoogle Scholar
Bursztejn, A-C, Cuny, J-F, Adam, J-L, et al. Usefulness of the script concordance test in dermatology. J Eur Acad Dermatol Venereol. 2011;25:1471-1475. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1468-3083.2011.04008.x CrossRefGoogle ScholarPubMed
Rambaldini, G, Wilson, K, Rath, D, et al. The impact of severe acute respiratory syndrome on medical house staff: a qualitative study. J Gen Intern Med. 2005;20(5):381-385. http://www.ncbi.nlm.nih.gov/pubmed/15963157 CrossRefGoogle ScholarPubMed
Yang, T, Buck, S, Evans, L, Auerbach, M. A telesimulation elective to provide medical students with pediatric patient care experiences during the COVID pandemic. Pediatr Emerg Care. 2021;37(2):119-122. http://www.ncbi.nlm.nih.gov/pubmed/33181792 CrossRefGoogle ScholarPubMed