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The effectiveness of training with an emergency department simulator on medical student performance in a simulated disaster

Published online by Cambridge University Press:  21 May 2015

Jeffrey Michael Franc-Law
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, Alta Department of Anesthesia and Intensive Care, l’Università degli Studi del Piemonte Orientale “Amedeo Avogadro,”, Novara, Italy
Pier Luigi Ingrassia
Affiliation:
Department of Anesthesia and Intensive Care, l’Università degli Studi del Piemonte Orientale “Amedeo Avogadro,”, Novara, Italy
Luca Ragazzoni
Affiliation:
Department of Anesthesia and Intensive Care, l’Università degli Studi del Piemonte Orientale “Amedeo Avogadro,”, Novara, Italy
Francesco Della Corte
Affiliation:
Department of Anesthesia and Intensive Care, l’Università degli Studi del Piemonte Orientale “Amedeo Avogadro,”, Novara, Italy
Corresponding
E-mail address:

Abstract

Objective:

Training in practical aspects of disaster medicine is often impossible, and simulation may offer an educational opportunity superior to traditional didactic methods. We sought to determine whether exposure to an electronic simulation tool would improve the ability of medical students to manage a simulated disaster.

Methods:

We stratified 22 students by year of education and randomly assigned 50% from each category to form the intervention group, with the remaining 50% forming the control group. Both groups received the same didactic training sessions. The intervention group received additional disaster medicine training on a patient simulator (disastermed.ca), and the control group spent equal time on the simulator in a nondisaster setting. We compared markers of patient flow during a simulated disaster, including mean differences in time and number of patients to reach triage, bed assignment, patient assessment and disposition. In addition, we compared triage accuracy and scores on a structured command-and-control instrument. We collected data on the students' evaluations of the course for secondary purposes.

Results:

Participants in the intervention group triaged their patients more quickly than participants in the control group (mean difference 43 s, 99.5% confidence interval [CI] 12 to 75 s). The score of performance indicators on a standardized scale was also significantly higher in the intervention group (18/18) when compared with the control group (8/18) (p < 0.001). All students indicated that they preferred the simulation-based curriculum to a lecture-based curriculum. When asked to rate the exercise overall, both groups gave a median score of 8 on a 10-point modified Likert scale.

Conclusion:

Participation in an electronic disaster simulation using the disastermed.ca software package appears to increase the speed at which medical students triage simulated patients and increase their score on a structured command-and-control performance indicator instrument. Participants indicated that the simulation-based curriculum in disaster medicine is preferable to a lecture-based curriculum. Overall student satisfaction with the simulation-based curriculum was high.

Résumé

RÉSUMÉ Objectif:

Il est souvent impossible de former les étudiants aux volets pratiques de la médecine des catastrophes. Or, la simulation pourrait être une méthode d'enseignement supérieure aux méthodes traditionnelles. Nous avons cherché à déterminer si le recours à un outil de simulation électronique pourrait aider les étudiants en médecine à mieux gérer une catastrophe simulée.

Méthodes:

Nous avons stratifié un échantillon de 22 étudiants selon l'année de formation et avons assigné de façon aléatoire 50 % de chaque catégorie au groupe d'intervention, et 50 % au groupe témoin. Les deux groupes ont reçu les mêmes séances de formation didactique. Le groupe d'intervention a reçu une formation supplémentaire en médecine des catastrophes sur un simulateur de patients (disastermed.ca), et le groupe témoin a passé autant de temps sur le simulateur dans un cadre de non-catastrophe. Nous avons comparé les marqueurs de déplacement des patients pendant une catastrophe simulée, y compris les différences moyennes en temps et en nombre de patients relatifs à l'arrivée au triage, à l'attribution d'un lit, à l'évaluation du patient et à leur prise en charge. Nous avons en outre comparé l'exactitude du triage et les scores sur un outil structuré de mesure des compétences de commandement et de contrôle. Nous avons recueilli des données sur les évaluations des étudiants du cours à des fins secondaires.

Résultats:

Les participants du groupe d'intervention ont procédé au triage de leurs patients plus rapidement que les participants du groupe témoin (différence moyenne de 43 s; intervalle de confiance [IC] à 99,5 % de 12 à 75 s). Le score des indicateurs de performance, sur une échelle normalisée, était aussi nettement plus élevé pour le groupe d'intervention (18/18) que pour le groupe témoin (8/18) (p < 0,001). Tous les étudiants ont indiqué qu'ils préféraient les méthodes d'en-seignement basées sur la simulation aux cours magistraux. Les deux groupes ont accordé une note moyenne de 8 sur 10, sur une échelle Likert modifiée, lorsqu'on leur a demandé d'évaluer l'exercice dans son ensemble.

Conclusion:

La participation à une simulation électronique de catastrophe avec le progiciel de disastermed.ca semble accélérer le triage des patients simulés par les étudiants en médecine et donner un score plus élevé pour les indicateurs de performance en matière de commandement et de contrôle. Les participants ont indiqué qu'ils préféraient les méthodes d'enseignement basées sur la simulation aux cours magistraux. La satisfaction générale des étudiants relative à la formation par simulation est élevée.

Type
Original Research • Recherche originale
Copyright
Copyright © Canadian Association of Emergency Physicians 2010

References

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