Increasing emergency medicine residents' confidence in disaster management: use of an emergency department simulator and an expedited curriculum.
Introduction: Disaster Medicine is an increasingly important part of medicine. Emergency Medicine residency programs have very high curriculum commitments, and adding Disaster Medicine 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.
Statistical analysis was performed using the “R” statistics package Version 2.10.1
Prospective, observational cohort study
Simple Triage and Rapid Treatment (START) criteriaDisaster knowledge
Disaster simulation using the Disastermed.Ca Emergency DisasterSimulator computer software Version 3.5.2 (Disastermed.Ca, Edmonton, Alberta,Canada)Curriculum design was centered around published guidelines for Canadian medical schools25 participants
pre-test was performed to evaluate initial resident knowledge.The teaching curriculum consisted of five one-hour academic sessions.Following the five academic sessions, the residents participated in the Disastermed.Ca Emergency Department disaster simulation.Immediately following the simulation, residents completed the post-test, which contained the same questions as the pre-test.
The study aimed to evaluate the efficacy of an expedited
class attendance was erratic, and no inventory of participant attendance was performedanswers to these question frequently were wrong in the post-testsince there are no validated instruments to assess knowledge of Disaster Medicine, it may be that the test simply is not valid for assessing knowledge
A simulation-based model of Disaster Medicine , requiring approximately eight hours of classroom time.All residents agreed that the course was a valuable experience, and felt that the simulation-based learning module was preferable to a module based solely on didactic lectures. Most felt that the curriculum was of appropriate length at approximately eight hours. Although there was no statistical improvement in test scoring, following the course, residents felt more confident in the ability to manage a disaster, both on an individual and departmental basis.
Twenty-five residents agreed to partake in the curriculum.The study protocol was approved by the University of Alberta Health Research Ethics Board.
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
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