Salerno Nicholas, Papanagnou Dimitrios, Mahesh Priyha, Bowers Kaitlin M, Pasichow Scott H, Paradise Sara, Zhang Xiao Chi
Emergency Medicine, Louisiana State University Health Sciences Center, New Orleans, USA.
Emergency Medicine, Thomas Jefferson University, Philadelphia, USA.
Cureus. 2018 Nov 8;10(11):e3563. doi: 10.7759/cureus.3563.
Medical simulation competitions have become an increasingly popular method to provide a hands-on "gamified" approach to education and training in the health professions. The most well-known competition, SimWars, consists of well-coordinated teams that are tasked with completing a series of mind-bending clinical scenarios in front of a live audience through 'bracket-style' elimination rounds. Similarly, challenging hazards amidst observational simulation (CHAOS) in the emergency department (ED) is another novel approach to gamification in both its structure and feel. Conducted at the Council of Emergency Medicine Resident Directors (CORD) 2018 National Assembly in San Antonio, Texas, instead of assigning premeditated teams, it placed random Emergency Medicine (EM) faculty, residents, and medical students together in teams to test them on a variety of fundamental EM content areas. Additionally, the event incorporated multiple levels within each round, allowing the inclusion of additional information to be shared with participants to support "switching gears," as is typical for teams working in the ED and augmenting the perceived level of "chaos." To assess this pilot project, formal quantitative and qualitative feedback was solicited at the end of the session. Quantitative evaluation of the intervention was obtained through an eight-item questionnaire using a five-point Likert-type scale from 19 of the 20 enrolled participants (95% response rate). Responses were generally positive with an overall course rating score of 4.45 out of 5 (SD +/- 0.62). Qualitative feedback revealed that learners enjoyed performing procedures and networking with their EM colleagues. The majority of residents (95%) recommend the activity be integrated into subsequent conferences. Areas for improvement included shorter cases and minimizing technical malfunctions. CHAOS in the ED was a successful pilot study that incorporated gamification as a means to deploy simulation-based training at a national emergency medicine conference in a community of simulation educators. Future studies should focus on incorporating learners' feedback into subsequent CHAOS iterations and reducing overhead costs to increase its adoption by both regional and national audiences.
医学模拟竞赛已成为一种越来越受欢迎的方法，为健康职业的教育和培训提供一种实践的“游戏化”方式。最著名的竞赛是SimWars，它由协调良好的团队组成，这些团队的任务是通过“淘汰赛制”的轮次，在现场观众面前完成一系列令人绞尽脑汁的临床场景。同样，急诊科（ED）的观察性模拟中的挑战性危害（CHAOS）在结构和体验上也是游戏化的另一种新方法。该活动于2018年在德克萨斯州圣安东尼奥举行的急诊医学住院医师主任委员会（CORD）全国会议上进行，它不是分配预先组建好的团队，而是将随机的急诊医学（EM）教员、住院医师和医学生组成团队，在各种基本的EM内容领域对他们进行测试。此外，该活动在每一轮中都包含多个层次，允许向参与者分享额外信息以支持“换挡”，这在急诊科工作的团队中很常见，并增加了“混乱”的感知程度。为了评估这个试点项目，在活动结束时征求了正式的定量和定性反馈。通过一份包含8个项目的问卷，使用从1（非常不同意）到5（非常同意）的五点李克特量表，从20名登记参与者中的19名（95%的回复率）获得了对干预措施的定量评估。回复总体上是积极的，课程总体评分在5分制中为4.45分（标准差±0.62）。定性反馈表明，学习者喜欢进行操作并与他们的EM同事建立联系。大多数住院医师（95%）建议将该活动纳入后续会议。改进的方面包括缩短病例时长并尽量减少技术故障。急诊科的CHAOS是一项成功的试点研究，它将游戏化作为一种手段，在模拟教育工作者群体的全国急诊医学会议上开展基于模拟的培训。未来的研究应侧重于将学习者的反馈纳入后续的CHAOS迭代中，并降低管理成本，以提高其在地区和全国受众中的采用率。
