Purdy Eve, Alexander Charlotte, Caughley Melissah, Bassett Shane, Brazil Victoria
Queen's University Kingston Ontario Canada.
Gold Coast University Hospital Southport Queensland Australia.
AEM Educ Train. 2019 Feb 27;3(2):118-128. doi: 10.1002/aet2.10325. eCollection 2019 Apr.
Simulation is commonly used in medical education. It offers the opportunity for participants to apply theoretical knowledge and practice nontechnical skills. We aimed to examine how simulation may also help to identify emergency medicine culture and serve as a tool to transmit values, beliefs, and practices to medical learners.
We undertook a focused ethnography of a simulated emergency department exercise delivered to 98 third-year medical students. This ethnography included participant observation, informal interviews, and document review. Analysis was performed using a recursive method, a simultaneous deductive and inductive approach to data interpretation.
All 20 staff (100%) and 92 of 98 medical students (94%) participated in the study. We identified seven core values-identifying and treating dangerous pathology, managing uncertainty, patients and families at the center of care, balancing needs and resources at the system level, value of the team approach, education as integral, and emergency medicine as part of self-identity-and 27 related beliefs that characterized emergency medicine culture. We observed that culture was transmitted during the simulation exercise.
This study contributes to the characterization of the culture of emergency medicine by identifying core values and beliefs that are foundational to the specialty. Simulation facilitated cultural compression, which allowed for ready identification of values, beliefs, and practices and also facilitated transmission of culture to learners. This study expands understanding of the culture of emergency medicine and the role of simulation in the process of cultural exchange.
模拟在医学教育中普遍应用。它为参与者提供了应用理论知识和实践非技术技能的机会。我们旨在探讨模拟如何还能有助于识别急诊医学文化，并作为一种工具将价值观、信念和实践传授给医学学习者。
我们对向98名三年级医学生开展的一次模拟急诊科演练进行了聚焦人种志研究。该人种志研究包括参与观察、非正式访谈和文件审查。分析采用递归方法，即对数据解释同时运用演绎和归纳的方法。
所有20名工作人员（100%）和98名医学生中的92名（94%）参与了研究。我们识别出七个核心价值观——识别和治疗危险病理状况、应对不确定性、以患者和家属为护理核心、在系统层面平衡需求与资源、团队协作方法的价值、教育不可或缺以及急诊医学是自我认同的一部分——以及27条体现急诊医学文化的相关信念。我们观察到在模拟演练过程中文化得以传播。
本研究通过识别该专业基础的核心价值观和信念，为急诊医学文化的特征描述做出了贡献。模拟促进了文化浓缩，这使得能够轻易识别价值观、信念和实践，还促进了文化向学习者的传播。本研究拓展了对急诊医学文化以及模拟在文化交流过程中作用的理解。
