Department of Emergency Medicine, The American University of Beirut Medical Center, Beirut, Lebanon.
Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
BMC Med Educ. 2021 Jan 7;21(1):33. doi: 10.1186/s12909-020-02430-9.
Simulation based medical education (SBME) allows learners to acquire clinical skills without exposing patients to unnecessary risk. This is especially applicable to Emergency Medicine training programs where residents are expected to demonstrate proficiency in the management of time critical, low frequency, and highly-morbidity conditions. This study aims to describe the process through which a SBME curriculum was created, in a limited simulation resource setting at a 4-year Emergency Medicine (EM) residency program at the American University of Beirut Medical Center.
A case-based pilot simulation curriculum was developed following Kern's 6 step approach to curriculum design. The curricular objectives were identified through an anonymous survey of the program's residents and faculty. Curriculum outcomes were assessed, and the curriculum was revised to address curricular barriers. Evaluations of the revised curriculum were collected during the simulation sessions and through a whole revised curriculum evaluation at the end of the first year of its implementation.
14/20 residents (70%) and 8/8 faculty (100%) completed the needs assessment from which objectives for the pilot curriculum were developed and implemented through 6 2-h sessions over a 1-year period. Objectives were not met and identified barriers included cost, scheduling, resources, and limited faculty time. The revised curriculum addressed these barriers and 24 40-min sessions were successfully conducted during the following year. The sessions took place 3 at a time, in 2-h slots, using the same scenario to meet the objectives of the different learners' levels. 91/91 evaluations were collected from participants with overall positive results. The main differences between the pilot and the revised curricula included: a better understanding of the simulation center resources and faculty's capabilities.
Simulation-based education is feasible even with limited-resources. However, understanding the resources available, and advocating for protected educator time are essential to implementing a successful EM simulation curriculum.
基于模拟的医学教育（SBME）允许学习者在不使患者面临不必要风险的情况下获得临床技能。这在急诊医学培训计划中尤其适用，因为住院医师需要在管理时间紧迫、低频和高发病率的情况下表现出熟练程度。本研究旨在描述在贝鲁特美国大学医学中心的四年制急诊医学（EM）住院医师计划中，在有限的模拟资源环境下创建 SBME 课程的过程。
采用 Kern 的 6 步课程设计方法，开发了基于案例的试点模拟课程。课程目标是通过对该计划的住院医师和教师进行匿名调查确定的。评估课程结果，并修改课程以解决课程障碍。在模拟课程期间和实施第一年结束时进行的整个修订课程评估中，收集了对修订课程的评估。
14/20 名住院医师（70%）和 8/8 名教师（100%）完成了需求评估，从而制定并实施了试点课程的目标，该课程在 1 年内通过 6 个 2 小时的课程进行。目标未实现，并确定了障碍，包括成本、日程安排、资源和有限的教师时间。修订后的课程解决了这些障碍，并在接下来的一年中成功进行了 24 次 40 分钟的课程。这些课程分 3 次进行，每次 2 小时，使用相同的场景来满足不同学习者水平的目标。从参与者那里收集了 91/91 项评估，结果总体为正面。试点课程和修订课程之间的主要区别包括：更好地了解模拟中心资源和教师的能力。
即使资源有限，基于模拟的教育也是可行的。但是，了解可用资源并倡导为教育者提供受保护的时间对于实施成功的急诊医学模拟课程至关重要。
