Sena Ariel, Forde Frank, Yu Catherine, Sule Harsh, Masters M Meredith
Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Rutgers New Jersey Medical School.
Clinical Instructor of Emergency Medicine and Assistant Director of Prehospital and Disaster Medicine, Department of Emergency Medicine, University Hospitals Cleveland Medical Center.
MedEdPORTAL. 2021 Mar 12;17:11119. doi: 10.15766/mep_2374-8265.11119.
Emergency medicine (EM) physicians serve at the frontline of disasters in our communities. The 2016 Model of Clinical Practice according to the American Board of EM identifies disaster management as an integral task of EM physicians. We described a low-cost and feasible tabletop exercise to implement such training for EM residents.
The exercise took place during 2 hours of resident didactic time. A lecture introduced the incident command system (ICS) and triage concepts, followed by a tabletop scenario with a map of a disaster scene or emergency department. Facilitators presented situational prompts of tasks for residents to address during the exercise. These exposed residents to challenges in disaster scenarios, such as surge and limited resources. The exercise concluded with a debrief and short lecture reviewing scenario-specific topics and challenges. Residents completed an online pre- and postexercise assessment, evaluating knowledge and perceptions of disaster scenario management.
Eighteen residents participated in this exercise. The response rates to the pre- and postsurvey were 76% and 72% respectively. Using a Mann Whitney U test, no statistically significant difference was demonstrated on the medical knowledge component of the survey. There was, however, a statistically significant increase in perceived confidence of the residents' ability to manage disaster incidents.
We developed a simple exercise that is an easily adaptable and practical option for introduction to disaster preparedness training. These concepts are difficult to teach and assess among learners, however it remains an important component of education for EM physicians-in-training.
急诊医学(EM)医生在我们社区的灾难应对中处于前线。根据美国急诊医学委员会2016年临床实践模式,灾害管理被确定为急诊医学医生的一项重要任务。我们描述了一种低成本且可行的桌面演练,用于对急诊医学住院医师进行此类培训。
演练在住院医师授课时间的2小时内进行。一场讲座介绍了 incident command system(ICS)和分诊概念,随后是一个桌面场景,配有灾难现场或急诊科的地图。主持人给出情景提示,让住院医师在演练中应对相关任务。这使住院医师面临灾难场景中的挑战,如患者激增和资源有限。演练最后进行了总结汇报和简短讲座,回顾了特定情景的主题和挑战。住院医师完成了在线的演练前和演练后评估,评估对灾难场景管理的知识和认知。
18名住院医师参加了此次演练。调查前和调查后的回复率分别为76%和72%。使用曼-惠特尼U检验,在调查的医学知识部分未显示出统计学上的显著差异。然而,住院医师在应对灾难事件能力方面的感知信心有统计学上的显著提高。
我们开发了一个简单的演练,它是一种易于调整且实用的灾难准备培训入门选项。这些概念在学习者中难以教授和评估,然而它仍然是急诊医学培训医生教育的一个重要组成部分。