• Southern medical journal · Aug 2022

    Telesimulation to Improve Critical Decision-Making in Prehospital Airway Management: A Feasibility Study.

    • David M French, Ragan A DuBose-Morris, Frances W Lee, Stanley J Sulkowski, Greig A Samuelson, and Edward C Jauch.
    • From Charleston County EMS, Charleston, the Center for Telehealth, Medical University of South Carolina, Charleston, Healthcare Simulation Center, Medical University of South Carolina, Charleston, and the Mission Research Institute, Mission Health System, Asheville, North Carolina.
    • South. Med. J. 2022 Aug 1; 115 (8): 639-644.

    ObjectivesTelesimulation, in which learners and evaluators use technology to connect remotely to simulation-based learning activities, is effective for skills and decision-making review. Historical models in which learners are colocated with the simulation equipment have inherent issues, especially for emergency medical services (EMS) providers. This feasibility study placed the evaluators in the simulation center, whereas the learners were at a distance steering the scenario evolution through telehealth technologies.MethodsVolunteer EMS providers across South Carolina with varying levels of training and experience completed difficult airway management scenarios focused on clinical decision making. The program consisted of pre- and postexperience examinations, a lecture, and increasingly complicated simulations using high-fidelity mannequins that were facilitated by local trainers under the direction of remote trainees. Audio and video content, including vital signs and cardiac monitoring, were live streamed. Participants worked in two-person teams with lead providers on each scenario clinically assessing and managing cases of anaphylaxis. Data were collected from the simulations using Laerdal software, as well as examination and survey results.ResultsA total of 24 participants completed all of the elements of the training. Trends toward improvement in times to bag-mask ventilation and initial epinephrine administration were noted. Average cognitive test scores increased by 9.6%, and learners reported improved comfort with simulation (75%, P ≥ 0.0001) and videoconferencing (83%, P ≥ 0.0001). They also reported high degrees of comfort with intubation (73.3%) following the training.ConclusionsThis method of telesimulation appears to be a viable addition to continuing EMS education and may address access issues for some providers.

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