CJEM
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Learners participating in simulation-based education may experience cognitive overload with potential detrimental effects to learning and performance. Multiple strategies have been proposed to mitigate this detrimental response. However, these strategies have not fully considered the potential benefits of using online platforms, such as accessibility, cost-effectiveness, efficiency, and scalability. Addressing this gap in the literature, preparatory online modules were developed by applying concepts from cognitive load theory and simulation-based education. This study assessed whether using preparatory online modules to deliver weekly pre-briefing content could impact cognitive load and performance. The participants were first-year postgraduate medical trainees participating in a simulation-based resuscitation curriculum. ⋯ Trainees using preparatory online modules during the course component of a simulation-based resuscitation curriculum experienced cognitive load changes consistent with cognitive optimization. This may have contributed to their superior performance in the subsequent OSCE. Future research should explore the long-term impacts of online preparatory training and consider potential barriers to implementation in diverse healthcare environments.
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Adults living in long-term care (LTC) are at increased risk of harm when transferred to the emergency department (ED), and programs targeting treatment on-site are increasing. We examined characteristics, clinical course, and disposition of LTC patients transported to the ED to examine the potential impact of alternative models of paramedic care for LTC patients. ⋯ This study found 7.9% of LTC patients transported to the ED did not receive diagnostics, medications, or treatment, and overall 11.1% of patients could have been treated by paramedics within current medical directives using 'treat-and-refer' pathways. This group could potentially expand utilizing community paramedics with expanded scopes of practice.