Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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A descriptive study was performed to better understand the possible utility of immersive virtual reality simulation for training first responders in a mass casualty event. ⋯ Learner feedback and expert performance review suggests that immersive training in a virtual environment has the potential to be a powerful tool to train first responders for high-acuity, low-frequency events, such as a terrorist attack.
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Participants in the 2008 Academic Emergency Medicine Consensus Conference "The Science of Simulation in Healthcare: Defining and Developing Clinical Expertise" morning workshop session on developing systems expertise were tasked with evaluating best applications of simulation techniques and technologies to small-scale systems in emergency medicine (EM). We collaborated to achieve several objectives: 1) describe relevant theories and terminology for discussion of health care systems and medical simulation, 2) review prior and ongoing efforts employing systems thinking and simulation programs in general medical sectors and acute care medicine, 3) develop a framework for discussion of systems thinking for EM, and 4) explore the rational application of advanced medical simulation methods to a defined framework of EM microsystems (EMMs) to promote a "quality-by-design" approach. This article details the materials compiled and questions raised during the consensus process, and the resulting simulation application framework, with proposed solutions as well as their limitations for EM systems education and improvement.
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The patient safety literature from the past decade emphasizes the importance of teamwork skills and human factors in preventing medical errors. Simulation has been used within aviation, the military, and now health care domains to effectively teach and assess teamwork skills. ⋯ This material was disseminated within the morning session and was discussed both during breakout sessions and via online messaging. Below we present a well-defined, well-described taxonomy that will help guide design, implementation, and assessment of simulation-based team training programs.
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The Institute of Medicine's report "To Err is Human" identified simulation as a means to enhance safety in the medical field, just as flight simulation is used to improve the aviation industry. Yet, while there is evidence that simulation may improve task performance, there is little evidence that simulation actually improves patient outcome. Similarly, simulation is currently used to model teamwork-communication skills for disaster management and critical events, but little research or evidence exists to show that simulation improves disaster response or facilitates intersystem or interagency communication. ⋯ As part of the 2008 Academic Emergency Medicine Consensus Conference on the Science of Simulation, our group sought to identify key research questions that would inform our understanding of simulation's impact at the organizational level. We combined an online discussion group of emergency physicians, an extensive review of the literature, and a "public hearing" of the questions at the Consensus Conference to establish recommendations. The authors identified the following six research questions: 1) what objective methods and measures may be used to demonstrate that simulator training actually improves patient safety? 2) How can we effectively feedback information from error reporting systems into simulation training and thereby improve patient safety? 3) How can simulator training be used to identify disaster risk and improve disaster response? 4) How can simulation be used to assess and enhance hospital surge capacity? 5) What methods and outcome measures should be used to demonstrate that teamwork simulation training improves disaster response? and 6) How can the interface of systems be simulated? We believe that exploring these key research questions will improve our understanding of how simulation affects patient safety, disaster surge capacity, and intersystem and interagency communication.
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The use of medical simulation has grown dramatically over the past decade, yet national data on the prevalence and growth of use among individual specialty training programs are lacking. The objectives of this study were to describe the current role of simulation training in emergency medicine (EM) residency programs and to quantify growth in use of the technology over the past 5 years. ⋯ Use of medical simulation has grown significantly in EM residency programs in the past 5 years and is now widespread among training programs across the country.