Abstract
BackgroundSimulation 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.MethodsA 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.Results14/20 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.ConclusionSimulation-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.
Highlights
Simulation based medical education (SBME) allows learners to acquire clinical skills without exposing patients to unnecessary risk
This study was determined to be exempt from review by the Johns Hopkins and the American University of Beirut (AUB) Institutional Review Boards
Even with Dagnone et al.’s faculty champions, the curriculum described required 2–3 faculty a year and the time support to attend weeklong training sessions at simulation centers of excellence. This model required 6 years to fully develop and is not feasible for most residency programs who desire to add SBME to their existing education curricula. For those programs with limited educator time, we found that incorporating SBME into pre-existing education conference time greatly increased curricular feasibility
Summary
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. Simulation based medical education (SBME) is a highly desired component of Emergency Medicine (EM) residency training programs as it allows learners to develop necessary knowledge, skills, and attitudes without exposing patients to unnecessary risk [1, 2] This is especially important for specialties where learners are expected to demonstrate proficiency in the management of timecritical, low-frequency, and highly-morbidity conditions. Simulation-based training has been shown to be superior to problem-based learning when teaching critical assessment and management skills [10] These characteristics make the addition of a robust SBME component to an EM residency curriculum highly desirable for both faculty and residents
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