TF3 Medic 5 Calling: Teaching On-Line Medical Direction via Simulation

Abstract

IntroductionEmergency physicians must be proficient at providing on-line medical command (OLMC) for out-of-hospital providers. Some emergency medicine (EM) residency programs, however, are located in jurisdictions in which local emergency medical services (EMS) protocols require relatively little OLMC, limiting training opportunities. An OLMC curriculum was developed utilizing simulation scenarios. The primary learners are residents at an EM residency.Study ObjectivesThe learners’ goals are to have an understanding of their local jurisdictional EMS protocols and to become competent at providing OLMC.MethodsThis curriculum involves a self-instructional module to be completed by EM interns during their EMS rotation. In this module, the learners are introduced to the concepts of out-of-hospital protocol development and familiarized with the role of emergency physicians in providing real-time EMS medical control. The module teaches learners a standardized method of receiving out-of-hospital radio reports and providing OLMC. The interns also review their local jurisdictional EMS protocols. A protocol test at the conclusion of their EMS week assesses their knowledge of these protocols. During simulation sessions, EM residents are exposed to OLMC scenarios. In the course of a regular simulation setting (for example, managing an emergency department patient with rapid atrial fibrillation), a simulated nurse hands the resident a radio, noting that a out-of-hospital provider is requesting medical command. Each OLMC scenario has critical criteria that must be met in order for the resident to pass. At the conclusion of the scenario, a faculty preceptor discusses the case with the learner, providing immediate feedback and reinforcing key concepts.ConclusionProviding OLMC is an important role of practicing emergency physicians. Many EMS protocols have reduced the need to contact physicians for medical orders, limiting opportunities for residents to learn this skill while in training. This novel curriculum introduces the concepts of OLMC through a self-instructional module. Various simulated OLMC scenarios are then utilized to provide exposure and feedback to learners. IntroductionEmergency physicians must be proficient at providing on-line medical command (OLMC) for out-of-hospital providers. Some emergency medicine (EM) residency programs, however, are located in jurisdictions in which local emergency medical services (EMS) protocols require relatively little OLMC, limiting training opportunities. An OLMC curriculum was developed utilizing simulation scenarios. The primary learners are residents at an EM residency. Emergency physicians must be proficient at providing on-line medical command (OLMC) for out-of-hospital providers. Some emergency medicine (EM) residency programs, however, are located in jurisdictions in which local emergency medical services (EMS) protocols require relatively little OLMC, limiting training opportunities. An OLMC curriculum was developed utilizing simulation scenarios. The primary learners are residents at an EM residency. Study ObjectivesThe learners’ goals are to have an understanding of their local jurisdictional EMS protocols and to become competent at providing OLMC. The learners’ goals are to have an understanding of their local jurisdictional EMS protocols and to become competent at providing OLMC. MethodsThis curriculum involves a self-instructional module to be completed by EM interns during their EMS rotation. In this module, the learners are introduced to the concepts of out-of-hospital protocol development and familiarized with the role of emergency physicians in providing real-time EMS medical control. The module teaches learners a standardized method of receiving out-of-hospital radio reports and providing OLMC. The interns also review their local jurisdictional EMS protocols. A protocol test at the conclusion of their EMS week assesses their knowledge of these protocols. During simulation sessions, EM residents are exposed to OLMC scenarios. In the course of a regular simulation setting (for example, managing an emergency department patient with rapid atrial fibrillation), a simulated nurse hands the resident a radio, noting that a out-of-hospital provider is requesting medical command. Each OLMC scenario has critical criteria that must be met in order for the resident to pass. At the conclusion of the scenario, a faculty preceptor discusses the case with the learner, providing immediate feedback and reinforcing key concepts. This curriculum involves a self-instructional module to be completed by EM interns during their EMS rotation. In this module, the learners are introduced to the concepts of out-of-hospital protocol development and familiarized with the role of emergency physicians in providing real-time EMS medical control. The module teaches learners a standardized method of receiving out-of-hospital radio reports and providing OLMC. The interns also review their local jurisdictional EMS protocols. A protocol test at the conclusion of their EMS week assesses their knowledge of these protocols. During simulation sessions, EM residents are exposed to OLMC scenarios. In the course of a regular simulation setting (for example, managing an emergency department patient with rapid atrial fibrillation), a simulated nurse hands the resident a radio, noting that a out-of-hospital provider is requesting medical command. Each OLMC scenario has critical criteria that must be met in order for the resident to pass. At the conclusion of the scenario, a faculty preceptor discusses the case with the learner, providing immediate feedback and reinforcing key concepts. ConclusionProviding OLMC is an important role of practicing emergency physicians. Many EMS protocols have reduced the need to contact physicians for medical orders, limiting opportunities for residents to learn this skill while in training. This novel curriculum introduces the concepts of OLMC through a self-instructional module. Various simulated OLMC scenarios are then utilized to provide exposure and feedback to learners. Providing OLMC is an important role of practicing emergency physicians. Many EMS protocols have reduced the need to contact physicians for medical orders, limiting opportunities for residents to learn this skill while in training. This novel curriculum introduces the concepts of OLMC through a self-instructional module. Various simulated OLMC scenarios are then utilized to provide exposure and feedback to learners.