Increasing Emergency Medicine Residents’ Confidence in Disaster Management: Use of an Emergency Department Simulator and an Expedited Curriculum

Franc, Jeffrey Michael; Nichols, Darren; Dong, Sandy L.

doi:10.1017/s1049023x11006807

Cited by 18 publications

(18 citation statements)

References 7 publications

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“…The measurable performance indicators extracted from this process have been used for many years in Swedish disaster management training. In addition, the same indicators have been used in an international study and as an evaluation tool in full-scale exercises [18-21]. …”

Section: Introductionmentioning

confidence: 99%

Performance indicators for initial regional medical response to major incidents: a possible quality control tool

Nilsson

Vikström

Jonson

2012

Scand J Trauma Resusc Emerg Med

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BackgroundTimely decisions concerning mobilization and allocation of resources and distribution of casualties are crucial in medical management of major incidents. The aim of this study was to evaluate documented initial regional medical responses to major incidents by applying a set of 11 measurable performance indicators for regional medical command and control and test the feasibility of the indicators.MethodsRetrospective data were collected from documentation from regional medical command and control at major incidents that occurred in two Swedish County Councils. Each incident was assigned to one of nine different categories and 11 measurable performance indicators for initial regional medical command and control were systematically applied. Two-way analysis of variance with one observation per cell was used for statistical analysis and the post hoc Tukey test was used for pairwise comparisons.ResultsThe set of indicators for regional medical command and control could be applied in 102 of the130 major incidents (78%), but 36 incidents had to be excluded due to incomplete documentation. The indicators were not applicable as a set for 28 incidents (21.5%) due to different characteristics and time frames. Based on the indicators studied in 66 major incidents, the results demonstrate that the regional medical management performed according to the standard in the early phases (1–10 min after alert), but there were weaknesses in the secondary phase (10–30 min after alert). The significantly lowest scores were found for Indicator 8 (formulate general guidelines for response) and Indicator 10 (decide whether or not resources in own organization are adequate).ConclusionsMeasurable performance indicators for regional medical command and control can be applied to incidents that directly or indirectly involve casualties provided there is sufficient documentation available. Measurable performance indicators can enhance follow- up and be used as a structured quality control tool as well as constitute measurable parts of a nationally based follow-up system for major incidents. Additional indicators need to be developed for hospital-related incidents such as interference with hospital infrastructure.

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Section: Introductionmentioning

confidence: 99%

Performance indicators for initial regional medical response to major incidents: a possible quality control tool

Nilsson

Vikström

Jonson

2012

Scand J Trauma Resusc Emerg Med

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“…Also in an international study results from using the same sets of indicators has recently been published [19]. …”

Section: Discussionmentioning

confidence: 99%

Combining performance and outcome indicators can be used in a standardized way: a pilot study of two multidisciplinary, full-scale major aircraft exercises

Rådestad

Nilsson

Castrèn

et al. 2012

Scand J Trauma Resusc Emerg Med

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BackgroundDisaster medicine is a fairly young scientific discipline and there is a need for the development of new methods for evaluation and research. This includes full-scale disaster exercisers. A standardized concept on how to evaluate these exercises, could lead to easier identification of pitfalls caused by system-errors in the organization. The aim of this study was to demonstrate the feasibility of using a combination of performance and outcome indicators so that results can be compared in standardized full-scale exercises.MethodsTwo multidisciplinary, full-scale exercises were studied in 2008 and 2010. The panorama had the same setup. Sets of performance indicators combined with indicators for unfavorable patient outcome were recorded in predesigned templates. Evaluators, all trained in a standardized way at a national disaster medicine centre, scored the results on predetermined locations; at the scene, at hospital and at the regional command and control.ResultsAll data regarding the performance indicators of the participants during the exercises were obtained as well as all data regarding indicators for patient outcome. Both exercises could therefore be compared regarding performance (processes) as well as outcome indicators. The data from the performance indicators during the exercises showed higher scores for the prehospital command in the second exercise 15 points and 3 points respectively. Results from the outcome indicators, patient survival and patient complications, demonstrated a higher number of preventable deaths and a lower number of preventable complications in the exercise 2010. In the exercise 2008 the number of preventable deaths was lower and the number of preventable complications was higher.ConclusionsStandardized multidisciplinary, full-scale exercises in different settings can be conducted and evaluated with performance indicators combined with outcome indicators enabling results from exercises to be compared. If exercises are performed in a standardized way, results may serve as a basis for lessons learned. Future use of the same concept using the combination of performance indicators and patient outcome indicators may demonstrate new and important evidence that could lead to new and better knowledge that also may be applied during real incidents.

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“…The sources of funding were as follows: five federal (two NIH, one Canada, and one Taiwan), five universitysponsored, two industry-supported, and two organizationally funded. Research methodology included 17 surveys (36%), 17,19,21,25,30,31,33,37,40,42,46,[50][51][52]54,60,61 15 (31%) observational analyses, [14][15][16]22,23,27,32,33,38,44,47,49,56,57,59 and three (6%) qualitative methodology studies. 19,28,45 There were only 12 (25%) with an experimental or quasi-experimental study design, 20,24,26,35,36,39,41,43,48,53,55,57 with five of the highlighted articles using this rigorous design.…”

Section: Trends In Medical Education Research In 2012mentioning

confidence: 99%

“…41,55 Each of the articles with a pediatric focus had the primary or supporting author with specialized pediatric training. Other prevalent subject areas with specialty author collaboration were psychiatry, 23,31,50,52,54 education, 15,16,18,20,33,34,36,57 and disaster medicine, 22,30,34,36,42 with all but one using simulation in their studies. Five articles (10%) this year evaluated tools that were developed for educational purposes 14,29,32,36,56 and learning methods were evaluated in eight articles (17%).…”

Section: Trends In Medical Education Research In 2012mentioning

confidence: 99%

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Critical Appraisal of Emergency Medicine Education Research: The Best Publications of 2012

Lin

Fisher

Coates

et al. 2014

Academic Emergency Medicine

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Objectives: The objective was to critically appraise and highlight medical education research published in 2012 that was methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine (EM).Methods: A search of the English language literature in 2012 querying Education Resources Information Center (ERIC), PsychInfo, PubMed, and Scopus identified EM studies using hypothesis-testing or observational investigations of educational interventions. Two reviewers independently screened all of the publications and removed articles using established exclusion criteria. This year, publications limited to a single-site survey design that measured satisfaction or self-assessment on unvalidated instruments were not formally reviewed. Six reviewers then independently ranked all remaining publications using one of two scoring systems depending on whether the study methodology was primarily qualitative or quantitative. Each scoring system had nine criteria, including four related to methodology, that were chosen a priori, to standardize evaluation by reviewers. The quantitative study scoring system was used previously to appraise medical education published annually in 2008 through 2011, while a separate, new qualitative study scoring system was derived and implemented consisting of parallel metrics.Results: Forty-eight medical education research papers met the a priori criteria for inclusion, and 33 (30 quantitative and three qualitative studies) were reviewed. Seven quantitative and two qualitative studies met the criteria for inclusion as exemplary and are summarized in this article. In this fifth installment of the annual critical appraisal series, the same six reviewers used previously published criteria to critically analyze and rank the EM education research from 2012. The focus of this article is to review and highlight the methodologically superior studies that are pertinent to teaching and education in EM. Trends in EM education research over the past 5 years are summarized. We hope that this paper will serve as a valuable resource for EM educators and researchers invested in the scholarship of teaching. 2 METHODS Article IdentificationA medical librarian (LM) performed the literature search in the medical and social sciences literature domains and supplied medical subject heading (MeSH) and keyword terms. MEDLINE was searched through PubMed using a Boolean search strategy that incorporated the following MeSH terms: emergency medicine and medical education, medical student, internship and residency, teaching rounds, undergraduate medical education, graduate medical education, and continuing medical education. Keyword variants for the MeSH terms were included in the search for comprehensiveness. Boolean searches of other databases, including Scopus ("medical education" and emergency), Education Resources Information Center (ERIC; emergency medicine), and PsychInfo (emergency medicine and education) were performed using keyword searching and where possible using the da...

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Increasing Emergency Medicine Residents’ Confidence in Disaster Management: Use of an Emergency Department Simulator and an Expedited Curriculum

Cited by 18 publications

References 7 publications

Performance indicators for initial regional medical response to major incidents: a possible quality control tool

Performance indicators for initial regional medical response to major incidents: a possible quality control tool

Combining performance and outcome indicators can be used in a standardized way: a pilot study of two multidisciplinary, full-scale major aircraft exercises

Critical Appraisal of Emergency Medicine Education Research: The Best Publications of 2012

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