The Simulation Module for Assessment of Resident’s Targeted Event Response (SMARTER-Shift): a novel teaching method in Emergency Medicine education

Document Type : Original Article

Authors

1 Department of Emergency, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Emergency Medicine, Faculty of Medicine, Azad University of Medical Sciences, Tehran, Iran

3 PhD student, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: Attention to several clinical issues simultaneously and timeliness of proper treatment is of prime importance in Emergency Medicine. Simulation Based Training is a growing trend for clinical resident training which has been proposed for enhancing of residents multi-tasking abilities. The Simulation Module for Assessment of Resident’s Targeted Event Response is a methodology which derives specific scenario scripts from core competencies intended for residents. In this study we take that methodology one step further and use it to design multiple patient scripts hoping to enhance multiple knowledge and skills including multitasking.
Methods: Using qualitative study of literature we derive multiple patient scripts incorporating simulation technologies which aim to obtain multiple clear educational objectives including the skills required for multitasking. Furthermore we test this teaching method on first year emergency medicine residents. We analyze the effects using paired student T-test of pre/posttests. Also the students’ satisfaction and impression about the method is measured using a questionnaire. Results: The step by step development of a multiple patient scrip is described and a sample script is presented. Cumulative scores of skill and knowledge for resident improved significantly (P<0.001) before and after the course. Almost all students (96%) preferred SMARTER-shift to a clinical shift for teaching purposes while only 52% preferred it for practicing the skills they had already obtained.
Conclusion: The SMARTER-shift is an effective way for education of multitasking skills to residents of emergency medicine and it is strongly preferred by residents.

Keywords

Main Subjects

References

1.         Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Simulation in healthcare. Simul Healthc. 2006;1(4):252-6.
2.         Cheng A, Lockey A, Bhanji F, Lin Y, Hunt EA, Lang E. The use of high-fidelity manikins for advanced life support training—a systematic review and meta-analysis. Resuscitation. 2015;93:142-9.
3.         Evans LV, Crimmins AC, Bonz JW, Gusberg RJ, Tsyrulnik A, Dziura JD, et al. A comprehensive, simulation-based approach to teaching clinical skills: the medical students’ perspective. Yale J Biol Med. 2014;87(4):575.
4.         Von der Heyden M, Meissner K. Simulation in preclinical emergency medicine. Best Pract Res Clin Anaesthesiol. 2015;29(1):61-8.
5.         Ende J. Feedback in clinical medical education. Jama. 1983;250(6):777-81.
6.         Rosen MA, Salas E, Silvestri S, Wu TS, Lazzara EH. A measurement tool for simulation-based training in emergency medicine: the simulation module for assessment of resident targeted event responses (SMARTER) approach. Simulation in Healthcare. 2008;3(3):170-9.
7.         Hays RT, Singer MJ. Simulation fidelity in training system design: Bridging the gap between reality and training: Springer Science & Business Media; 2012.
8.         Sawyer T, White M, Zaveri P, Chang T, Ades A, French H, et al. Learn, See, Practice, Prove, Do, Maintain: An Evidence-Based Pedagogical Framework for Procedural Skill Training in Medicine. Acad Med. 2015 Aug;90(8):1025-33.
9.         Silvestri S, Wu T, Salas E, Rosen M, Lyons R, Lazarra E. Beyond the basics: brining simulation theory and technology together.  Council of Emergency Medicine Residency Directors (CORD) Academic Assembly 2007.
10.       Swing SR. Assessing the ACGME general competencies: general considerations and assessment methods. Academic Emergency Medicine. 2002;9(11):1278-88.
11.       Swing S, Bashook PG. ACGME Outcome Project—Toolbox of Assessment Methods. ACGME/ABMS Joint Initiative. 2000.
12.       Swick S, Hall MS, Beresin E. Assessing the ACGME competencies in psychiatry training programs. Academic Psychiatry. 2006;30(4):330-51.
13.       Rosen MA, Lazzara EH, Lyons R, Weaver SJ, Salas E, Wu T, et al., editors. SMARTER-Team: Adapting Event-based Tools for Simulation-based Training in Healthcare. Proceedings of the Human Factors and Ergonomics Society Annual Meeting; 2008: SAGE Publications.
14.       Salas E, Priest HA, Wilson KA, Burke CS. Scenario-based training: Improving military mission performance and adaptability.  Military life: The psychology of serving in peace and combat Vol 2: Operational stress. 2006. p. 32-53.
15.       Issenberg SB, Mcgaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005;27(1):10-28.
16.       McFetrich J. A structured literature review on the use of high fidelity patient simulators for teaching in emergency medicine. Emerg Med J. 2006;23(7):509-11.
17.       Heng KW. Teaching and evaluating multitasking ability in emergency medicine residents - what is the best practice? Int J Emerg Med. 2014;7:41.
18.       2011 EM Model Review Task Force, Perina DG, Brunett CP, Caro DA, Char DM, Chisholm CD, et al. The 2011 model of the clinical practice of emergency medicine. Acad Emerg Med. 2012;19(7):e19-40.
19.       Stephens RJ, Fairbanks RJ. Humans and multitask performance: let's give credit where credit is due. Academic emergency medicine: Acad Emerg Med. 2012;19(2):232-4.
20.       Wang EE, Dyne PL, Du H. Systems‐based Practice: Summary of the 2010 Council of Emergency Medicine Residency Directors Academic Assembly Consensus Workgroup—teaching and evaluating the difficult‐to‐teach competencies. Acad Emerg Med. 2011;18(s2):S110-S20.
21.       Kobayashi L, Shapiro MJ, Gutman DC, Jay G. Multiple encounter simulation for aigh‐acuity multipatient environment training. Acad Emerg Med. 2007;14(12):1141-8.
22.       Norcini J. Being smarter about SMARTER: A commentary on "a measurement tool for simulation-based training in emergency medicine: the simulation module for assessment of resident targeted event responses approach". Simul Healthc. 2008;3(3):131-2.
23.       Chapman DM, Hayden S, Sanders AB, Binder LS, Chinnis A, Corrigan K, et al. Integrating the accreditation council for graduate medical education core competencies into the model of the clinical practice of emergency medicine. Acad emerg med. 2004;11(6):674-85.
24.       Small SD, Wuerz RC, Simon R, Shapiro N, Conn A, Setnik G. Demonstration of high-fidelity simulation team training for emergency medicine. Acad emerg med. 1999;6(4):312-23.
25.       Gjeraa K, Moller TP, Ostergaard D. Efficacy of simulation-based trauma team training of non-technical skills. A systematic review. Acta Anaesthesiol Scand. 2014;58(7):775-87.
26.       Cant RP, Cooper SJ. Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse Educ Today. 2017;49:63-71.
27.       Lapkin S, Fernandez R, Levett-Jones T, Bellchambers H. The effectiveness of using human patient simulation manikins in the teaching of clinical reasoning skills to undergraduate nursing students: a systematic review. JBI Libr Syst Rev. 2010;8(16):661-94.
28.       Dubovsky SL, Antonius D, Ellis DG, Ceusters W, Sugarman RC, Roberts R, et al. A preliminary study of a novel emergency department nursing triage simulation for research applications. BMC Res Notes. 2017;10(1):15.
29.       Zakeri H, Najafi Z, Mousavi SM, Tabatabaey A. Effects of a virtual classroom in social media platform on the knowledge of emergency department interns: A randomized interventional trial. FMEJ. 2018; 8(3):3-8.
Future of Medical Education Journal
Volume 9, Issue 1
Spring
March 2019
Pages 30-37

Files

Share

How to cite

Statistics