A Simple Low-Cost Method to Integrate Telehealth Interprofessional Team Members During In Situ Simulation.

Area of Science:

• Medical Simulation
• Telehealth Technology
• Emergency Medicine Training

Background:

• The expansion of telehealth necessitates integrating remote personnel into medical training.
• This study focused on incorporating remote electronic intensive care unit (eICU) staff into in situ simulations for rural emergency departments (EDs).
• Key challenges involved establishing shared awareness of patient status and team progress between simulation participants and remote eICU personnel.

Purpose of the Study:

• To integrate remote eICU personnel into in situ simulations with rural ED teams.
• To introduce telehealth technology and new processes for engaging eICU support during sepsis care.
• To overcome technical challenges in creating shared awareness during simulations.

Main Methods:

• Developed simulation scenarios involving sepsis care in two rural EDs, incorporating telehealth and emergency medicine experts.
• Implemented a shared in situ simulation clinical actions observational checklist using survey software.
• Utilized teleconferencing software to share checklist progress and cue remote eICU nurse engagement.
• Assessed participant confidence in telehealth use and sepsis management via pre- and post-simulation surveys.

Main Results:

• Successfully engaged 60 participants (nurses, physicians, technicians) across two EDs.
• The observational checklist and teleconferencing effectively facilitated remote eICU nurse participation and debriefing.
• Post-simulation confidence significantly increased: telehealth use (5.3 to 8.9, P < 0.05) and sepsis management (7.1 to 8.9, P < 0.05).
• The method avoided disruption to real ED or eICU operations.

Conclusions:

• A low-cost method using survey software and teleconferencing successfully created shared awareness between remote eICU personnel and rural ED in situ simulations.
• This approach enhances telehealth integration in medical training for improved patient care in remote settings.