What do you do if your relief comes to work intoxicated: An Impaired Provider Scenario

Area of Science:

• Medical Education
• Emergency Medicine
• Healthcare Professionalism

Background:

• Physicians, particularly emergency physicians, have a significant prevalence of substance use disorder.
• Current emergency medicine residency programs lack standardized best practices for teaching impairment recognition and reporting.
• Accreditation Council for Graduate Medical Education mandates understanding of personal roles in recognizing impairment.

Purpose of the Study:

• To introduce a novel simulation scenario for emergency medicine residents to practice recognizing and reporting an impaired colleague.
• To equip learners with skills to identify, address, and remove an impaired provider from patient care.
• To foster discussion on wellness resources and ensure continuity of patient care.

Main Methods:

• A simulated emergency department encounter involving a colleague presenting with signs of alcohol intoxication.
• Learners are tasked with managing a trauma patient while addressing the colleague's impairment.
• Evaluation of the simulation's effectiveness through internally developed surveys with Likert scale and free-response questions.

Main Results:

• Learners rated the simulation and instructors very positively, with high scores across all aspects.
• Free-response feedback indicated the simulation was highly useful for training on an under-taught topic.
• The scenario effectively provided a practical learning experience for recognizing and reporting impaired providers.

Conclusions:

• This simulation provides a realistic and effective curricular tool for emergency medicine programs to teach impairment recognition and reporting.
• Formal instruction in this area is crucial for ensuring patient safety and supporting provider well-being.
• The simulation successfully developed learner competency in a critical aspect of professionalism and patient care.