Capstone Simulation: A Multipatient Simulation for Senior Emergency Medicine Residents

Area of Science:

• Medical Education
• Simulation-Based Learning
• Emergency Medicine

Background:

• Emergency medicine (EM) trainees require proficiency in managing multiple patients simultaneously, a skill known as task-switching.
• While multipatient scenarios are recognized teaching tools, few studies have explored their use in assessing residents' task-switching abilities.

Purpose of the Study:

• To develop and evaluate a curriculum for formative assessment of core EM skills using simulations that necessitate frequent task-switching.
• To provide educators with a tool for reflective feedback on senior EM learners' resuscitation, leadership, and task-switching skills.

Main Methods:

• A sequence of three simulation scenarios was implemented: medical resuscitation, advanced trauma life support for two patients, and communication of bad news.
• Faculty observers utilized scenario-specific checklists to identify knowledge, communication, and task-switching deficits during reflective debriefs.
• Checklist data and post-session evaluations were analyzed to identify trends and areas for improvement.

Main Results:

• Key areas for improvement identified included specific clinical actions like checking glucose, planning for intubation backup, specifying blood products, and seeking team input.
• Nine out of 12 participants completed evaluations, with the majority agreeing the simulation was relevant and promoted reflection on task-switching.

Conclusions:

• This simulation-based curriculum offers a valuable method for assessing and providing feedback on essential EM skills, particularly task-switching.
• The curriculum can be further refined to support deliberate practice in managing complex patient care scenarios.