Overcrowding in the Dispatching Centre During the COVID-19 Crisis: Are Medical Students a Resource?
Delphine Douillet1,2, Delphine Plard1, François Morin1
1Emergency Department, Angers University Hospital, University of Angers, Angers, France.
Insights
Medical students provided relevant COVID-19 call assessments, achieving 76% agreement with experts. Their support is valuable during healthcare system strain, though they required more time per call.
Area of Science:
- Emergency Medicine
- Public Health
- Medical Education
Background:
- The COVID-19 pandemic necessitated rapid adaptation of emergency services, including dispatch centers.
- Increased call volumes required additional support staff, leading to the integration of medical students.
- The study evaluated the effectiveness of medical students in managing initial COVID-19 related calls.
Purpose of the Study:
- To assess the accuracy of medical students' responses to initial COVID-19 calls.
- To compare medical students' performance with experienced call handlers.
- To determine the relevance of medical student support in emergency call centers during a health crisis.
Main Methods:
- A prospective, observational cohort study involving 20 medical students as first-line call takers.
- Expert review of calls handled by students and experienced personnel to assess prioritization and orientation.
- Comparison of agreement rates and call handling times between students and experienced staff.
Main Results:
- Medical students achieved an average prioritization agreement rate of 76.16% with medical experts.
- Experienced call handlers showed a higher agreement rate (87.50%), though the difference was not statistically significant (P=0.15).
- Medical students took significantly longer per call (average difference of 2 minutes 16 seconds, P < 0.001).
Conclusions:
- Medical students can provide relevant support in managing initial COVID-19 calls.
- Their involvement should be considered during periods of high demand on healthcare systems.
- Further training may optimize their efficiency and reduce call handling times.
Introduction:
In February, the emergence of COronaVIrus Disease 2019 (COVID - 19) in France made it necessary to rapidly adapt emergency and SAMU services in order to take care of many infected patients. To respond to the increase in the number of calls in the dispatch centers, reinforcements were necessary on the fronts of the Medical Regulation Assistants (ARM). The aim of this study was to assess the relevance of medical students' responses to first calls exclusively concerning COVID-19.
Methods:
This prospective, observational cohort study was carried out at the University Hospital Centre (CHU) in Angers. Twenty medical students mostly in the 5th year were voluntarily enrolled in the first line COVID-19 call taker team. Calls on the 1st, 3rd, and 5th starting day for each medical student, and randomly selected calls from the experienced first-line call taker were listened to by a medical expert to assess the adequate level of prioritization and orientation (emergency physician or general practitioner). The percentage of agreement between the expert, students, and experienced first-line call handlers were assessed. All participants gave their free consent to participate. The study was approved by the Ethics Committee of Angers (N° 2020-48).
Results:
From March 18 to April 23, 2020, 302 calls from medical students (n = 20 students) and 40 calls from experienced first-line call handlers were analyzed. The average prioritization agreement rate between the expert and students was 76.16% (95% Confidence Interval: 71.04 to 80.62%) (n = 230/302) compared to 87.50% (95% CI: 73.9 to 94.5%) (n = 45/50) for the experienced first-line call handlers (P = 0.15). Medical students took more time per call with an absolute difference of 2 minutes 16 seconds (P < 0.001).
Conclusion:
The lessons to be observed from this COVID-19 crisis are that in the early days of increasing calls heralding a strain on the healthcare system, support by medical students must be considered.
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