APGO

Background: Emergency response skills are essential to manage procedural complications in the outpatient setting, and simulation-based training may optimize skills.

Methods: OB-GYN and Family Medicine trainees enrolled in simulation-based, outpatient emergency training. The curriculum consisted of 2 components:  an online emergency preparedness module and two faculty-led hands-on Basic Life Support and advanced airway sessions. Participants completed pre- and post-training self-efficacy questionnaires and 3 video-recorded simulated scenarios:  seizure, over-sedation and hemorrhage. Scenarios were evaluated with a graded rubric covering five domains (patient care, medical knowledge, interpersonal skills and communication, professionalism and systems-based practice). Self-efficacy data were analyzed using McNemar’s test and Student’s t-tests and objective performance was analyzed using t-tests to determine if the curriculum improved management of simulated outpatient emergencies.

Results: Thirty residents completed hands-on training as well as pre- and post- evaluations.  Perceived self-efficacy in emergency management improved. Video performance scores improved in all five domains (p < .05) in all scenarios. When stratified by level of training, subjects in their first two years of training demonstrated significantly greater improvement in interpersonal skills, communication and professionalism in the seizure scenario compared to upper level residents. When stratified by prior outpatient simulation experience, global performance scores did not differ.

Discussions: Simulation-based training improves self-efficacy and global performance in management of outpatient medical emergencies.  Simulation training should be incorporated into OB/Gyn and Family Medicine residency training.

Keywords: Resident, Simulation, Curriculum