Demonstration of High-fidelity Simulation Team Training for Emergency Medicine

Authors

  • Stephen D. Small MD,

    Corresponding author
    1. Departments of Anesthesiology (SDS) and Emergency Services (AC), Massachusetts General Hospital, Boston, MA
    2. Harvard Medical School (SDS, RCW, NS, AC, GS), Harvard Division of Emergency Medicine (RCW), and Harvard Affiliated Emergency Medicine Residency (NS), Boston, MA
    3. Center for Medical Simulation (SDS), Boston, MA
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  • Richard C. Wuerz MD,

    1. Harvard Medical School (SDS, RCW, NS, AC, GS), Harvard Division of Emergency Medicine (RCW), and Harvard Affiliated Emergency Medicine Residency (NS), Boston, MA
    2. Department of Emergency Medicine (RCW), Brigham and Women's Hospital, Boston, MA
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  • Robert Simon EdD,

    1. MedTeams, Crew Performance Group, Dynamics Research Corporation (RS), Boston, MA
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  • Nathan Shapiro MD,

    1. Harvard Medical School (SDS, RCW, NS, AC, GS), Harvard Division of Emergency Medicine (RCW), and Harvard Affiliated Emergency Medicine Residency (NS), Boston, MA
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  • Alasdair Conn MD,

    1. Departments of Anesthesiology (SDS) and Emergency Services (AC), Massachusetts General Hospital, Boston, MA
    2. Harvard Medical School (SDS, RCW, NS, AC, GS), Harvard Division of Emergency Medicine (RCW), and Harvard Affiliated Emergency Medicine Residency (NS), Boston, MA
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  • Gary Setnik MD

    1. Harvard Medical School (SDS, RCW, NS, AC, GS), Harvard Division of Emergency Medicine (RCW), and Harvard Affiliated Emergency Medicine Residency (NS), Boston, MA
    2. Department of Emergency Medicine (GS), Mount Auburn Hospital, Boston, MA.
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*Department of Anesthesiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. Fax: 617-726-7536; e-mail: small@etherdome.mgh.harvard.edu

Abstract

Abstract. Emergency medicine (EM) presents many cognitive, social, and systems challenges to practitioners. Coordination and communication under stress between and among individuals and teams representing a number of disciplines are critical for optimal care of the patient. The specialty is characterized by uncertainty, complexity, rapidly shifting priorities, a dependence on teamwork, and elements common to other risky domains such as perioperative medicine and aviation. High-fidelity simulators have had a long tradition in aviation, and in the past few years have begun to have a significant impact in anesthesiology. A national, multicenter research program to document the costs of teamwork failures in EM and provide a remedy in the form of an Emergency Team Coordination Course has developed to the point that high-fidelity medical simulators will be added to the hands-on training portion of the course. This paper describes an evolving collaborative effort by members of the Center for Medical Simulation, the Harvard Emergency Medicine Division, and the MedTeams program to design, demonstrate, and refine a high-fidelity EM simulation course to improve EM clinician performance, increase patient safety, and decrease liability. The main objectives of the paper are: 1) to present detailed specifications of tools and techniques for high-fidelity medical simulation; 2) to share the results of a proof-of-concept EM simulation workshop introducing multiple mannequin/three-patient scenarios; and 3) to focus on teamwork applications. The authors hope to engage the EM community in a wide-ranging discussion and handson exploration of these methods.

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