School of Medicine and Health Sciences Poster Presentations

Title

Implementation of “Microsim” training to improved readiness for mass casualty scenario in a pediatric trauma center emergency department

Document Type

Poster

Abstract Category

Clinical Specialties

Keywords

microsim, MCI, drill, trauma

Publication Date

Spring 5-1-2019

Abstract

It is essential that all emergency department (ED) staff be trained to prepare for and respond to Mass Casualty Incidents (MCI). Traditional MCI training often requires significant resources, leading to laborious and infrequent drilling. Microsimulations (“MicroSims”) are a novel training strategy focused on abbreviated drill scenarios testing knowledge and execution of critical tasks. We hypothesize that implementation of MicroSims will increase staff preparedness and performance in an MCI. Children's National Medical Center (CNMC) ED conducted a 7-point readiness pre-survey of all ED staff before implementing microsim MCI exercises. 3 pre-scripted microsim MCI scenarios were exercised on a weekly basis alternating AM and PM shifts and days of the week to ensure random sampling of staff. The primary measure was the completion of 8 critical tasks on a rating scale of 0 – did not perform, 1- performed inadequately, or 2- adequately performed. Study staff led a debrief at the conclusion of each drill. Staff also completed an evaluation survey at the end of each exercise. Equal numbers of drills were performed during day and night shifts. Average drill length was 8:12 (m:s) and an average debrief length of 2:51. Completion of critical tasks was significantly better during night shift drills (p=0.024). The task most missed during the exercise was review of the MCI leader job action sheet. Key themes in drill evaluations included: (1) clarification of roles (2) task prioritization (3) awareness of job action sheet and (4) need for more repetitions of drills. It is possible to conduct an MCI microsim training in under 10 minutes in a Level 1 Pediatric Trauma Center ED that can impact staff knowledge about the MCI protocol and available resources. Qualitative assessment of microsim evaluations show that ED staff appreciate these frequent drills and can identify opportunities for improvement without being disruptive to their workflow. Additional microsims are needed to identify best practices for MCI management in a pediatric ED.

Open Access

1

Comments

Presented at Research Days 2019.

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Implementation of “Microsim” training to improved readiness for mass casualty scenario in a pediatric trauma center emergency department

It is essential that all emergency department (ED) staff be trained to prepare for and respond to Mass Casualty Incidents (MCI). Traditional MCI training often requires significant resources, leading to laborious and infrequent drilling. Microsimulations (“MicroSims”) are a novel training strategy focused on abbreviated drill scenarios testing knowledge and execution of critical tasks. We hypothesize that implementation of MicroSims will increase staff preparedness and performance in an MCI. Children's National Medical Center (CNMC) ED conducted a 7-point readiness pre-survey of all ED staff before implementing microsim MCI exercises. 3 pre-scripted microsim MCI scenarios were exercised on a weekly basis alternating AM and PM shifts and days of the week to ensure random sampling of staff. The primary measure was the completion of 8 critical tasks on a rating scale of 0 – did not perform, 1- performed inadequately, or 2- adequately performed. Study staff led a debrief at the conclusion of each drill. Staff also completed an evaluation survey at the end of each exercise. Equal numbers of drills were performed during day and night shifts. Average drill length was 8:12 (m:s) and an average debrief length of 2:51. Completion of critical tasks was significantly better during night shift drills (p=0.024). The task most missed during the exercise was review of the MCI leader job action sheet. Key themes in drill evaluations included: (1) clarification of roles (2) task prioritization (3) awareness of job action sheet and (4) need for more repetitions of drills. It is possible to conduct an MCI microsim training in under 10 minutes in a Level 1 Pediatric Trauma Center ED that can impact staff knowledge about the MCI protocol and available resources. Qualitative assessment of microsim evaluations show that ED staff appreciate these frequent drills and can identify opportunities for improvement without being disruptive to their workflow. Additional microsims are needed to identify best practices for MCI management in a pediatric ED.