Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Learning Objectives: Describe the process of converting “Foundations of Emergency Medicine” cases to high-fidelity simulation scenarios, implement cases for PGY-1 EM, EM/IM, and EM/FM residents, and survey simulation specialists and residents regarding the resources required and the curriculum’s educational value.

Introduction: Foundations of Emergency Medicine (FoEM) is an open-access curriculum that involves case-based table-top exercises, and is an established part of our weekly conference. Case-based simulation has been shown to improve clinical knowledge and comfort levels in the care of critical patients. The educational need for this pilot study arose from PGY-1 residents’ requests for more time to run cases in our simulation center.

Educational Objectives: To convert FoEM cases into high-fidelity simulation cases to enhance PGY-1 residents’ learning experience, and to evaluate the feasibility of the process.

Curricular Design: Simulation specialists converted 18 FoEM cases to high-fidelity simulation cases. A total of 17 PGY-1 EM, EM/IM and EM/FM residents performed FoEM simulation cases on 6 separate conference days during the 2020-2021 academic year in lieu of the standard FoEM table-top exercise. Three cases were run per session. Each case was 10 minutes long followed by a 20 minute debrief by EM faculty. Residents were surveyed to gauge educational satisfaction and clinical confidence. Simulation specialists were surveyed to identify resources required and to ascertain barriers to implementation.

Impact/Effectiveness: The post-implementation surveys had an overall response rate of 70%. All residents agreed or strongly agreed that performing FoEM through simulation was a positive addition to the curriculum and the information and skills were applicable to patient care. The majority reported that scenarios helped to solidify foundational knowledge and confidence in caring for patients. Simulation specialists reported taking 1-4 hours to prepare a case. Challenges included predicting learner decisions and interpreting the cases as a non-physician. We conclude that FoEM cases can be converted to simulation with reasonable effort and are a valuable addition to the curriculum. We have continued this curricular innovation in the 2021-2022 academic year.