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

Learning Objectives: The purpose of this educational innovation was to examine first year emergency medicine resident (EM-1) perspectives on the ED patient experience and examine how EM-1 empathy may change after experiencing a simulated ED encounter.

Introduction/Background: Empathy is an essential trait for compassionate physicians and the importance of a positive patient experience in the emergency department (ED) is being increasingly emphasized. Currently, there is no best practice guidelines as to how to educate emergency medicine residents about patient experience.

Curricular Design: During the first week of EM-1 orientation, 12 residents at a community academic emergency medicine residency program consented to serve the role of patient, family member or observer. In groups of three, EM-1s navigated through four simulated ED encounters in their assigned role (left arm weakness, suicidal ideation, dyspnea, eye pain). Those role-playing as patient or family received a script based on chief complaint to utilize during the ED encounter. EM-1s individually completed a pre- and post-simulation written activity in which they listed all the tasks they believed the patient would encounter. Task totals of pre- and post-activity lists were compared using paired t-test (a=0.05). A debriefing session was conducted immediately after the simulation to obtain qualitative feedback. The entire activity took 2 hours (5 minute introduction, 15 minute pre-activity, 40 minutes in the ED, 15 minute post-activity, 45 minute debrief).

Impact/Effectiveness: No significant difference was observed between pre- and post-activity task lists (p=0.17). Overall, qualitative feedback revealed the activity felt very realistic and provided a positive learning experience. Simulated patients felt “vulnerable” and “frazzled.” Simulated family felt “anxious” and “stressed.” Observers were surprised at how many steps occurred simultaneously in the encounter. All participants reported the importance of communication.