Utilization of an Asynchronous Online Learning Module Followed by Simulated Scenario to Train Emergency Medicine Residents in Mass-Casualty Triage.

Abstract

Audience: This is a combined independent study and simulation session designed to teach and drill Mass Casualty Incident (MCI) Triage and is intended for emergency medicine residents at all levels.

Introduction: The training of emergency medicine residents to assume leadership roles in disaster response is important. However, lack of accepted specific educational goals on the national level leads to significant variability between residencies.

Educational objectives: The purpose of this session is to train EM residents in the use of the Simple Triage and Rapid Treatment (START) and pediatric JumpSTART algorithms for triage in mass casualty incidents (MCIs) using an asynchronous model. By the end of this small group session, learners will be able to: 1) describe START triage for adult MCI victims; 2) describe JumpSTART triage for pediatric MCI victims; 3) demonstrate the ability to apply the START and JumpSTART triage algorithms in a self-directed learning environment; 4) demonstrate the ability to apply the START and JumpSTART triage algorithms in a simulated mass casualty scenario under time constraints; and 5) demonstrate appropriate use of acute life-saving interventions as dictated by the START and JumpSTART triage algorithms in a high-pressure simulated environment.

Educational methods: This session utilizes an online independent study module that was created de novo for this specific purpose by the authors followed by a high-pressure in-person simulation session where learners practice applying the START triage model with multiple simulated patients under time constraint.

Research methods: Learner feedback was collected after completion of the session. Retention of learning objectives was tested at four months via multiple-choice quiz.

Results: The session was very well received by our residents, who appreciated the opportunity to practice applying START triage under pressure. The average score on the pretest was 49%. Response rates to the post-test were low, but residents scored an average of 73%, indicating a trend towards retention of learning objectives.

Discussion: Overall, the utilization of a de novo online learning module followed by simulation proved to be a well-received method of teaching MCI triage to emergency medicine residents. We consider this to be an effective way to train MCI Triage with minimal in-conference time utilization. We plan to implement this training annually to provide our residents with longitudinal reinforcement of this vital skill.

Topics: Mass casualty, MCI, triage, START triage, JumpSTART Triage, disaster, disaster preparedness, disaster curriculum, prehospital, EMS.