The Simulation Module for Assessment of Resident’s Targeted Event Response (SMARTER-Shift): a novel teaching method in Emergency Medicine education

Background: Attention to several clinical issues simultaneously and timeliness of proper treatment is of prime importance in Emergency Medicine. Simulation Based Training is a growing trend for clinical resident training which has been proposed for enhancing of residents multi-tasking abilities. The Simulation Module for Assessment of Resident’s Targeted Event Response is a methodology which derives specific scenario scripts from core competencies intended for residents. In this study we take that methodology one step further and use it to design multiple patient scripts hoping to enhance multiple knowledge and skills including multitasking. Methods: Using qualitative study of literature we derive multiple patient scripts incorporating simulation technologies which aim to obtain multiple clear educational objectives including the skills required for multitasking. Furthermore we test this teaching method on first year emergency medicine residents. We analyze the effects using paired student T-test of pre/posttests. Also the students’ satisfaction and impression about the method is measured using a questionnaire. Results: The step by step development of a multiple patient scrip is described and a sample script is presented. Cumulative scores of skill and knowledge for resident improved significantly (P<0.001) before and after the course. Almost all students (96%) preferred SMARTER-shift to a clinical shift for teaching purposes while only 52% preferred it for practicing the skills they had already obtained. Conclusion: The SMARTER-shift is an effective way for education of multitasking skills to residents of emergency medicine and it is strongly preferred by residents.