BACKGROUND

Goldflam et al. found that a majority of emergency medicine residencies teach wilderness medicine content. Of those programs, greater than 80% create their own curriculum. The American Board of Emergency Medicine has a framework of wilderness medicine topics that are covered on emergency medicine board examinations. How these topics are taught, and the effectivness of that teaching, has not been evaluated.

PROJECT DESCRIPTION

We undertook a survey-based knowledge acquisition study for hypothesis generation regarding medical simulation as a modality to teach wilderness medicine topics to emergency medicine residents.

The Brown Emergency Medicine Residency has a wilderness medicine simulation day structured loosely around the concept of Medical Wilderness Adventure Race (MedWAR.) Residents are placed into teams, with a variety of PGY levels on each team. On the day of the simulation, residents navigate through a state park and treat simulated victims afflicted with maladies one might encounter in the wilderness. Topics include altitude illness, submersion injury, lighting strikes, mass casualty incidents, traumatic injuries in the wilderness, crush and entrapment injuries, etc.

Faculty facilitate the scenarios. Some faculty are given structured scenarios, whereas others are given topics and encouraged to create their own scenarios.

PROJECT FINDINGS

We sent pre and post knowledge assessment questions to residents participating in the simulation event. Thirty-six residents completed both assessments, and we found a signal in the data showing that scenarios that were structed and provided to faculty facilitators. While the data did not reach statical significance, likely due to the low response rate, we did see a trend to more knowledge acquisition from the scenarios that were structured vs those that were not.

FUTURE DIRECTIONS

More structured assessment of simulation as a teaching modality for wilderness medicine will need to be undertaken to fully elucidate the effectiveness of this teaching modality.

AUTHOR: Sean Bildoeau, DO, is a fourth year emergency medicine resident and a Chief Administrative Resident at Brown Emergency Medicine

FACULTY REVIEWER: Andrew Musits, MD, MS, is an Assistant Professor of Emergency Medicine at The Warren Alpert Medical School of Brown University and Director of the Lifespan Medical Simulation Center