A novel emergency medicine simulation addressing high risk scenarios with fire first responders

Introduction: Simulation has been shown to improve resident understanding of high-risk scenarios, especially with topics that are not covered in graduate medical education. Simulation training in health-professionals education is associated with positive effects on knowledge, skills, behaviors, and patient outcomes. This novel interprofessional simulation with paramedic trained firefighters and emergency medicine (EM) residents was created on the belief that physician residents would benefit from a better understanding of the pre-hospital identification, assessment, and treatment of trauma and fire-related patients.

Methods (Innovation/Implementation): We outline a novel framework for designing, implementing, and evaluating the impact of a fire simulation event for an EM residency program that is concordant with ACGME standards. After touring the fire simulation site, the EM and fire department leadership collaborated on the development of fire scenarios. The three learning groups, consisting of 8-9 resident physicians (PGY1-4), rotated through the stations: a smoke house structure fire simulation case, a collapsed building trauma simulation case, and a fire hose dynamics activity. Following the identification and rescue potion, the case was transitioned to EM and simulation faculty who led the resuscitation portion. When the scenario concluded in field stabilization of the patient, the case was coded to the local emergency department and the simulation mannequin was loaded into an ambulance.

Results (Evaluation): Evaluation of the simulation was determined by participant’s feedback and informal commentary on areas of improvement. An initial debriefing was conducted with the learners to evaluate the immediate impact on their knowledge and understanding of the simulation. A subsequent debriefing was held with the planning team to discuss successes and areas for future enhancements.

Conclusions: We have described the design and implementation of a novel EM resident fire simulation to address the needs of our 4-year EM residency program located within an urban hospital. Not only does this project highlight the importance of collaboration in patient care, but it also emphasizes the critical role of interdisciplinary understanding of roles and challenges. This project has the potential for expansion in similar urban settings and could also serve as a valuable tool for training rural physicians in first responder and fire rescue education. This study provides valuable insight into the development and implementation of a novel simulation event and can serve as an adjunct to the EM residency curriculum.