Impact of Simulation-Based Training on Procedural Competency

Document Type

Abstract

Publication Date

5-1-2025

Abstract

Background and Objectives: The ACGME model for procedural competency utilizes index procedure minimums as a measure of emergency medicine (EM) procedural competency. As clinical opportunity for these procedures is inconsistent, simulation has been used increasingly to address these gaps. The purpose of this study was to characterize the impact of simulation-based training during residency. Methods: This was a cross-sectional survey of recent graduates of 17 EM residency programs representing a diverse sample of national residencies. IRB approval was obtained from St. Luke's Hospital. Content validity evidence was developed via literature review and expert involvement. Response process validity evidence was developed by piloting with think-aloud resting. Each program contact sent 3 weekly emails to their recently graduated residents. Descriptive statistics were used to summarize the data and a chi-squared analysis was done to compare 3-and 4-year programs. Results: 88 out of a possible 195 respondents answered (45%), coming from both 3-year residencies (46/114 from 11 programs) and 4-year residencies (42/81 from 6 programs). 5/88 (6%) reported their simulation curriculum was inadequate, 34/88 (39%) reported it was adequate, 43/88 (49%) reported it was superb, and 6/88 (7%) reported it was superfluous. The most common procedures requiring simulation to graduate were cricothyrotomy (78/88; 89%), pericardiocentesis (77/88, 88%) and lateral canthotomy (64/88, 73%). Four year programs report 531/601 procedures (88%) were done without simulation; while 580/782 (76%) of procedures in 3 year programs were done without simulation (p < 0.05). Conclusion: Simulation plays an important role in resident education and was a graduation requirement at every surveyed program. For each unique procedure, we found at least one graduate relying upon simulation to supplement minimum procedure numbers. Most residents felt their simulation training was at least adequate. Graduates of 4-year programs relied less on simulation. This study adds to literature supporting robust simulation training to fill gaps in procedural clinical opportunity. More work is needed to guide timing and assessment of competency through non-numerical methods. Additional work can help to identify which procedures may best benefit from simulation-based education in order to be more efficient and effective with this high-resource educational strategy.

Publication Title

Academic Emergency Medicine

Volume

32

Issue

Supplement 1

First Page

60

Last Page

60

Comments

2025 SAEM Annual Meeting held 2025-05-13 to 2025-05-16 in Philadelphia, PA

Link to Full Text

Open Access

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