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Training Healthcare Personnel for Mass-Casualty Incidents in a Virtual Emergency Department: VED II

Published online by Cambridge University Press:  28 June 2012

Wm. LeRoy Heinrichs ,
Patricia Youngblood ,
Phillip Harter ,
Laura Kusumoto  and
Parvati Dev
Wm. LeRoy Heinrichs*
Affiliation:
SUMMIT, Stanford University Medical Center, Stanford, California, USA Innovation in Learning, Inc., Los Altos, California, USA Professor (Emeritus) and Past Chair, Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California, USA
Patricia Youngblood
Affiliation:
SUMMIT, Stanford University Medical Center, Stanford, California, USA
Phillip Harter
Affiliation:
Department of Surgery, Division of Emergency Medicine, Stanford University Medical Center, Stanford, California, USA
Laura Kusumoto
Affiliation:
Forterra Systems, Inc., San Mateo, California, USA
Parvati Dev
Affiliation:
Innovation in Learning, Inc., Los Altos, California, USA
*
8 Campbell Lane, Menlo Park, California 94025 USA, E-mail: wlh@stanford.edu
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Abstract

Introduction:

Training emergency personnel on the clinical management of a mass-casualty incident (MCI) with prior chemical, biological, radioactive, nuclear, or explosives (CBRNE)-exposed patients is a component of hospital preparedness procedures.

Objective:

The objective of this research was to determine whether a Virtual Emergency Department (VED), designed after the Stanford University Medical Center's Emergency Department (ED) and populated with 10 virtual patient victims who suffered from a dirty bomb blast (radiological) and 10 who suffered from exposure to a nerve toxin (chemical), is an effective clinical environment for training ED physicians and nurses for such MCIs.

Methods:

Ten physicians with an average of four years of post-training experience, and 12 nurses with an average of 9.5 years of post-graduate experience at Stanford University Medical Center and San Mateo County Medical Center participated in this IRB-approved study. All individuals were provided electronic information about the clinical features of patients exposed to a nerve toxin or radioactive blast before the study date and an orientation to the “game” interface, including an opportunity to practice using it immediately prior to the study. An exit questionnaire was conducted using a Likert Scale test instrument.

Results:

Among these 22 trainees, two-thirds of whom had prior Code Triage (multiple casualty incident) training, and one-half had prior CBRNE training, about two-thirds felt immersed in the virtual world much or all of the time. Prior to the training, only four trainees (18%) were confident about managing CBRNE MCIs. After the training, 19 (86%) felt either “confident” or “very confident”, with 13 (59%) attributing this change to practicing in the virtual ED. Twenty-one (95%) of the trainees reported that the scenarios were useful for improving healthcare team skills training, the primary objective for creating them. Eighteen trainees (82%) believed that the cases also were instructive in learning about clinical skills management of such incidents. Conclusions: These data suggest that training healthcare teams in online, virtual environments with dynamic virtual patients is an effective method of training for management of MCIs, particularly for uncommonly occurring incidents.

Conclusions:

These data suggest that training healthcare teams in online, virtual environments with dynamic virtual patients is an effective method of training for management of MCIs, particularly for uncommonly occurring incidents.

Keywords

chemicalbiologicalradioactivenuclearand explosivemass-casualty incidentsIncident CommandtrainingsimulationSerious Virtual WorldVirtual Emergency Department
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 5 , October 2010 , pp. 424 - 432
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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