Demonstration of high-fidelity simulation team training for emergency medicine

Emergency medicine (EM) presents many cognitive, social, and systems challe nges to practitioners. Coordination and communication under stress between and among individuals and teams representing a number of disciplines are cr itical for optimal care of the patient. The specialty is characterized by u ncertainty, complexity, rapidly shifting priorities, a dependence on teamwo rk, and elements common to other risky domains such as perioperative medici ne and aviation. High-fidelity simulators have had a long tradition in avia tion, and in the past few years have begun to have a significant impact in anesthesiology. A national, multicenter research program to document the co sts of teamwork failures in EM and provide a remedy in the form of an Emerg ency Team Coordination Course has developed to the point that high-fidelity medical simulators will be added to the hands-on training portion of the c ourse. This paper describes an evolving collaborative effort by members of the Center for Medical Simulation, the Harvard Emergency Medicine Division, and the MedTeams program to design, demonstrate, and refine a high-fidelit y EM simulation course to improve EM clinician performance, increase patien t safety, and decrease liability. The main objectives of the paper are: 1) to present detailed specifications of tools and techniques for high-fidelit y medical simulation; 2) to share the results of a proof-of-concept EM simu lation workshop introducing multiple mannequin/three-patient scenarios; and 3) to focus on teamwork applications. The authors hope to engage the EM co mmunity in a wide-ranging discussion and hands-on exploration of these meth ods.