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Medical simulation and team training is widely used and the effect on learning is generally accepted. However, full scale simulation is expensive and time consuming. Mornings in the Emergency Department (ED) are often quiet leaving time for other activities.
The trauma teams are well organized, and they participate in team training regularly. In contrast, even though medical and surgical patients are often at least as complex as trauma patients, they are managed only by a few nurses and a junior physician, and the team work is rarely trained.
We wanted to test the feasibility of a simple and costfree setup, aimed at increasing the teamwork abilities of our staff.
The training was organized by two junior physicians, both ALS provider trained, and a nurse specialist, ATCN educated. It took place in a regular ED room with a simple CPR manikin torso.
On three separate days, two teams consisting of 2 nurses and 2 junior physicians from the ED were selected. The two teams went through a scenario from 8.30 to 9.00 am, and from 9.00 to 9.30 am, respectively.
The organizing physician explained the scenario and gave information about the manikin's reply and status. Vital signs were written on a piece of paper, changing as the scenario progressed. The teams were instructed to act as they would in a real clinical situation, e.g. talk to the patient and the team and to carry out relevant procedures. After finishing the scenario five minutes were used for debriefing of the team.
12 nurses and 12 junior physicians had basic team training in a simulated clinical situation, while a similar number of staff observed. All active participants found the training highly valuable. The training also revealed that some essential utensils and medications for resuscitation were too far away from the regular ED room. Hence, part of the ED was reorganized on the basis of these observations.
Basic medical team training can be carried out without advanced equipment and with no cost if fitted into the daily programme. It is also a valuable way to test the equipment and physical set-up of the ED.