COVID-19 RESURGENCE MASS CASUALTY INCIDENT SIMULATION

Steven Bolger1 , Yasamin Soltanianzadeh,1 Heidi Baer,1 Joshua McHugh,1 Daniel Satnick,1 Sage Wexner,2 Julie Sayegh,3 Nubaha Elahi4 Mount Sinai Morningside and West,1 Kern Medical,2 Los Alamitos Medical Center,3 University of Central Florida4

BACKGROUND:

Adapting simulation-based curriculum for medical education to the virtual realm presents a unique challenge for educators. We created a virtual simulation of a mass-casualty incident (MCI) in which learners navigate through multiple cases using a track board which they control.

METHODS:

We created a novel virtual MCI simulation in which patients are displayed on a track board allowing the learners to simultaneously manage multiple patients. The scenario involved a local fire and a bus crash in which 6 patients are transported by EMS and 3 patients walk into the hospital. The learners had 8 minutes to simultaneously manage the 9 patients with access to unlimited nursing support and any consultant. The track board provided the patients’ age, gender, chief complaint, vital signs, and a picture of any pertinent injury or physical examination finding. The learners were provided with history and physical examination information by asking questions to the examiners following the ABEM Oral Certification Examination format. We provided the learners with prompts including any significant changes in vital signs or changes in respiratory status for the patients.

Figure 1. Track board which the learners use to navigate between patients

Figure 2. Example of information provided to learners after selecting one of the icons on the track board

RESULTS:

We had multiple groups of 4-5 emergency medicine resident physicians complete the virtual MCI simulation. We observed variation in the approach of different groups of learners ranging from rapidly evaluating all 9 patients and appropriately triaging care to sequentially navigating between patients. Some teams prioritized dispositioning patients quickly while other teams prioritized resource allocation.

CONCLUSIONS:

We created a novel model for simulating a MCI virtually using a track board which learners can use to navigate through multiple cases. We have applied this model to multiple groups of emergency medicine resident physicians for medical education.