gms | German Medical Science

Introduction: In the past, the integration of simulation in education and training of clinical emergency medicine took place at the University Hospital of Cologne (UKK) mainly in student teaching and less in continuing medical education, although the effectiveness of simulation training on the management of emergency situations is well documenteda,b. Simulation has been used primarily for resuscitation training (e.g., Advanced Cardiac Life Support [ACLS]). Care of critically ill patients in the emergency room goes beyond these basic skills and additionally requires a high level of organizational skills and teamwork. Several new course formats (EMCC, ACiLSc) address this. The Emergency Medicine Core Competencies (EMCC) course developed by Eric Dryver (Lund University Hospital, Sweden) is particularly suited for continuing education. Participants (TN) are trained in theory and practice in small groups. The course addresses the core competencies of clinical emergency medicine, following the curriculum of the European Society of Emergency Medicine (EUSEM). The target audience of the course is primarily physicians, but also nurses who regularly participate in the care of emergency patients. A special feature of the EMCC is the training on a checklist (CL) compendium. This serves – similar to the use of CL in aviation – the structured processing of complex situations. This reduces the stress level when there is high pressure to act and trains a step-by-step treatment of the patient according to the principle: “treat first, what kills first”.

In the department of clinical acute and emergency medicine at UKK, a course according to EMCC specifications was held for the first time in 2021, initially with the support of three external EMCC instructors. In the meantime, several members of the focus are authorized to train as instructors.

Description of the Course: Before the start of the course, participants receive a summary of the topics and a pretest to work through. The course lasts three days and includes theoretical and practical lessons as well as simulations, which vary in duration and complexity (see below). The course size is 12-14 participants and 5 instructors.

1.

Theory: A total of 13 hours with the contents: cardiovascular, neurological, traumatological and pediatric emergencies, intoxications as well as ABG and ECG interpretation.

2.

Practical classes and scenarios: A total of 9 h. Training of airway management, including surgical airway, chest tube placement, intraosseous vascular access, transvenous pacing. The scenarios are divided into Procedure Stations (teams of 2, focus on basic measures) and Resuscitation Stations (complex scenarios with team leader and 2-3 helpers, focus on organization, communication, resource management).

All scenarios start with a sign-in and the determination of the team lead. The scenarios are conducted as close to reality as possible. All actions announced by the TN must be actively performed, diagnostics must be requested, etc. The tutors finish the scenario when predefined contents and steps in the scenario have been achieved, then a debriefing is conducted. Here, the focus is on teamwork and communication in addition to the technical details. The participants finally evaluate the course with an evaluation and receive a certificate of participation.

Summary: The EMCC course has become an important part of the training and continuing education of the department of clinical acute and emergency medicine at the University Hospital of Cologne. It uses realistic scenarios to train the integration of theoretical and practical skills in everyday clinical practice. The course is very well received; the anonymous evaluation resulted in a rating of 5.3/6 of the participants in 2022. Specialists and senior physicians of the focus participate in this format once a year. The plan is to open it to external colleagues in the fall of 2023.