Investigation of clinical skill level of emergency medicine residents on medical toxicology

Aim: The aim of the study is to design and apply simulation-based objective structured clinicaş examinations (OSCE) to evaluate the clinical skill level of emergency medicine residents about medical toxicology, clinical decision-making and medical management process and to determine the existing deficiencies. Method: For the research, 5 OSCE scenarios in the field of Medical Toxicology were developed by experts in the field. A total of five stations were created for OSCE, two case scenarios using two simulated case videos, a standard patient scenario and high (including technology) realistic models and applied to the participants within two days. At each station, the clinical skill levels of the participants were evaluated with a standard form by the evaluators and their performances were recorded on video. The clinical skill levels of the participants were evaluated as adequate, developable and inadequate for each station according to medical history taking, diagnostic interventions and treatment modalities. All data were analyzed by transferring to SPSS 22.0 statistical program. Results: 51 emergency medicine residents are participated to our study. In our study, the station which the emergency medicine assistants showed the highest success was the snake bite case presented in the video editing in the fourth station. The station where the participants showed the least success was the high-tech mock- up scenario presented as a Tricyclic Antidepressant (TCA) poisoning case in the first station. While there is only one successful person at all stations, the number of unsuccessful people at any station is 32. Statistically significant factors examined between people who were successful at least one station and those who were unsuccessful at any station; having participated in a simulation study, attended a toxicology course, managed a toxicology case, received toxicology training and worked as an assistant for 24 months. 14 Conclusion: With this research, simulation based and standardizable OSCE scenarios were developed that are remerkable, reproducible and applicable in other centers and able to measure the level of knowledge and skills of emergency medicine residents in poisoning case management. This is the first study in the field of medical toxicology with this measurement and evaluation method and with the results obtained, the aspects that need to be improved in the management of poisoning cases of emergency medicine residents have been revealed and thus the necessity of establishing a standard medical toxicology training curriculum and rotation in emergency medicine residency training was emphasized. KeyWords: Mexical Toxicology, simulation, education, emergency medicine, toxicology