Investigation of clinical skill level of emergency medicine residents on toxic terrorism preparedness-emergency management

Objective: The primary purpose of our study is to measure the clinical skill level of emergency medicine residents by developing a simulation-based clinical exam that can measure toxic terrorism preparation and medical management skills. The secondary purpose is to analyze the identified deficiencies and contribute to the development of solutions for this. Method: Our study was developed by experts in the field for a clinical skills exam based on simulation of 5 case scenarios on toxic terrorism preparedness and emergency management. After the approval of the ethics committee, it was applied to the residents working in Karadeniz Technical University Faculty of Medicine, Department of Emergency Medicine and Health Sciences University Trabzon Kanuni Training and Research Hospital, Department of Emergency Medicine, on consecutive days at KTÜ MEDSİM-Good Medicine Practices and Medical Simulation Center. For the applied exam, a total of five stations were created, including two simulated case videos, two standardized patient scenarios, and a case scenario using a high (technology-containing) reality model. At each station, evaluators evaluated the participants using standardized forms. According to their diagnostic interventions and treatment management, each station was evaluated as adequate, improvable and inadequate. SPSS 22.0 statistical package program was used in the analysis of the obtained data. Statistical alpha significance level was accepted as p<0.05. Results: 48 emergency medicine residents participated in our study. In our study, the third station (botulinum exposure scenario) was found to have the highest success rate of emergency medicine residents, with 16 (33.3%) compared to stations. At the second station (contamination scenario with radioactive substance), all of the residents performed poorly and no successful participant was identified at all stations. When comparing the descriptive and educational information of emergency medicine residents and their success in at least 1 station, statistically higher proficiency rates were found among women, those who worked as residents for over 24 months, those who received CBRN training and those who received simulation-based training. Conclusion: With this study, a standard and simulation-based assessment method has been developed that measures the clinical skills of emergency medicine physicians about toxic terrorism. In the light of the data obtained from the emergency medicine residents to whom this method was applied, the necessity of developing the existing core education curriculum on CBRN/toxic terrorism and the need for repeatable, measurable evaluation methods of the emergency physicians on the medical management of this rare but high threat to society, toxic terrorism emerges.