Canadian emergency physicians are willing to distribute take-home naloxone, but thoughtful systems are required to facilitate opioid OEND implementation. These data will inform the development of these programs, with emphasis on multidisciplinary training and education.
This study describes the development and validation of a novel modifiable anchored global assessment scoring tool for simulation-based OSCE assessment of resuscitation competence in postgraduate EM trainees.
The Department of Emergency Medicine at Queen's University developed, implemented, and evaluated an interprofessional simulation-based competition called the Simulation Olympics with the purpose of encouraging health care providers to practice resuscitation skills and foster strong team-based attitudes. Eleven teams (N 5 45) participated in the competition. Teams completed three standardized resuscitation scenarios in a high-fidelity simulation laboratory with teams composed of nurses, respiratory therapists, and undergraduate and postgraduate medical trainees. Trained standardized actors and a dedicated technician were used for all scenarios. Judges evaluated team performance using standardized assessment tools. All participants (100%) completed an anonymous two-page questionnaire prior to the competition assessing baseline characteristics and evaluating participant attitudes, motivation, and barriers to participation. The majority of participants (71%) completed an evaluation form following the event focusing on highlights, barriers to participation, and desired future directions. Evaluations were uniformly positive in short-answer feedback and attitudinal scoring measures. To our knowledge, the Simulation Olympics competition is the first of its kind in Canada to be offered at an academic teaching hospital. RÉ SUMÉLe dé partement de mé decine d'urgence de l'Université Queen's a é laboré , ré alisé , et é valué une compé tition interprofessionnelle, axé e sur la simulation et appelé e « Simulation Olympics », dans le but d'inciter des professionnels de la santé à mettre en pratique leurs compé tences en ré animation et de faciliter l'adoption de fortes attitudes d'é quipe. Onze é quipes (N 5 45) ont participé à la compé tition. Les é quipes, composé es d'infirmiè res, d'inhalothé rapeutes, d'é tudiants diplô mé s, et non diplô mé s en mé decine, ont concouru dans trois scé narios uniformes de ré animation, dans un laboratoire simulant trè s bien la ré alité . Des acteurs normalisé s, ayant reç u une formation particuliè re, et un technicien dé voué é taient pré sents dans tous les scé narios. Les juges ont é valué la performance des é quipes à l'aide d'outils d'é valuation normalisé s. Tous les participants (100%) ont ré pondu à un questionnaire anonyme, de deux pages, avant la compé tition, visant à é valuer leurs caracté ristiques de base, leurs attitudes, et leur motivation ainsi que les obstacles à la participation. La plupart des participants (71%) ont rempli un formulaire d'é valuation aprè s la compé tition, portant surtout sur les faits saillants, les obstacles à la participation, et les orientations futures souhaité es. Les é valuations se sont ré vé lé es uniformé ment favorables dans de courtes ré troactions et des mesures de cotation des attitudes. À notre connaissance, la compé tition « Simulation Olympics » est la premiè re du genre, au Canada, à avoir é té organisé e dans un hô pital d'enseignement.
Introduction: Unintentional overdose is the leading cause of injurious death among Americans aged 25-64 years. A similar epidemic is underway in Canada. Community-based opioid overdose education and naloxone distribution (OOEND) programs distribute take-home naloxone kits to people at risk of overdose in several cities across Canada. Due to the high rate of drug-related visits, recurrent opioid prescribing, and routine encounters with opioid overdose, Emergency Departments (ED) may represent an under-utilized setting to deliver naloxone to people at risk of opioid overdose or likely to witness overdose. The goal of this study was to identify Canadian emergency physician attitudes and perceived barriers to the implementation of take-home naloxone programs. Methods: This was an anonymous web-based survey of physician and trainee members of the Canadian Association of Emergency Physicians. Survey questions were developed by the research team and piloted for face validity and clarity. Two reminder emails were sent to non-responders at 2-week intervals, per the modified Dillman method. Respondent demographics were collected and Likert scales used to assess attitudes and barriers to the prescription of naloxone from the ED. Results: A total of 347/1658 CAEP members responded (20.9%). Of the respondents, 62.1% were male and residents made up 15.6%. The majority (48.2%) worked in Ontario and 55.7% worked in an urban tertiary centre. Overall attitudes to OOEND were strongly positive: 86.6% of respondents identified a willingness to prescribe naloxone from the ED. Perceived barriers included allied health support for patient education (56.4%), access to follow-up (40.3%), and inadequate time in the clinical encounter (37.7%). In addition to people at risk of overdose, 78% of respondents identified that friends and family members may benefit from OOEND programs. Conclusion: Canadian emergency physicians are willing to prescribe take-home naloxone to at-risk patients, but better systems and tools are required to facilitate opioid overdose education and naloxone distribution implementation. This data will inform the development of these programs, with emphasis on allied health support, training and education.
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