Bridging the Gap

Abstract

Introduction: Adolescents are attending emergency departments (EDs) in increasing numbers, accounting for 21% attendances in the United Kingdom. A recent report by the Northern Ireland Commissioner for Children and Young People highlighted deficiencies in the support offered by EDs to adolescents. Aim:The aim of this study was to develop a high-fidelity simulation-based course focused on managing common adolescent presentations to the ED.Methodology: A 1-day mixed-modality course comprising of simulations, lectures, and skill stations, mapped to the pediatric and emergency medicine curriculum, was designed. The faculty developed and delivered 8 high-fidelity simulations. Precourse and immediate postcourse questionnaires were used to assess confidence levels and gain qualitative data. Delayed feedback was collected at 3 months.Results: There were 36 participants; 86% (n = 31) completed the precourse feedback, 96% (n = 34) completed the postcourse feedback, and 47% (n = 17) completed the delayed feedback. There was a statistically significant increase in self-reported confidence across all domains with a median increase of 21.25% immediately, sustained at 20% on delayed 3-month feedback. Qualitative feedback noted a change in practice, "I used (the knowledge) regularly while working in children's A + E."Conclusions: This was a feasible, high-fidelity simulation-based study day covering the key components of adolescent medicine. The sustained increase in confidence at 3 months and the positive qualitative and quantitative feedback are supportive of the use of simulation to improve adolescent emergency care.

Improving Adolescent Psychosocial Assessment through Standardized Patient Simulation: An Interdisciplinary Quality Improvement Initiative

“…Another significant finding was the increase in residents’ self-reported performance of a full HEEADSSS assessment with adolescent patients through the designations of either Frequently or Almost Always by 17%. Similarly, another study noted in their adolescent emergency medicine SP simulation quality improvement project that at the three-month follow-up, participants indicated an increased use of new skills in practice, especially through the use of the HEEADSSS assessment tool [ 30 ]. Other researchers found that individuals were less likely to present with future self-harm injuries following participation in psychosocial assessments [ 31 ]; therefore, the increase in the frequency of HEEADSSS assessments was beneficial to the adolescent populations.…”

Perceptions of paramedic educators on assessments used in the first year of a paramedic programme: a qualitative exploration

“…International research specific to paramedic assessments is limited and while some papers describe simulation [ 13 , 18 ] and simulation in the education of paramedics [ 18 ] or the assessment of paramedics in both simulation and workplace settings [ 19 , 20 ] there are few exploring the opinions of educators and examiners about assessment [ 5 , 21 , 22 ]. Formative assessment in paramedic education has received very limited attention.…”

Assessing the Gap in Adolescent Emergency Care Training for Emergency Medicine Residents: A Systematic Review

“…Subsequently, during the writing of this manuscript, one additional study was identified in the literature (e-publication ahead of print) meeting our initial relevance criteria, as it focused on training emergency medicine residents to care for adolescent patients [ 16 ]. On closer review, this study did not specify the participants’ level of training and thus would not have been eligible for inclusion.…”