Resuscitation simulation among people who are likely to witness opioid overdose: Experiences from the SOONER Trial

Abstract

The opioid crisis is a growing public health emergency and increasing resources are being directed towards overdose education. Simulation has emerged as a novel strategy for training overdose response, yet little is known about training non-clinicians in bystander resuscitation. Understanding the perspectives of individuals who are likely to experience or witness opioid overdose is critical to ensure that emergency response is effective. The Surviving Opioid Overdose with Naloxone Education and Resuscitation (SOONER) study evaluates the effectiveness of a novel naloxone education and distribution tool among people who are non-clinicians and likely to witness opioid overdose. Participants’ resuscitation skills are evaluated using a realistic overdose simulation as the primary outcome of the trial. The purpose of our study is to describe the experience of participants with the simulation process in the SOONER study. We employed a semi-structured debriefing interview and a follow up qualitative interview to understand the experience of participants with simulation. A qualitative content analysis was performed using data from 21 participants who participated in the SOONER study. Our qualitative analysis identified 5 themes and 17 subthemes which described the experience of participants within the simulation process. These themes included realism, valuing practical experience, improving self-efficacy, gaining new perspective and bidirectional learning. Our analysis found that simulation was a positive and empowering experience for participants in the SOONER trial, most of whom are marginalized in society. Our study supports the notion that expanding simulation-based education to non-clinicians may offer an acceptable and effective way of supplementing current opioid overdose education strategies. Increasing the accessibility of simulation-based education may represent a paradigm shift whereby simulation is transformed from a primarily academic practice into a patient-based community resource.

Developing medical simulations for opioid overdose response training: A qualitative analysis of narratives from responders to overdoses

“…The current study provides data regarding characteristics of illicit and prescription opioid overdose scenes from the points of view of a variety of observers, allowing the development of effective medical simulations for various groups [ 12 , 15 , 46 ]. The narratives and experiences shared by opioid overdose responders in this study provide valuable context and details for developing medical simulations authentic to people who use opioids (PWUO).…”

“…Other researchers are actively employing simulation methodologies for opioid overdose response training and have published research on its mutually beneficial outcomes [ 46 , 47 ]. However, no prior studies have offered detailed and specific observations as evidence for deriving key elements in the creation of medical simulations.…”

“…It is interesting to note that Whittall et al (2022) found that PWUO view simulation as a valuable opportunity to gain practical experience and improve their self-efficacy in responding to opioid overdoses [ 46 ]. This suggests that involving PWUO in the development and implementation of opioid overdose response simulations could be beneficial in promoting their engagement and effectiveness.…”

“…The authors also highlight the potential benefits of low-fidelity simulations, which are more accessible and feasible in low-resource settings [ 60 , 61 ], and can offer important learning opportunities that can be adapted to suit the needs of different communities [ 62 ]. Bringing simulation education to community settings, such as shelters or harm reduction facilities, could increase accessibility and help to address the unique challenges of overdose response in these settings [ 46 , 63 , 64 ]. Overall, incorporating diverse perspectives and considering the practical constraints of different settings is important in developing effective and accessible simulation-based training programs for opioid overdose response.…”

“…These qualitative findings were used to inform the development of medical simulations for opioid overdose response training, with contextual information organized around two conditions: one for a person in respiratory depression requiring one or more doses of naloxone, and another for a person experiencing an opioid-associated cardiac arrest requiring ventilations, chest compressions, and defibrillation. More information on these contextual details can be found in S5 Table . It is interesting to note that Whittall et al (2022) found that PWUO view simulation as a valuable opportunity to gain practical experience and improve their self-efficacy in responding to opioid overdoses [46]. This suggests that involving PWUO in the development and implementation of opioid overdose response simulations could be beneficial in promoting their engagement and effectiveness.…”