101 - Quality Improvement: Resident Response to Emergencies in IPR Unit

Objectives: The objective of this project was to improve resident confidence and medical knowledge in providing emergent care to patients as well as reduce the number of medical response team calls on the IPR floor.

Design: PGY-2 residents, PGY-4 residents, and a PM&R attending participated in an IPR emergency scenario lecture, five simulated scenarios conducted on the IPR floor, and self-assessment surveys that evaluated the PGY-2 residents’ perceived skill level and competency upon completion of the training. Pre- and post-training survey included multiple-choice medical knowledge questions plus scaled (1-10) confidence questions. Surveys were administered after the lecture but before the case-based scenarios.

Results: The aggregated results of these surveys showed an improvement in the residents’ knowledge base plus confidence following the training with an improvement factor of 25.72% (p=.002). However, a comparison of the aggregated results of the medical knowledge multiple-choice surveys of the residents yielded no statistical improvement (p = 0.134) when comparing pre-training score (58% mean correct) to after (73% mean correct). Additionally, comparing resident confidence before (6.1/10) and after the simulation (7.7/10) yielded no significant difference (p=.206).

Conclusions: This project demonstrated a statistically significant increase in PGY-2 confidence level plus medical knowledge, but not confidence or medical knowledge alone. One possibility could be that several questions utilized on the quiz were only discussed during the lecture and not the case-based scenarios. Another possibility is that residents might not have actually improved their knowledge of clinical medicine enough to be reflected in the post-case scenario survey as much as they were becoming familiar with the logistics of running an emergency. This may have manifested in a global but not focal improvement. Further iterations should include more subjects, quiz material addressed in both the lecture and case based scenarios, and tests between lecture and case-based scenario to track respective learning.