Video in situ simulation for medical student education during the COVID-19 pandemic.

The COVID-19 pandemic has limited in-person experiences for medical students, especially in situations involving aerosol-generating procedures. We designed a video in situ simulation to orient students to critical steps in COVID-19 intubation algorithms. Small groups of students were paired virtually with facilitators (faculty and residents) and watched a video of an in situ simulation of emergency staff performing a protected intubation, with discussion points appearing on screen at discrete times. The simple design drives engagement, discussion and allows for scheduling flexibility with no risk to the learners. It can be adapted to several different scenarios or levels of training.

La pandémie de la COVID-19 a limité les expériences en personne pour les étudiants en médecine, en particulier les interventions qui produisent des aérosols. Nous avons conçu une simulation in situ par vidéo portant sur les étapes critiques des algorithmes de l'intubation dans les cas de COVID-19. De petits groupes d'étudiants, jumelés virtuellement avec des animateurs (enseignants et résidents), ont regardé une vidéo de la simulation in situ d'une intubation sécuritaire effectuée par une équipe d'urgence. À des moments précis de la simulation, des points de discussion apparaissaient à l'écran. Cette formule simple, sans risque pour les apprenants, favorise l'engagement et la discussion et elle permet la planification en toute souplesse. Elle peut être adaptée à plusieurs scénarios et à divers niveaux de formation.

Developing the Virtual Resus Room: Fidelity, Usability, Acceptability, and Applicability of a Virtual Simulation for Teaching and Learning.

PROBLEM: Physical distancing restrictions during the COVID-19 pandemic led to the transition from in-person to online teaching for many medical educators. This report describes the Virtual Resus Room (VRR)-a free, novel, open-access resource for running collaborative online simulations. APPROACH: The lead author created the VRR in May 2020 to give learners the opportunity to rehearse their crisis resource management skills by working as a team to complete virtual tasks. The VRR uses Google Slides to link participants to the virtual environment and Zoom to link participants to each other. Students and facilitators in the emergency medicine clerkship at McMaster University used the VRR to run 2 cases between June and August 2020. Students and facilitators completed a postsession survey to assess usability and acceptability, applicability for learning or teaching, and fidelity. In addition, students took a knowledge test pre- and postsession. OUTCOMES: Forty-six students and 11 facilitators completed the postsession surveys. Facilitators and students rated the VRR's usability and acceptability, applicability for learning and teaching, and fidelity highly. Students showed a significant improvement in their postsession (mean = 89.06, standard deviation [SD] = 9.56) compared with their presession knowledge scores (mean = 71.17, SD = 15.77; t(34) = 7.28, P < .001, with a large effect size Cohen's d = 1.23). Two perceived learning outcomes were identified: content learning and communication skills development. The total time spent (in minutes) facilitating VRR simulations (mean = 119, SD = 36) was significantly lower than time spent leading in-person simulations (mean = 181, SD = 58; U = 20.50, P < .008). NEXT STEPS: Next steps will include expanding the evaluation of the VRR to include participants from additional learner levels, from varying sites, and from other health professions.

Converting to Connect: A Rapid RE-AIM Evaluation of the Digital Conversion of a Clerkship Curriculum in the Age of COVID-19.

BACKGROUND: With the advent of the 2019 coronavirus pandemic, a decision was made to remove medical students from clinical rotations for their own safety. This forced students on a core emergency medicine (EM) rotation at McMaster University to immediately cease all in-person activities. An urgent need for a virtual curriculum emerged. METHODS: A virtual curriculum consisting of asynchronous case-based learning on Slack, ask-me-anything webinars, and online e-modules was created to fill the need. We describe a program evaluation using the RE-AIM framework and a social networking analysis of participants. RESULTS: Medical students (n = 23) and 11 facilitators (five residents, six faculty members) participated in this pilot study. Faculty members sent a mean (±SD) of 115 (±117) messages (n = 6), and mean (±SD) message counts for students and residents were 49.96 (±25; n = 23) and 39 (±38; n = 5), respectively. A total of 62,237 words were written by the participants, with a mean of 1,831 per person. Each message consisted of a mean (±SD) of 25 words (±29). Students rapidly acquitted themselves to digital technology. Using the RE-AIM framework we highlight the feasibility of a virtual curriculum, discuss demands on faculty time, and reflect on strategies to engage learners. CONCLUSIONS: The use of asynchronous digital curricula creates opportunities for faculty-resident interaction and engagement. We report the successful deployment of a viable model for undergraduate EM training for senior medical students in the COVID-19 era of physical distancing.