The practical management of emergencies in primary care: Taking simulation out of the classroom and into real-life environments.

Abstract

Life threatening emergencies in the community are relatively infrequent and therefore provide a challenge for doctors in keeping up-to-date and maintaining confidence. Training in managing emergencies typically takes place through role play and classroom based simulation. In this project, we took simulation out of the classroom and into community environments where emergencies actually occur creating 'real-life' scenarios. These included the practical management of meningitis, anaphylaxis, hypoglycaemia, convulsions and cardiac arrest. Doctors had to find and utilize the equipment in their surgeries and were asked to physically draw up the appropriate medication. The simulation training was led by a GP and a Consultant in Intensive Care Medicine. Participants' confidence in managing emergencies significantly increased after the workshops. Qualitative feedback illustrated the need for more simulation based learning: "I hope this can be done regularly as it will make a huge difference to patient care", "Excellent - life like to make more memorable", "Good to use the actual surgery equipment". Many of the participants knew the theory of what to do but lacked the practical skills to efficiently manage emergency scenarios. Training doctors through simulation needs to be taken out of the classroom and into real life environments. This is particularly important for 'time critical illnesses' where delays can have a direct impact on morbidity and mortality.