A group of four emergency medicine residents used teamwork and their medical training to win a simulation competition this month.
Emergency medicine residents Drs. Stephen Godfrey, Henry Higby, Erik Loescher and Joshua Recknagel captured first place at the Michigan College of Emergency Physicians Emergency Medicine Residents’ Association of Michigan SimWars Competition.
The team faced several simulated situations, including a patient with a vitamin D overdose, a patient demanding opiates whose family member became aggressive and pulled a gun, a patient who overdosed on toluene, and an infant who suffered injuries after being thrown off a balcony. In the final round, the team faced a multi-casualty incident with more than a dozen patients, where they had to triage and treat the patients and manage the disaster incident.
“All the teams showed that the key to success for managing simulated cases as well as real patients is a combination of teamwork and communication skills as well as the basic knowledge of emergency medicine,” said Dr. Richard Lammers, a professor in the Department of Emergency Medicine and the medical school’s former assistant dean for Simulation.
WMed’s residents had experience in managing disaster scenarios going into the competition, which allowed them to practice their skills against teams that may not have had that experience, said Dr. John Hoyle, the medical school’s assistant dean of Simulation and a professor in the departments of Emergency Medicine and Pediatric and Adolescent Medicine. WMed’s Emergency Management residency holds Wilderness Medicine Day in September, which includes working a mock mass casualty incident. Residents also take a course called Advanced Disaster Life Support, where they have to triage several patients in a disaster situation, figure out how to treat them and how to transport them for more treatment.
WMed’s team was comfortable managing multiple ill and injured patients because of the emphasis of EMS in the Emergency Medicine residency, and the residents expertly handled individual patients in the simulated hospital rooms because they spend a day every month training in simulations involving pediatric cases, adult critical care cases, trauma cases, and obstetrics and gynecology.
“If you don’t have any prior experience with simulated cases, the exercise may seem a little artificial, and that can interfere with decision making and your ability to function in that setting,” Dr. Lammers said. “Once you get past the inherent limitations in realism, you perform like you would in an actual clinical environment.”
It was the first year the medical school sent a team to the competition, and the fact that WMed’s team, comprised of three second-year residents and one first-year resident, beat out other teams of third-year residents was not lost on their leaders. Dr. Lammers and Dr. Hoyle also served as judges.
“A lot of this shows the strength of the clinical, didactic and simulation education our residents get,” Dr. Hoyle said.
“In the case that I judged, they showed some really fine polish and really good clinical skills.”
WMed’s team seamlessly worked each situation as they have been trained to do, from splitting up duties on the fly while managing to resuscitate a child, talking to family members and taking a patient history while helping a crashing patient, said Dr. Recknagel, a first-year resident.
While teamwork under pressure isn’t foreign during an emergency medicine residency, Dr. Recknagel said he appreciated having multiple scenarios back-to-back to be able to practice skills that need to become second nature.
“It was a privilege to get to practice advanced teamwork with some talented doctors,” Dr. Recknagel said. “It feels like you learn exponentially more in those complex scenarios where you don’t know what’s coming.”
Second-year resident Erik Loescher said participating in the competition showed him how unique WMed’s training opportunities are, from shifts with West Michigan Air Care to the medical school’s robust simulation center to MSU-1, the resident-staffed Medical Support Unit that responds to major EMS incidents. The training prepares residents to tackle complex, evolving situations outside of the Emergency Department, he said.
“I learned how strong the WMed Emergency Medicine residency is and how well prepared it’s making us,” Dr. Loescher said. “This isn’t just my experience, but I also saw this watching my co-residents in the same situations. I was really proud of how we all did together as a team.”