Low-fidelity hybrid sexual assault simulation training's effect on the comfort and competency of resident physicians

J Emerg Med. 2015 Mar;48(3):344-50. doi: 10.1016/j.jemermed.2014.09.032. Epub 2014 Nov 27.

Abstract

Background: Alternative training methods are needed for resident physicians to ensure that care is not compromised should they practice in settings without well-established Sexual Assault Nurse Examiner (SANE) programs.

Objective: The purpose of this study is to determine the effectiveness of a simulation-based sexual assault response course for resident physicians at an institution without an on-site SANE program.

Methods: Educational intervention study of 12 emergency medicine residents using a low-fidelity hybrid simulation model. The study was comprised of eight male and four female physicians at a military medical center in San Diego, CA. Assessment occurred using three separate metrics. The first was a written knowledge test. The second was a simulated interview and evidentiary examination. These metrics were given 1 month before and 3 months after an 8-h training course. The final metric was Likert-scale questionnaires surveying pre- and post-course feelings of competency and comfort.

Results: The emergency medicine residents showed a 13% improvement (95% confidence interval [CI] 7-20%) in written examination scores pre and post intervention. Post-course interview and examinations reflected a 44% improvement (95% CI 24-64%) in critical action completion. Pre-course comfort and competency questionnaires were a median of 2 (interquartile range [IQR] 1-3) on a Likert Scale. Post-course survey responses were a median of 4 (IQR 2-5).

Conclusions: Low-fidelity hybrid simulation is a useful tool to train inexperienced physicians to perform evidentiary examinations and interviews without sacrificing the privacy and direct care of sexual assault victims.

Keywords: domestic violence; emergency medicine; graduate medical education; rape; resident; sexual assault; simulation.

MeSH terms

  • Clinical Competence*
  • Educational Measurement
  • Emergency Medicine / education*
  • Emergency Service, Hospital
  • Female
  • Forensic Medicine / education
  • Health Knowledge, Attitudes, Practice
  • Hospitals, Military
  • Humans
  • Internship and Residency*
  • Male
  • Self Efficacy*
  • Sex Offenses*
  • Simulation Training / methods*
  • Surveys and Questionnaires
  • United States