Upcoming Presentations and Showcases

• October 2025: AHS eSIM Alberta SIMposium

The D&D Tour So Far

• May 2025: International Conference on Emergency Medicine (ICEM) @ Montreal

• May 2025: Canadian Paramedicine Research Day @ Virtual

• January 2025: International Meeting on Simulation in Healthcare (IMSH)

• November 2024: SimExpo

• October 2024: AHS eSIM Alberta SIMposium

• June 2024: Canadian Association of Emergency Physicians (CAEP) Conference

• June 2024: Lifesaving Society AB & NWT AGM at "Vivo for Healthier Genreations"

• May 2025: World Association for Disaster and Emergency Medicine (WADEM) Conference @ Japan

D&D SIM versus Prop SIM

Title

Draw & Doodle SIM (low-fidelity simulation) versus Prop SIM (medium-fidelity simulation) to prepare for emergencies at electronic dance music festivals

Authors

Anthony Seto BHSc(Hons) MD CCFP(EM)

Connor Hass BSc(Hons)

Ella Krane BSc(Hons)

Liam Montgomery BSc(Hons) MESc

David Lam BSc

Michael McCue BScN MD

Background

Simulation fidelity is “realism”, divided into physical/environmental, emotional/psychological, and conceptual domains. Some favour higher physical-fidelity, because of perceived improved engagement; however, literature reveals no significant difference in education effectiveness for high physical-fidelity versus lower technological options. Modality choice should align with learning objectives.

Summary of Work

We developed “Draw & Doodle SIM” (D&D SIM), a low-fidelity, zero-technological simulation to prepare medical teams for emergencies at electronic dance music festivals. Using chart paper, the facilitator draws a patient. As the case progresses, the facilitator draws patient status updates and findings. Participants doodle interventions.

D&D SIM was compared with “Prop SIM” (medium-fidelity simulation) involving a CPR manikin and medical props (e.g., oxygen mask and syringes). Participants joined two cases, one in each modality. This crossover study included four track variations, with each track starting on a different modality or case.

No significant difference in overall rating of D&D (4.43/5, n=28) vs Prop (4.23/5, n=30) SIM was detected. “Felt engaged” (4.71/5 vs 4.50/5) and “adequate opportunity to participate” (4.71/5 vs 4.67/5) also revealed no significant difference. Fidelity domains showed no significant difference for perceived physical (D&D 4.13/5 vs Prop 4.03/5), emotional (3.82/5 vs 4.07/5), or conceptual realism (4.54/5 vs 4.55/5). Self-efficacy for clinical and teamwork competency showed no significant difference for perceived clinical competency post-simulation (D&D 4.23/5 vs Prop 4.27/5) or for teamwork competency post-simulation (4.32/5 vs 4.35/5).

Conclusion

D&D SIM is a well-received, low-cost SIM option that is perceived to provide adequate realism and improves participants’ self-efficacy in clinical and teamwork competencies, as compared to a medium-physical-fidelity simulation.

D&D SIM versus Theatre-Based SIM

Title

Draw & Doodle Simulation versus Theatre-Based Simulation to prepare medical students for acute care scenarios at electronic dance music festivals

Authors

Anthony Seto BHSc(Hons) MD CCFP(EM)

Connor Hass BSc(Hons)

Ali Bayrouti BN RN

Makayla Skrlac BSc BHPE

Leo Ochieng BN

Melissa Monaghan BSc

Liam Montgomery BSc(Hons) MESc

Ella Krane BSc(Hons)

David Lam BSc

Background

Medical students help manage emergencies at electronic dance music (EDM) festivals. In-situ simulations prepare students for these acute situations. With limited on-site resources, low-tech simulations are ideal for convenient setup/take-down. The effectiveness and realism of "Draw & Doodle Simulation" (D&D SIM), our innovative low-tech simulation strategy, compared to higher-tech, theatre-based simulation is unknown.

Summary of Work 

This study compared D&D SIM and “Theatre-Based Simulation” (TB SIM) in training medical students for EDM festival emergencies.

Randomized to D&D or TB SIM, students completed a “training” simulation (anaphylaxis). Next, students attended a "Cognitive Inference" (CI) session, answering Jeopardy-style medical questions. Finally, students completed a complex "testing" TB SIM (cocaine toxicity). The CI session's purpose was challenging retention of knowledge/skills from initial “training”.

D&D SIM facilitators used drawings to progress cases; students doodled interventions. TB SIMs employed high-fidelity manikins within simulation suites. Surveys on educational quality, realism, and self-efficacy were completed after “training” simulations. Students and facilitators marked team performance after "testing" simulations.

Summary of Results

Student ratings showed no significant difference (p=0.17) between D&D (4.00/5, n=29) and TB SIM (4.29/5, n=35). Realism scores showed no significant differences (p=0.30, 0.12, 0.89) for physical (D&D 3.90/5 vs TB 4.04/5), emotional (3.78/5 vs 4.04/5), or conceptual realism (4.41/5 vs 4.43/5). Self-efficacy in medical and teamwork competency increased for D&D (medical +17%, teamwork +15%) and TB SIM (medical +24%, teamwork +21%) without significant differences between groups (medical p=0.17; teamwork p=0.12).

Student-rated team performance scores in “testing” simulations were similar for D&D-trained (75%, n=24) and TB-trained (78%, n=30) (p=0.40). Facilitator ratings favoured D&D-trained over TB-trained (71% vs 62%, n=6/group), but were not significant (p=0.18).

Discussion and Conclusion

D&D SIM appears non-inferior to TB SIM in student ratings, perceived realism, and boosting self-efficacy in medical and teamwork competency. D&D and TB-trained teams performed well (75%+) in "testing" simulations, even after CI, suggesting D&D is similarly effective for performance in new scenarios. Facilitator ratings imply D&D-training may outperform TB-training; however, small sample sizes limit this finding.

Take-home Message(s)

The low-tech D&D SIM is comparable to TB SIM in perceived realism, self-efficacy, and performance assessments.