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216 Evaluation of the use of tele-sim in the examination setting for final year emergency medicine residents in India
  1. Shweta Gidwani1,
  2. Tania Ahluwalia2,
  3. Katherine Douglass3
  1. 1Chelsea and Westminster NHS Trust
  2. 2Children’s National Hospital, Washington D.C., USA
  3. 3George Washington University, Washington D.C., USA


Aims/Objectives/Background Travel restrictions during this Covid-19 pandemic created a barrier to bringing external examiners to conduct simulation assessments, a crucial component of emergency medicine examinations in India. Indefinite postponement would prevent several final year trainees from progressing and would have added to their stress and frustration during an already challenging time.

We conducted these evaluation via tele-simulation and sought to evaluate the feasibility and effectiveness of tele-simulation as tool for assessing the management of critically ill or injured patients by emergency medicine (EM) trainees. Our secondary outcome was a survey evaluating the attitudes and perceptions of fairness of this remote simulation modality for both faculty and trainees.

Methods/Design 104 residents from 14 separate hospitals across India were evaluated in pairs by a local facilitator and a remote examiner via Zoom. There were 14 local facilitators and 10 remote examiners based in the US, UK and India. All residents examined were given the same simulation case he examination over the course of 7 hours. Real time online structured evaluation forms were completed by both evaluators and each candidate was discussed after every pair to agree a pass/fail grade. The external examiners were blinded to the students overall 3 year performance, theory and thesis results. The tele-simulation evaluation was triangulated with the final examination theory and thesis exam grades and overall clinical performance and feedback over 3 yrs from their local supervisor. We surveyed local faculty, remote examiners and trainees.

Results/Conclusions 52 paired tele-simulation examinations were conducted by 24 local and remote examiners from India, United Kingdom and USA over 7 hours. Of the 14 candidates who failed, their tele-simulation grades correlated with overall performance. The interim data analysis of the survey results show that 96.7% thought the exam was fair Tele-simulation is a feasible and effective way to evaluate EM trainees.

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