Audience: This session is intended for first- and second-year medical students, or any pre-clinical medical students.
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Introduction: Preclinical learners build skills and confidence when they practice first responder tasks early in training, and simulation helps them to perform basic procedures better.1,2 A small group case competition uses a game format to reinforce rapid assessment, clear team roles, and closed-loop communication.3,4
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Out-of-hospital cardiac arrest affects hundreds of thousands of people in the United States each year, and survival to discharge is low. Bystander cardiopulmonary resuscitation (CPR) and early use of an automated external defibrillator (AED) improve outcomes.5,6 Anaphylaxis is a time-sensitive emergency seen in the community and in the emergency department (ED). Epinephrine is the first-line treatment, and delay to administration worsens outcomes.7,8 Opioid overdose remains a major cause of preventable death. Early recognition, respiratory support, and Naloxone administration are key steps.9
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Educational Objectives: By the end of this activity, learners will be able to: 1) demonstrate the application of skills in real-life first responder scenarios, including suspected opioid overdose, cardiac arrest, and anaphylaxis; 2) apply knowledge of scene safety and the role of the first responder in various situations; and 3) assess the challenges while applying the skills necessary for collaborative work within a medical team.
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Educational Methods: A competition combining simulation-based and team-based learning reinforced first responder skills among first- and second-year medical students. Attending physicians evaluated simulated out-of-hospital emergency scenarios using a detailed rubric. This method was chosen to engage learners in a lower-stakes (but still simulated high-pressure) assessment of their skills where undifferentiated patients challenge recall and application in new, previously unknown scenarios.
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This format was chosen to keep preclinical students active and focused while they practice time-critical first responder skills. Simulation allows decision-making, hands-on actions, and immediate feedback in a safe setting. Team-based learning mirrors ED teamwork by assigning clear roles, prompting closed-loop communication, and requiring shared problem-solving. Station design supports repeated practice and brief debriefs, which builds retention and confidence for early learners. Faculty-scored rubrics provide observable, standardized performance measures and make feedback specific and actionable.
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Research Methods: Pre- and post-intervention surveys assessed the effectiveness of the case competition featuring three simulation scenarios in improving students' confidence in managing emergency situations.
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Results: The competition increased participants' confidence in responding to various scenarios, particularly opioid overdoses. Most participants expressed high likelihood of participating in future competitions. Ten preclinical students completed pre- and post-session surveys. Confidence increased across the cohort. For the opioid overdose scenario, “complete confidence” rose from 1/10 (10%) pre- to 6/10 (60%) post. Confidence in cardiac arrest and anaphylaxis also trended upward. Likelihood to respond to a public emergency changed minimally. Interest in future events was high, with 6/10 (60%) extremely likely and 4/10 (40%) somewhat likely to participate again.
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Discussion: The competition successfully increased confidence and fostered collaboration but faced recruitment challenges due to its optional nature and scheduling. Future implementations could include more advanced learners.
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","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\n\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"First Aid"},{"word":"first responder"},{"word":"Competition"},{"word":"pre-clinical"}],"section":"Small Groups","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5zb9155n","frozenauthors":[{"first_name":"Harrison","middle_name":"","last_name":"Fillmore","name_suffix":"","institution":"Columbia University Vagelos College of Physicians and Surgeons","department":"Department of Emergency Medicine"},{"first_name":"Thomas","middle_name":"","last_name":"Heisler","name_suffix":"","institution":"Columbia University Vagelos College of Physicians and Surgeons","department":"Department of Emergency Medicine"},{"first_name":"Marissa","middle_name":"","last_name":"Nadeau","name_suffix":"","institution":"Columbia University Irving Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Emmagene","middle_name":"","last_name":"Worley","name_suffix":"","institution":"Columbia University Irving Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Lauren","middle_name":"M.","last_name":"Titone","name_suffix":"","institution":"Columbia University Irving Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Tiffany","middle_name":"","last_name":"Murano","name_suffix":"","institution":"Columbia University Irving Medical Center","department":"Department of Emergency Medicine"},{"first_name":"Jimmy","middle_name":"","last_name":"Truong","name_suffix":"","institution":"Columbia University Irving Medical Center","department":"Department of Emergency Medicine"}],"date_submitted":"2024-09-01T23:09:53+06:00","date_accepted":"2026-01-09T01:57:29.602000+06:00","date_published":"2026-01-31T19:20:00+06:00","render_galley":{"label":"Fillmore H, et al. Pre-Clinical Case Competition to Assess Confidence in Responding to Select Out-Of-Hospital Medical Emergencies. JETem 2026. 11(1)SG29-58","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52198/galley/48064/download/"},"galleys":[{"label":"Fillmore H, et al. Pre-Clinical Case Competition to Assess Confidence in Responding to Select Out-Of-Hospital Medical Emergencies. JETem 2026. 11(1)SG29-58","type":"pdf","path":"https://journalpub.escholarship.org/uciem_jetem/article/52198/galley/48064/download/"}]}