IS THERE A DOCTOR IN THE HOUSE? Chris Miller, MICP Kendrick Davis, PhD Paul Lyons, MD Maegen Dupper, MD Michael Nduati, MD, MBA, MPH Andrew Alexander, MD

Goals Instruct medical students in basic life saving skills beyond CPR. Introduce CERT (Civilian Emergency Response Team) precepts. Reinforce critical thinking and clinical reasoning skills in an out-of-hospital environment. Create better community healthcare partners. Reduce the participant’s stress in an emergency situation.

Background 1 passenger in 11,000 suffers an in-flight medical emergency.1 The percentage of out-of-hospital births increased from 1.26% of U.S. births in 2011 to 1.36% in 2012, continuing an increase that began in 2004.2 208 pedestrians a day are struck by an automobile, one every 7 minutes.3 1Is There a Doctor on the Aircraft: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119071/pdf/1336.pdf 2CDC NCHS Data Brief No. 144 3National Highway Traffic Safety Administration, Traffic Safety Facts, 2012

Participants

Doctor in the House Topics He’s Been Cut Real Bad “Help, I Think I’m Having My Baby NOW!” Splinting Suspected & Known Fractures “Is There a Doctor Onboard”, Inflight Medical Emergencies CPR & AED Review Patient Emergency Medications – EpiPens, Inhalers, NTG, Glucose Paste “Hurry, He’s Been Hit By a Car!” BLS Trauma Assessment

Doctor in the House Lesson Plan

Lesson Presentation MEDIA ACTIVITY ACIVITY REVIEW TABLE DISCUSSION/PRACTICE SCENARIO PRACTICE EVALUATION

Community Partnerships American Medical Response Cedars Sinai Medical Center Gaumard Scientific National College of Technical Instruction Riverside City Fire Department Riverside Community College Paramedic Academy Riverside County Fire Department

Evaluative Measures An evaluative-assessment was generated and administered following each training workshop Evaluative-assessment measurement components: 3 Self-report items – gauging student’s resulting confidence in their competence (or self-efficacy) 2 Assessment items - assessing student’s ability to demonstrate competence on newly acquired skills

Sample Student Feedback: “This is great practical real world instruction. I hope I never need it.” “I was standing on a street corner and saw a woman in the crosswalk get struck by a car. I felt so helpless and useless. Now, I have the basic skills to handle the same event if it ever occurs to me again.” “I certainly feel better prepared for a medical emergency if it happens in front of me. It’s crazy that this instruction isn’t mandatory in every medical school.” “Since coming to California I’ve heard all this information about disasters and being prepared for them. Now, I know how the system works and how I would fit into it in the event of a real disaster.”

Future plans Integrating the workshops into the curriculum. Staging a mock disaster every two years so students get the benefit of working inside the incident command system with actual fire responders. Placing more media online for viewing before the actual course. Offering the program to other UC Schools of Medicine.

References: Is There a Doctor on the Aircraft: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119071/pdf/1336.pdf CDC NCHS Data Brief No. 144. National Highway Traffic Safety Administration, Traffic Safety Facts, 2012. Perkins GD, Hulme J. Basic life support training for health care students. Resuscitation 1999; 41:19-23. Tan I.S. First aid and basic life support of junior doctors: a prospective study in Nijmegen. Medical Teacher 2006; 28(2):189-192. Nelson M. A first aid and CPR course for first-year medical students. Medical Education 1982; 16:7-11. Das M, Elzubeir M. First aid and basic life support skills training early in the medical curriculum. Teaching and Learning in Medicine 2001; 13(4): 240-246.