Game-Based EMS Training Delivers Results
People like playing games. Could training EMS personnel using a game-based method deliver positive results? According to a recent study, the answer is yes.
Specifically, this type of training is being used to train EMS personnel on a specific method of working a scene. Published in the International Journal of Emergency Medicine as “The pit crew card game: a novel gamification exercise to improve EMS performance in critical care scenarios,” the study used a card game to teach the “Pit Crew Approach” to 96 EMS personnel from the Osceola County Fire Department and the Kissimmee Fire Department in Florida. A post-session survey revealed 84% of respondents preferred the game-based approach to traditional lecture-based learning.
“77% agreed that the game improved their understanding of how to utilize the pit crew approach for critical care scenarios and that it was an effective teaching, teamwork, and communication tool,” the study reported.
Dr. Ayanna Walker is one of the study’s co-authors. She is the chief medical officer and system medical director for St. Cloud Fire Rescue and Kissimmee Fire Department. Walker is also the EMS Fellowship Program Director for the UCF/HCA Florida EMS Fellowship Program as well as an Associate Professor of Emergency Medicine and Core Faculty for the UCF/HCA Florida Healthcare (Greater Orlando/Osceola) Emergency Medicine Residency Program.
EMS World recently spoke with Dr. Walker to learn more about game-based EMS training.
EMS World: Please tell us about your gamified approach to EMS training. What did it take to make it work?
Walker: This was a pretty involved design. Rather than taking an already established game such as Charades, Taboo, or Jeopardy, we decided to create a game from scratch.
At the time, we wanted to teach our EMS personnel the pit crew approach to care. Rather than presenting a lecture, we wanted them to get some hands-on experience.
This could certainly be done by simulation alone. However, we also wanted the game to prove to them that the pit crew design made for a better experience in terms of team dynamics. It’s one thing for us to tell them it works; it’s another thing for them to see it works.
EMS World: Please walk us through your game-based approach. How did it work?
Walker: For this particular design, we presented a verbal scenario to the lead paramedic and had them verbalize how they would manage the patient. For each task they verbalized correctly, we gave them a “game card” with the task on it. Their objective was to delegate the task to a crew member based on their scope of practice. This reinforced the concept of a team lead and allowed them practice with delegation. We were less focused on the actual management of the patient and more interested in focusing on the team approach and delegation.
After the scenario was completed, we compared their delegation to the “ideal” delegation. The “ideal” delegation was defined by a group of EMS physicians and EMS training lieutenants. Points were awarded for the number of task cards teams received. Based on this ideal delegation, we then had the EMS crew practice a simulation of a similar case with these tasks already assigned.
Our goal was to show them that if tasks were delegated prior to the patient encounter, team dynamics would be optimized, leading to better patient care, which could translate to better outcomes. Each session lasted one hour, and we rotated all our stations and crews through this activity at a central training site.
This was one of the first times we strategically implemented gamification into our EMS training. With this in mind, we designed a survey to assess their satisfaction with this approach compared to traditional learning. To make for a slightly more robust design we also included a post-test to assess their understanding of the pit crew approach for critical scenarios.
In research we always want to know how our concepts translate to patient care. This particular study was not designed for this but it's certainly something we would want to evaluate in the future.
EMS World: What were the key results you observed by using a gamified approach in this educational setting?
Walker: We noticed right away that many more of our EMS personnel were engaged in this type of learning. The majority, if not all, participated. What they seem to like most, is finding out how other teams did in comparison to their team. They like the idea of having stations/crews compete against each other.
Objectively, based on the survey, 77% of participants agreed that being delegated a task in the card game made patient management easier. 88% of them found it easier to understand their role. The majority (81%) also found that using the pit crew approach decreased the chances of missing important tasks. Overall, the card game was highly favored with 84% indicating they preferred a game to traditional learning.
EMS World: What are the potential implications of your findings for EMS personnel training?
Walker: There seems to be an increasing need for non-traditional learning modalities given the non-traditional environment of EMS and the newer generation of learnings. The newer generation of learners seem to engage in interactive educational strategies such as small group sessions, gamification, and simulation.
In the prehospital setting, ongoing training is needed and much of this must be completed while actively on duty. Therefore, curriculums of short duration are necessary. There is also a need for a more team-based curriculum and an adaptation of traditional methods in adverse environments.
EMS World: Are there any future gamification studies or initiatives that your department is currently planning?
Walker: Since this study, our department has heavily integrated gamification into our routine training. Examples include a pediatric Jeopardy, a medical capacity relay race, a trauma escape room, an airway preparedness game, a pediatric matching board game, and a transport destination board game.
EMS World: What has been the general reaction from the EMS community to your research and its outcomes?
Walker: It doesn’t come as a surprise to the EMS community that this subset of learners enjoy the competitive aspect. There is a general interest in applying that mindset and motivation to EMS training and to things that are required but require much more motivation, such as documentation and viewing online learning modules.
EMS World: Do you anticipate gamification having an increasingly significant role in EMS education in the future?
Walker: Yes, but perhaps only using certain elements of it. For example, this game was very involved and took a lot of planning. Our team had a background of EMS education, simulation, and medical education. Every system may not have access to instructors with these backgrounds. With that, gamification can still be a part of the curriculum. Taking small elements such as simply awarding points/prizes or using a pre-existing game concept are great alternatives.
In many cases, the duration of the session has to be short, as many agencies will need to complete the training while on shift. Limited time due to the need to be out of service, while other EMS personnel run calls, makes gamification an ideal approach.
