Table 1 Definitions for items common to all cases. Vital signs were provided by a monitor that gave pulse oximetry, heart rate, respiratory rate and blood pressure. As the monitor does not provide temperature, this was scored as a separate task
Item | Definition for task completion |
|---|---|
Resuscitation Code status | Any discussion with the patient or nurse about whether the patient wants CPR and/or intubation |
Primary assessment: Airway | Explicitly addresses any of the following: Airway compromise, stridor, wheezing; Alternatively may say something like: “adequate airway”, etc. |
Primary assessment: Breathing | Explicitly addresses any of the following: Poor air entry, Crackles, Work of Breathing; Alternatively may say something like: “apparently no breathing problems”, or ask for/do lung auscultation etc. |
Primary assessment: Cardiac | Explicitly addresses any of the following: ECG monitor, pulse status, mottling; Alternatively may ask for “cardiac monitoring”, or say something such as: “intact circulation”, etc. |
Primary assessment: Disability | Explicitly addresses any of the following): Level of consciousness (AVPU: Awake, verbal responsive, pain responsive, unresponsive), seizures, focal deficits; Alternatively may say something like: “apparently awake and oriented/ unresponsive”, etc. |
Primary assessment: Exposure | Explicitly addresses any of the following): Abdominal distension, overt bleeding, skin abnormalities evaluation (rash, wound, Jaundice, Sc. emphysema, edema) |
Check vital signs | Asks for vital signs |
Check temperature | Asks for temperature; Alternatively may ask for fever or if the patient feels hot/cold etc. |
Review past medical history | Asking for past medical history/previous diagnoses to the mannequin or nursing personnel |
Review medications | Asking for home medications to the mannequin or nursing personnel |
Review allergies | Asking for known drug allergies to the mannequin or nursing personnel |
Review differential diagnosis | Considers and verbalizes at least one alternative diagnosis different from the (apparent) working hypothesis |
Order labs | Ordering any lab tests (including point-of-care labs) |
Order oxygen | Verbalizes consideration of the need of or ordering supplemental oxygen (any FiO2, any device) |