Opioid Overdose Simulation in Medical Student Education
Correspondence should be addressed to James Mangano, DO at manganoj@upstate.edu
DOI: https://doi.org/10.5070/M5.52230
ABSTRACT:
Audience: The target audience for this simulation is third-year medical students, specifically those in an emergency medicine clerkship.
Introduction: This topic is critically important in emergency medicine due to the ongoing opioid epidemic, which has led to a dramatic rise in overdose cases and deaths across the United States. Overdose deaths involving opioids numbered nearly 50,000 in 2019, a nearly six-fold increase since 1999.1 Over 70% of drug overdose deaths in 2019 involved opioids. Emergency department visits for opioid overdoses rose 30% from 2016 to 2017 in all parts of the United States. 2Emergency departments often serve as the front line in treating opioid overdoses, where rapid recognition and timely administration of Naloxone can be lifesaving. Training medical students to recognize and manage opioid overdoses is essential to prepare them for real-world scenarios, ensuring they are equipped with the skills and confidence to respond effectively in emergencies. Educating future healthcare providers on this topic could ultimately reduce opioid-related mortality and improve patient outcomes in these high-stakes situations.
Educational Objectives: By the end of the simulation session, learners will be able to: 1) accurately identify the three key clinical signs of opioid overdose (respiratory depression, pinpoint pupils, unresponsiveness), 2) identify and administer the correct dose and route of Naloxone within five minutes of recognizing an opioid overdose, 3) perform at least two basic life support (BLS) interventions, such as airway management and bag-valve mask ventilation, 4) communicate effectively with team members by providing clear instructions and patient status updates at least three times during the simulation.
Educational Methods: In this study, high-fidelity simulation was implemented by creating a patient scenario of an opioid overdose, where students were required to recognize the symptoms and administer appropriate treatment, specifically Naloxone. The simulation was a component of the third-year emergency medicine clerkship curriculum.
Research Methods: Learners completed pre- and post-simulation surveys assessing confidence in recognizing and managing opioid overdose, administering Naloxone, and performing airway interventions. The surveys used 5-point Likert scales to evaluate perceived competence and simulation effectiveness.
Results: The simulation significantly improved learners’ confidence and knowledge in recognizing, managing, and treating opioid overdoses. Post-simulation surveys demonstrated marked gains across all domains of assessment, confirming the educational effectiveness of the scenario.
Discussion: Overall, the educational content was highly effective. The significant increase in students’ confidence and knowledge regarding the recognition and treatment of opioid overdoses demonstrates that the hands-on, high-fidelity simulation successfully met its objectives. By immersing students in a realistic scenario and allowing them to practice administering Naloxone, the simulation prepared them to handle real-life cases with greater confidence and competence.
From its implementation, we learned that simulation-based education is a powerful tool for teaching critical skills in emergency medicine, particularly for life-threatening situations like opioid overdose. The overwhelmingly positive feedback from students further reinforced that they found the simulation valuable and informative.
Topics: Opioid overdose recognition and treatment, emergency medicine education, high-fidelity simulation, Naloxone administration, recognition of overdose symptoms, treatment of opioid overdose, clinical confidence, patient-simulated experience, opioid epidemic, mu-opioid receptor antagonism, knowledge and confidence assessed via pre- and post-simulation surveys.
