Outcome of triage results between two groups of interns subjected to different model of simulation


  • Jeevan Pereira Department of Orthopaedics, Yenepoya Medical College, Deralakatte, Mangalore, Karnataka, India
  • Aswini Dutt Raghavendra Department of Physiology, Yenepoya Medical College, Deralakatte, Mangalore, Karnataka, India
  • Eknath Jayapalan Department of Orthopaedics, Kanachur Institute of Medical Sciences, Mangalore, Karnataka, India




Triage, Simulation, Emergency, Interns


Background: In the emergency department, triaging is a very important for mass casualties and should not lead to any errors while doing so. In spite of subjecting interns to triaging theory classes in their final year of MBBS, they are not confident in triaging when need comes. To address this, we designed this study which aims at understanding the efficacy and type of triage based simulation education for medical interns during their 1 year internship programme.

Methods: A cross sectional study with 186 intern students of a Yenepoya Medical College Hospital of Karnataka was selected for the triage simulation. The interns who could attend the entire programme were randomly divided into 2 groups of n=91 each. One group underwent desktop based triage simulation (n1=91) and the other group faced enacted patient based triage simulation training followed by test. Evaluation comprised of tests to 2 groups of interns. The first group were subjected to test following desktop triage simulation and the second group were subjected to test following enacted patient simulation based triaging.

Results: The test result showed that there was significant improvement in the result obtained from the group that underwent high fidelity simulation (p<0.05).

Conclusions: Simulation based training which is closed to reality leads to a significant increase in learning and recalling output compared to the traditional method.


Deering S, Auguste T, Lockrow E. Obstetric simulation for medical student, resident, and fellow education. Semin Perinatol. 2013;37(3):143–5.

Norman G, Dore K, Grierson L. The minimal relationship between simulation fidelity and transfer of learning. Med Educ. 2012;46(7):636–47.

Alessi SM. Fidelity in the design of instructional simulations. J Comput-Based Ins. 1988;15:40–7.

Justice J, Gossman WG. EMS Reverse Triage. Treasure Island (FL): Stat Pearls Publishing; 2018.

Ryan K, George D, Liu J, Mitchell P, Nelson K, Kue R. The Use of Field Triage in Disaster and Mass Casualty Incidents: A Survey of Current Practices by EMS Personnel. Prehosp Emerg Care. 2018;22(4):520-6.

Hoff JJ, Carroll G, Hong R. Presence of undertriage and overtriage in simple triage and rapid treatment. Am J Disaster Med. 2017;12(3):147-54.

Shartar SE, Moore BL, Wood LM. Developing a Mass Casualty Surge Capacity Protocol for Emergency Medical Services to Use for Patient Distribution. South. Med. J. 2017;110(12):792-5.

Benson M, Koenig KL, Schultz CH. Disaster triage: START, then SAVE-a new method of dynamic triage for victims of a catastrophic earthquake. Prehospital Disaster Med. 1996;11(2):117-24.

Kolb DA. Experiential learning: experience as the source of learning and development. 2nd ed. Saddle River: Pearson Education; 2015.

Kolb DA. Management and the learning process. Calif Manag Rev. 1976;18(3):21–31.

Kolb DA. Experiential learning. Englewood Cliffs: Prentice-Hall; 1984.

Dreyfus SE, Dreyfus HL. A five-stage model of the mental activities involved in directed skill acquisition. Berkeley: DTIC Document; 1980.

Dreyfus SE. The five-stage model of adult skill acquisition. Bull SciTechnol Soc. 2004;24(3):177–81.

Ericsson KA. The influence of experience and deliberate practice on the development of superior expert performance. In: Ericsson KA, Charness N, Feltovich PJ, Hoffman RR, editors. The Cambridge handbook of expertise and expert performance. Cambridge: Cambridge University Press; 2006: 683–704.

Iputo JE, Kwizera E. Problem‐based learning improves the academic performance of medical students in South Africa. Med Educ. 2005;39(4):388-93.

McLaughlin SA, Doezema D, Sklar DP. Human simulation in emergency medicine training: a model curriculum. Acad Emerg Med. 2002;9:1310–18.

Binstadt ES, Walls RM, White BA. A comprehensive medical simulation education curriculum for emergency medicine residents. Ann Emerg Med. 2007;49:495–507.

Small SD, Wuerz RC, Simon R. Demonstration of high-fidelity simulation team training for emer- gency medicine. Acad Emerg Med. 1999;6:312–23.

Van Merrienboer JJG, Sweller J. Cognitive load theory and complex learning: recent developments and future directions. Educ Psychol Rev. 2005;17(2):147–77.

Reedy GB. Using cognitive load theory to inform simulation design and practice. Clin Simul Nurs. 2015;11(8):355–60.






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