{
  "abstract": "Background\n\nToxic terrorism is a rare but potentially catastrophic threat that can result in mass casualties and overwhelm healthcare systems. Effective management of such incidents requires specialized clinical competencies and preparedness that may be underemphasized in standard emergency medicine training. This study aimed to assess emergency medicine residents' competencies in toxic terrorism preparedness and emergency medical management using a structured simulation-based examination.Methods\n\nEmergency medicine residents working in the emergency departments of two tertiary university hospitals in Trabzon participated in a simulation-based clinical assessment. The examination comprised five realistic, fully immersive objective structured clinical examination (OSCE) stations designed to evaluate diagnostic decision-making and treatment planning in toxic terrorism scenarios. Each station was scored using standardized checklists developed by medical toxicologists. Factors associated with improved performance were also examined.Results\n\nAlthough 33.3% of participants successfully passed the botulism scenario (Station 3), no participant successfully completed all five stations. The radiation exposure scenario (Station 2) was the most challenging. Higher performance was significantly associated with having more than 24 months of residency training, prior chemical, biological, radiological, and nuclear (CBRN) training, and previous exposure to simulation-based education.Conclusion\n\nThese findings suggest that current training may not adequately prepare emergency medicine residents to manage toxic terrorism incidents. Incorporating standardized simulation-based assessments, such as OSCEs, into residency curricula may help identify training gaps and improve preparedness for low-frequency, high-impact events.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon-Türkiye.",
    "Department of Emergency Medicine, Medical Toxicology ICU, University of Health Sciences Basaksehir Cam and Sakura City Hospital, Istanbul-Türkiye; Department of Emergency Medicine, Division of Medical Toxicology, Emory University, Atlanta, Georgia-USA.",
    "Department of Emergency Medicine, Faculty of Medicine, Trabzon University, Trabzon-Türkiye.",
    "Department of Medical Education, Karadeniz Technical University Faculty of Medicine, Trabzon-Türkiye.",
    "Department of Emergency Medicine Division of Medical Toxicology, Emory University School of Medicine, Atlanta-USA.",
    "Medical Education and Training Simulation Center, Karadeniz Technical University.",
    "Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon-Türkiye; PHCC Leabaib Health Center-Qatar.",
    "Department of Emergency Medicine, Istanbul Medipol University, İstanbul-Türkiye."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Abdul Samet Sahin"
    },
    {
      "affs": [
        1
      ],
      "name": "Aynur Sahin"
    },
    {
      "affs": [
        0
      ],
      "name": "Vildan Ozer"
    },
    {
      "affs": [
        2
      ],
      "name": "Ozgen Gonenc Cekic"
    },
    {
      "affs": [
        3
      ],
      "name": "Selçuk Akturan"
    },
    {
      "affs": [
        3
      ],
      "name": "Bilge Delibalta"
    },
    {
      "affs": [
        4
      ],
      "name": "Emily Kiernan"
    },
    {
      "affs": [
        5
      ],
      "name": "Ebru Turhal"
    },
    {
      "affs": [
        6
      ],
      "name": "Sinan Pasli"
    },
    {
      "affs": [
        0
      ],
      "name": "Yunus Karaca"
    },
    {
      "affs": [
        0
      ],
      "name": "Melih Imamoglu"
    },
    {
      "affs": [
        0
      ],
      "name": "Ozgur Tatli"
    },
    {
      "affs": [
        7
      ],
      "name": "Semih Korkut"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3b558c7s7w77j.bib",
  "cited_by": 0,
  "doi": "10.14744/tjtes.2026.63739",
  "fulltext_url": "https://europepmc.org/articles/PMC13678142",
  "id": "3b558c7s7w77j",
  "issns": [
    "1306-696X",
    "1307-7945"
  ],
  "landing_url": "https://europepmc.org/article/MED/42841895",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3604|Disaster Response and Management"
    ]
  ],
  "openalex": "W7220716073",
  "pdf_url": "https://europepmc.org/articles/PMC13678142?pdf=render",
  "pmcid": "PMC13678142",
  "pmid": "42841895",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3b558c7s7w77j.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:10Z",
      "native_id": "MED:42841895",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42841895"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Simulation-based evaluation of emergency medicine residents' preparedness for toxic terrorism.",
  "title_text": "Simulation-based evaluation of emergency medicine residents' preparedness for toxic terrorism.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:10Z",
  "url": "https://research.draconitic.com/paper/3b558c7s7w77j",
  "venue": "Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES",
  "versions": []
}