Simulation-based evaluation of emergency medicine residents' preparedness for toxic terrorism.
8 affiliations
- 1Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon-Türkiye.
- 2Department 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.
- 3Department of Emergency Medicine, Faculty of Medicine, Trabzon University, Trabzon-Türkiye.
- 4Department of Medical Education, Karadeniz Technical University Faculty of Medicine, Trabzon-Türkiye.
- 5Department of Emergency Medicine Division of Medical Toxicology, Emory University School of Medicine, Atlanta-USA.
- 6Medical Education and Training Simulation Center, Karadeniz Technical University.
- 7Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon-Türkiye; PHCC Leabaib Health Center-Qatar.
- 8Department of Emergency Medicine, Istanbul Medipol University, İstanbul-Türkiye.
Abstract
Background
Toxic 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
Emergency 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
Although 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
These 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.
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BibTeX
@article{sahin2026simulationbased,
title = {{Simulation-based evaluation of emergency medicine residents' preparedness for toxic terrorism.}},
author = {Abdul Samet Sahin and Aynur Sahin and Vildan Ozer and Ozgen Gonenc Cekic and Selçuk Akturan and Bilge Delibalta and Emily Kiernan and Ebru Turhal and Sinan Pasli and Yunus Karaca and Melih Imamoglu and Ozgur Tatli and Semih Korkut},
journal = {Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma \& emergency surgery : TJTES},
year = {2026},
month = oct,
doi = {10.14744/tjtes.2026.63739},
url = {https://europepmc.org/article/MED/42841895},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Simulation-based evaluation of emergency medicine residents' preparedness for toxic terrorism.
AU - Abdul Samet Sahin
AU - Aynur Sahin
AU - Vildan Ozer
AU - Ozgen Gonenc Cekic
AU - Selçuk Akturan
AU - Bilge Delibalta
AU - Emily Kiernan
AU - Ebru Turhal
AU - Sinan Pasli
AU - Yunus Karaca
AU - Melih Imamoglu
AU - Ozgur Tatli
AU - Semih Korkut
PY - 2026
DA - 2026/10/01
JO - Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
DO - 10.14744/tjtes.2026.63739
UR - https://europepmc.org/article/MED/42841895
AB - Background Toxic 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 Emergency 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 Although 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 These 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.
SN - 1306-696X
SN - 1307-7945
ER -