Sammeln oder Simulieren? Eine vergleichende Evaluation zwischen Einsatzbegleitung und Einsatzsimulationen unter Teilnehmenden an NaSim25-Kursen

The qualification as an emergency physician requires practical training under supervision covering at least 50 prehospital emergency missions. Since their implementation, NaSim25 (Notarzt-Simulationskurs) courses have been recognized as an equivalent for 25 of 50 supervised missions by all German medical councils.

This survey-based study compares experience of participants from real emergency missions with simulated emergency missions, as well as the participants’ self-assessment (Likert scale 1–6), and exemplary knowledge (point score) before and after course participation at five German course centers. Primary outcome parameters of the comparative criteria were the severity of the emergency (National Advisory Committee for Aeronautics [NACA] score), time invested (minutes), as well as observed and performed emergency medical skills (type and quantity).

A total of 141 matched pre- and postsurveys were included in the study. Before participating in the course, participants had already completed an average of 23 prehospital emergency missions, investing a mean time of 3.2 h (standard deviation ± 2.4 h) per mission. In all, 16% of the real missions were rated with a NACA score ≥4, and overall, (invasive) medical measures were more frequently observed than performed. The (self-)evaluations showed a significant increase: participants felt better prepared for their tasks as emergency physicians and simulation was recognized as a valuable substitute for practical experience more often.

Simulated emergency missions are more time-efficient compared to supervised real emergency missions. The self-evaluation was positively reinforced through simulation, leading also to increased confidence and knowledge. Nevertheless, practical internships should not be completely replaced.