Adequate emergency department resource usage Applying simulation-based workshop to improve teaching competence among elementary and junior high school teachers in Taiwan

Introduction: More than 80% of patients who visited Emergency Department (ED) was not urgent in Taiwan in 2019. It causes insufficient medical services and a latent fiscal threat to the Nation Health Insurance (NHI). This study adopted simulation-based educating modules to explore the effect in teaching competence among primary and middle school teachers for efficient AEDRU (adequate emergency department resource usage) education in the future. Method: The subjects were 414 elementary and junior high school teachers in Taiwan. 214 participants attended the simulationbased workshop as the simulation-based group, whereas 200 participants took an online self-learning module as the self-learning group. The workshop was created by an expert panel for decreasing the unnecessary usage amount of ED medial resources. The materials are lecture, board games, miniature ED modules, and simulation-based scenarios. A teaching competence questionnaire including ED knowledge, teaching attitude, teaching skills, and teaching self-efficacy was conducted among participants before and after the intervention. Data were analyzed via McNemar, paired t test and the generalized estimating equations (GEE). Results: The study showed that teachers who participated in the simulation-based workshop had improved more in teaching competence than those who received the online self-learning module. In addition, there were significant differences between the pretest and post-Test among the two groups in teaching competence. Conclusion: The simulation-based workshop is effective and it should be spread out. When students know how to use ED medical resources properly, they could affect their families. It can help the ED service to be used properly and benefits the finance of the NHI. The health care cost will be managed while also improving health. Abbreviations: AEDRU = adequate emergency department resource usage, ED = Emergency Department, GDP = Gross Domestic Product, GEE = the generalized estimating equations, KAP = Knowledge, attitude, and practice, NHI = the National Health Insurance program, OPD = Outpatient.