C56-06 Rapid Response and Code Simulation Education for Internal Medicine Interns

Abstract Rationale Effective management of rapid response and code situations is critical in early internal medicine training, yet real-world codes are unpredictable, chaotic, and offer limited opportunities for structured teaching. Simulation-based education provides a controlled, reproducible environment for deliberate practice, standardized evaluation, and immediate feedback. We hypothesized that structured simulation training would significantly improve interns’ performance in managing rapid deterioration scenarios and their confidence as team leaders. Methods We conducted a prospective educational study during Spring-Summer 2025 at the Simulation Center involving all first-year categorical internal medicine residents (n = 31). Each resident completed a pre-intervention questionnaire assessing basic critical care and ACLS (Advanced Cardiovascular Life Support) knowledge. During the simulation sessions, each resident was then presented with a unique patient presentation with real-time vitals and labs in response to their medical management and were required to respond accordingly as the primary caretaker. Performance was evaluated using an OSCE (Objective Structured Clinical Examination)-based checklist aligned with ACLS and rapid response best practices, encompassing initial patient assessment, prioritization, key interventions, communication, and leadership. Following this, residents participated in a structured facilitated debrief plus a targeted didactic session on rapid response and code management. Subsequently, each resident was asked to complete a post-intervention questionnaire, which was identical to their pre-intervention questionnaire, to assess knowledge acquisition. Results Post-intervention questionnaires demonstrated an improved average performance of 12.3% per question when compared to the resident pre-intervention responses. Notable improvements were seen with proper identification and definitions pertaining to sepsis and its initial management (+34.9% and +28.2% on repeat questions, respectively). The smallest improvements were seen with identification and management of obstructive shock (+5.2 and +4.1%), however these questions had high baseline scores of 83% and 90% correct, respectively. Notably there was a decrease in correct responses from 76.6% to 70.5% regarding NIV (Non-Invasive Ventilator) management (Table 1). The main limitation of this study was the attrition bias as post-intervention questionnaire had 17 responses while the pre-intervention questionnaire had 30. Conclusions Simulation-based rapid response training significantly enhances both objective performance and confidence among first-year internal medicine residents. Integration of structured simulation and debriefing into early residency curricula holds promise for strengthening resuscitation preparedness and patient safety. This abstract is funded by: None