A Randomized Controlled Trial on Teaching the Safe Handling of Firearms Using a Simulation-Based Assessment

Jake Hoyne; Jennifer Yee; Charles Lei; Anne V Grossestreuer; Simiao Li-Sauerwine; William Burns; Nate Olson; Matthew Pirotte; Nicole Dubosh; Andrew R Ketterer

doi:10.1097/SIH.0000000000000829

A Randomized Controlled Trial on Teaching the Safe Handling of Firearms Using a Simulation-Based Assessment

Simul Healthc. 2024 Oct 22. doi: 10.1097/SIH.0000000000000829. Online ahead of print.

Authors

Jake Hoyne¹, Jennifer Yee, Charles Lei, Anne V Grossestreuer, Simiao Li-Sauerwine, William Burns, Nate Olson, Matthew Pirotte, Nicole Dubosh, Andrew R Ketterer

Affiliation

¹ From the Department of Emergency Medicine (J.K., A.V.G., N.D.), Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA; Department of Emergency Medicine (J.Y., S.L.-S.), The Ohio State University, Columbus, OH; Department of Emergency Medicine (C.L., M.P.), Vanderbilt University Medical Center, Nashville, TN; BerbeeWalsh Department of Emergency Medicine (W.B.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Medicine (N.O.), Section of Emergency Medicine, University of Chicago, Chicago, IL; and Department of Emergency Medicine (A.R.K.), Northwestern University Feinberg School of Medicine, Chicago, IL.

PMID: 39432464
DOI: 10.1097/SIH.0000000000000829

Abstract

Introduction: Emergency providers risk encountering firearms in the emergency department, but a minority report familiarity with handling firearms. It may be unsafe if unfamiliar, untrained providers attempt to remove a firearm from the clinical care space. This study assessed the efficacy of an educational intervention training resident physicians in this task.

Methods: Five emergency medicine residency programs conducted a prospective, single-blinded randomized controlled trial assessing performance of safely removing a firearm from the clinical care space during a simulated patient encounter. The primary outcome was completion of critical actions previously assessed in a pilot study. Residents viewed a 5-minute educational video developed for this study detailing the principles of safely removing a firearm from the clinical care space. The training video was emailed to prospective participants in the intervention group ahead of the simulation session. Afterward, a debriefing session was held with all participants to review the safe handling of firearms.

Results: Sixty-six of 170 prospective participants (38.8%) consented to participate. There were no significant differences in gender, clinical training level, environment of upbringing, confidence in handling firearms, firearm usage frequency, or prior firearm training. Twenty-nine participants handled the firearm during simulation. The intervention group performed significantly better than the control group, completing a median of 7 critical actions (interquartile range, 7-8) versus 6 critical actions (interquartile range, 5-7), P = 0.035. This effect held among participants who handle firearms outside of work and/or have prior firearms training.

Conclusions: This study demonstrates how a brief educational intervention was associated with improvement in participants' ability to safely remove a firearm from a simulated clinical care space. This approach can be integrated into existing curricula, and its success suggests broad applicability.