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

AbstractIntroduction: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...

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Published inMedicine (Baltimore) Vol. 100; no. 37; p. e27258
Main Authors Lin, Geng-Shiau, Tseng, Pei-Ling, Chang, Chia-Chen, Yiang, Giou-Teng, Yen, Zui-Shen, Jian, Jang-Wei, Tung, Chen-Yin
Format Journal Article
LanguageEnglish
Published Hagerstown, MD Lippincott Williams & Wilkins 17.09.2021
Subjects
Online AccessGet full text
ISSN0025-7974
1536-5964
1536-5964
DOI10.1097/MD.0000000000027258

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Abstract AbstractIntroduction: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 simulation-based 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 pre-test 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.
AbstractList AbstractIntroduction: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 simulation-based 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 pre-test 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.
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.INTRODUCTIONMore 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.The subjects were 414 elementary and junior high school teachers in Taiwan. 214 participants attended the simulation-based 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).METHODThe subjects were 414 elementary and junior high school teachers in Taiwan. 214 participants attended the simulation-based 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).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 pre-test and post-test among the two groups in teaching competence.RESULTSThe 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 pre-test and post-test among the two groups in teaching competence.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.CONCLUSIONThe 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.
Author Lin, Geng-Shiau
Tseng, Pei-Ling
Yiang, Giou-Teng
Yen, Zui-Shen
Chang, Chia-Chen
Jian, Jang-Wei
Tung, Chen-Yin
AuthorAffiliation d Emergency Medicine Department, Buddhist Tzu Chi General Hospital, New Taipei, Taiwan
b Emergency Medicine Department, Taipei City Hospital, Taipei, Taiwan
e Emergency Medicine Department, National Taiwan University Hospital, Taipei, Taiwan
c Department of Senior Citizen Service Business, College of Human Ecology and Design, St. John's University, New Taipei, Taiwan
a Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan
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Cites_doi 10.1111/hex.12866
10.1353/dss.2008.0096
10.1097/MD.0000000000025982
10.1002/pds.1712
10.1186/1471-227X-11-16
10.1097/MLR.0b013e31826c870f
10.2196/ijmr.4090
10.1016/j.jcomdis.2017.07.002
10.2147/AMEP.S204816
10.1136/emj.20.5.402
10.1111/acem.13220
10.2147/IJWH.S242432
10.1378/chest.07-0131
10.1186/s12936-020-03233-5
10.1016/j.ejvs.2019.06.952
10.1016/j.jacr.2016.07.013
10.2105/AJPH.2015.302908
10.1016/j.healthplace.2019.05.010
10.1016/j.jesf.2019.08.004
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Issue 37
Keywords simulation-based workshop
teaching competence
schoolteachers
adequate emergency department resource usage (AEDRU)
Language English
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This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
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Notes Correspondence: Chen-Yin Tung, Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taipei, Taiwan (e-mail: s09144@ntnu.edu.tw).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.How to cite this article: Lin GS, Tseng PL, Chang CC, Yiang GT, Yen ZS, Jian JW, Tung CY. Adequate emergency department resource usage: applying simulation-based workshop to improve teaching competence among elementary and junior high school teachers in Taiwan. Medicine. 2021;100:37(e27258).Funding received from the first author.Declaration of any potential financial and nonfinancial conflicts of interest: To the best of our knowledge, the named authors have no conflict of interest, financial or otherwise.All data generated or analyzed during this study are included in this published article [and its supplementary information files]; The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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References (R30) 2018; 12
(R21) 2017; 14
SainatoM. "I live on the street now": how Americans fall into medical bankruptcy. The Guardian 2019. Available at https://www.theguardian.com/us-news/2019/nov/14/health-insurance-medical-bankruptcy-debt. Accessed October 26, 2020.
(R34) 2020; 18
(R12) 2017; 24
(R13) 2014; 18
(R18) 2008; 133
(R4) 2011; 11
(R6) 2013; 29
Ministry of Health and Welfare. Taipei: The statistics of the National Health Insurance Program in 2019; 2019, p. 4-18.
(R24) 2014; 2014
(R25) 2016; 106
American Hospital Association, Physician Leadership Forum.Chicago: Appropriate use of medical resources; 2013, p 1-14.
Ningyi. Chinese-style bankruptcy: people stayed in the bottom of socioeconomic condition again due to a serious illness. Sina 2018. Available at http://chinanews.sina.com/bg/chnlocal/phoenixtv/2018-07-09/doc-ivnxtzyu2390810.shtml. Accessed October 26, 2020.
(R37) 2015; 1
(R22) 2020; 74
(R10) 2018; 2
(R3) 2003; 20
(R19) 2015; 19
(R17) 2019; 58
National Health Insurance Administration. Taipei: Progress tracking of the overall effectiveness of medical services; 2020, p. 1-13.
(R36) 2019; 57
(R14) 2008; 75
(R35) 2020; 19
(R5) 2014; 18
(R39) 2021; 100
National Health Insurance Administration, Ministry of Health and Welfare. Taipei: National Health Insurance Annual Statistical Report 2018; 2019, p. 1-30.
(R16) 2015; 4
(R38) 2019; 10
(R33) 2019; 7
(R8) 2012; 50
(R11) 2019; 22
(R20) 2018; 15
(R32) 2020; 12
(R9) 2015; 47
(R23) 2017; 69
(R7) 2009; 18
National Health Insurance Administration. Taipei: 2020-2021 Handbook of Taiwan's National Health Insurance; 2019, p. 6-7.
(R29) 2008; 55
Aacharya (R4-20250504) 2011; 11
Pope (R11-20250504) 2019; 22
Zavaleta (R20-20250504) 2018; 15
Piryani (R38-20250504) 2019; 10
Yang (R16-20250504) 2015; 4
Cliffford A Coleman (R9-20250504) 2015; 47
Temtanakitpaisan (R32-20250504) 2020; 12
Wang (R21-20250504) 2017; 14
Coster (R12-20250504) 2017; 24
Wang (R24-20250504) 2014; 2014
Zeng (R34-20250504) 2020; 18
Nayahangan (R17-20250504) 2019; 58
Jones (R37-20250504) 2015; 1
Chin-Wei (R19-20250504) 2015; 19
Rietveld (R23-20250504) 2017; 69
Chiu (R6-20250504) 2013; 29
Chu (R8-20250504) 2012; 50
Trzeciak (R3-20250504) 2003; 20
Chan (R7-20250504) 2009; 18
Cheng (R5-20250504) 2014; 18
Yin (R33-20250504) 2019; 7
Wayne (R18-20250504) 2008; 133
Moreno-Gutierrez (R35-20250504) 2020; 19
Harris (R36-20250504) 2019; 57
Chang (R30-20250504) 2018; 12
Williams (R29-20250504) 2008; 55
Gonçalves-Bradley (R10-20250504) 2018; 2
Wu (R14-20250504) 2008; 75
Chiang (R13-20250504) 2014; 18
Himmelstein (R25-20250504) 2016; 106
Smith (R22-20250504) 2020; 74
Wang (R39-20250504) 2021; 100
References_xml – volume: 69
  start-page: 44
  year: 2017
  end-page: 57
  ident: R23
  article-title: The paired t test and beyond: recommendations for testing the central tendencies of two paired samples in research on speech, language and hearing pathology
  publication-title: J Commun Disord
– volume: 18
  start-page: 01
  year: 2020
  end-page: 6
  ident: R34
  article-title: Evaluation for the effects of nutritional education on Chinese elite male young soccer players: the application of adjusted dietary balance index (DBI)
  publication-title: J Exerc Sci Fit
– volume: 100
  start-page: e25982
  year: 2021
  ident: R39
  article-title: Exploration of simulation-based medical education for undergraduate students
  publication-title: Medicine
– reference: Ministry of Health and Welfare. Taipei: The statistics of the National Health Insurance Program in 2019; 2019, p. 4-18.
– volume: 18
  start-page: 31
  year: 2014
  end-page: 2
  ident: R13
  article-title: Introduction: looking forward to a better national health insurance
  publication-title: Formosan J Med
– volume: 47
  start-page: 388
  year: 2015
  end-page: 92
  ident: R9
  article-title: A health literacy training intervention for physicians and other health professionals
  publication-title: Fam Med
– reference: National Health Insurance Administration, Ministry of Health and Welfare. Taipei: National Health Insurance Annual Statistical Report 2018; 2019, p. 1-30.
– volume: 18
  start-page: 327
  year: 2009
  end-page: 34
  ident: R7
  article-title: Characteristics of outpatient prescriptions for frail Taiwanese elders with long-term care needs
  publication-title: Pharmacoepidemiol Drug Saf
– volume: 55
  start-page: 13
  year: 2008
  end-page: 7
  ident: R29
  article-title: Health care in Taiwan: why can't the United States learn some lessons?
  publication-title: Dissent
– volume: 19
  start-page: 01
  year: 2020
  end-page: 6
  ident: R35
  article-title: Economic costs analysis of uncomplicated malaria case management in the Peruvian Amazon
  publication-title: Malaria J
– volume: 11
  start-page: 16
  year: 2011
  ident: R4
  article-title: Emergency department triage: an ethical analysis
  publication-title: BMC Emerg Med
– reference: National Health Insurance Administration. Taipei: 2020-2021 Handbook of Taiwan's National Health Insurance; 2019, p. 6-7.
– reference: Ningyi. Chinese-style bankruptcy: people stayed in the bottom of socioeconomic condition again due to a serious illness. Sina 2018. Available at http://chinanews.sina.com/bg/chnlocal/phoenixtv/2018-07-09/doc-ivnxtzyu2390810.shtml. Accessed October 26, 2020.
– volume: 29
  start-page: 16
  year: 2013
  end-page: 21
  ident: R6
  article-title: The experience of healthcare matrix introduce on clinical pharmacy teaching
  publication-title: J Taiwan Pharm
– volume: 12
  start-page: 68
  year: 2018
  end-page: 75
  ident: R30
  article-title: Effectiveness of education in teaching elementary students about the correct use of medication and Taiwan's National Health Insurance
  publication-title: J Healthc Qual
– volume: 2014
  start-page: 01
  year: 2014
  end-page: 11
  ident: R24
  article-title: Generalized estimating equations in longitudinal data analysis: a review and recent developments
  publication-title: Adv Stat
– volume: 7
  start-page: 30
  year: 2019
  ident: R33
  article-title: Social media usage and influenza beliefs, risk perceptions and behavioral intentions among students at a University in Southeastern US
  publication-title: J Georgia Pub Health Assoc
– volume: 1
  start-page: 55
  year: 2015
  end-page: 63
  ident: R37
  article-title: Braghiroli OFM: simulation in medical education: brief history and methodology
  publication-title: Princ Pract Clin Res
– volume: 20
  start-page: 402
  year: 2003
  end-page: 5
  ident: R3
  article-title: Emergency department overcrowding in the United States: an emerging threat to patient safety and public health
  publication-title: Emerg Med J
– volume: 50
  start-page: 1002
  year: 2012
  end-page: 9
  ident: R8
  article-title: Continuity of care, potentially inappropriate medication, and health care outcomes among the elderly: evidence from a longitudinal analysis in Taiwan
  publication-title: Med Care
– volume: 24
  start-page: 1137
  year: 2017
  end-page: 49
  ident: R12
  article-title: Why do people choose emergency and urgent care services? A rapid review utilizing a systematic literature search and narrative synthesis
  publication-title: Acad Emerg Med
– volume: 12
  start-page: 295
  year: 2020
  ident: R32
  article-title: Knowledge, attitude, and practices (KAP) survey towards pelvic floor muscle training (PFMT) among pregnant women
  publication-title: Int J Women's Health
– volume: 133
  start-page: 56
  year: 2008
  end-page: 61
  ident: R18
  article-title: Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case-control study
  publication-title: Chest
– volume: 2
  year: 2018
  ident: R10
  article-title: Primary care professionals providing non-urgent care in hospital emergency departments
  publication-title: Cochrane Database oSystem Rev
– volume: 10
  start-page: 547
  year: 2019
  ident: R38
  article-title: Simulation-based education workshop: perceptions of participants
  publication-title: Adv Med Educ Pract
– volume: 15
  start-page: 01
  year: 2018
  end-page: 7
  ident: R20
  article-title: Improving community resilience through disaster simulation: how simulation-based education augments emergency management exercises
  publication-title: J Homeland Secur Emerg Manage
– volume: 106
  start-page: 56
  year: 2016
  end-page: 7
  ident: R25
  article-title: Public health's falling share of US health spending
  publication-title: Am J Pub Health
– volume: 19
  start-page: 356
  year: 2015
  end-page: 62
  ident: R19
  article-title: Application of medical simulation in clinical skills training
  publication-title: Formosa J Med
– volume: 58
  start-page: e333
  year: 2019
  end-page: 4
  ident: R17
  article-title: Achieving consensus to define curricular content for simulation-based education in vascular surgery: a European-wide needs assessment initiative
  publication-title: Eur J Vasc Endovasc Surg
– volume: 14
  start-page: 103
  year: 2017
  end-page: 10
  ident: R21
  article-title: Comparative effectiveness of hands-on versus computer simulation-based training for contrast media reactions and teamwork skills
  publication-title: J Am Coll Radiol
– volume: 22
  start-page: 435
  year: 2019
  end-page: 43
  ident: R11
  article-title: Navigating and making sense of urgent and emergency care processes and provision
  publication-title: Health Expect
– reference: American Hospital Association, Physician Leadership Forum.Chicago: Appropriate use of medical resources; 2013, p 1-14.
– volume: 4
  start-page: e9
  year: 2015
  ident: R16
  article-title: Web-based and telephone surveys to assess public perception toward the National Health Insurance in Taiwan: a comparison of cost and results
  publication-title: Interact J Med Res
– volume: 57
  start-page: 330
  year: 2019
  end-page: 8
  ident: R36
  article-title: Muddying the waters: a political ecology of mosquito-borne disease in coastal Ecuador
  publication-title: Health Place
– volume: 75
  start-page: 24
  year: 2008
  end-page: 5
  ident: R14
  article-title: People of Taiwan is high satisfaction for promotion and implementation of the national health insurance
  publication-title: Bimonthly Natl Health Insurance
– volume: 18
  start-page: 74
  year: 2014
  end-page: 84
  ident: R5
  article-title: Health care system under National Health Insurance Scheme
  publication-title: Formosan J Med
– volume: 74
  start-page: 01
  year: 2020
  end-page: 9
  ident: R22
  article-title: Effective use of the McNemar test
  publication-title: Behav Ecol Sociobiol
– reference: SainatoM. "I live on the street now": how Americans fall into medical bankruptcy. The Guardian 2019. Available at https://www.theguardian.com/us-news/2019/nov/14/health-insurance-medical-bankruptcy-debt. Accessed October 26, 2020.
– reference: National Health Insurance Administration. Taipei: Progress tracking of the overall effectiveness of medical services; 2020, p. 1-13.
– volume: 74
  start-page: 01
  year: 2020
  ident: R22-20250504
  article-title: Effective use of the McNemar test
  publication-title: Behav Ecol Sociobiol
– volume: 22
  start-page: 435
  year: 2019
  ident: R11-20250504
  article-title: Navigating and making sense of urgent and emergency care processes and provision
  publication-title: Health Expect
  doi: 10.1111/hex.12866
– volume: 55
  start-page: 13
  year: 2008
  ident: R29-20250504
  article-title: Health care in Taiwan: why can’t the United States learn some lessons?
  publication-title: Dissent
  doi: 10.1353/dss.2008.0096
– volume: 100
  start-page: e25982
  year: 2021
  ident: R39-20250504
  article-title: Exploration of simulation-based medical education for undergraduate students
  publication-title: Medicine
  doi: 10.1097/MD.0000000000025982
– volume: 18
  start-page: 327
  year: 2009
  ident: R7-20250504
  article-title: Characteristics of outpatient prescriptions for frail Taiwanese elders with long-term care needs
  publication-title: Pharmacoepidemiol Drug Saf
  doi: 10.1002/pds.1712
– volume: 11
  start-page: 16
  year: 2011
  ident: R4-20250504
  article-title: Emergency department triage: an ethical analysis
  publication-title: BMC Emerg Med
  doi: 10.1186/1471-227X-11-16
– volume: 18
  start-page: 31
  year: 2014
  ident: R13-20250504
  article-title: Introduction: looking forward to a better national health insurance
  publication-title: Formosan J Med
– volume: 75
  start-page: 24
  year: 2008
  ident: R14-20250504
  article-title: People of Taiwan is high satisfaction for promotion and implementation of the national health insurance
  publication-title: Bimonthly Natl Health Insurance
– volume: 50
  start-page: 1002
  year: 2012
  ident: R8-20250504
  article-title: Continuity of care, potentially inappropriate medication, and health care outcomes among the elderly: evidence from a longitudinal analysis in Taiwan
  publication-title: Med Care
  doi: 10.1097/MLR.0b013e31826c870f
– volume: 4
  start-page: e9
  year: 2015
  ident: R16-20250504
  article-title: Web-based and telephone surveys to assess public perception toward the National Health Insurance in Taiwan: a comparison of cost and results
  publication-title: Interact J Med Res
  doi: 10.2196/ijmr.4090
– volume: 12
  start-page: 68
  year: 2018
  ident: R30-20250504
  article-title: Effectiveness of education in teaching elementary students about the correct use of medication and Taiwan's National Health Insurance
  publication-title: J Healthc Qual
– volume: 69
  start-page: 44
  year: 2017
  ident: R23-20250504
  article-title: The paired t test and beyond: recommendations for testing the central tendencies of two paired samples in research on speech, language and hearing pathology
  publication-title: J Commun Disord
  doi: 10.1016/j.jcomdis.2017.07.002
– volume: 10
  start-page: 547
  year: 2019
  ident: R38-20250504
  article-title: Simulation-based education workshop: perceptions of participants
  publication-title: Adv Med Educ Pract
  doi: 10.2147/AMEP.S204816
– volume: 15
  start-page: 01
  year: 2018
  ident: R20-20250504
  article-title: Improving community resilience through disaster simulation: how simulation-based education augments emergency management exercises
  publication-title: J Homeland Secur Emerg Manage
– volume: 18
  start-page: 74
  year: 2014
  ident: R5-20250504
  article-title: Health care system under National Health Insurance Scheme
  publication-title: Formosan J Med
– volume: 2014
  start-page: 01
  year: 2014
  ident: R24-20250504
  article-title: Generalized estimating equations in longitudinal data analysis: a review and recent developments
  publication-title: Adv Stat
– volume: 20
  start-page: 402
  year: 2003
  ident: R3-20250504
  article-title: Emergency department overcrowding in the United States: an emerging threat to patient safety and public health
  publication-title: Emerg Med J
  doi: 10.1136/emj.20.5.402
– volume: 47
  start-page: 388
  year: 2015
  ident: R9-20250504
  article-title: A health literacy training intervention for physicians and other health professionals
  publication-title: Fam Med
– volume: 24
  start-page: 1137
  year: 2017
  ident: R12-20250504
  article-title: Why do people choose emergency and urgent care services? A rapid review utilizing a systematic literature search and narrative synthesis
  publication-title: Acad Emerg Med
  doi: 10.1111/acem.13220
– volume: 29
  start-page: 16
  year: 2013
  ident: R6-20250504
  article-title: The experience of healthcare matrix introduce on clinical pharmacy teaching
  publication-title: J Taiwan Pharm
– volume: 2
  year: 2018
  ident: R10-20250504
  article-title: Primary care professionals providing non-urgent care in hospital emergency departments
  publication-title: Cochrane Database oSystem Rev
– volume: 12
  start-page: 295
  year: 2020
  ident: R32-20250504
  article-title: Knowledge, attitude, and practices (KAP) survey towards pelvic floor muscle training (PFMT) among pregnant women
  publication-title: Int J Women's Health
  doi: 10.2147/IJWH.S242432
– volume: 7
  start-page: 30
  year: 2019
  ident: R33-20250504
  article-title: Social media usage and influenza beliefs, risk perceptions and behavioral intentions among students at a University in Southeastern US
  publication-title: J Georgia Pub Health Assoc
– volume: 133
  start-page: 56
  year: 2008
  ident: R18-20250504
  article-title: Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case-control study
  publication-title: Chest
  doi: 10.1378/chest.07-0131
– volume: 19
  start-page: 01
  year: 2020
  ident: R35-20250504
  article-title: Economic costs analysis of uncomplicated malaria case management in the Peruvian Amazon
  publication-title: Malaria J
  doi: 10.1186/s12936-020-03233-5
– volume: 58
  start-page: e333
  year: 2019
  ident: R17-20250504
  article-title: Achieving consensus to define curricular content for simulation-based education in vascular surgery: a European-wide needs assessment initiative
  publication-title: Eur J Vasc Endovasc Surg
  doi: 10.1016/j.ejvs.2019.06.952
– volume: 14
  start-page: 103
  year: 2017
  ident: R21-20250504
  article-title: Comparative effectiveness of hands-on versus computer simulation–based training for contrast media reactions and teamwork skills
  publication-title: J Am Coll Radiol
  doi: 10.1016/j.jacr.2016.07.013
– volume: 106
  start-page: 56
  year: 2016
  ident: R25-20250504
  article-title: Public health's falling share of US health spending
  publication-title: Am J Pub Health
  doi: 10.2105/AJPH.2015.302908
– volume: 57
  start-page: 330
  year: 2019
  ident: R36-20250504
  article-title: Muddying the waters: a political ecology of mosquito-borne disease in coastal Ecuador
  publication-title: Health Place
  doi: 10.1016/j.healthplace.2019.05.010
– volume: 18
  start-page: 01
  year: 2020
  ident: R34-20250504
  article-title: Evaluation for the effects of nutritional education on Chinese elite male young soccer players: the application of adjusted dietary balance index (DBI)
  publication-title: J Exerc Sci Fit
  doi: 10.1016/j.jesf.2019.08.004
– volume: 19
  start-page: 356
  year: 2015
  ident: R19-20250504
  article-title: Application of medical simulation in clinical skills training
  publication-title: Formosa J Med
– volume: 1
  start-page: 55
  year: 2015
  ident: R37-20250504
  article-title: Braghiroli OFM: simulation in medical education: brief history and methodology
  publication-title: Princ Pract Clin Res
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Snippet AbstractIntroduction:More than 80% of patients who visited Emergency Department (ED) was not urgent in Taiwan in 2019. It causes insufficient medical services...
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...
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SubjectTerms Clinical Trial/Experimental Study
Subtitle Applying simulation-based workshop to improve teaching competence among elementary and junior high school teachers in Taiwan
Title Adequate emergency department resource usage
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https://pubmed.ncbi.nlm.nih.gov/PMC8448039
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