Abstract
Background
Effective medical education requires both didactic instruction and practical hands-on experience. Wilderness medicine presents unique challenges including environmental concerns and limited resources. Medical Wilderness Adventure Race (MedWAR) was developed to teach and test knowledge and skills specific to wilderness medicine by incorporating simulated medical scenarios into an adventure race. This event has gained acceptance nationally in wilderness medical circles as an excellent way to appreciate the challenges of wilderness medicine; however, its effectiveness as a teaching tool has not yet been verified.
Objectives
To determine if improvement in simulated clinical and didactic performance can be demonstrated by teams participating in a typical MedWAR event.
Methods
We developed a complex clinical scenario and written exam to test the basic tenets that are reinforced through the MedWAR curriculum. Teams were administered the written exam and standardized scenario immediately before and after the 2011 Midwest MedWAR Race. Teams were not given feedback on their pre-race performance. Scenario performance was based on critical actions correctly performed in the appropriate time. Scenario and written exam data was analyzed using a standard paired difference t test.
Results
A total of 31 teams participated in both the pre- and post-event scenarios. Pre-race scenario performance averaged 71.0% (SD = 17.0, n = 31) of critical actions met compared to a post-race performance of 89.7% (SD = 11.4, n = 31). Mean improvement was 18.7% (SD = 18.7, n = 31, CI, 12.1–25.3) with a significant paired two-tailed t test (P ≤.01). A total of 95 individual subjects took the written pre- and post-tests. The written scores averaged pre-race 84.5% (SD = 12.5, n = 95) and post-race 88.7% (SD = 11.5, n = 95). Mean improvement was 4.2% (SD = 11.7, n = 95, CI, –7.5 to 15.9), with a significant paired two-tailed t test (P ≤.01).
Conclusions
MedWAR participants demonstrated significant improvement in both written exam scores and the management of a simulated complex wilderness medical scenario. This strongly suggests that MedWAR is an effective teaching platform for both wilderness medicine knowledge and skills.