INTRODUCTION: Toxic terrorism is the use of a chemical, biological, radiological, or nuclear (CBRN) agent for threat or at- tack to cause panic, illness, injury, and death in a civil society. The cases of toxic terrorism in which CBRN agents are used are increasing every day. Diagnostic uncertainty and inexperience in emergency management might delay the initiation of life-saving interventions and increase the morbidity and mortality of patients in cases of toxic terrorism. A limited number of topics on toxic terrorism readiness and medical management is included in the current core curriculum of Emergency Medicine Specialization training, and these are handled at different levels in each department [1]. OSCEs (Objective Struc- tured Clinical Examination) are employed to evaluate clinical skills in emergency medicine residency training programs, and studies showing that OSCEs can predict future performance in both general and specific core competencies are in- cluded in the literature [2-4].

The purpose of the present study was to develop clinical scenarios to be applied as a standard to measure toxic terrorism readiness and medical management skills by applying simulation-based clinical exams to the emergency medicine de- partment residents and to identify the missing and insufficient aspects of medical management in toxic terrorism clinical scenarios in the specialty education curriculum.

METHOD: The present study had a descriptive and cross-sectional design. The emergency medicine residents of Karadeniz Technical University (KTU), Faculty of Medicine, Emergency Medicine Department, and Health Sciences University, Trabzon Kanuni Training and Research Hospital, Emergency Medicine Department participated in the study.

A total of five OSCE stations were designed by two medical toxicologists. The scenarios and evaluation forms for the sta- tions were formally evaluated by the study team with medical toxicologists and attending physicians. The design consisted of a total of five stations, one high-reality model, two with standardized patients, and two video scenarios recorded during the study. The performance of the residents in the first three stations was evaluated under three main headings: overall as- sessment stabilization, diagnostic approach, and specific treatment. The participants were asked to answer the prepared questions in writing after watching the video footage, which was specially shot at the last two stations.

RESULTS: A total of 48 Emergency Medicine residents participated in the study.