Acquisition of critical intraoperative event management skills in novice anesthesiology residents by using high-fidelity simulation-based training.

Acquisition of critical intraoperative event management skills in novice anesthesiology residents by using high-fidelity simulation-based training.

Park CS, Rochlen LR, Yaghmour E, Higgins N, Bauchat JR, Wojciechowski KG, Sullivan JT, McCarthy RJ

Anesthesiology. 2010 Jan;112(1):202-11

Authors: Park CS, Rochlen LR, Yaghmour E, Higgins N, Bauchat JR, Wojciechowski KG, Sullivan JT, McCarthy RJ


Abstract

BACKGROUND: Early acquisition of critical competencies by novice anesthesiology residents is essential for patient safety, but traditional training methods may be insufficient. The purpose of this study was to determine the effectiveness of high-fidelity simulation training of novice residents in the initial management of critical intraoperative events.

METHODS: Twenty-one novice residents participated in this 6-week study. Three hypoxemia and three hypotension scenarios were developed and corresponding checklists were validated. Residents were tested in all scenarios at baseline (0 weeks) and divided into two groups, using a randomized crossover study design. Group 1 received simulation-based training in hypoxemic events, whereas Group 2 was trained in hypotensive events. After intermediate (3 weeks) testing in all scenarios, the groups switched to receive training in the other critical event. Final testing occurred at 6 weeks. Raters blinded to subject identity, group assignment, and test date scored videotaped performances by using checklists. The primary outcome measure was composite scores for hypoxemia and hypotension scenarios, which were compared within and between groups.

RESULTS: Baseline performance between groups was similar. At the intermediate evaluation, the mean hypoxemia score was higher in Group 1 compared with Group 2 (65.5% vs. 52.4%, 95% CI of difference 6.3-19.9, P < 0.003). Conversely, Group 2 had a higher mean hypotension score (67.4% vs. 45.5%, 95% CI of difference 14.6-29.2, P < 0.003). At Week 6, the scores between groups did not differ.

CONCLUSIONS: Event-specific, simulation-based training resulted in superior performance in scenarios compared with traditional training and simulation-based training in an alternate event.
PMID: 20010420 [PubMed - indexed for MEDLINE]

Internal medicine residency graduates' perceptions of the systems-based practice and practice-based learning and improvement competencies.

Internal medicine residency graduates' perceptions of the systems-based practice and practice-based learning and improvement competencies.

Didwania A, McGaghie WC, Cohen E, Wayne DB
Teach Learn Med. 2010 Jan;22(1):33-6

Authors: Didwania A, McGaghie WC, Cohen E, Wayne DB

Resident education in Systems-Based Practice (SBP) and Practice-Based Learning and Improvement (PBLI) is required but underemphasized.

PMID: 20391281 [PubMed - indexed for MEDLINE]