Learning crisis resource management: Practicing versus an observational role in simulation training - a randomized controlled trial

被引：35

作者：

Lai, Anita ^{[1
]}

Haligua, Alexis ^{[2
]}

Bould, M. Dylan ^{[3
,4
]}

Everett, Tobias ^{[5
]}

Gale, Mark ^{[6
]}

Pigford, Ashlee-Ann ^{[7
]}

Boet, Sylvain ^{[3
,7
]}

机构：

[1] Univ Calgary, Alberta Hlth Serv, Dept Emergency Med, Room C231,1403-29 St NW, Calgary, AB T2N 2T9, Canada

[2] Univ Ottawa, Montfort Hosp, Dept Emergency Med, 713 Montreal Rd, Ottawa, ON K1K 0T2, Canada

[3] Univ Ottawa, Fac Med, Dept Innovat Med Educ, Roger Guidon Hall Room 2211,451 Smyth Rd, Ottawa, ON K1H 85M, Canada

[4] Univ Ottawa, Childrens Hosp Eastern Ontario, Dept Anesthesiol, 401 Smyth Rd, Ottawa, ON K1H 8L1, Canada

[5] Univ Toronto, Hosp Sick Children, Dept Anesthesiol, Room 2303,555 Univ Ave, Toronto, ON M5G 1X8, Canada

[6] Univ Calgary, Alberta Childrens Hosp, Dept Anesthesiol, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada

[7] Ottawa Hosp, Res Inst, Dept Anesthesiol, Gen Campus,501 Smyth Rd,Critical Care Wing 1401, Ottawa, ON K1H 8L6, Canada

来源：

ANAESTHESIA CRITICAL CARE & PAIN MEDICINE | 2016年 / 35卷 / 04期

关键词：

Crisis resource management; Debriefing; Inter-professional care; Teamwork; Communication; Dyad learning; HIGH-FIDELITY SIMULATION; PERFORMANCE; EDUCATION; MEDICINE; SKILLS; CARE;

D O I：

10.1016/j.accpm.2015.10.010

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Aim: Simulation training has been shown to be an effective way to teach crisis resource management (CRM) skills. Deliberate practice theory states that learners need to actively practice so that learning is effective. However, many residency programs have limited opportunities for learners to be "active'' participants in simulation exercises. This study compares the effectiveness of learning CRM skills when being an active participant versus being an observer participant in simulation followed by a debriefing. Methods: Participants were randomized to two groups: active or observer. Active participants managed a simulated crisis scenario (pre-test) while paired observer participants viewed the scenario via video transmission. Then, a trained instructor debriefed participants on CRM principles. On the same day, each participant individually managed another simulated crisis scenario (post-test) and completed a post-test questionnaire. Two independent, blinded raters evaluated all videos using the Ottawa Global Rating Scale (GRS). Results: Thirty-nine residents were included in the analysis. Normally distributed data were analyzed using paired and unpaired t-tests. Inter-rater reliability was 0.64. Active participants significantly improved from pre-test to post-test (P = 0.015). There was no significant difference between the post-test performance of active participants compared to observer participants (P = 0.12). Conclusion: We found that learning CRM principles was not superior when learners were active participants compared to being observers followed by debriefing. These findings challenge the deliberate practice theory claiming that learning requires active practice. Assigning residents as observers in simulation training and involving them in debriefing is still beneficial. (C) 2016 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

引用

页码：275 / 281

页数：7

共 25 条

[1] Complex procedural skills are retained for a minimum of 1 yr after a single high-fidelity simulation training session [J].