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

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.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

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

doi

10.1097/ALN.0b013e3181c62d43

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

202-11

issue

eissn

0003-3022

issn

1528-1175

journal_volume

112

pub_type

杂志文章,随机对照试验

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