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Use of a hand-held digital cognitive aid in simulated crises: the MAX randomized controlled trial.

Abstract：

Background:Cognitive aids improve the technical performance of individuals and teams dealing with high-stakes crises. Hand-held electronic cognitive aids have rarely been investigated. A randomized controlled trial was conducted to investigate the effects of a smartphone application, named MAX (for Medical Assistance eXpert), on the technical and non-technical performance of anaesthesia residents dealing with simulated crises. Methods:This single-centre randomized, controlled, unblinded trial was conducted in the simulation centre at Lyon, France. Participants were anaesthesia residents with >1 yr of clinical experience. Each participant had to deal with two different simulated crises with and without the help of a digital cognitive aid. The primary outcome was technical performance, evaluated as adherence to guidelines. Two independent observers remotely assessed performance on video recordings. Results:Fifty-two residents were included between July 2015 and February 2016. Six participants were excluded for technical issues; 46 participants were confronted with a total of 92 high-fidelity simulation scenarios (46 with MAX and 46 without). Mean (sd) age was 27 (1.8) yr and clinical experience 3.2 (1.0) yr. Inter-rater agreement was 0.89 (95% confidence interval 0.85-0.92). Mean technical scores were higher when residents used MAX [82 (11.9) vs 59 (10.8)%; P<0.001]. Conclusion:The use of a hand-held cognitive aid was associated with better technical performance of residents dealing with simulated crises. These findings could help digital cognitive aids to find their way into daily medical practice and improve the quality of health care when dealing with high-stakes crises. Clinical trial registration:NCT02678819.

journal_name

Br J Anaesth

journal_title

British journal of anaesthesia

authors

Lelaidier R,Balança B,Boet S,Faure A,Lilot M,Lecomte F,Lehot JJ,Rimmelé T,Cejka JC

doi

10.1093/bja/aex256

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

1015-1021

issue

5

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)53917-3

journal_volume

119

pub_type

杂志文章,随机对照试验

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