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anesthesia non technical skills

Michelle Chiu, Jordan Tarshis, Andreas Antoniou, T Laine Bosma, Jessica E Burjorjee, Neil Cowie, Simone Crooks, Kate Doyle, David Dubois, Tobias Everett, Rachel Fisher, Megan Hayter, Genevieve McKinnon, Diana Noseworthy, Noel O'Regan, Greg Peachey, Arnaud Robitaille, Michael Sullivan, Marshall Tenenbein, Marie-Helene Tremblay
The specialty of anesthesiology will soon adopt the Competence By Design (CBD) approach to residency education developed by the Royal College of Physicians and Surgeons of Canada (RCPSC). A foundational component of CBD is frequent and contextualized assessment of trainees. In 2013, the RCPSC Anesthesiology Specialty Committee assembled a group of simulation educators, representing each of the 17 Canadian anesthesiology residency programs, to form the Canadian National Anesthesiology Simulation Curriculum (CanNASC) Task Force...
December 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Teresa Skelton, Isaac Nshimyumuremyi, Christian Mukwesi, Sara Whynot, Lauren Zolpys, Patricia Livingston
BACKGROUND: Safe anesthesia care is challenging in developing countries where there are shortages of personnel, drugs, equipment, and training. Anesthetists' Non-technical Skills (ANTS)-task management, team working, situation awareness, and decision making-are difficult to practice well in this context. Cesarean delivery is the most common surgical procedure in sub-Saharan Africa. This pilot study investigates whether a low-cost simulation model, with good psychological fidelity, can be used effectively to teach ANTS during cesarean delivery in Rwanda...
August 2016: Anesthesia and Analgesia
Linda L Wunder
Simulation-based education provides a safe place for student registered nurse anesthetists to practice non-technical skills before entering the clinical arena. An anesthetist's lack of nontechnical skills contributes to adverse patient outcomes. The purpose of this study was to determine whether an educational intervention on nontechnical skills could improve the performance of nontechnical skills during anesthesia crisis simulation with a group of first-year student registered nurse anesthetists. Thirty-two first-year students volunteered for this quasi-experimental study...
February 2016: AANA Journal
Liisa Rovamo, Elisa Nurmi, Minna-Maria Mattila, Pertti Suominen, Minna Silvennoinen
BACKGROUND: Video analyses of real-life newborn resuscitations have shown that Neonatal Resuscitation Program (NRP) guidelines are followed in fewer than 50% of cases. Multidisciplinary simulation is used as a first-rate tool for the improvement of teamwork among health professionals. In the study we evaluated the impact of the crisis resource management (CRM) and anesthesia non-technical skills instruction on teamwork during simulated newborn emergencies. METHODS: Ninety-nine participants of two delivery units (17 pediatricians, 16 anesthesiologists, 14 obstetricians, 31 midwives, and 21 neonatal nurses) were divided to an intervention group (I-group, 9 teams) and a control group (C-group, 6 teams)...
2015: BMC Research Notes
Roy Phitayakorn, Rebecca D Minehart, Maureen W Hemingway, May C M Pian-Smith, Emil Petrusa
BACKGROUND: Optimal team performance in the operating room (OR) requires a combination of interactions among OR professionals and adherence to clinical guidelines. Theoretically, it is possible that OR teams could communicate very well but fail to follow acceptable standards of patient care and vice versa. OR simulations offer an ideal research environment to study this relationship. The goal of this study was to determine the relationship between ratings of OR teamwork and communication with adherence to patient care guidelines in a simulated scenarios of malignant hyperthermia (MH)...
November 2015: Surgery
A Irwin, A E Weidmann
BACKGROUND: Non-technical skills refer to the social and cognitive factors that may influence efficient and safe job performance. Non-technical skills are an important element of patient safety in a variety of health care disciplines, including surgery, anesthesia and nursing. However, the use of non-technical skills in pharmacy practice has not yet been fully assessed. OBJECTIVE: To examine attitudes toward, and use of, non-technical skills by pharmacy personnel...
September 2015: Research in Social & Administrative Pharmacy: RSAP
Grace A Nicksa, Cristan Anderson, Richard Fidler, Lygia Stewart
IMPORTANCE: The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. OBJECTIVE: To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations...
March 1, 2015: JAMA Surgery
Kong Eric You-Ten, M Dylan Bould, Zeev Friedman, Nicole Riem, Devin Sydor, Sylvain Boet
PURPOSE: Non-adherence to airway guidelines in a 'cannot intubate-cannot oxygenate' (CICO) crisis situation is associated with adverse patient outcomes. This study investigated the effects of hands-on training in cricothyrotomy on adherence to the American Society of Anesthesiologists difficult airway algorithm (ASA-DAA) during a simulated CICO scenario. METHODS: A total of 21 postgraduate second-year anesthesia residents completed a pre-test teaching session during which they reviewed the ASA-DAA, became familiarized with the Melker cricothyrotomy kit, and watched a video on cricothyrotomy...
May 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Mrinalini Balki, Subrata Chakravarty, Aliya Salman, Randy S Wax
PURPOSE: The objective of this study was to assess the influence of a teaching plan consisting of didactic teaching and repeated simulations on the performance of anesthesia residents in the management of general anesthesia (GA) for emergency Cesarean delivery (CD). METHODS: Twenty-one postgraduate year 2 (PGY2) and 3 (PGY3) anesthesia residents from the University of Toronto were recruited in this prospective cohort study. All participants received didactic teaching in the management of GA for emergency CD, which was followed one week later by assessment of performance in the same scenario using a high-fidelity simulator...
October 2014: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Roy Phitayakorn, Rebecca Minehart, May C M Pian-Smith, Maureen W Hemingway, Tanya Milosh-Zinkus, Danika Oriol-Morway, Emil Petrusa
BACKGROUND: High-quality teamwork among operating room (OR) professionals is a key to efficient and safe practice. Quantification of teamwork facilitates feedback, assessment, and improvement. Several valid and reliable instruments are available for assessing separate OR disciplines and teams. We sought to determine the most feasible approach for routine documentation of teamwork in in-situ OR simulations. We compared rater agreement, hypothetical training costs, and feasibility ratings from five clinicians and two nonclinicians with instruments for assessment of separate OR groups and teams...
July 2014: Journal of Surgical Research
A Kjellin, L Hedman, C Escher, L Felländer-Tsai
BACKGROUND AND AIMS: Crew resource management-based operating room team training will be an evident part of future surgical training. Hybrid simulation in the operating room enables the opportunity for trainees to perform higher fidelity training of technical and non-technical skills in a realistic context. We focus on situational motivation and self-efficacy, two important factors for optimal learning in light of a prototype course for teams of residents in surgery and anesthesiology and nurses...
December 2014: Scandinavian Journal of Surgery: SJS
Chul-Ho Chang
Many medical schools and hospitals throughout the world are equipped with a simulation center for the purpose of training anesthesiologists to perform both technical and non-technical skills. Because induction, maintenance, and emergence of general anesthesia are critical to patient welfare, various simulation mannequins and tools are utilized for the purpose of training anesthesiologists for safer patient care. Traditionally, anesthesia residency training mostly consisted of didactic lectures and observations...
March 2013: Korean Journal of Anesthesiology
H Trimmel, R Fitzka, J Kreutziger, A von Goedecke
Adverse events are not unusual in a more and more complex anesthesiological environment. The main reasons for this are an increasing workload, economic pressure, growing expectations of patients and deficits in planning and communication. However, these incidents mostly do not refer to medical deficits but to flaws in non-technical skills (team organisation, task orientation, decision making and communication). The introduction of the WHO Safe Surgery Checklist depicted that a structural approach can improve the situation...
January 2013: Der Anaesthesist
Victor M Neira, M Dylan Bould, Amy Nakajima, Sylvain Boet, Nicholas Barrowman, Philipp Mossdorf, Devin Sydor, Amy Roeske, Stephen Noseworthy, Viren Naik, Dermot Doherty, Hilary Writer, Stanley J Hamstra
PURPOSE: Our objective was to develop and evaluate a Generic Integrated Objective Structured Assessment Tool (GIOSAT) to integrate Medical Expert and intrinsic (non-medical expert) CanMEDS competencies with non-technical skills for crisis simulation. METHODS: An assessment tool was designed and piloted using two pediatric anesthesia scenarios (laryngospasm and hyperkalemia). Following revision of the tool, we used previously recorded videos of anesthesia residents (n = 50) who managed one of two intraoperative advanced cardiac life support (ACLS) scenarios (ventricular tachycardia or ventricular fibrillation)...
March 2013: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Adrian Harvey, Glen Bandiera, Avery B Nathens, Vicki R LeBlanc
BACKGROUND: Training and practice in medicine are inherently stressful. The effects of stress on performance in clinical situations are poorly understood. The purpose of this study was to examine the stress responses and clinical performance of residents during low and high stress (HS) simulated trauma resuscitations. METHODS: Thirteen emergency medicine and general surgery residents were evaluated in HS and low stress (LS) trauma resuscitation simulations. Subjective and physiologic (heart rate, salivary cortisol) responses were measured at baseline and in response to the scenarios...
February 2012: Journal of Trauma and Acute Care Surgery
Alexander Matveevskii, David L Moore, Paul J Samuels
BACKGROUND: In this article some definitions of competency and professionalism will be discussed, and an overview of existing methods that assess competency and professionalism in anaesthesia resident doctors (residents) is provided. In addition, we will discuss how progression to professionalism, education in anaesthesiology and other medical specialties may be improved using the adult skill acquisition model. The goal of this paper is to refine the definitions of professionalism and competency, and to propose a new approach to medical education...
April 2012: Clinical Teacher
Adrian Harvey, Glen Bandiera, Avery B Nathens, Vicki R Leblanc
BACKGROUND:: Training and practice in medicine are inherently stressful. The effects of stress on performance in clinical situations are poorly understood. The purpose of this study was to examine the stress responses and clinical performance of residents during low and high stress (HS) simulated trauma resuscitations. METHODS:: Thirteen emergency medicine and general surgery residents were evaluated in HS and low stress (LS) trauma resuscitation simulations. Subjective and physiologic (heart rate, salivary cortisol) responses were measured at baseline and in response to the scenarios...
July 29, 2011: Journal of Trauma
C M Schulz, E Schneider, L Fritz, J Vockeroth, A Hapfelmeier, T Brandt, E F Kochs, G Schneider
BACKGROUND: Situation awareness (SA) is considered to be an important non-technical skill for delivering safe anaesthesia. The spatial distribution of visual attention (VA) is an underlying process for attaining adequate SA. In the present study, a novel technology was used to assess the distribution of VA in anaesthetists delivering anaesthesia. The impact of a critical incident on VA in relation to individual experience is analysed in a descriptive and exploratory manner. METHODS: Fifteen anaesthetists induced general anaesthesia in a full-scale simulator while wearing a head-mounted eye-tracking camera system...
June 2011: British Journal of Anaesthesia
Sylvain Boet, M Dylan Bould, Heinz R Bruppacher, François Desjardins, Deven B Chandra, Viren N Naik
OBJECTIVE: To examine the effectiveness of self-debriefing as compared to instructor debriefing in the change of nontechnical skills performance of anesthesiology residents. DESIGN: Prospective, randomized, controlled study. SETTING: A university hospital simulation center. SUBJECTS: : Fifty anesthesiology residents. INTERVENTIONS: Subjects were instructed in the principles of nontechnical skills for crisis management...
June 2011: Critical Care Medicine
E Fioratou, R Flin, R Glavin, R Patey
Situation awareness (SA) is one of the essential non-technical skills for effective and safe practice in high-risk industries, such as healthcare; yet, there is limited research of its significance in anaesthetic practice. In this paper, we review this scant research that focuses on SA as patient monitoring alone and advocate for a more comprehensive view of SA in anaesthetic practice and training that extends beyond monitoring, namely, a distributed cognition approach. We identify further factors influencing anaesthetists' SA and provide a case that resulted in an anaesthetic fatality to illustrate the application of an alternative view of SA in anaesthesia...
July 2010: British Journal of Anaesthesia
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