anesthesia non technical skills

Simulation training is useful to become familiar with new technology, to practice behaviours and strategies, to acquire routines for specific scenarios, and to reflect on one's behaviour. Processes that have to function almost automatically (e.g., resuscitation) have to be practised repeatedly until they can be reliably executed even under stress or fatigue. Simulators offer the opportunity to acquire these skills without endangering the patient. Various types of simulators (from pig liver to premature baby simulator) are already being used extensively for this purpose...

Non-technical skills play an integral role in providing safe and excellent anesthesia. Currently there is little standardization in the assessment of non-technical skills in clinical practice, although various instruments exist. The aim of this study was to explore the use of the Nurse Anaesthetists' Non-Technical Skills-Norway (NANTS-no) structured assessment instrument in developing and assessing non-technical skills in clinical practice. This cohort study had a longitudinal design. Twenty student nurse anesthetists' nontechnical skills were assessed by their mentors (N=31) and clinical supervisors (N=7) at three time-points over a 12-month period, after providing anesthesia to a patient...

In recent years, several studies have demonstrated that the experience derived from video games improves interventions that require technical skills. Airway management is crucial to anesthesiologists, requiring technical and non-technical skills. We evaluated the benefits of video games for video stylet-guided tracheal intubation, which allows the use of video technology in airway management of residents with anesthesiology training. In the present study, the residents working in the Department of Anesthesiology and Reanimation at the Health Sciences University of Kartal Dr...

BACKGROUND: Communication and teamwork are critical non-technical skills in the operating theatre. However, prevention of events associated with communication failures by large simulation-based programs remains to be evaluated. The objective was to assess the impact of an interprofessional simulation-based training course on communication, teamwork, checklist adherence, and safety culture. METHODS: We aimed to assess the impact of an interprofessional simulation-based training course on communication, teamwork, checklist adherence, and safety culture...

INTRODUCTION: Intraoperative surgical complications pose significant potential risks to patients. Uncontrolled bleeding during laparoscopic partial nephrectomy is one such event that requires collaboration and communication between surgical team members. We developed and evaluated a multidisciplinary surgical simulation scenario and model of intraoperative hemorrhage during a laparoscopic partial nephrectomy to facilitate the practice of these crucial non-technical skills. METHODS: A simulation scenario using a novel, titratable, bleeding partial nephrectomy model was developed...

BACKGROUND: Competency-based medical education (CBME) has revolutionized approaches to training by making expectations more concrete, visible, and relevant for trainees. Designing, applying, and updating CBME requirements challenges residency programs, which must address many aspects of training simultaneously. This challenge also exists for educational regulatory bodies in creating and adjusting national competencies to standardize training expectations. We propose that an international approach for mapping residency training requirements may provide a baseline for assessing commonalities and differences...

BACKGROUND: Anesthesia personnel was among the first to implement simulation and team training including non-technical skills (NTS) in the field of healthcare. Within anesthesia practice, NTS are critically important in preventing harmful undesirable events. To our best knowledge, there has been little documentation of the extent to which anesthesia personnel uses recommended frameworks like the Standards of Best Practice: SimulationSM to guide simulation and thereby optimize learning...

Introduction Operating Room Black Box (ORBB) technology can be used to capture information during surgery for analysis and potential identification of root causes that jeopardize safety and efficiency. In this study, our objective was to identify and characterize procedural steps, intraoperative distractions, errors, and threats, as well as the non-technical skills of the team during a common minimally invasive gynecologic procedure. Methodology This was a cross-sectional pilot study of 25 patients undergoing total laparoscopic hysterectomy between May 2019 and February 2020 at a Canadian tertiary care academic hospital...

INTRODUCTION: The growing number of learners implies that all of them cannot play an active role during high-fidelity scenarios. Studies suggest a positive educational value when learners are observers only, but it remains uncertain whether learning outcomes might be improved by using an observer tool (OT). METHODS: Eighty-nine anesthesia residents were randomized to use an OT (n = 44, OT+; based on a cognitive aid) or not (n = 45, OT-) when not role-playing. The main outcome parameter was the learning outcomes assessed by comparing the change (before-after) in the response score to a questionnaire dedicated to medical knowledge obtained in the OT+ and OT- groups...

BACKGROUND: High-fidelity (HF) pediatric patient simulators are expensive. This randomized study aimed to compare the quality and educational impact of a full-scale simulation workshop with an HF infant simulator (SimBaby™, Laerdal) or with a low-cost (LC) simulator composed of an inert infant manikin with SimBaby™ software that displays respiratory/hemodynamic parameters on a monitor for medical education in pediatric difficult airway management. METHODS: After written informed consent, anesthetists and emergency or ICU physicians participated in teams (4 to 6 participants) in a training session that included direct participation and observation of two difficult intubation scenarios...

Objective: Sequelae of medical errors are a significant problem in acute care. Human-factor-based events are frequent but avoidable causes. Thus, non-technical skills are crucial. In 2008, crisis-resource-management (CRM)-based simulation training was established for the medical staff of the Lower Austria Regional Hospitals, one of the largest hospital operators in Europe. Methods: Implementation and development of simulation training from 2008 until today are described, costs and performance data retrospectively analysed over a 10-year period...

BACKGROUND: Medical simulation trainings lead to an improvement in patient care by increasing technical and non-technical skills, procedural confidence and medical knowledge. For structured simulation-based trainings, objective assessment tools are needed to evaluate the performance during simulation and the learning progress. In surgical education, objective structured assessment of technical skills (OSATS) are widely used and validated. However, in emergency medicine and anesthesia there is a lack of validated assessment tools for technical skills...

INTRODUCTION: Debriefing is a critical phase in simulation-based education that is extremely time-consuming for the instructors. The aim of the study was to assess whether a collective debriefing was non-inferior to an individual debriefing to improve learning outcomes after a simulation session. METHODS: This randomised controlled multicentre non-inferiority study included pairs comprising one resident and one student nurse in anaesthesia. Each pair underwent two sessions of a simulated life-threatening emergency held at a 6-week interval...

OBJECTIVE: Nontechnical skills, such as situation awareness, decision making, leadership, communication, and teamwork play a crucial role on the quality of care and patient safety in the operating room (OR). In our previous work, we developed an interdisciplinary training program, based on the NOTSS (Non-Technical Skills for Surgeons) taxonomy. The aim of this study was to understand the challenges faced by Rwandan surgical providers, who had undergone NOTSS training, to apply these nontechnical skills during subsequent operative surgery...

OBJECTIVES: Administering anesthesia to the inferior alveolar nerve is 1 of the most stressful processes in dental training. Most studies using virtual reality (VR) for dental training have used non-immersive technologies. The purpose of this work is to assess the impact of immersive technologies on skills training. METHODS: On May 2019, an experimental study was conducted with 163 clinical dental students, divided into 4 groups across 2 phases (preceptorship and training) with haptic feedback either On or Off...

BACKGROUND: There is an association between video game practice and laparoscopic expertize in trainee surgeons. Ultrasound-guided regional anesthesia has many parallels with laparoscopic surgery. The aim of this study was to explore whether video game experience is associated with enhanced performance in a simulated ultrasound-guided task in novice operators. METHODS: In this prospective observational study, 60 medical student volunteers were recruited. Following characterization of video game experience, they underwent an assessment of visuospatial abilities...

There are major challenges in teaching and assessing skills expected from practicing anesthesiologists and residents in anesthesia training programs. It is important to measure two separate aspects of skilled performance in managing crises: implementing appropriate technical actions (technical performance), manifesting appropriate crisis solving, and management of anesthesia non-technical behaviors. Anesthesia nontechnical skills (ANTS) can be divided into two subgroups: (1) cognitive or mental skills (decision-making, planning, strategy, risk assessment, situation awareness); and (2) social or interpersonal affective skills (teamwork, communication, leadership)...

This article describes a high-fidelity (Hi-Fi) simulation-based innovative educational strategy intended to introduce anesthesiology residents to key ethical considerations and how they apply to their practice. Three Hi-Fi simulation scenarios involving situations with various ethical issues are described with their debriefing objectives and the trainees' subjective feedback. Three high-fidelity simulation scenarios are described: (a) teaching critical incident disclosure, (b) disclosing and discussing patient awareness during general anesthesia, and (c) would physicians override a do-not-resuscitate (DNR) order if the cause of a cardiac arrest is iatrogenic? We used Hi-Fi simulation in an innovative way to teach these principles of ethics...

Background: Non-technical skills are interpersonal and cognitive skills involved in safe performance and preventing adverse events during surgery. it is necessary to dominate the non-technical skills to ensure patient safety. This study has aimed to assess the validity and reliability of Oxford Non-technical skills 2 system (Oxford NOTECHS 2) in Iran and to evaluate surgical teams' non-technical skills in orthopedic surgery wards. Methods: This cross-sectional study was conducted in Tehran, Iran during 2015...

Background: Anesthesia crisis management (ACM) simulation would expose anesthesiology residents and trainees to dynamic emergencies that need quick yet effective responses to gain their core strength and capabilities as anesthesiologists. Our department had already employed ACM simulation into modules and practiced in examinations. The aim is to enhance professional working ethics and human responsibility in residents, which would be accomplished in semi-realistic simulation. This would be a useful tool for lecturers to evaluate current teaching methods and measure protégés in daily emergencies, which should be done better in continuous pattern...