Use of simulation as a needs assessment to develop a focused team leader training curriculum for resuscitation teams

Advances in Simulation - Tập 5 Số 1 - 2020
Susan Coffey Zern1, William Marshall1, Patricia A. Shewokis2,3, Michael T. Vest4
1Virtual Education and Simulation Training (VEST) Center, Christiana Care Health System, 4755 Ogletown-Stanton Road, Ammon MEC LE86B, Newark, Delaware, 19718, USA
2Nutrition Sciences Department, College of Nursing and Health Professions
3School of Biomedical Engineering, Science and Health Systems, and Department of Teaching, Learning & Curriculum, School of Education, Drexel University, 3rd Floor, Room 382, Parkway Building, 1601 Cherry Street, Mail Stop 31030, Philadelphia, PA, 19102, USA
4Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Christiana Care Health System, 4755 Ogletown-Stanton Road, Medical Intensive Care Unit, 3E, Newark, Delaware, 19713, USA

Tóm tắt

AbstractBackgroundMany inpatients experience cardiac arrest and mortality in this population is extremely high. Simulation is frequently used to train code teams with the goal of improving these outcomes. A key step in designing such a training curriculum is to perform a needs assessment. We report on the effectiveness of a simulation-based training program for residents designed using unannounced in-situ simulation cardiac arrest data as a needs assessment.MethodsIn order to develop the curriculum for training, a needs assessment was done using in-situ simulation. Prior to instruction, residents were assessed in their ability to lead a simulated resuscitation using a standardized checklist. During the intervention phase, residents participated in didactic and team training. The didactic training consisted of pharmacology review, ACLS update and TeamSTEPPS training. Residents took turns as code team leader in three simulation sessions. Rapid cycle deliberate practice (RCDP) was employed as part of simulation sessions. All residents returned, for post-intervention assessment. Mean pre-post test scores were analyzed to determine if there was a significant difference.ResultsTwenty-seven residents participated. Mean pre-training assessment score was 47.6 (95% CI 37.5-57.9). The mean post-training assessment score was 84.4 (95% CI 79.0-89.5). The mean time to defibrillation after pads were placed in scenario with shockable rhythm decreased from 102.2 seconds (95% CI 74.0-130.5) to 56.3 (95% CI 32.7-79.8).ConclusionUsing unannounced in-situ cardiac arrest simulations as a needs assessment, a simulation-based training program was developed that significantly improved resident performance as team leader. Future work is needed to determine if this improvement translates into patient benefits and is sustainable. However, in-situ simulation is a promising tool for curriculum development.

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