An experiential teaching session on the anesthesia machine check improves resident performance

Abstract

Purpose A preoperative machine check is imperative, yet machine faults are missed despite experience. We hypothesized that a simulation training session would improve junior residents' ability to perform a machine check beyond the level of final year residents who received only didactic training. Methods In 2005, an experiential machine check training session was introduced into residency training at the postgraduate year 1 (PGY-1) level. Three weeks later, the simulation residents were asked to perform a machine check and detect ten preset faults. The control group consisted of PGY-5 residents who had received a didactic anesthesia machine lecture during their residency; these control residents were asked to perform the same machine check as the simulation residents. Data were collected from 2005 to 2008 with each cohort of incoming PGY-1 residents and graduating PGY-5 residents. When the first group of PGY-1 residents became PGY-5 residents in 2009, they were invited to return for a retention test. In all tests, the number of faults detected was recorded, and the machine check was evaluated using a checklist. Results Thirty-seven simulation residents and 27 control residents participated in the study. Simulation residents had significantly higher checklist scores than the control residents, and they identified more machine faults (both P \ 0.001). Twenty-one simulation residents repeated the study in their senior year, and they continued to achieve higher checklist scores and identify more machine faults than the control residents (both P \ 0.001). Conclusion Our results suggest that an experiential training session allowed junior residents to achieve skills superior to those of senior colleagues after a five-year residency. This training was retained for two to four years as they continued to outperform their comparative controls. RésuméObjectif La ve´rification pre´ope´ratoire d'une machine est impe´ratif, toutefois des pannes de l'appareil ne sont pas de´tecte´es en de´pit de l'expe´rience. Nous avons e´mis l'hypothe`se qu'une session de formation sous forme de simulation pouvait ame´liorer la capacite´des re´sidents juniors a`effectuer une ve´rification de la machine avec un meilleur re´sultat qu'un re´sident de dernie`re anne´e n'ayant reçu qu'une formation didactique. Méthodes En 2005, une session de formation expe´rientielle de ve´rification de machines a e´te´introduite dans le programme de la premie`re anne´e de re´sidence (PGY-1). Trois semaines plus tard, il a e´te´demande´aux re´sidents ayant suivi la simulation d'effectuer une ve´rification de la machine et de´tecter dix pannes pre´e´tablies. Le groupe te´moin comportait des re´sidents PGY-5 qui avaient suivi un cours didactique sur la machine d'anesthe´sie pendant leur re´sidence; ces re´sidents « te´moins » ont e´te´invite´s à faire la meˆme ve´rification de la machine que les re´sidents ayant suivi la simulation. Les donne´es ont e´te´collecte´es de 2005 a`2008 aupre`s de chaque cohorte de nouveaux re´sidents PGY-1 et de re´sidents PGY-...

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