Attitudinal Changes Resulting from Repetitive Training of Operating Room Personnel Using High-Fidelity Simulation at the Point of Care

Abstract

We investigated the impact of repetitive training using high-fidelity simulation (HFS) at the point of care on the teamwork attitudes of operating room (OR) personnel. Members of the general surgical OR teams at an academic medical center participated in two half-day point-of-care HFS team training sessions. Module 1 targeted teamwork competencies; Module 2 included a preoperative briefing strategy. Modules were separated by 1 month. For each training, participants completed pre- and postsession questionnaires that included a 15-item self-efficacy tool targeting teamwork competencies using a 6-point Likert-type scale. Pre- and postsession mean scores were compared with a t test. Matched pre- and postsessions questionnaires were collected from 38 and 39 participants for Module 1 and Module 2, respectively. Mean item improvement from pre- to posttraining was 0.43 units (range, 0.23 to 0.69 units) for Module 1 and 0.42 units (range, 0.15 to 0.53 units) for Module 2. After Bonferroni adjustment, statistically significant improvement in scores from pre- to posttraining increased from four items after Module 1 to nine items after Module 2. Repetitive training of interdisciplinary OR teams through HFS at the point of care increases the effectiveness of promoting attitudinal change toward team-based competencies among participants.

Multidisciplinary team simulation for the operating theatre: a review of the literature

“…Twelve of 23 programmes were conducted in simulated OTs, which contained similar equipment to a fully functioning procedural theatre. Six programmes were defined as point‐of‐care or in situ where simulations were conducted on actual inpatient care units (OT or intensive care unit) involving local health care teams . Two groups used live animal and/or human cadaver models for teaching and were set‐up in a wet laboratory .…”

“…This set‐up was thought to be more realistic and that it enhanced interpersonal/team dynamics by creating a more psychologically engaging learning experience. It also identified and rectified systemic problems within the hospital environment . Volk et al .…”

“…described that during simulated training, inadequate signage for the emergency call button was identified and this issue was subsequently resolved by the OT administration . In addition, simulation at the point‐of‐care results in less disruption to individual work commitments because hospital staff are not taken away from work more than is absolutely necessary, and allows more flexibility in scheduling conflicts . Some authors reported that point‐of‐care simulation has the potential to reduce costs while others describe that it adds costs because both simulation and OT‐related fixed and variable expenses must be taken into account.…”

“…The type of equipment and the level of equipment fidelity used for simulation varied greatly among the studies. Most described the use of manikins with electronically mediated physiological parameters . Six studies incorporated a synthetic model into their full scale team simulators .…”

“…Most described the use of manikins with electronically mediated physiological parameters . Six studies incorporated a synthetic model into their full scale team simulators . One used a virtual reality cholecystectomy machine and three programmes were conducted using live porcine models .…”