Evaluation of a Pilot Project to Introduce Simulation-Based Team Training to Pediatric Surgery Trauma Room Care

Abstract

Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings. Each scenario incorporated elements of pediatric trauma management as well as Crew Resource Management (CRM) educational objectives. Participants completed anonymous pre- and postcourse questionnaires and rated the course itself as well as their own medical qualification and knowledge of CRM. Results. Participants found the course very realistic and selected scenarios highly relevant to their daily work. They reported a feeling of improved medical and nontechnical skills as well as no uncomfortable feeling during scenarios or debriefings. Conclusion. To our knowledge this pilot-project represents the first successful implementation of a simulation-based team-training course focused on pediatric trauma care in German-speaking countries with good acceptance.

Does team reflexivity impact teamwork and communication in interprofessional hospital-based healthcare teams? A systematic review and narrative synthesis

“…It was also applied within reciprocal peer review. All included articles were set in high-risk hospital environments and set out to engender optimisation of daily practice25 36–38; evaluate specific reflexive methods as quality improvement strategies39–45; and/or develop NTS to improve safe and effective working practice46–49 (table 2). All included articles were published between 2006 and 2017.…”

“…There was limited discussion of relevant theories to guide the methods used. Detailed recruitment information was not well reported; for example, most studies using videos did not provide appropriate detail of the process of consent or what would happen if members of a team did not provide consent 25 36 37 40–44 46–49…”

“…Limited detail regarding specific elements of team reflexivity made it difficult to determine how reflexive feedback was delivered. This was particularly true of the facilitation of feedback and how the feedback session itself was structured 37 39–49. There was limited detail regarding the methods used to analyse the effect of team reflexivity specifically with respect to NTS in most articles,25 37–39 41–43 45 making it difficult to learn about what works and what does not.…”

“…Three methods currently promoting reflexive practice in interprofessional healthcare teams were identified from the reviewed articles: team debrief postsimulation,40 44–49 reciprocal peer review39 and VRE 25 36–38 41–43. While the aims of these interventions are consistent, differences were apparent with respect to data collection and outcome measures.…”

“…In seven studies, team reflexivity was embedded in simulation training programmes as collective debriefing. Teams were asked to participate in simulated practices replicating regularly occurring real-world emergencies40 44–48 or routine care practices 49. Simulating scenarios allowed staff to develop and refine skills and practices without the risk of causing harm to patients, to focus on their role within the team, and on how the team worked together to achieve specific clinical outcomes.…”