Performance Under Stress Conditions During Multidisciplinary Team Immersive Pediatric Simulations*

Ghazali, Daniel Aiham; Darmian-Rafei, Ivan; Ragot, Stéphanie; Oriot, D.

doi:10.1097/pcc.0000000000001473

Cited by 21 publications

(20 citation statements)

References 39 publications

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“…We noticed a strong correlation between the technical and non-technical skills of students. A similar relationship has been demonstrated among French Emergency Medical Service workers during simulations at both the individual and team levels [19]. In addition, the performance of simulation participants was positively associated with their self-confidence and negatively associated with their dissatisfaction.…”

Section: Discussionsupporting

confidence: 73%

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations

Łoś

Chmielewski

Łuczyński

2020

IJERPH

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Over the past decade, high-fidelity medical simulation has become an accepted and widely used teaching method in pediatrics. Both simulation and work in the real conditions of emergency departments are accompanied by stress that affects the executive functions of participants. One of the methods for reducing stress among medical students and healthcare professionals is the practice of mindfulness. The aim of this study was to examine whether executive functions, mindfulness, and stress are related to the technical and non-technical skills of medical students participating in medical simulations in pediatrics. The study included 153 final-year medical students. A total of 306 high-fidelity simulations of life-threatening situations involving children were conducted. Results: Stress and the coping mechanism of the participants were correlated to their skills during pediatric simulations. Some components of mindfulness, such as non-judgment and conscious action, were positively related to the skills of medical team leaders. Executive functions correlated with the non-technical skills and mindfulness of the medical students. Conclusions: Stress, mindfulness, and executive functions modeled the behavior and skills of medical students during pediatric simulations of life-threatening events. Further research in this area may prove whether mindfulness training will improve learning outcomes in pediatric emergency medicine.

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Section: Discussionsupporting

confidence: 73%

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations

Łoś

Chmielewski

Łuczyński

2020

IJERPH

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“…One of two subject matter experts (J-MG and MH) experienced in using the Clinical Teamwork Scale (CTS) directly observed simulations in real time and measured teamwork using the CTS, a validated instrument that measures overall teamwork and 15 specific elements in five overarching domains in addition to overall teamwork: communication, decision-making, role responsibility (leadership and followership), situational awareness/resource management and patient-friendliness 19. CTS was selected because the authors were skilled in its use having developed it over a decade ago with a diverse team (that included one of the founders of crew resource management), it was designed specifically to allow quick assessments of teamwork during rapidly moving clinical emergencies, it is free, and has been successfully used by us and numerous others to measure teamwork in emergent clinical scenarios similar to our intended purpose: paediatric resuscitations, obstetrics, trauma, advanced cardiac life support and emergency medical services 20–27. Evaluators rate the performance of the care team using a Likert scale of zero (unacceptable) to 10 (perfect) and are given space to insert narrative comments.…”

Section: Methodsmentioning

confidence: 99%

Association between measured teamwork and medical errors: an observational study of prehospital care in the USA

et al. 2019

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ObjectivesThe goal of this study was to examine the relationship between measured teamwork and adverse safety events in the prehospital emergency care of children using high-fidelity simulation. We posit that non-technical skills such as leadership, teamwork, situation awareness and decision-making are associated with the clinical success of teams.DesignObservational study.SettingEmergency medical services (EMS) responders were recruited from public fire and private transport agencies in Oregon State to participate in four simulations of paediatric emergencies using high-fidelity patient simulators, scene design, and professional actors playing parents and bystanders.ParticipantsForty-four fire/transport teams consisting of 259 EMS professionals consented to participate and completed simulations.Primary and secondary outcome measuresTeams were assessed using the Clinical Teamwork Scale (CTS), a validated instrument that measures overall teamwork and 15 specific elements in five overarching domains: communication, decision-making, role responsibility (leadership and followership), situational awareness/resource management and patient-friendliness. We used generalised estimating equations to estimate the odds of error with increasing overall CTS teamwork score while adjusting for clinical scenario and potential clustering by team.ResultsAcross 176 simulations, the mean overall score on the CTS was 6.04 (SD 2.10; range 1=poor to 10=perfect) and was normally distributed. The distribution of scores was similar across the four clinical scenarios. At least one error was observed in 82% of the simulations. In simulations with at least one observed error, the mean CTS score was 5.76 (SD 2.04) compared with 7.16 (SD 1.95) in scenarios with no observed error. Logistic regression analysis accounting for clustering at the team level revealed that the odds of an error decreased 28% with each unit increase in CTS (OR 0.72, 95% CI 0.59 to 0.88).ConclusionsThis study found that overall teamwork among care delivery teams was strongly associated with the risk of serious adverse events in simulated scenarios of caring for critically ill and injured children.

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“…Use of NRS has been validated in EDs [ 19 ], Pain assessment duration (minutes). Secondary end points Training Measurement of the delta between pre and post test results after nurses' training, Performance in simulation will be assessed, using the TAPAS scale, a valid and reliable scale (Cronbach alpha = 0.745, Intra-class coefficient = 0.862) [ 20 ], Measurement of satisfaction by self-assessment survey (score of 0–10). Care Time to initiate analgesic treatment (time in minutes from patient arrival to delivery of treatment), Use of analgesics in accordance with ED protocols, Satisfaction of patients through a self-assessment survey (score of 0–10), Satisfaction of caregivers through a self-assessment survey (score of 0–10).…”

Section: Methods and Analysismentioning

confidence: 99%

“…Training Measurement of the delta between pre and post test results after nurses' training, Performance in simulation will be assessed, using the TAPAS scale, a valid and reliable scale (Cronbach alpha = 0.745, Intra-class coefficient = 0.862) [ 20 ], Measurement of satisfaction by self-assessment survey (score of 0–10). …”

Section: Methods and Analysismentioning

confidence: 99%

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A multicenter randomized control trial evaluating professional practice assessment of patient pain management after simulation training course: Study protocol

Ghazali

Kenway²,

Clery³

et al. 2019

Contemporary Clinical Trials Communications

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AimsPain is underestimated and insufficiently treated in Emergency Departments (ED). The primary objective of this multicenter, prospective, observational, and interventional study is to analyze the clinical impact of a simulation-based training for Emergency Nurses on pain assessment and management. Secondary objectives are to measure instructed staff's satisfaction with the simulation training and to evaluate the progress of participants as well as studying the clinical impact of this course: level of correlation between accuracy of analgesia and level of pain, assessment of patient and caregiver satisfaction.Designthis study will be undertaken in EDs at two university hospitals (Paris, France: Bichat and Beaujon) with randomly selected experimental and control groups.MethodsDuring the first phase, inventories in the EDs of current professional practice will be realized. Then, the control group will have theoretical classes and the experimental group will have both the theoretical class and simulation courses for all the nurses (with simulated patients in trauma pain scenarios). Post course assessment will be established of triage nurses' and other nurses’ practice changes concerning trauma pain management in EDs. Moreover, this study will include an assessment of the impact on patient and caregiver satisfaction. All patients over 18 years old who are admitted to the ED for a non-vital trauma are included. Exclusion criteria are patients who are admitted by an EMS ambulance.Clinical implicationthis study seeks to demonstrate that the implementation of a theoretical course combined with a simulation session will improve pain management in EDs by Emergency Nurses.

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Performance Under Stress Conditions During Multidisciplinary Team Immersive Pediatric Simulations*

Cited by 21 publications

References 39 publications

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations

Association between measured teamwork and medical errors: an observational study of prehospital care in the USA

A multicenter randomized control trial evaluating professional practice assessment of patient pain management after simulation training course: Study protocol

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