Promoting anaesthesia providers' non-technical skills through the Vital Anaesthesia Simulation Training (VAST) course in a low-resource setting

Abstract

Background: Short educational programmes are important in building global anaesthesia workforce capacity. The Vital Anaesthesia Simulation Training (VAST) course is a 3-day immersive simulation-based programme concentrating on core clinical challenges and non-technical skills required by anaesthesia providers in low-resource settings.Methods: This mixed methods study prospectively evaluated the impact of VAST in Rwanda. Anaesthetists' Non-Technical Skills (ANTS) scores were quantitatively assessed for 30 course participants at three time points (pre-, post-, and 4 months after VAST). Qualitative data were gathered during focus groups (4 months after VAST) to learn of participants' experiences implementing new knowledge into clinical practice. Results: The ANTS total scores improved from pre-(11.0 [2.3]) (mean [standard deviation]) to post-test (14.0 [1.6]), and improvements were maintained at retention (14.2 [1.7]). A similar pattern was observed when data were analysed using the four ANTS categories (all P<0.001). The key theme that emerged during focus group discussions was that the use of cognitive aids and clinical algorithms, repeated and reinforced across simulated scenarios, encouraged a systematic approach to patient care. The participants attributed the systematic approach to improving their problem-solving skills and confidence, particularly during emergencies. They found value in well-functioning teams and shared decision-making. After VAST, the participants described empowerment to advocate for better patient care and system improvement. Conclusions: VAST offers a simulation-based training to anaesthesia providers working in low-resource settings. Skills retention and self-reported application of learning into the workplace reflect the scope of impact of this training.

Qualities of Effective Vital Anaesthesia Simulation Training Facilitators Delivering Simulation-Based Education in Resource-Limited Settings

“…5 VAST has demonstrated the capacity to produce sustained improvements in course participants' nontechnical skills. 37 Competencies of effective VAST facilitators identified in this study reflect the core qualities promoted in best practice standards for simulation educators. 22,38 Key points of difference from this study are the requirements for facilitators in resource-limited settings to be highly flexible and to explore the contextual, cultural, and communication factors that may impact learners' performance.…”

“…5 VAST has demonstrated the capacity to produce sustained improvements in course participants’ nontechnical skills. 37 Competencies of effective VAST facilitators identified in this study reflect the core qualities promoted in best practice standards for simulation educators. 22,38…”

Transfer of Clinical Decision-Making–Related Learning Outcomes Following Simulation-Based Education in Nursing and Medicine: A Scoping Review

“…From a pool of 5,969 unique records, 61 articles 26–86 were included in this review (Figure 1). Study characteristics are presented in Table 1.…”

Anesthesia Patient Safety: Still a Long Way to Go

“…High-tech simulation is not always required. There are several widely used low-tech programs such as Safer Anaesthesia from Education Operating Room (SAFE OR) 16 and Vital Anaesthesia Simulation Training (VAST) 17 that work on team nontechnical skills. These are readily accessible to everyone, everywhere.…”