Simulation-Based Training of Internal Medicine Residents in Advanced Cardiac Life Support Protocols: A Randomized Trial

Wayne, Diane B.; Butter, John; Siddall, Viva J.; Fudala, Monica J.; Linquist, Lee A; Feinglass, Joe; Wade, Leonard D.; McGaghie, William C.

doi:10.1207/s15328015tlm1703_3

Cited by 273 publications

(184 citation statements)

References 22 publications

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“…Prior studies have evaluated the feasibility of virtual simulation and the effects of simulation on teamwork [2,3], and these studies have found a positive effect on team dynamics via these simulation methods, similar to our study. To our knowledge, no studies have examined the feasibility of long-distance, remote simulation to improve teamwork.…”

Section: Discussionsupporting

confidence: 86%

“…Clinical experience alone has not been associated with improved team performance [5]; therefore, training programs are focusing on team dynamics during medical crises as a point of improvement. Since team dynamics can be taught and practiced in simulated environments [6,7], various types of simulation have been developed – computer-based, manikin, and standardized patient [2,3,8]. These training tools may not be available in many hospitals and training facilities in low-middle income countries.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of TEAM dynamics before and after remote simulation training utilizing CERTAIN platform

Pennington

Dong

Coville

et al. 2018

Medical Education Online

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Objective: The current study examines the feasibility and potential effects of long distance, remote simulation training on team dynamics.Design: The study design was a prospective study evaluating team dynamics before and after remote simulation.Subjects: Study subjects consisted of interdisciplinary teams (attending physicians, physicians in training, advanced care practitioners, and/or nurses).Setting: The study was conducted at nine training sites in eight countries.Interventions: Study subjects completed 2–3 simulation scenarios of acute crises before and after training with the Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN).Measurements and main results: Pre- and post-CERTAIN training simulations were evaluated by two independent reviewers utilizing the Team Emergency Assessment Measure (TEAM), which is a 11-item questionnaire that has been validated for assessing teamwork in the intensive care unit. Any discrepancies of greater than 1 point between the two reviewers on any question on the TEAM assessment were sent to a third reviewer to judge. The score that was deemed discordant by the third judge was eliminated. Pre- and post-CERTAIN training TEAM scores were averaged and compared. Of the nine teams evaluated, six teams demonstrated an overall improvement in global team performance following CERTAIN virtual training. For each of the 11 TEAM assessments, a trend toward improvement following CERTAIN training was noted; however, no assessment had universal improvement. ‘Team composure and control’ had the least absolute score improvement following CERTAIN training. The greatest improvement in the TEAM assessment scores was in the ‘team’s ability to complete tasks in a timely manner’ and in the ‘team leader’s communication to the team’.Conclusion: The assessment of team dynamics using long distance, virtual simulation training appears to be feasible and may result in improved team performance during simulated patient crises; however, language and video quality were the two largest barriers noted during the review process.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Evaluation of TEAM dynamics before and after remote simulation training utilizing CERTAIN platform

Pennington

Dong

Coville

et al. 2018

Medical Education Online

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“…Our data support prior work showing that procedural skills that are poor at baseline can be increased significantly using simulation-based training and deliberate practice. [11][12][13][14][15][16][17][18]28 This report on CVC insertion adds to the growing body of literature showing that simulation training complements standard medical education, [11][12][13][14][15][16][17][18][19]28 and expands the clinical application of the mastery model beyond thoracentesis and ACLS. 11,12 Use of the mastery model described in this study also has important implications for patients.…”

mentioning

confidence: 99%

Use of simulation‐based mastery learning to improve the quality of central venous catheter placement in a medical intensive care unit

McGaghie

Cohen

Balachandran

et al. 2009

Journal of Hospital Medicine

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Disclosure: The authors have no financial or other potential conflicts of interest.BACKGROUND: Central venous catheter (CVC) insertions are performed frequently by internal medicine residents.Complications, including arterial puncture and pneumothorax, decrease when operators use fewer needle passes to insert the CVC. In this study, we evaluated the effect of simulation-based mastery learning on CVC insertion skill. DESIGN:This was a cohort study of internal jugular (IJ) and subclavian (SC) CVC insertions by 41 internal medicine residents rotating through the medical intensive care unit (MICU) over a five-month period. Thirteen traditionallytrained residents were surveyed about the number of needle passes, complications, and procedural self-confidence on CVCs inserted in the MICU. Concurrently, 28 residents completed simulation-based training in IJ and SC CVC insertions. Simulator-trained residents were expected to perform CVC insertions to mastery standards on a central line simulator. Simulator-trained residents then rotated through the MICU and were surveyed regarding CVC placement. The impact of simulation training was assessed by comparing group survey results. Central venous catheter (CVC) insertions are commonly performed at the bedside in medical intensive care unit (MICU) settings. Internal medicine residents are required to demonstrate knowledge regarding CVC indications, complications, and sterile technique, 1 and often perform the procedure during training. Education in CVC insertion is needed because many internal medicine residents are uncomfortable performing this procedure. 2 CVC insertion also carries the risk of potentially life-threatening complications including infection, pneumothorax, arterial puncture, deep vein thrombosis, and bleeding. Education and training may also contribute to improved patient care because increased physician experience with CVC insertion reduces complication risk. 3,4 Similarly, a higher number of needle passes or attempts during CVC insertion correlates with mechanical complications such as pneumothorax or arterial punctures. 4-8 Pneumothorax rates for internal jugular (IJ) CVCs have been reported to range from 0% to 0.2% and for subclavian (SC) CVCs from 1.5% to 3.1%. 4,5 The arterial puncture rate for IJ CVCs ranges from 5.0% to 9.4% and for SC CVCs from 3.1% to 4.9%. 4,5 Proper use of ultrasound to assist with IJ CVC insertion has been shown to decrease these mechanical complications. 4,5 However, studies of ultrasound use with SC CVC insertion have mixed results. 4 Simulation-based training has been used in medical education to increase knowledge, provide opportunities for deliberate and safe practice, and shape the development of RESULTS: Journal of Hospital Medicine Vol 4 No 7 September 2009 397clinical skills. 9,10 We previously used simulation-based mastery learning to improve the thoracentesis and advanced cardiac life support (ACLS) skills of internal medicine residents. 11,12 Although a few small studies have linked simulation-based interventions to imp...

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“…29,30 Residents more frequently follow standardized resuscitation measures during actual events after receiving training that utilizes simulation and deliberate practice. 31,32 Using simulation for procedural skill training improves pediatric residents' short-term skill retention. 33 Feedback is often quite variable and inconsistent after resident training experiences, and is generally dependent on individual educators whose own experiences may be limited.…”

Section: Discussionmentioning

confidence: 99%

A delivery room-focused education and deliberate practice can improve pediatric resident resuscitation training

2012

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Simulation-Based Training of Internal Medicine Residents in Advanced Cardiac Life Support Protocols: A Randomized Trial

Abstract: Performance improved significantly after simulator training. No improvement was detected as a function of clinical experience alone. The educational program was rated highly.

Cited by 273 publications

References 22 publications

Evaluation of TEAM dynamics before and after remote simulation training utilizing CERTAIN platform

Evaluation of TEAM dynamics before and after remote simulation training utilizing CERTAIN platform

Use of simulation‐based mastery learning to improve the quality of central venous catheter placement in a medical intensive care unit

A delivery room-focused education and deliberate practice can improve pediatric resident resuscitation training

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