Surgical Crisis Management Skills Training and Assessment

Moorthy, Krishna; Munz, Yaron; Forrest, Damien; Pandey, Vikas; Undre, Shabnam; Vincent, Charles; Darzi, Ara

doi:10.1097/01.sla.0000217618.30744.61

Cited by 144 publications

(39 citation statements)

References 19 publications

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“…Despite these limitations, high-fidelity simulation has become an accepted part of medical practice for training providers to deal with medical emergencies, 24 and simulation studies have demonstrated face validity and initial construct validity. 25–29 We believe that our findings may be comparable to other tertiary care obstetric centers. Although a team of experienced physicians developed the checklist, the checklist did not undergo validation testing.…”

Section: Discussionsupporting

confidence: 80%

Checklists and multidisciplinary team performance during simulated obstetric hemorrhage

Hilton

Daniels

Goldhaber-Fiebert

et al. 2016

International Journal of Obstetric Anesthesia

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Background Checklists can optimize team performance during medical crises. However, there has been limited examination of checklist use during obstetric crises. In this simulation study we exposed multidisciplinary teams to checklist training to evaluate checklist use and team performance during a severe postpartum hemorrhage. Methods Fourteen multidisciplinary teams participated in a postpartum hemorrhage simulation occurring after vaginal delivery. Before participating, each team received checklist training. The primary study outcome was whether each team used the checklist during the simulation. Secondary outcomes were the times taken to activate our institution-specific massive transfusion protocol and commence red blood cell transfusion, and whether a designated checklist reader was used. Results The majority of teams (12/14 (86%)) used the checklist. Red blood cell transfusion was administered by all teams. The median [IQR] times taken to activate the massive transfusion protocol and transfuse red blood cells were 5 min 14 s [3:23–6:43] and 14 min 40 s [12:56–17:28], respectively. A designated checklist reader was used by 7/12 (58%) teams that used the checklist. Among teams that used a checklist with versus without a designated reader, we observed no differences in the times to activate the massive transfusion protocol or to commence red blood cell transfusion (P>0.05). Conclusions Although checklist training was effective in promoting checklist use, multidisciplinary teams varied in their scope of checklist use during a postpartum hemorrhage simulation. Future studies are required to determine whether structured checklist training can result in more standardized checklist use during a postpartum hemorrhage.

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Section: Discussionsupporting

confidence: 80%

Checklists and multidisciplinary team performance during simulated obstetric hemorrhage

Hilton

Daniels

Goldhaber-Fiebert

et al. 2016

International Journal of Obstetric Anesthesia

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“…Similar comprehensive training programs exist for anesthesia, and recent studies [24–26] suggest including cognitive training for surgeons. Accordingly, Helmreich [27] stresses the use of a deliberated training method tailored to conditions and considers human performance limiters such as fatigue and stress.…”

Section: Discussionmentioning

confidence: 99%

Do absorption and realistic distraction influence performance of component task surgical procedure?

et al. 2009

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BackgroundSurgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological distracting conditions may influence surgical performance.MethodsTwelve medical interns performed a laparoscopic cholecystectomy task with the Xitact LC 3.0 virtual reality simulator under distracting conditions (exposure to music, conversation, and nonoptimal handling of the laparoscope) versus nondistracting conditions (control condition) as part of a 2 x 2 within-subject experimental design.ResultsUnder distracting conditions, the medical interns showed a significant decline in task performance (overall task score, task errors, and operating time) and significantly increased levels of irritation toward both the assistant handling the laparoscope in a nonoptimal way and the sources of social distraction. Furthermore, individual differences in cognitive style (i.e., cognitive absorption and need for cognition) significantly influenced the levels of irritation experienced by the medical interns.ConclusionThe results suggest careful evaluation of the social and technological sources of distraction in the operation room to reduce irritation for the surgeon and provision of proper preclinical laparoscope navigation training to increase security for the patient.

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“…Nontechnical skills were assessed using a previously described and validated, modified NOTECHS rating scale used in aviation simulations. 9,11 The scale consists of five categories for the assessment of communication and interaction skills, vigilance and situation awareness, team skills, leadership, and management and decision making in crisis. Each of the categories consists of three to five elements scaled 1 to 6 from worst to best.…”

Section: Nontechnical Skill Evaluationmentioning

confidence: 99%

“…8 Technical task trainers have evolved into completely simulated operating room environments, where surgical teams can practice and perfect their technical and team skills protecting patients and themselves from possible errors encountered in during the learning curve of procedures. 9,10 At the Beth Israel Deaconess Medical Center's, Carl J. Shapiro Simulation and Skills Center (SACS), Boston, MA, USA, our team has validated a simulated scenario of intraabdominal hemorrhage complication of a routine laparoscopic cholecystectomy in an obese patient. This laparoscopic crisis scenario is played out in a mock laparoscopic operating room where the patient and procedure are simulated; however, all members of the surgical team are present, and the equipment is exactly what one would find in the operating room.…”

mentioning

confidence: 99%

Seasoned Surgeons Assessed in a Laparoscopic Surgical Crisis

Powers

Rehrig

Schwaitzberg

et al. 2009

Journal of Gastrointestinal Surgery

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Surgical Crisis Management Skills Training and Assessment

Abstract: We have described the development of a novel simulated setting for the training of crisis management skills and the variability in performance both in between and within the 2 groups.

Cited by 144 publications

References 19 publications

Checklists and multidisciplinary team performance during simulated obstetric hemorrhage

Checklists and multidisciplinary team performance during simulated obstetric hemorrhage

Do absorption and realistic distraction influence performance of component task surgical procedure?

Seasoned Surgeons Assessed in a Laparoscopic Surgical Crisis

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