Effectiveness of a Multiprofessional, Online and Simulation-Based Difficult Conversations Training Program on Self-Perceived Competence of Oncology Healthcare Provider Trainees

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

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Simulation-based ultrasound-guided central venous cannulation training program

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502014000200010 ◽

2014 ◽

Vol 29 (2) ◽

pp. 132-144 ◽

Cited By ~ 6

Author(s):

Rafael Denadai ◽

Andreia Padilha Toledo ◽

Danielle Milani Bernades ◽

Felipe Daldegan Diniz ◽

Fernanda Brandão Eid ◽

...

Keyword(s):

Training Program ◽

Venous Cannulation ◽

Central Venous Cannulation ◽

Ultrasound Guided ◽

Central Venous ◽

Simulation Based

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Differences in Safety Climate Among Hospital Anesthesia Departments and the Effect of a Realistic Simulation-Based Training Program

Anesthesia & Analgesia ◽

10.1213/01.ane.0000296462.39953.d3 ◽

2008 ◽

Vol 106 (2) ◽

pp. 574-584 ◽

Cited By ~ 27

Author(s):

Jeffrey B. Cooper ◽

Richard H. Blum ◽

John S. Carroll ◽

Mark Dershwitz ◽

David M. Feinstein ◽

...

Keyword(s):

Training Program ◽

Safety Climate ◽

Realistic Simulation ◽

Simulation Based

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Abstract 12052: A Comprehensive Simulation-Based Training for E-CPR Improves the Neurological Outcome of Patients With Refractory Cardiac Arrest

Circulation ◽

10.1161/circ.144.suppl_2.12052 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Takaaki Toyofuku ◽

Takashi Unoki ◽

Junya Matsuura ◽

Yutaka Konami ◽

Hiroto Suzuyama ◽

...

Keyword(s):

Cardiac Arrest ◽

Training Program ◽

Neurological Outcome ◽

Hazard Analysis ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Coronary Syndrome ◽

Simulation Based ◽

Favorable Neurological Outcome ◽

Cpr Training ◽

Refractory Cardiac Arrest

Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) has been utilized as a rescue strategy for patients with refractory cardiac arrest (CA). To improve the outcome of E-CPR, we developed a comprehensive simulation-based E-CPR training program. In the present study we assessed whether the E-CPR training improved the mortality and the neurological outcome. Methods: We have implemented the comprehensive E-CPR simulation training program twice a year to the medical team, which consists of emergency physicians, cardiologists, nurses, clinical engineers, and radiographers using a mock vascular model for E-CPR (ECMO cannulation). We assessed collapse to ECMO time, cumulative 30-day survival and good neurological outcome at hospital discharge defined as the cerebral performance categories (CPC) of 1 or 2. Results: Fifty-three consecutive patients received E-CPR for OHCA from January 2012 to December 2020 in which 31 patients were prior to (until September 2017) and 22 were after (from October 2017) the initiation of the E-CPR training. No differences were found in age, rates of witnessed and bystander-CPR, shockable rhythms, or acute coronary syndrome (ACS). Intra-aortic balloon pump was used in 87% patients prior to and 27% patients after the training (p<0.001), and a microaxial Impella pump was used in 55% after the training. Collapse to ECMO time was significantly shorter after the training (p<0.001). Cumulative 30-day survival and the rate of favorable neurological outcome were significantly higher after the training (p<0.05). Multivariate cox proportional hazard analysis revealed that age (hazard ratio [HR], 1.38 (10 years increase), 95% confidence interval [CI], 1.12-1.73, p=0.002), Collapse to ECMO time (HR, 1.14, 95%CI, 1.04-1.23, p=0.006), and additional Impella use (HR, 0.23, 95% CI, 0.08-0.69, p=0.0009) were significantly associated with the 30-day survival. Conclusions: The E-CPR training significantly improved the collapse to ECMO time. The faster deployment of ECMO improves the neurological outcome and 30-day survival in patients with refractory CA. Additional use of Impella may improve the survival.

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