Impact of a large interprofessional simulation-based training course on communication, teamwork, and safety culture in the operating theatre: a mixed-methods interventional study

The evidence for using surgical simulators in training and assessment is growing rapidly. A systematic review has demonstrated the validity of different simulators for a range of procedures. Research suggests that skills developed on simulators can be transferred to the operating theatre. The increased interest in simulation comes as a result of the need to streamline surgical training. This is reflected by the numerous simulation-based courses that have become an essential part of modern surgical training.

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Can a Simulation-based Sedation Training Course Improve the Safety of Sedation in Various Areas?

THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA ◽

10.2199/jjsca.34.281 ◽

2014 ◽

Vol 34 (2) ◽

pp. 281-285

Author(s):

Nobuyasu KOMASAWA ◽

Shunsuke FUJIWARA ◽

Ryusuke UEKI ◽

Hironobu UESHIMA ◽

Kazuaki ATAGI ◽

...

Keyword(s):

Training Course ◽

Simulation Based

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Professional practice assessment for minor head injury management in emergency department and clinical impact of a simulation-based training: interventional study (before/after)

Turkish Journal of Trauma and Emergency Surgery ◽

10.14744/tjtes.2020.91589 ◽

2020 ◽

Author(s):

Pierre Vandingenen

Keyword(s):

Emergency Department ◽

Head Injury ◽

Professional Practice ◽

Clinical Impact ◽

Minor Head Injury ◽

Interventional Study ◽

Injury Management ◽

Simulation Based ◽

Practice Assessment

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Patient safety culture in the perception of health professionals: A mixed methods research study

Revista Gaúcha de Enfermagem ◽

10.1590/1983-1447.2021.20200418 ◽

2021 ◽

Vol 42 ◽

Author(s):

Cassiana Gil Prates ◽

Rita Catalina Aquino Caregnato ◽

Ana Maria Müller de Magalhães ◽

Daiane Dal Pai ◽

Janete de Souza Urbanetto ◽

...

Keyword(s):

Patient Safety ◽

Mixed Methods ◽

Safety Culture ◽

Health Professionals ◽

Mixed Methods Research ◽

Work Organization ◽

Patient Safety Culture ◽

Integrated Analysis ◽

Explanatory Mixed Methods ◽

Perception Of Health

ABSTRACT Objective: To analyze the patient safety culture perceived by health professionals working in a hospital and to understand the elements influencing it. Methods: A sequential explanatory mixed methods study, conducted in 2017 in two interrelated stages in a hospital. The quantitative stage was carried out by applying the questionnaire to 618 professionals and the qualitative stage, with ten, using the focus group technique. The analysis was descriptive statistics for the quantitative data and of content for the qualitative data. Subsequently, the data were submitted to integrated analysis. Results: Of the 12 dimensions, seven were considered weak, the most critical being “non-punitive response to error” with 28.5% of positive answers. Bureaucratic, poorly designed and uncoordinated processes, regional decisions, communication failures, hierarchy, overload, punishment and judicialization were related to the perception. Conclusions: The patient safety culture was considered weak, and elements related to work organization, people management and legal risk influenced this negative perception.

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Educational impact of a pilot paediatric simulation-based training course in Botswana

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2019-000501 ◽

2019 ◽

Vol 6 (5) ◽

pp. 279-283

Author(s):

Nicolaus W Glomb ◽

Manish I Shah ◽

Adeola A Kosoko ◽

Cara B Doughty ◽

Cafen Galapi ◽

...

Keyword(s):

Test Scores ◽

Self Efficacy ◽

Limited Resource ◽

Knowledge And Skills ◽

Training Course ◽

Resource Setting ◽

Simulation Based ◽

And Performance ◽

Training Programmes ◽

The Impact

BackgroundAs emergency medical services (EMS) systems develop globally in resource-limited settings, equipping providers with paediatric training is essential. Low-fidelity simulation-based training is an effective modality for training healthcare workers, though limited data exist on the impact of such training programmes. The objective of this study was to evaluate the paediatric portion of a simulation-based curriculum for prehospital providers in Botswana.MethodsThis was a prospective cohort study of EMS providers from more populated regions of Botswana, who attended a 2-day training that included didactic lectures, hands-on skills stations and low-fidelity simulation training. We collected data on participant self-efficacy with paediatric knowledge and skills and performance on both written and simulation-based tests. Self-efficacy and test data were analysed, and qualitative course feedback was summarised.ResultsThirty-one EMS providers participated in the training. Median self-efficacy levels increased for 13/15 (87%) variables queried. The most notable improvements were observed in airway management, newborn resuscitation and weight estimation. Mean written test scores increased by 10.6%, while mean simulation test scores increased by 21.5% (p<0.0001). One hundred per cent of the participants rated the course as extremely useful or very useful.Discussion/ConclusionWe have demonstrated that a low-fidelity simulation-based training course based on a rigorous needs assessment may enhance short-term paediatric knowledge and skills for providers in a developing EMS system in a limited-resource setting. Future studies should focus on studying larger groups of learners in similar settings, especially with respect to the impact of educational programmes like these on real-world patient outcomes.

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Impact of the Norwegian National Patient Safety Program on implementation of the WHO Surgical Safety Checklist and on perioperative safety culture

BMJ Open Quality ◽

10.1136/bmjoq-2020-000966 ◽

2020 ◽

Vol 9 (3) ◽

pp. e000966

Author(s):

Arvid Steinar Haugen ◽

Eirik Søfteland ◽

Nick Sevdalis ◽

Geir Egil Eide ◽

Monica Wammen Nortvedt ◽

...

Keyword(s):

Patient Safety ◽

Safety Culture ◽

Patient Safety Culture ◽

Operating Theatre ◽

Secondary Outcome ◽

Safety Program ◽

Surgical Safety ◽

Hospital Managers ◽

Culture Dimensions ◽

National Patient

ObjectivesOur primary objective was to study the impact of the Norwegian National Patient Safety Campaign and Program on Surgical Safety Checklist (SSC) implementation and on safety culture. Secondary objective was associations between SSC fidelity and safety culture. We hypothesised that the programme influenced on SSC use and operating theatre personnel’s safety culture perceptions.SettingA longitudinal cross-sectional study was conducted in a large Norwegian tertiary teaching hospital.ParticipantsWe invited 1754 operating theatre personnel to participate in the study, of which 920 responded to the surveys at three time points in 2009, 2010 and 2017.Primary and secondary outcome measuresPrimary outcome was the results of the patient safety culture measured by the culturally adapted Norwegian version of the Hospital Survey on Patient Safety Culture. Our previously published results from 2009/2010 were compared with new data collected in 2017. Secondary outcome was correlation between SSC fidelity and safety culture. Fidelity was electronically recorded.ResultsSurvey response rates were 61% (349/575), 51% (292/569) and 46% (279/610) in 2009, 2010 and 2017, respectively. Eight of the 12 safety culture dimensions significantly improved over time with the largest increase being ‘Hospital managers’ support to patient safety’ from a mean score of 2.82 at baseline in 2009 to 3.15 in 2017 (mean change: 0.33, 95% CI 0.21 to 0.44). Fidelity in use of the SSC averaged 88% (26 741/30 426) in 2017. Perceptions of safety culture dimensions in 2009 and in 2017 correlated significantly though weakly with fidelity (r=0.07–0.21).ConclusionThe National Patient Safety Program, fostering engagement from trust boards, hospital managers and frontline operating theatre personnel enabled effective implementation of the SSC. As part of a wider strategic safety initiative, implementation of SSC coincided with an improved safety culture.

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The EACTS simulation-based training course for endoscopic mitral valve repair: an air-pilot training concept in action

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz323 ◽

2020 ◽

Vol 30 (5) ◽

pp. 691-698 ◽

Cited By ~ 1

Author(s):

Peyman Sardari Nia ◽

Samuel Heuts ◽

Jean H T Daemen ◽

Jules R Olsthoorn ◽

W Randolph Chitwood ◽

...

Keyword(s):

Mitral Valve ◽

Mitral Valve Repair ◽

Course Evaluation ◽

Pilot Training ◽

Valve Repair ◽

Training Course ◽

Simulation Based ◽

Training Concept ◽

Post Assessment

Abstract OBJECTIVES We have developed a high-fidelity minimally invasive mitral valve surgery (MIMVS) simulator that provides a platform to train skills in an objective and reproducible manner, which has been incorporated in the European Association for Cardiothoracic Surgery (EACTS) endoscopic mitral valve repair course. The aim of the study is to provide data on the application of simulation-based training in MIMVS using an air-pilot training concept. METHODS The 2-day EACTS endoscopic mitral training course design was based on backwards chaining, pre- and post-assessment, performance feedback, hands-on training on MIMVS, theoretical content and follow-up. One hundred two participants who completed the full programme throughout 2016–2018 in the EACTS endoscopic mitral training courses were enrolled in the current study. RESULTS Of the 102 participants, 83 (83.3%) participants were staff/attending surgeons, 12 (11.8%) participants had finished residency and 5 (4.9%) participants were residents. Theoretical pre- and post-assessment showed that participants scored significantly higher on post-assessment (median score 58% vs 67%, P < 0.001). Pre- and post-assessment of skills on MIMVS showed that participants could work with long-shafted instruments more accurately (suture accuracy 43% vs 99%, P < 0.001) and faster (87 vs 42 s, P < 0.001). Follow-up, based on course evaluation and a survey, had a response rate of 55% (57 participants). Of all surveyed participants, 33.3% (n = 19) had started an endoscopic mitral programme successfully, while 66.7% (n = 38) did not yet start. CONCLUSIONS The MIMVS is a valuable tool for the development and assessment of endoscopic mitral repair skills. This EACTS course provides surgeons with theoretical knowledge and necessary skills to start an endoscopic mitral valve programme successfully.

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P100: Iterative prototype development of a mobile tele-simulation unit for remote training: an update

CJEM ◽

10.1017/cem.2017.302 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S112 ◽

Cited By ~ 2

Author(s):

M.H. Parsons ◽

A. Smith ◽

K.J. Hoover ◽

J. Jewer ◽

S. Noseworthy ◽

...

Keyword(s):

Emergency Medicine ◽

Mixed Methods ◽

Learning Experience ◽

Rural And Remote ◽

Mixed Methods Approach ◽

Technical Performance ◽

Prototype Development ◽

Simulation Based ◽

Technical Issues ◽

Simulation Unit

Introduction/Innovation Concept: Rural and remote practice of emergency medicine presents unique challenges, particularly when faced with infrequently encountered cases and procedures. Simulation-based training is a valuable tool in the acquisition and maintenance of knowledge and skills; however, simulators are often located in larger centers and they are not widely outside these centers due to geographic, cost and time constraints. Mobile tele-simulation has the potential to overcome barriers but challenges such as comfort, technical issues and ability to teach desired content via tele-simulation must be addressed. We are developing a mobile-tele-simulation unit (MTU) prototype that will enable emergency medicine practitioners and trainees to access simulation-based instruction in rural and remote settings. Methods: Through application of a mixed-methods approach with input of a multidisciplinary team we are iteratively developing an MTU prototype to assess key factors in design and function, including: technical issues, environmental features, and human factors. The Delphi method is being used to collect input from experts on key design components and feedback is also being collected from trainees after participating in trial deployments of the MTU in different educational and environmental settings. Curriculum, Tool, or Material: The effective application of the MTU in a variety of learning settings will be optimized through ongoing evaluation in the iterative design cycle. Feedback to ensure a quality learning experience in the MTU will direct features of physical design and technical performance that can be applied in deployment of the unit. In addition, challenges to the delivery of module content and instructional modality/ features of lessons to be executed will be important considerations as we move toward developing content that can effectively be taught using the MTU. Conclusion: To ensure effective use of tele-simulation in the delivery of a meaningful simulation experience to rural and remote trainees a number of important challenges must be overcome. We describe our evolving multidisciplinary mixed-methods approach to develop an effective mobile tele-simulation unit.

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