Abstract P38: Just-In-Time Simulation Training Improves ICU Physician Trainee Airway Resuscitation Participation without Compromising Procedural Success or Safety

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Akira Nishisaki ◽  
Shawn Colborn ◽  
Christine Watson ◽  
Dana Niles ◽  
Susan Ferry ◽  
...  
Keyword(s):  
Simulation Training ◽  
Orotracheal Intubation ◽  
Healthcare Research ◽  
Just In Time ◽  
Resident Participation ◽  
Exact Test ◽  
Time Simulation ◽  
Simulation Based ◽  
Physician Trainee ◽  
Procedural Success

Introduction : Competence in orotracheal intubation is a requirement for Pediatric residency. However, opportunities for residents are limited. We hypothesize Just-in-Time simulation-based multi-disciplinary team training for acute airway resuscitation in a pediatric ICU (PICU) would improve physician trainee intubation participation and success, and decrease undesired T racheal I ntubation A ssociated E vents ( TIAE ) such as esophageal intubation, or mainstem intubation. Methods : With IRB approval, on-call residents in a tertiary PICU received 30 minute airway resuscitation multidisciplinary simulation training before 24 hour on-call duties. Airway resuscitation performance was captured in both simulated and real airway resuscitations using a validated airway registry (NEAR-4-KIDS) tool. Resident participation, success, first attempt success, and the incidence of TIAE were compared before and after this intervention (Pre: Jan 2005–Jun11, 2007; Post: Jun12, 2007–May2008). Analysis by time series analysis, and Fisher’s exact test. Results : 150 simulation training sessions were conducted, and 123 consecutive real orotracheal intubations were evaluated. Resident participation significantly increased: Pre 23 % vs Post 36 % (p=0.016). Overall resident airway resuscitation success (58% vs. 68%, p=0.39) and first attempt success (44% vs. 56%, p= 0.30) improvement were not statistically significant. Despite the increased participation by resident trainees, there was no increase in TIAE (23% vs. 21%, p=0.78) in real airway resuscitation. Conclusion : Simulation-based “Just-in-Time” multidisciplinary training for pediatric advanced airway resuscitation improved actual resident trainee participation in real ICU intubations, but did not compromise airway resuscitation procedural success or patient safety. Supported by Agency for Healthcare Research and Quality (AHRQ), and CHOP Endowed Chair, Critical Care Medicine

scholarly journals Effect of Just-in-time Simulation Training on Tracheal Intubation Procedure Safety in the Pediatric Intensive Care Unit

2010 ◽  
Vol 113 (1) ◽  
pp. 214-223 ◽  
Author(s):  
Akira Nishisaki ◽  
Aaron J. Donoghue ◽  
Shawn Colborn ◽  
Christine Watson ◽  
Andrew Meyer ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tracheal Intubation ◽  
Pediatric Intensive Care ◽  
Just In Time ◽  
Resident Participation ◽  
Intervention Phase ◽  
Refresher Training ◽  
Time Simulation ◽  
Simulation Based ◽  
Multidisciplinary Simulation

Background Tracheal intubation-associated events (TIAEs) are common (20%) and life threatening (4%) in pediatric intensive care units. Physician trainees are required to learn tracheal intubation during intensive care unit rotations. The authors hypothesized that "just-in-time" simulation-based intubation refresher training would improve resident participation, success, and decrease TIAEs. Methods For 14 months, one of two on-call residents, nurses, and respiratory therapists received 20-min multidisciplinary simulation-based tracheal intubation training and 10-min resident skill refresher training at the beginning of their on-call period in addition to routine residency education. The rate of first attempt and overall success between refresher-trained and concurrent non-refresher-trained residents (controls) during the intervention phase was compared. The incidence of TIAEs between preintervention and intervention phase was also compared. Results Four hundred one consecutive primary orotracheal intubations were evaluated: 220 preintervention and 181 intervention. During intervention phase, neither first-attempt success nor overall success rate differed between refresher-trained residents versus concurrent non-refresher-trained residents: 20 of 40 (50%) versus 15 of 24 (62.5%), P = 0.44 and 23 of 40 (57.5%) versus 18 of 24 (75.0%), P = 0.19, respectively. The resident's first attempt and overall success rate did not differ between preintervention and intervention phases. The incidence of TIAE during preintervention and intervention phases was similar: 22.0% preintervention versus 19.9% intervention, P = 0.62, whereas resident participation increased from 20.9% preintervention to 35.4% intervention, P = 0.002. Resident participation continued to be associated with TIAE even after adjusting for the phase and difficult airway condition: odds ratio 2.22 (95% CI 1.28-3.87, P = 0.005). Conclusions Brief just-in-time multidisciplinary simulation-based intubation refresher training did not improve the resident's first attempt or overall tracheal intubation success.

Qualitative Evaluation of Just-in-Time Simulation-Based Learning

2013 ◽  
Vol 8 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Gunjan Kamdar ◽  
David O. Kessler ◽  
Lindsey Tilt ◽  
Geetanjali Srivastava ◽  
Kajal Khanna ◽  
...  
Keyword(s):  
Qualitative Evaluation ◽  
Just In Time ◽  
Time Simulation ◽  
Simulation Based

scholarly journals Simulation in Canadian postgraduate emergency medicine training – a national survey

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 132-141 ◽  
Author(s):  
Evan Russell ◽  
Andrew Koch Hall ◽  
Carly Hagel ◽  
Andrew Petrosoniak ◽  
Jeffrey Damon Dagnone ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
National Survey ◽  
Simulation Training ◽  
Survey Question ◽  
Resident Participation ◽  
Residency Programs ◽  
Training Strategy ◽  
Content Assessment ◽  
Simulation Based ◽  
National Organizations

AbstractObjectivesSimulation-based education (SBE) is an important training strategy in emergency medicine (EM) postgraduate programs. This study sought to characterize the use of simulation in FRCPC-EM residency programs across Canada.MethodsA national survey was administered to residents and knowledgeable program representatives (PRs) at all Canadian FRCPC-EM programs. Survey question themes included simulation program characteristics, the frequency of resident participation, the location and administration of SBE, institutional barriers, interprofessional involvement, content, assessment strategies, and attitudes about SBE.ResultsResident and PR response rates were 63% (203/321) and 100% (16/16), respectively. Residents reported a median of 20 (range 0–150) hours of annual simulation training, with 52% of residents indicating that the time dedicated to simulation training met their needs. PRs reported the frequency of SBE sessions ranging from weekly to every 6 months, with 15 (94%) programs having an established simulation curriculum. Two (13%) of the programs used simulation for resident assessment, although 15 (94%) of PRs indicated that they would be comfortable with simulation-based assessment. The most common PR-identified barriers to administering simulation were a lack of protected faculty time (75%) and a lack of faculty experience with simulation (56%). Interprofessional involvement in simulation was strongly valued by both residents and PRs.ConclusionsSBE is frequently used by Canadian FRCPC-EM residency programs. However, there exists considerable variability in the structure, frequency, and timing of simulation-based activities. As programs transition to competency-based medical education, national organizations and collaborations should consider the variability in how SBE is administered.

“Just-In-Time” Simulation Training Using 3-D Printed Cardiac Models After Congenital Cardiac Surgery

2016 ◽  
Vol 7 (2) ◽  
pp. 164-168 ◽  
Author(s):  
Laura J. Olivieri ◽  
Lillian Su ◽  
Conor F. Hynes ◽  
Axel Krieger ◽  
Fahad A. Alfares ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Simulation Training ◽  
Just In Time ◽  
Congenital Cardiac Surgery ◽  
Time Simulation ◽  
Cardiac Models

Screening residents for infant lumbar puncture readiness with just-in-time simulation-based assessments

2016 ◽  
Vol 3 (1) ◽  
pp. 17-22 ◽  
Author(s):  
David O Kessler ◽  
Todd P Chang ◽  
Marc Auerbach ◽  
Daniel M Fein ◽  
Megan E Lavoie ◽  
...  
Keyword(s):  
Clinical Success ◽  
Point Of Care ◽  
Just In Time ◽  
First Year ◽  
Competency Development ◽  
Readiness Assessment ◽  
Process Measures ◽  
Simulation Based ◽  
Procedural Success ◽  
Removal Technique

BackgroundDetermining when to entrust trainees to perform procedures is fundamental to patient safety and competency development.ObjectiveTo determine whether simulation-based readiness assessments of first year residents immediately prior to their first supervised infant lumbar punctures (LPs) are associated with success.MethodsThis prospective cohort study enrolled paediatric and other first year residents who perform LPs at 35 academic hospitals from 2012 to 2014. Within a standardised LP curriculum, a validated 4-point readiness assessment of first year residents was required immediately prior to their first supervised LP. A score ≥3 was required for residents to perform the LP. The proportion of successful LPs (<1000 red blood cells on first attempt) was determined. Process measures included success on any attempt, number of attempts, analgesia usage and use of the early stylet removal technique.ResultsWe analysed 726 LPs reported from 1722 residents (42%). Of the 432 who underwent readiness assessments, 174 (40%, 95% CI 36% to 45%) successfully performed their first LP. Those who were not assessed succeeded in 103/294 (35%, 95% CI 30% to 41%) LPs. Assessed participants reported more frequent direct attending supervision of the LP (diff 16%; 95% CI 8% to 22%), greater use of topical analgesia (diff 6%; 95% CI 1% to 12%) and greater use of the early stylet removal technique (diff 11%; 95% CI 4% to 19%) but no difference in number of attempts or overall procedural success.ConclusionsSimulation-based readiness assessments performed in a point-of-care fashion were associated with several desirable behaviours but were not associated with greater clinical success with LP.

scholarly journals Just-in-time simulation-based training

2017 ◽  
Vol 26 (11) ◽  
pp. 866-868 ◽  
Author(s):  
Rajesh Aggarwal
Keyword(s):  
Just In Time ◽  
Time Simulation ◽  
Simulation Based

Just-In-Time Simulation Training for Nasopharyngeal Specimen Collection During the SARS-CoV-2 Pandemic

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kristy J. Carlson ◽  
Lauren M. Klute ◽  
Jayme R. Dowdall ◽  
Samuel Pate ◽  
Elizabeth R. Lyden ◽  
...  
Keyword(s):  
Simulation Training ◽  
Just In Time ◽  
Specimen Collection ◽  
Time Simulation

scholarly journals MANAGING OVERNIGHT EVENTS IN THE ICU: JUST-IN-TIME SIMULATION TRAINING FOR RESIDENTS ON CALL

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A1309-A1310
Author(s):  
Raphael Rabinowitz ◽  
Carolyn Drake ◽  
Sunil Nair ◽  
Alexandria Imperato ◽  
Molly Forster ◽  
...  
Keyword(s):  
Simulation Training ◽  
Just In Time ◽  
Time Simulation

scholarly journals Reinstating a national simulation programme in anaesthesiology during the coronavirus pandemic

2021 ◽  
pp. bmjstel-2021-000894
Author(s):  
Sinead Campbell ◽  
Sarah Corbett ◽  
Crina L Burlacu
Keyword(s):  
Simulation Training ◽  
Online Video ◽  
Safety Measures ◽  
Face To Face ◽  
Video Assisted ◽  
Simulation Based ◽  
High Standards ◽  
Strongly Agree ◽  
Training Opportunities ◽  
Simulation Programme

BackgroundWith the introduction of strict public health measures due to the coronavirus pandemic, we have had to change how we deliver simulation training. In order to reinstate the College of Anaesthesiologists Simulation Training (CAST) programme safely, we have had to make significant logistical changes. We discuss the process of reopening a national simulation anaesthesiology programme during a pandemic.MethodsWe approached how to reinstate the programme with three distinct but intertwined projects, as in the following: (1) a survey of effects of the pandemic on training opportunities for anaesthesiology trainees, (2) proposals for methods of reinstating simulation were developed under the headings avoidance, compromise, accommodation and collaboration. A small online video-assisted simulation pilot was carried out to test the compromise method, (3) having opted for combined accommodation (onsite with smaller participant numbers and safety measures) and collaboration (with other regional centres), a postreinstatement evaluation during a 4-month period was carried out.Results(1) Eighty-five per cent of 64 trainees surveyed felt that they had missed out not only just on simulation-based education (43%) but also on other training opportunities, (2) when five trainees were asked to state on a 1 to 5 Likert scale (strongly disagree, disagree, undecided, agree and strongly agree) whether online video-assisted simulation was similar to face-to-face simulation in four categories (realism, immersion, sense of crisis and stress), only 9 (45%) of the 20 answers agreed they were similar, (3) When onsite simulation was reinstated, the majority of trainees felt that training was similar to prepandemic and were happy to continue with this format.ConclusionIn order to reinstate simulation, we have identified that accommodation and collaboration best suited the CAST while compromise failed to rank high among trainees’ preferences. Onsite courses will continue to be delivered safely while meeting the high standards our trainees have come to expect.

Sign in / Sign up

Export Citation Format

Share Document