Anesthesiology Handoff Simulation Case: A Handoff From Intensive Care Unit to Operating Room for Anesthesiology Learners

Anesthesiology Patient Handoff Education Interventions: A Systematic Review

BACKGROUND

Anesthesiology provider handoffs are complex, occur frequently, and have been associated with adverse patient outcomes. The authors sought to determine the degree to which anesthesiology handoff studies with educational interventions incorporated tenets of educational best practices.

METHODS

The research team conducted a systematic review of the peer-reviewed literature focused on handoff studies with education interventions that included anesthesiology providers. Searches were conducted using PubMed, Embase, Scopus, Cochrane, and ERIC (2010-September 2021). Each phase of the article review process included at least two trained independent reviewers. In addition, pairs of trained reviewers abstracted study characteristics RESULTS: Twenty-six articles met inclusion criteria. Two thirds (18/26; 69.2%) were published after 2017, and almost three fourths (19/26; 73.1%) included learners. Education intervention descriptions varied, with only 15.4% (4/26) briefly mentioning education theory, 7.7% (2/26) with clear education objectives, and 7.7% (2/26) assessing curriculum via participant satisfaction. Most (22/26; 84.6%) assessed Kirkpatrick's level 3 (handoff behavior change), and 26.9% (7/26) assessed level 4b (patient outcomes). Medical education quality scores were low (range 6-24, mean 11.3; max 32), with more than half (15/26; 57.7%) receiving scores ≤ 10.

CONCLUSION

Educational interventions demonstrate marked heterogeneity in the use of educational theoretical concepts and established curriculum development best practices. Future studies should report on important aspects of educational interventions, which would allow for comparison across studies, yield the essential data needed to identify handoff education best practices, and improve patient safety.

Acquisition of skills in Critical Emergency Medicine: an experimental study on the SIAARTI Academy CREM experience

BACKGROUND

In 2019 the SIAARTI developed a seven-days course for residents, focused on critical emergency medicine (CREM) in a hostile environment, that grounds on simulation-based education and training with hands-on simulation, high-fidelity simulators and part-task trainers. This project aimed to evaluate the efficacy of this course in comparison to traditional learning programs in term of technical (TS) and non-technical (NTS) skills. We assessed the improvement in TS and NTS over time, and the ability to involve trainees in corporate activities.

METHODS

Three-hundred and twenty-seven trainees completed the study. Trainees were allocated into 3 groups: those who joined the SIAARTI-Academy-CREM course and received a study kit (SAKit, n=124), those who received only a study kit (Kit, n=108), and Control (n=95). Eighty-five tests were administered to investigate skills at 3 timepoints: T0=baseline, T1=post-training/kit, and T2=4-months later.

RESULTS

TS differed among groups (p<0.0001), with the highest points in the SA-Kit group at T1 (post-hoc comparison, p<0.0001 vs Kit; p<0.0001 vs Control), and T2 (post-hoc comparison, p<0.0001 vs Kit; p<0.0001 vs Control). NTS differed among groups (p=0.0406), with the highest points in the SA-Kit group at T1 (post-hoc comparison, p=0.0337 vs Kit; p=0.0416 vs Control), and T2 (post-hoc comparison, p=0.0073 vs Kit; p=0.3308 vs Control). SA-Kit group significantly improved TS (p<0.0001) and NTS (p=0.0006) over time. Involvement in corporate activities of SAkit was significantly higher than Kit and Control (p=0.0012).

CONCLUSIONS

SA-Kit improvement in TS and NTS was higher than Kit and Control and was maintained over time. Participation in this course implemented participation in corporate activities among attendees.