Simulation Training Effects on Resident-Perceived Readiness for Obstetric Anesthesia Rotation

Background

Beginning an unfamiliar rotation can be challenging as residents must expand their knowledge and skills to meet new clinical expectations, work with a new team of providers, and sometimes care for a new patient demographic. This may detract from learning, resident well-being, and patient care.

Methods

We implemented an obstetric anesthesia simulation session for anesthesiology residents prior to their first obstetric anesthesia rotation and measured the effect on residents' self-perceived preparedness.

Results

The simulation session increased residents' feelings of preparedness for the rotation and increased residents' confidence in specific obstetric anesthesia skills.

Conclusions

Importantly, this study shows the potential for the use of a prerotation, rotation-specific simulation session to better prepare learners for rotations.

A Simulated Scenario to Improve Resident Efficiency in an Emergency Department

Introduction

Multitasking is a core competency in emergency medicine. Simulation has been shown to be an effective method of education, which allows learners to prepare for real-world challenges in a controlled environment.

Methods

In this study, trainees were given a scenario that simulated the experience of managing two patient encounters within a time metric while addressing interruptions that take place in a typical ED. Residents were evaluated using an internally developed scoresheet, which assessed task-switching abilities, documentation skills, and adherence to door to disposition time metric. Residents were asked to evaluate their experience with a survey.

Results

All the participants reported that they would translate some of the skills learned to their daily clinical practice. Five out of six residents reported improvements in their skills as a result of the task-switching training. The following three common themes were pervasive in the debrief discussion: (1) the residents felt the added pressure of the door-to-disposition metric, (2) the objectives of the simulation did not fit within their pre-constructed concept of a successful simulation equating to establishing the correct diagnosis, and (3) the interruptions were very realistic.

Discussion

Emergency physicians are interrupted approximately every 9-14 minutes, and this number increases with the number of patients being managed simultaneously. By developing a safe, simulated training environment, we sought to transfer key strategies for improving focus and learning to prioritize while also helping them to identify how certain pressures and interruptions affected their stress levels and concentration.

Patient Handover in Emergency Trauma Situations

Miscommunication during patient handover can be a major cause of preventable medical errors. Emergency traumas are situations where high stress and cognitive load make communication more difficult. Simulation allows for junior learners to practice emergency scenarios in a low-risk setting. This technical report outlines a simulation involving patient handover in emergency trauma scenarios. The intended group of learners are first-year surgery and emergency medicine residents. The scenarios were developed based on the learning objectives of communication, collaboration, and information transfer. Using a high-fidelity simulation mimicking a tertiary care facility, the skills performed in these scenarios can be applied to everyday practice.