Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-25T22:51:09.552Z Has data issue: false hasContentIssue false
  • English
  • Français

Simulation-based training in critical resuscitation procedures improves residents' competence

Published online by Cambridge University Press:  21 May 2015

Trevor S. Langhan ,
Ian J. Rigby ,
Ian W. Walker ,
Daniel Howes ,
Tyrone Donnon  and
Jason A. Lord
Trevor S. Langhan*
Affiliation:
Division of Emergency Medicine, University of Calgary, Calgary, Alta.
Ian J. Rigby
Affiliation:
Division of Emergency Medicine, University of Calgary, Calgary, Alta.
Ian W. Walker
Affiliation:
Division of Emergency Medicine, University of Calgary, Calgary, Alta.
Daniel Howes
Affiliation:
Department of Emergency Medicine, Queen's University, Kingston, Ont.
Tyrone Donnon
Affiliation:
Undergraduate Medical Education, University of Calgary, Calgary, Alta.
Jason A. Lord
Affiliation:
Department of Critical Care, University of Calgary, Calgary, Alta.
*
Division of Emergency Medicine, University of Calgary, 1403 29th St. NW, Rm. C231, Calgary AB T2N 2T9; [email protected]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

Residents must become proficient in a variety of procedures. The practice of learning procedural skills on patients has come under ethical scrutiny, giving rise to the concept of simulation-based medical education. Resident training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the impact of a simulation-based procedural skills training course on residents' competence in the performance of critical resuscitation procedures.

Methods:

We solicited self-assessments of the knowledge and clinical skills required to perform resuscitation procedures from a cross-sectional multidisciplinary sample of 28 resident study participants. Participants were then exposed to an intensive 8-hour simulation-based training program, and asked to repeat the self-assessment questionnaires on completion of the course, and again 3 months later. We assessed the validity of the self-assessment questionnaire by evaluating participants' skills acquisition through an Objective Structured Clinical Examination station.

Results:

We found statistically significant improvements in participants' ratings of both knowledge and clinical skills during the 3 self-assessment periods (p < 0.001). The participants' year of postgraduate training influenced their self-assessment of knowledge (F2,25 = 4.91, p < 0.01) and clinical skills (F2,25 = 10.89, p < 0.001). At the 3-month follow-up, junior-level residents showed consistent improvement from their baseline scores, but had regressed from their posttraining measures. Senior-level residents continued to show further increases in their assessments of both clinical skills and knowledge beyond the simulation-based training course.

Conclusion:

Significant improvement in self-assessed theoretical knowledge and procedural skill competence for residents can be achieved through participation in a simulation-based resuscitation course. Gains in perceived competence appear to be stable over time, with senior learners gaining further confidence at the 3-month follow-up. Our findings support the benefits of simulation-based training for residents.

Keywords

emergency medicineresidenteducationsimulationprocedurescritical care
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 6 , November 2009 , pp. 535 - 539
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

References

REFERENCES

1.Kohn, LT, Corrigan, JM, Donaldson, MS, editors. To err is human: building a safer health system. Washington (DC): National Academies Press; 1999.Google Scholar
2.Kneebone, RL, Scott, W, Darzi, A,et al. Simulation and clinical practice: strengthening the relationship. Med Educ 2004;38:1095–102.Google Scholar
3.Ziv, A, Ben-David, S, Ziv, M. Simulation based medical education: an opportunity to learn from errors. Med Teach 2005;27:193–9.Google Scholar
4.Ziv, A, Wolpe, PR, Small, SD, et al. Simulation-based medical education: an ethical imperative. Acad Med 2003;78:783–8.CrossRefGoogle ScholarPubMed
5.Newble, DI. Assessing clinical competence at the undergraduate level. Med Educ 1992;26:504–11.Google Scholar
6.Kneebone, R, Nestel, D, Wetzel, C, et al. The human face of simulation: patient-focused simulation training. Acad Med 2006;81:919–24.CrossRefGoogle ScholarPubMed
7.Dawson, S. Procedural simulation: a primer. Radiology 2006;241:17–25.CrossRefGoogle ScholarPubMed
8.Vozenilek, J, Huff, JS, Reznek, M, et al. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med 2004;11:1149–54.Google Scholar
9.Beaubien, JM, Baker, DP. The use of simulation for training teamwork skills in health care: how low can you go? Qual Saf Health Care 2004;13(Suppl 1):i51–6.Google Scholar
10.Gaba, DM. The future vision of simulation in health care. Qual Saf Health Care 2004;13(Suppl 1):i2–10.CrossRefGoogle ScholarPubMed
11.Seropian, MA, Brown, K, Gavilanes, JS, et al. Simulation: not just a manikin. J Nurs Educ 2004;43:164–9.Google Scholar
12.Weller, J, Dowell, A, Kljakovic, M, et al. Simulation training for medical emergencies in general practice. Med Educ 2005;39:1154.CrossRefGoogle ScholarPubMed
13.Norris, TE, Cullison, SW, Fihn, SD. Teaching procedural skills. J Gen Intern Med 1997;12(Suppl 2):S64–70.Google Scholar
14.Fincher, RM, Lewis, LA. Learning, experience, and self-assessment of competence of third-year medical students in performing bedside procedures. Acad Med 1994;69:291–5.CrossRefGoogle ScholarPubMed
15.Lockyer, J. Multisource feedback in the assessment of physician competencies. J Contin Educ Health Prof 2003;23:4–12.CrossRefGoogle ScholarPubMed