Evaluation of a multidisciplinary simulation training curriculum for local anesthetic systemic toxicity management: a quasi-experimental study using the Kirkpatrick model in India.

Abstract

Background: Local anesthetic systemic toxicity (LAST) is a rare life-threatening complication of regional anesthesia. Simulation-based training offers an effective educational approach to improve the management of infrequent events. This quasi-experimental study assessed the impact of a multidisciplinary simulation-based educational intervention on managing LAST as a real peri-operative team.

Methods: Twelve anesthesia trainees and eight nursing staff members participated in the study. The intervention included pre-course learning materials, cognitive aids, and immersive simulation scenarios. Simulation scenarios were conducted at baseline (O1), one week after a boot camp (O2), and six months later (O3). Participants' reactions to the training were evaluated using a 5-point Likert scale, while knowledge acquisition was measured through pre- and post-test questionnaires. Team-based skills acquisition and retention were assessed using a modified checklist from the simulation team assessment tool. Data were analyzed using paired t-tests, with P < 0.05 considered statistically significant.

Results: All participants rated the LAST curriculum as satisfactory to very satisfactory. Significant improvements in both technical and non-technical skills were observed post-intervention (O2), with checklist scores increasing from an average of 39 (4.2) (95% confidence interval [CI], 34.88; 43.11) at O1 to 83.5 (5.7) (95% CI, 77.91; 89.08) at O2 (mean difference, 44.5; P < 0.001). At six months (O3), skill retention was indicated by an average score of 72 (7.8) (95% CI, 62.36; 77.64).

Conclusions: Multidisciplinary, simulation-based educational interventions remarkably improve knowledge and skills related to LAST management, with effective skill retention observed at six months when implemented by multiprofessional teams in real-world settings.