Effects of a pilot simulation training on interdisciplinary closed-loop communication and time to critical actions at an emergency centre in Burundi

Abstract

Introduction

Emergency medicine simulation is an effective training modality in both high and low resource settings. We describe the authors’ experiences conducting a four-week interdisciplinary, in situ, simulation training series at an emergency centre in Burundi.

Methods

Training emphasized effective closed loop communication, early airway, breathing, and circulation assessment, as well as time to vital signs, IV placement, and oxygen administration when appropriate. Six doctor-nursing teams participated in four training sessions as well as pre- and post-test simulation cases which were graded by an independent evaluator.

Results

The training resulted in a statistically significant improvement in closed loop communication as well as notable narrowing in standard deviation of times to critical actions after the training intervention. Although the small sample size and large variation of data limited their statistical significance, these results may indicate a short-term benefit towards early assessment, management and team communication when simulating management of critical patients. Additionally, we found that interdisciplinary, in situ simulation was a safe and likely beneficial option for training and team building in a resource-limited emergency centre.

Conclusion

While this pilot study establishes feasibility of low-cost, interdisciplinary emergency simulation training in resource-limited settings, further research is needed to establish educational effectiveness on quality-of-care measures and its generalizability to other contexts prior to implementing similar trainings.