Kathleen M. Waters MD, Ruth Hwu MD, Mona Kulkarni MD, Jeffrey Okonye MD, Ronine Zamor MD, MPH, Sofia Chaudhary MD, Andrew Jergel MPH, Scott Gillespie MS, MSPH, Abby Lewis MD, Rachel Krieger DO, MS, Vidya Menon MD, Geovonni Bell MD, Jacob Levy DO, Tory Prynn MD, Jacqueline Regan MD, MPH, Claire Mathai BSN, Nandranie Goodwin BSN, Sherita Holmes MD
{"title":"利用现场模拟提高团队绩效，并使用快速顺序插管清单。","authors":"Kathleen M. Waters MD, Ruth Hwu MD, Mona Kulkarni MD, Jeffrey Okonye MD, Ronine Zamor MD, MPH, Sofia Chaudhary MD, Andrew Jergel MPH, Scott Gillespie MS, MSPH, Abby Lewis MD, Rachel Krieger DO, MS, Vidya Menon MD, Geovonni Bell MD, Jacob Levy DO, Tory Prynn MD, Jacqueline Regan MD, MPH, Claire Mathai BSN, Nandranie Goodwin BSN, Sherita Holmes MD","doi":"10.1002/aet2.11039","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Intubation checklists have emerged as tools to reduce adverse events and improve efficiency during rapid sequence intubation (RSI) in pediatric emergency departments (PEDs). This study aimed to use multidisciplinary simulation (SIM) training as an educational tool to improve PED team performance during RSI scenarios through utilization of an RSI checklist.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We created a checklist modeled after previously published PED checklists. PED multidisciplinary teams participated in video-recorded SIM training sessions involving a scenario requiring intubation three times, first without interruption then while receiving our intervention of rapid-cycle deliberate practice (RCDP) debriefing focusing on checklist utilization and team dynamics. Learners went through the scenario once more uninterrupted to apply learned skills. Team performance was evaluated via video review using the Simulation Team Assessment Tool (STAT) focusing on airway management and human factors sections. Scores were compared before and after intervention along with pre- and postintervention surveys.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 483 learners participated in 64 SIM training sessions, 44 of whom met inclusion criteria and were included for data analysis. Scores increased postintervention for airway management, human factors and in total. Least-squares mean differences for total, airway, and human factors scores were 9.55 (95% confidence interval [CI] 7.24–11.85), 4.22 (95% CI 2.91–5.52), and 5.33 (95% CI 3.86–6.8), respectively, which was statistically significant with <i>p</i>-value of <0.001 across all categories. Surveys demonstrated improved role understanding and checklist utilization comfort postintervention.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>This study supports the benefit of multidisciplinary SIM training with RCDP-style methodology as an educational method for improving airway management, teamwork skills, and RSI checklist utilization for PED staff. Incorporation of additional maintenance SIM sessions for ongoing education is likely to be further beneficial and would allow evaluation of degradation of skills over time following initial training.</p>\n </section>\n </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"8 6","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Use of in situ simulation to improve team performance and utilization of a rapid sequence intubation checklist\",\"authors\":\"Kathleen M. Waters MD, Ruth Hwu MD, Mona Kulkarni MD, Jeffrey Okonye MD, Ronine Zamor MD, MPH, Sofia Chaudhary MD, Andrew Jergel MPH, Scott Gillespie MS, MSPH, Abby Lewis MD, Rachel Krieger DO, MS, Vidya Menon MD, Geovonni Bell MD, Jacob Levy DO, Tory Prynn MD, Jacqueline Regan MD, MPH, Claire Mathai BSN, Nandranie Goodwin BSN, Sherita Holmes MD\",\"doi\":\"10.1002/aet2.11039\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Intubation checklists have emerged as tools to reduce adverse events and improve efficiency during rapid sequence intubation (RSI) in pediatric emergency departments (PEDs). This study aimed to use multidisciplinary simulation (SIM) training as an educational tool to improve PED team performance during RSI scenarios through utilization of an RSI checklist.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We created a checklist modeled after previously published PED checklists. PED multidisciplinary teams participated in video-recorded SIM training sessions involving a scenario requiring intubation three times, first without interruption then while receiving our intervention of rapid-cycle deliberate practice (RCDP) debriefing focusing on checklist utilization and team dynamics. Learners went through the scenario once more uninterrupted to apply learned skills. Team performance was evaluated via video review using the Simulation Team Assessment Tool (STAT) focusing on airway management and human factors sections. Scores were compared before and after intervention along with pre- and postintervention surveys.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 483 learners participated in 64 SIM training sessions, 44 of whom met inclusion criteria and were included for data analysis. Scores increased postintervention for airway management, human factors and in total. Least-squares mean differences for total, airway, and human factors scores were 9.55 (95% confidence interval [CI] 7.24–11.85), 4.22 (95% CI 2.91–5.52), and 5.33 (95% CI 3.86–6.8), respectively, which was statistically significant with <i>p</i>-value of <0.001 across all categories. Surveys demonstrated improved role understanding and checklist utilization comfort postintervention.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>This study supports the benefit of multidisciplinary SIM training with RCDP-style methodology as an educational method for improving airway management, teamwork skills, and RSI checklist utilization for PED staff. Incorporation of additional maintenance SIM sessions for ongoing education is likely to be further beneficial and would allow evaluation of degradation of skills over time following initial training.</p>\\n </section>\\n </div>\",\"PeriodicalId\":37032,\"journal\":{\"name\":\"AEM Education and Training\",\"volume\":\"8 6\",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-11-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AEM Education and Training\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/aet2.11039\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"EDUCATION, SCIENTIFIC DISCIPLINES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AEM Education and Training","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/aet2.11039","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
Use of in situ simulation to improve team performance and utilization of a rapid sequence intubation checklist
Background
Intubation checklists have emerged as tools to reduce adverse events and improve efficiency during rapid sequence intubation (RSI) in pediatric emergency departments (PEDs). This study aimed to use multidisciplinary simulation (SIM) training as an educational tool to improve PED team performance during RSI scenarios through utilization of an RSI checklist.
Methods
We created a checklist modeled after previously published PED checklists. PED multidisciplinary teams participated in video-recorded SIM training sessions involving a scenario requiring intubation three times, first without interruption then while receiving our intervention of rapid-cycle deliberate practice (RCDP) debriefing focusing on checklist utilization and team dynamics. Learners went through the scenario once more uninterrupted to apply learned skills. Team performance was evaluated via video review using the Simulation Team Assessment Tool (STAT) focusing on airway management and human factors sections. Scores were compared before and after intervention along with pre- and postintervention surveys.
Results
A total of 483 learners participated in 64 SIM training sessions, 44 of whom met inclusion criteria and were included for data analysis. Scores increased postintervention for airway management, human factors and in total. Least-squares mean differences for total, airway, and human factors scores were 9.55 (95% confidence interval [CI] 7.24–11.85), 4.22 (95% CI 2.91–5.52), and 5.33 (95% CI 3.86–6.8), respectively, which was statistically significant with p-value of <0.001 across all categories. Surveys demonstrated improved role understanding and checklist utilization comfort postintervention.
Conclusions
This study supports the benefit of multidisciplinary SIM training with RCDP-style methodology as an educational method for improving airway management, teamwork skills, and RSI checklist utilization for PED staff. Incorporation of additional maintenance SIM sessions for ongoing education is likely to be further beneficial and would allow evaluation of degradation of skills over time following initial training.
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