2004 OPEN FORUM Abstracts
Initial Experience of a Respiratory Care Focused Program of Medical simulation in a pedatric teaching hospital
Barry
Grenier, RRT, Liana Stanley, MEd, Lindsay Farragher, Jeffrey
Burns, MD.
Children’s Hospital
Boston and Harvard Medical School, Boston, MA
Background:
Sophisticated simulation environments are routinely used for
military training and for training airline pilots. Similar training
is increasingly being used to teach crisis resource management (CRM)
to medical personnel in the critical care environment.
Methods:
New staff therapists (< 3 years in department) participated in a
battery of 4 critical care scenarios: a multi-disciplinary CRM (code
team) scenario followed by three scenarios specific to respiratory
critical care. These included an endotracheal tube emergency,
initiation of pediatric high frequency oscillatory ventilation
(HFOV), and a tracheostomy-related scenario. Veteran therapists (>
3 years in department), directed to act as a resource to the new
staff, also participated in the HFOV scenario. Each scenario was
followed by a facilitator-led analysis (debriefing session) utilizing
video tape of the scenario.
Participants
completed post-simulation questionnaires that included general
qualitative questions regarding the program and debriefing as well as
a self-assessment of critical care teamwork skills, assessment and
management skills, and the ability to deliver safer patient care.
All responses were based on a 5 point Likert scale (1-strongly
disagree to 5-strongly agree).
Results:
Twenty therapists (10 new staff, 10 veteran staff) participated.
Differences in the responses between the 2 groups of therapists were
not significant (p = .135). Twenty questionnaire items were
grouped into 5 distinct categories. Subgroups of items were combined
into a composite statement for each category.
| Evaluation Categories | Median (Range)* |
| 1. The scenarios were realistic and believable. | 4 (4 -5) |
| 2. The debriefings were open, non-threatening, and informative. | 4 (4 -5) |
| 3. The program improved therapist communication and teamwork skills. | 4 (3 -5) |
| 4. The program will help therapists provide safer patient care. | 4 (3 -5) |
| 5. Therapists feel better prepared to assess and manage critical care situations. | 4 (3 -5) |
* Response range: 1 (strongly
disagree) to 5 (strongly agree)
Conclusions:
The RC staff found the simulation scenarios realistic and the
debriefing process open, non-threatening, and informative. Both new
and veteran staff self-reported: 1) improved critical care
communication and team work skills; 2) improved ability to provide
safe patient care; and 3) improved ability to assess and manage
critical patient care situations.