Best practice & research. Clinical anaesthesiology
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Simulation has become a significant training tool in the operating room (OR). It can be used in both simple task training and complex scenarios. The challenge for simulation in the OR is how to translate that which is learned, and perceived to beneficial, into behavioral change and improved patient outcomes. Simulation in the developing world is progressing, but is still hampered by a shortage of material, personnel funding.
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Best Pract Res Clin Anaesthesiol · Mar 2015
ReviewInstitutional needs and faculty development for simulation.
This review focuses on simulation in anaesthesiology as an educational intervention from a learning perspective. Simulation-based education in anaesthesiology has implications for both faculty development and institutional needs. ⋯ The corresponding factor concerning faculty development in simulation-based education is feedback. These three factors are closely interrelated, and to understand them and how to design high-quality simulation interventions from a learning perspective, it is important to look not only to the simulation literature but also to the pedagogical literature.
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Simulation has become a major player in the medical world. Still way behind other high-risk industries, simulation is being increasingly accepted and finds its ways into many clinical areas. Simulation offers the possibility to train individual skills as well as to evaluate performance, provide group crisis management training or even investigate the safety of installed systems and algorithms without risking patient's life. ⋯ Simulators can be used to improve communication skills and workload distribution, and specifically drill for obstetric-relevant crisis scenarios. However, it remains unclear how well these trainings do transfer into clinical performance and improved patient outcome. Being a relevant cost factor, simulation will have to provide answers to these questions; hence, more research is needed in the future.
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Best Pract Res Clin Anaesthesiol · Mar 2015
ReviewBriefing and debriefing during simulation-based training and beyond: Content, structure, attitude and setting.
In this article, we review the debriefing literature and point to the dilemma that although debriefings especially intend to enhance team (rather than individual) learning, it is particularly this team setting that poses risks for debriefing effectiveness (e.g., preference-consistent information sharing, lack of psychological safety inhibiting structured information sharing, ineffective debriefing models). These risks can be managed with a mindful approach with respect to content (e.g., specific learning objectives), structure (e.g., reactions phase, analysis phase, summary phase), attitude (e.g., honesty, curiosity, holding the trainee in positive regard) and setting (e.g., briefings to provide orientation and establish psychological safety). We point to the potential of integrating systemic methods such as circular questions into debriefings, discuss the empirical evidence for debriefing effectiveness and highlight the importance of faculty development.
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Best Pract Res Clin Anaesthesiol · Mar 2015
ReviewBasic concepts for crew resource management and non-technical skills.
In this paper, we explain the conceptual background to non-technical skills and show how they can influence job performance in anaesthesia. We then describe the taxonomy of anaesthetists' non-technical skills (ANTS) and related systems, such as ANTS-AP for anaesthetic practitioners. We discuss the training courses that have been designed to teach these non-technical skills, which are called crew resource management (CRM), crisis resource management (CRM) or crisis avoidance resource management (CARMA). Finally, we discuss the application of non-technical skills assessment systems.