High-fidelity simulation as an experiential model for teaching root cause analysis

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Simulation

Background:

• Root cause analysis (RCA) is crucial for improving patient safety.
• Effective teaching strategies for RCA in graduate medical education are needed.
• Systems-based approaches are essential for medical error reduction.

Purpose of the Study:

• To evaluate the efficacy of high-fidelity simulation in teaching root cause analysis (RCA) to medical residents.
• To compare the impact of simulation-based versus didactic-only RCA training.
• To assess long-term knowledge retention and attitude changes regarding RCA.

Main Methods:

• Thirty anesthesiology residents were randomized into two groups.
• Group A received RCA didactics plus a high-fidelity simulation exercise.
• Group B received RCA didactics only.
• Assessments of RCA knowledge and attitudes were conducted at baseline, post-intervention, and 6-month follow-up.

Main Results:

• Post-intervention knowledge scores were similar between groups.
• Group B showed increased skepticism towards RCA and systems improvement strategies.
• At 6 months, Group A retained knowledge and positive attitudes, while Group B showed significant knowledge decline and persistent skepticism.

Conclusions:

• High-fidelity simulation combined with didactics is an effective strategy for teaching RCA and systems theory in graduate medical education.
• Simulation enhances knowledge retention and promotes positive attitudes toward systems improvement.
• This approach is superior to didactic-only training for long-term impact.