Emergency medicine resident crisis resource management ability: a simulation-based longitudinal study

Area of Science:

• Medical Simulation
• Physician Education
• Emergency Medicine

Background:

• Simulation is recognized for assessing technical skills but lacks evidence for longitudinal evaluation of non-technical clinical abilities.
• This study investigates the development of crisis resource management (CRM) skills using simulation.
• The Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS) was employed to assess CRM skill progression.

Purpose of the Study:

• To evaluate the longitudinal growth of crisis resource management (CRM) skills in emergency medicine residents.
• To determine if the Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS) reflects progressive development of CRM abilities throughout residency.
• To identify specific CRM domains that predict overall performance growth.

Main Methods:

• Forty-five emergency medicine residents underwent annual simulation assessments from 2006 to 2011.
• Mixed-methods repeated-measures regression analyses were used to evaluate Ottawa GRS elements by training level.
• Performance growth was predicted across a 3-year residency program.

Main Results:

• Ottawa GRS scores demonstrated a significant increase over the residency period.
• Leadership, problem-solving, and resource utilization domains were particularly predictive of overall performance.
• Significant gains in CRM skills were observed between postgraduate years 1 and 2, with no significant difference between years 2 and 3.

Conclusions:

• Crisis resource management (CRM) skills exhibit progressive development during residency.
• Simulation serves as a valuable tool for monitoring the advancement of CRM skills.
• The current assessment tool may require modifications to effectively measure performance gains in advanced learners.