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Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum
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Exposure to Simulated Mortality Affects Resident Performance During Assessment Scenarios.

Andrew Goldberg1, Stefan Samuelson, Yury Khelemsky

  • 1From the Departments of Anesthesiology (A.G., Y.K., D.K., S.S., A.L., S.D.) and Population Health Science and Policy (A.W.), Icahn School of Medicine at Mount Sinai, New York, NY.

Simulation in Healthcare : Journal of the Society for Simulation in Healthcare
|October 5, 2017
PubMed
Summary

Simulated patient deaths in medical training improved resident performance when outcomes were tied to actions. This approach enhanced nontechnical skills without increasing anxiety, unlike constant exposure to simulated mortality.

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Area of Science:

  • Medical Education
  • Simulation-Based Training
  • Anesthesiology

Background:

  • The role of simulated mortality in medical training is debated.
  • This study investigated its impact on resident performance and psychological responses.

Purpose of the Study:

  • To determine if varying levels of simulated mortality affect resident performance.
  • To assess differences in anxiety, attitudes, and engagement based on simulation group assignment.

Main Methods:

  • Fifty junior anesthesiology residents were randomized into three groups: always survival, always mortality, or variable mortality.
  • All residents completed 12 identical simulations with differing outcomes.
  • Performance and anxiety were assessed 6 weeks post-training.

Main Results:

  • Residents in the variable mortality group showed improved nontechnical skills (Anesthetists' Nontechnical Skills Score).
  • The 'always death' group reported higher anxiety during assessment compared to others.
  • No significant difference in nontechnical skills was observed between 'always death' and 'never death' groups.

Conclusions:

  • Variable simulated mortality, linked to performance, enhances resident nontechnical skills.
  • This training method may improve performance without detrimentally increasing anxiety.