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Using Fully-Immersive Simulation Training with Structured Debrief to Improve Nontechnical Skills in Emergency
Anoopama Ramjeeawon1, Anna E Sharrock2, Abigail Morbi3
1Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
Journal of Surgical Education
|April 23, 2020
Summary
Simulation training significantly improved teamwork, technical skills, and radiation safety behaviors in surgical trainees performing emergency thoracic endovascular aortic repair (TEVAR). This approach enhances surgical performance and may reduce errors in operating rooms.
Area of Science:
- Medical Education
- Surgical Simulation
- Endovascular Surgery
Background:
- Teamwork is crucial in complex surgical procedures like emergency thoracic endovascular aortic repair (TEVAR).
- Assessing and improving non-technical skills (NTS) alongside technical skills (TS) is vital for surgical training.
- Simulation-based training offers a controlled environment to practice emergency scenarios.
Purpose of the Study:
- To evaluate the impact of fully-immersive simulation training with structured debriefing on the teamwork performance of lead surgeons during standardized emergency TEVAR scenarios.
- To assess concurrent improvements in technical skills (TS) and radiation safety behaviors (RSB).
Main Methods:
- A pre-post study design involving 16 general and vascular surgical trainees in the UK.
- Trainees underwent standardized emergency TEVAR technical training followed by two fully-immersive endovascular surgery simulations.
- Non-technical skills (NTS) were assessed using the Observational Teamwork Assessment for Surgery tool, TS by procedure completion time, and RSB by fluoroscopy time and specific safety actions.
Main Results:
- Significant improvements were observed in overall teamwork scores (p=0.005) and all its domains: communication, coordination, cooperation, leadership, and monitoring.
- Technical skills improved, with trainees completing 12 out of 13 procedural steps faster (p<0.027).
- Radiation safety behaviors showed positive trends, including decreased fluoroscopy time and increased adherence to safety protocols.
Conclusions:
- Fully-immersive simulation training with structured debriefing is an effective method for enhancing non-technical skills and technical skills in surgical trainees.
- Integrating this simulation approach into surgical training curricula has the potential to reduce operating room errors, increase efficiency, and improve radiation safety behaviors.
- Further research is needed to demonstrate the effective translation of these simulated improvements into clinical practice.
