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Published on: May 14, 2019
A simulation workshop to introduce coping skills
Elizabeth M Putnam1,2, Kelcey J Stratton3,4, Laura E Lehrian5
1Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA.
Background:
Experiencing clinical catastrophes can result in long-lasting emotional and psychological impacts. In other fields, crisis simulation has been used to train professionals in coping skills.
Approach:
Our workshop combined a simulated case with a clinical debrief and expert-led teaching on coping skills. The '4Rs' mnemonic, Recognise, Reflect, Reframe and Reach-out, describes the key elements. This is grounded in social, cognitive and behavioural theories of stress and coping.
Evaluation:
All 96 anesthesiology residents from one residency programme participated, in small groups, and a mixed methods analysis was used. The scenario was deemed stressful. The workshop introduced new techniques, with 72/87 (82.75%) reporting new coping skills in use at 1-month follow-up. For many residents, the descriptive language regarding their performance and abilities shifted from critical, negative self-talk to positive and team-focused immediately following the workshop. A striking finding from evaluations at all timepoints was that negative comments were typically self-referencing whereas positive ones referenced colleague support and the team.
Implications:
Combining stress exposure with formal exploration of emotional responses and coping skills teaching in this workshop was feasible, with benefits at 1-month follow-up. This laid the groundwork for a resilience curriculum and wider departmental interest in the topic of coping and stress responses.
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