Leveraging just-in-time simulation to train ad hoc teams

Simulation prepares clinicians for managing healthcare emergencies in ad hoc teams. However, simulation curricula are often resource, personnel, and time intensive. Applying "just-in-time" (JIT) methodology to simulation training for ad hoc teams may provide similar benefits with fewer resources, although its effectiveness and perceived benefit remain unknown.

To determine if JIT teamwork simulation for ad hoc teams is perceived to increase confidence in managing emergencies and improve teamwork during a call shift, anesthesiology residents participated in JIT teamwork simulation training immediately prior to their overnight call shift from 2020 to 2022. After the call shift, residents completed a survey gathering feedback about the simulation, its impact on their confidence managing the simulated emergencies, and their perception of the call team's dynamic and management of real emergencies overnight.

Of 109 participants, 66 (60.5%) completed the survey. Confidence in managing emergencies rose from 39.8 (SD = 20.7) to 66.4 (SD = 17.9) out of 100 after simulation (P < 0.001, Cohen's d = 1.38). Content analysis of the open-ended responses focusing on the residents' perception of the call team's dynamic and management of real emergencies overnight resulted in two categories: (1) improved ad hoc teaming and (2) improved use of crisis resource management skills by the overnight team.

After a single session before an overnight shift, JIT teamwork simulation increased anesthesia residents' self-reported confidence in managing emergencies, and residents perceived an improvement in ad hoc teamwork and use of crisis resource management skills overnight.