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A new surgical crisis simulator effectively trained residents and fellows in managing major abdominal hemorrhage. The simulation highlighted the link between technical skills, non-technical skills, and performance under stress.

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Area of Science:

  • Surgical education
  • Medical simulation
  • Crisis management

Background:

  • Surgical trainees face cognitive overload during stressful events.
  • A novel simulation model was developed to assess learner performance in intraoperative crises.

Purpose of the Study:

  • To evaluate learner experiences and performance in a simulated intraoperative crisis.
  • To assess the validity of a novel major abdominal hemorrhage simulator.

Main Methods:

  • A curriculum focused on psychomotor, leadership, and stress-management skills was implemented.
  • Surgical residents and fellows used a simulator for major abdominal hemorrhage, with assessments including vascular repair, blood loss, Objective Structured Assessment of Technical Skills (OSATS), and Non-Technical Skills for Surgeons (NOTSS) Scale.
  • Qualitative analysis of focus groups and interviews explored stress and cognitive load.

Main Results:

  • Fellows demonstrated superior performance in completing the simulation within 20 minutes (P = .02) and higher OSATS scores (P = .01).
  • Significant blood loss (>1,000 mL) occurred in 74% of residents and 60% of fellows.
  • Thematic analysis revealed interrelations between technical and non-technical skills, the need for methodical crisis response, and stress levels correlating with experience and performance.

Conclusions:

  • The novel simulation effectively challenged junior residents and validated fellow performance.
  • Opportunities exist to enhance fellows' non-technical skills through targeted training.