Abstract 263: Emergencies and Resuscitation in the Catheter Laboratory: High-Fidelity Simulation as a Training Tool to Improve Multidisciplinary Team Communication and Confidence

Abstract

Purpose: Multi disciplinary team (MDT) emergency and resuscitation training for acute device related complications in the catheter laboratory commonly takes the form of didactic instruction or post event debriefing. High fidelity simulation offers the opportunity to role-play clinical emergencies in a controlled environment in a dynamic and interactive setting. This technique allows for immersive training whilst protecting patients from unnecessary risk and may enhance performance. Methods: Two sessions, each with two high fidelity in-situ resuscitation scenarios, using a simulation manikin, were run as a pilot (Session 1 - pacing failure during device generator change; tamponade during lead extraction, Session 2 - Primary angioplasty with cardio pulmonary arrest, Primary angioplasty requiring acute temporary pacing). These were viewed by other members of the department on a live video feed. 45 members of the MDT (including Cardiologists, Anesthetists, Radiographers, Nurses and Physiologists of all levels) participated in each the session, attending a formal facilitated debrief after each scenario. The debrief outcome of scenario 1 was designed to influence the behavioral strategy during the conduct of scenario 2. Anonymous pre and post scenario questionnaires measured improvement in confidence, clinical knowledge and inter-professional relationships. Results: We collected 72 pre-course and 67 post-course questionnaires in total. 92% agreed or strongly agreed that the session enhanced inter-professional working relationships and communication skills. 73% felt their clinical knowledge was increased. The number of people who felt ‘confident’ or ‘very confident’ in ‘speaking up about something they disagreed with in a clinical emergency’ increased from 45% to 65% (p<0.05). All respondents would recommend the session to a colleague & attend themselves again. Conclusions: High fidelity in-situ simulation may be a useful tool to actively engage the MDT in improving clinical knowledge and communication in emergency resuscitation situations, whilst enhancing inter-professional relationships. This may have important implications for patient safety in the Catheter Laboratory.