Durability of Non-Technical Skills Following Crisis Resource Management Training.

Abstract

BACKGROUND: Non-technical skills, such as task management, team working, situation awareness and decision making, are vital to anesthesia crisis resource management.(1) These skills are often taught using a high fidelity patient simulator. Previous studies have demonstrated improvement in non-technical skills following a debriefing of a simulated crisis, and sustained skills two months after the training session. This same study showed these skills are not learned through clinical duties exclusively.(2) We conducted this study to examine the durability of teaching non-technical skills over time. METHODS: After institutional ethics approval, 8 junior anesthesia residents were recruited as subjects. Each had one individual debriefing of their management of a crisis prior to a pre-test. The pre-test was the management of a simulated intraoperative cardiopulmonary arrest, followed by a videotape-assisted debriefing focused on their non-technical skills. No subjects participated in a simulator session for eight months. Eight months after their pre-test, each subject returned to manage a post-test, consisting of the management of a similar intraoperative cardiopulmonary arrest. Videotaped performances were reviewed by two expert blinded independent assessors who rated each subject’s non-technical skills, using a previously validated and reliable marking system.(1) RESULTS: A significant improvement in non-technical skills was observed eight months after a simulated crisis resource management training session (p<0.001)(see Figure).FigureCONCLUSIONS: Not only are measurements of residents’ non-technical skills sustained with respect to simulated crisis management eight months following a training session - they are improved. Residents’ reflection on their simulated crisis experience and debriefing may have lead to improvement. Improvement may also be secondary to non-technical skills that were practiced clinically, after simulator sessions. Educators should be reassured that the non-technical skills learned during simulated crisis management training sessions are durable.