Identification of Human Factors Elucidated during Obstetrical Team Training using High-Fidelity Simulation

Abstract

INTRODUCTION: The issue of patient safety is at the forefront of both public and medical discussions. This study involves the development of a multidisciplinary program using realistic high-fidelity simulation that promotes patient safety in parturients. METHODS: After REB approval, 6 obstetricians, 3 obstetrics residents, 6 anesthesiologists, 3 anesthesia residents and 15 obstetric nurses were invited to participate. Teams managed 4 high-fidelity obstetrical emergency scenarios: 1) urgent Caesarean section (C/S), difficult airway; 2) urgent C/S, severe preeclampsia; 3) twin gestation, cord prolapse; 4) emergent C/S, abruption, massive blood loss. Participants were asked to complete a questionnaire regarding the realism and usefulness of the session and as well to identify important human factors that contributed to the teams’ performances in either a negative or positive way. RESULTS: Thirty-four physicians and nurses participated in the study. Their opinions of the simulation scenarios are represented in Table 1. There was no statistically significant difference in opinions between RNs and MDs except the item concerning the feeling of intimidation in the setting. Figure 1 identifies the participants’ opinions of what human factors were most important to how the teams performed during the obstetrical crises.Table: Scenario Opinions Mean ± SD (1=strongly disagree, 5=strongly agree)FigureDISCUSSION: The use of simulation is a valuable teaching tool for obstetric teams and scenarios were felt to be realistic and relevant to clinical practice. Important human factors items were identified by participants and can be used to guide future education and evaluation of teams using high-fidelity simulation. Conflict of Interest: Authors indicated they have nothing to disclose.