Individual Debriefing vs. Computer Based Multimedia Instruction After Patient Crisis Simulation

Abstract

BACKGROUND: Several advantages of simulation over didactic and patient dependent teaching have lead to a proliferation of patient simulators in academic centers. Although simulation experience alone seems insufficient for learning, research evaluating different modes of instruction following simulation is lacking (1). Standardized multimedia has shown to be useful in teaching surgical skills, but has not been evaluated for use as an adjunct in crises management training. The primary purpose of this study is to determine whether standardized computer-based multimedia instruction is effective for learning in patient crises scenarios. The secondary purpose is to compare multimedia debriefing to personal oral debriefing with an expert. METHODS: Thirty anesthesia residents were recruited to manage three different simulated resuscitation crises using a high-fidelity patient simulator. Following the first scenario, subjects were randomized to either a computer-based multimedia tutorial or a personal debriefing with an expert followed by a posttest and retention test five weeks later. To date, the performances of 20 residents were independently rated by two expert blinded assessors using the previously validated Anesthesia Non Technical Skills (ANTS) marking system (2). RESULTS: Resident performance of non-technical skills improved significantly in both groups compared to pretest p<0.05). The improvement was sustained after five weeks for both groups (p<0.05)(see Figure). No significant difference in the performance of residents receiving either type of debriefing was demonstrated in any of the tests.FigureCONCLUSION: Computer based multimedia instruction is an effective method of teaching non-technical skills in simulated crisis scenarios and may be as effective as oral personalized debriefing. Multimedia may be a valuable adjunct to centers when debriefing expertise is not available. Multimedia may also improve simulation utilization by reducing anxiety of peer evaluation in continuing medical education. (1) Savodelli GL et al., submitted 2005. (2) Fletcher G et al., Br J Anaesth 2003; 90 (5) 580–588. Conflict of Interest: Authors indicated they have nothing to disclose.