SIMULATED TEAM-BASED CPB EMERGENCY PREPAREDNESS TRAINING

Abstract

BackgroundSafe and consistent conduct of CPB is critical and must be mastered by both the cardiac surgical resident and perfusion student. Although technical skill is essential to ensure patient safety, human factors such as communication and teamwork also contribute to medical error. Simulation provides learners with the opportunity to master common management situations during CPB. Similarly, uncommon high-risk occurrences can also be practiced. Existing literature indicates that engaging healthcare practitioners to work together early in their studies has a positive impact on effective interprofessional care and improved patient safety.MethodsA half-day workshop was conducted with 10 cardiac surgery residents and 15 perfusion students divided into three groups. Six scenarios were simulated: routine conduct of CPB, aortic dissection, massive air embolism, poor venous return, severe protamine reaction and a deprimed circuit. Practicing clinical perfusionists facilitated the participants through the high-intensity scenarios. Group debriefing sessions were interspersed throughout the day to review and share key learning and experiences. All of the proceedings were recorded for future debriefs and analysis. At the workshop conclusion anonymous feedback was solicited from all participants.ResultsAll groups successfully completed all six scenarios. Information regarding their experiences was gathered and discussed during the debriefing sessions. The workshop was very well received by all the participants. Two themes resounded repeatedly: the value of clear and consistent communication, and the common goal of patient safety. Notably, the participants all valued the opportunity to interact with their professional counterparts. The perfusion students who, in many cases for the first time, had the chance to interact with their surgical colleagues made poignant insights regarding perceptions of power balance.ConclusionAll participants reported increased confidence and improved technical and non-technical skills following the workshop. There was unanimous agreement that more of these sessions should be conducted. The perceived benefits of this form of team-based high-intensity training include: increased team building and preparedness, communication, role refinement, improved technical knowledge, increased team and individual confidence and enhanced trust. Altogether, a culture of prioritizing patient safety is created during these simulations. Notably, participants recognize the values based upon their lived experiences during a realistic but risk-free environment. Additionally, these exercises serve as an ice-breaker that helps dissolve preconceived notions and expectations of interprofessional relationships. The benefits of offering this type of training with simulated exercises to existing surgical teams may also realize similar improvements. BackgroundSafe and consistent conduct of CPB is critical and must be mastered by both the cardiac surgical resident and perfusion student. Although technical skill is essential to ensure patient safety, human factors such as communication and teamwork also contribute to medical error. Simulation provides learners with the opportunity to master common management situations during CPB. Similarly, uncommon high-risk occurrences can also be practiced. Existing literature indicates that engaging healthcare practitioners to work together early in their studies has a positive impact on effective interprofessional care and improved patient safety. Safe and consistent conduct of CPB is critical and must be mastered by both the cardiac surgical resident and perfusion student. Although technical skill is essential to ensure patient safety, human factors such as communication and teamwork also contribute to medical error. Simulation provides learners with the opportunity to master common management situations during CPB. Similarly, uncommon high-risk occurrences can also be practiced. Existing literature indicates that engaging healthcare practitioners to work together early in their studies has a positive impact on effective interprofessional care and improved patient safety. MethodsA half-day workshop was conducted with 10 cardiac surgery residents and 15 perfusion students divided into three groups. Six scenarios were simulated: routine conduct of CPB, aortic dissection, massive air embolism, poor venous return, severe protamine reaction and a deprimed circuit. Practicing clinical perfusionists facilitated the participants through the high-intensity scenarios. Group debriefing sessions were interspersed throughout the day to review and share key learning and experiences. All of the proceedings were recorded for future debriefs and analysis. At the workshop conclusion anonymous feedback was solicited from all participants. A half-day workshop was conducted with 10 cardiac surgery residents and 15 perfusion students divided into three groups. Six scenarios were simulated: routine conduct of CPB, aortic dissection, massive air embolism, poor venous return, severe protamine reaction and a deprimed circuit. Practicing clinical perfusionists facilitated the participants through the high-intensity scenarios. Group debriefing sessions were interspersed throughout the day to review and share key learning and experiences. All of the proceedings were recorded for future debriefs and analysis. At the workshop conclusion anonymous feedback was solicited from all participants. ResultsAll groups successfully completed all six scenarios. Information regarding their experiences was gathered and discussed during the debriefing sessions. The workshop was very well received by all the participants. Two themes resounded repeatedly: the value of clear and consistent communication, and the common goal of patient safety. Notably, the participants all valued the opportunity to interact with their professional counterparts. The perfusion students who, in many cases for the first time, had the chance to interact with their surgical colleagues made poignant insights regarding perceptions of power balance. All groups successfully completed all six scenarios. Information regarding their experiences was gathered and discussed during the debriefing sessions. The workshop was very well received by all the participants. Two themes resounded repeatedly: the value of clear and consistent communication, and the common goal of patient safety. Notably, the participants all valued the opportunity to interact with their professional counterparts. The perfusion students who, in many cases for the first time, had the chance to interact with their surgical colleagues made poignant insights regarding perceptions of power balance. ConclusionAll participants reported increased confidence and improved technical and non-technical skills following the workshop. There was unanimous agreement that more of these sessions should be conducted. The perceived benefits of this form of team-based high-intensity training include: increased team building and preparedness, communication, role refinement, improved technical knowledge, increased team and individual confidence and enhanced trust. Altogether, a culture of prioritizing patient safety is created during these simulations. Notably, participants recognize the values based upon their lived experiences during a realistic but risk-free environment. Additionally, these exercises serve as an ice-breaker that helps dissolve preconceived notions and expectations of interprofessional relationships. The benefits of offering this type of training with simulated exercises to existing surgical teams may also realize similar improvements. All participants reported increased confidence and improved technical and non-technical skills following the workshop. There was unanimous agreement that more of these sessions should be conducted. The perceived benefits of this form of team-based high-intensity training include: increased team building and preparedness, communication, role refinement, improved technical knowledge, increased team and individual confidence and enhanced trust. Altogether, a culture of prioritizing patient safety is created during these simulations. Notably, participants recognize the values based upon their lived experiences during a realistic but risk-free environment. Additionally, these exercises serve as an ice-breaker that helps dissolve preconceived notions and expectations of interprofessional relationships. The benefits of offering this type of training with simulated exercises to existing surgical teams may also realize similar improvements.