Multidisciplinary Simulation Research Articles

Correlation between medical management and teamwork in multidisciplinary high-fidelity obstetrics simulations

Teamwork and communication gaps are consistently cited as contributors to adverse outcomes in obstetrics. The Critical Care in Obstetrics Course provides an innovative experience by combining brief interactive didactics with the opportunity to practice and implement the knowledge gained with hands-on simulation. Most participants have never worked together, which creates a unique environment to evaluate the importance of teamwork and communication. This study aimed to evaluate the association between teamwork and medical management in high-fidelity critical care simulations. The participants were separated into multidisciplinary teams and taken through simulations, including placental abruption, hypertensive emergency, eclampsia, sepsis, cardiac arrest, venous thromboembolism, diabetic ketoacidosis, and thyroid storm. Facilitators completed a validated checklist assessment for each group's performance in medical care and teamwork. Each element was rated on a scale from 1 to 5, with 1 being unacceptable and 5 being perfect. We evaluated 5 communication measures, including the use of closed-loop communication and orientation of new team members. A Spearman correlation was used to evaluate the relationship between total medical management and total teamwork scores and specific measures of team communication. Receiver operating characteristic curves were created for total teamwork score as a predictor of good or perfect medical management. A total of 354 multidisciplinary teams participated in 1564 high-fidelity simulations. There was a significant correlation between medical management and teamwork and communication scores for all scenarios. The strongest correlation was for the total teamwork score for all simulations (ρ=0.84). Teamwork scores were highly predictive of medical management scores with an area under the curve of at least 0.88 for all simulations, although this was not significant for diabetic ketoacidosis. The quality of teamwork and communication correlated with the quality of clinical performance in newly formed multidisciplinary teams. This demonstrates the importance of teamwork training, with a focus on key communication tools and strategies, among medical providers to optimize the management of complex and emergent obstetrical conditions.

695 QUALITY IMPROVEMENT PROJECT ON TRANSFER TIMES OF ACUTE HIP FRACTURE PATIENTS FROM ED TO INPATIENT BED POST SIMULATION TRAINING

IntroductionThe care of patients with hip fractures is a surrogate marker of trauma care. Irish hip Fracture Standard (IHFS) 1 involves patients with a hip fracture being admitted to an orthopaedic ward bed within 4 hours of attending the ED. We wanted to audit our current practice and introduce a quality improvement project to improve the timeliness and efficiency of care of our hip fracture patients compared with the gold standard IHFS 1. We introduced a 90 minute multidisciplinary simulation training programme on the hip fracture pathway to our ED in February 2021. All key stakeholders were represented; from Emergency Medicine, Orthopaedics, Nursing (EM and Orthopaedic), Radiology, Radiography, Porters (32 people overall). Because of covid-19, the training was available in person and online via zoom.MethodsWe performed a retrospective audit of patients presenting to TUH ED with a proximal third of femur fracture between 4th February and 31st March inclusive in 2020 and 2021, pre and post introduction of multidisciplinary simulation based medical education on the hip fracture pathway. Data was collected from the electronic record database (symphony). We recorded the following data;Results2020 n = 31 Average time to ward—8 hrs 29 mins. 26% patients reached ward <4 hours. (8/31) 2021 n = 25 Average time to ward—5 hrs 58 mins (32% reduction vs 2020) 72% patients reached ward <4 hours. (18/25) (46% increase vs 2020).ConclusionSimulation based medical education is a successful intervention to improve compliance with our hip fracture pathway, time from presentation to transfer to an orthopaedic ward bed and achieve IHFS 1.

Trauma bay virtual reality-A game changer for ATLS instruction and assessment.

Medical educational research highlights the need for high-fidelity, multidisciplinary simulation training to teach complex decision-making skills, such as those taught in Advanced Trauma Life Support (ATLS). This approach is, however, expensive and time-intensive. Virtual reality (VR) education simulation may improve skill acquisition in a cost-effective and time-sensitive manner. We developed a novel trauma VR simulator (TVRSim) for providers to apply ATLS principles. We hypothesized in this pilot study that TVRSim could differentiate practitioner competency with increasing experience and would be well accepted. Providers at a Level I trauma center (acute care surgeons, novice (MS4 & PGY1), junior (PGY2 & 3), senior (PGY4-6) residents) ran a blunt, polytrauma VR code. Ten critical decision points were assessed: intubation, cricothyroidotomy, chest tube, intravenous access, focused abdominal sonography for trauma examination, pelvic binder, activation of massive transfusion protocol, administration of hypertonic saline, hyperventilation and decision to go to the operating room (OR). Learner assessment was based on frequency and time to correct decisions. Participant satisfaction was measured using validated surveys. All 31 providers intubated and obtained intravenous access. Novices and juniors frequently failed at hypertonic saline and hyperventilation decisions. Juniors often failed at cricothyroidotomy (60%) and OR (100%) decisions. Mean time to all decisions except going to the OR was longer for all groups compared to acute care surgeons. Mean number of decisions/min was significantly higher for surgeons and seniors compared to juniors and novices. Mortality was 92.3% for novices, 80% for juniors, 25% for seniors and 0% for the attendings. Participants found TVRSim comfortable, easy to use/interact with/performance enhancing, and helped develop skills and learning. In this pilot study using a sample of convenience, TVRSim was able to discern decision-making abilities among trainees with increasing experience. All trainees felt that the platform enhanced their performance and facilitated skill acquisition and learning. TVRSim could be a useful adjunct to teach and assess ATLS skills. Diagnostic Test or Criteria; Level IV.

A multidisciplinary simulation programme to improve advance care planning skills and engagement across primary and secondary care

In the context of an ageing population, many healthcare professionals have limited experience and confidence in having necessary advance care planning (ACP) conversations. We conducted nine half-day simulation sessions, using professional actors. One-hundred and thirty-two participants attended from multidisciplinary backgrounds across primary and secondary care. Following the course, 90.2% felt confident or very confident initiating conversations, compared with 14.4% beforehand. Understanding of when ACP is appropriate also increased from 70% to 100%. Post-course, 98% of participants stated that they would be more likely to initiate an ACP. Three months later, 86% had a sustained change in practice. All participants said they would recommend this simulation course and multidisciplinary approach. Multidisciplinary simulation training is an effective way to teach ACP to doctors, nurses and allied healthcare professionals. The simulation was shown to improve participant understanding, confidence and reduce barriers to discussions, both immediately and 3 months later.

Simulation educational technologies as an element of additional professional education

In the Izhevsk Medical Academy, on the basis of a multidisciplinary accreditation and simulation center, training is provided at all stages of continuous professional education, including the development of CME programs. The use of such technology is possible both for training with the help of highly realistic simulators and for quality control of the work of practicing doctors. In some programs, it is possible to use case-tasks to consolidate practical skills in diagnostics and treatment tactics.

Multi-disciplinary team-based simulation training in acute care settings: a systematic review of the impact on team performance

Multi-disciplinary team-based simulation training in acute care settings: a systematic review of the impact on team performance

Impact of simulation training for teamwork and communication intervention on patient safety in the emergency department

Background: The emergency department (ED) is the hospital division that is most vulnerable to poor communication and teamwork-based medical errors that affect patient safety. One approach to prevent medical errors is by training and assessing healthcare workers using simulation-based (SB) teamwork and communication training. This study aimed to explore the extent to which SB training could improve teamwork and communication and reduce preventable medical errors in the ED. Method: The study was conducted at the Ministry of National Guard Health Affairs, a tertiary care center with a 39-bed ED, in Saudi Arabia. A total of 123 ED healthcare staff participated in the study. This study adopted a single-subject experimental design with the intervention of simulation training in ED cases. The methodology focused on three domains: 1) patient safety in the ED, 2) inter-professional and multidisciplinary simulation team training, and 3) team dynamic enhancement use. Staff perceptions regarding teamwork and communication pre-and post-intervention and the relationship between changes in their perception of performance in the ED and patient outcomes. The chi-square test was used for univariate analysis, and a generalized linear regression model was adjusted for demographics in multivariate analysis. Results: Staff perceptions were collected from all multidisciplinary team members before and after simulation training. The data revealed a significant improvement in overall staff perceptions toward teamwork and communication (8% to 34%, p-value = 0.001). Conclusion: SB communication and teamwork training in the ED resulted in a sustained and measurable improvement in ED staff perceptions toward teamwork and communication. The results suggest that simulation sessions may improve staff perceptions and multidisciplinary team communication during critical situations in the ED.

Experience of pharmacy involvement in a disaster simulation exercise within a pediatric hospital emergency department: A pilot project.

In this descriptive report, we describe a unique trial of pharmacist participation in a multidisciplinary pediatric emergency department disaster simulation exercise. With the number of disasters increasing worldwide, the role of pharmacists in disaster response is of particular interest to the profession. This observational study describes pharmacist participation in a disaster simulation exercise. An evaluation tool was developed to assess participants' performance in the following domains: communication, pharmacotherapy, problem solving/decision making, and teamwork/organization. The observers used a rating scale of "concise/prompt," "needs improvement," or "not done" to evaluate performance on each objective. The participants' self-perceived knowledge of disaster response was assessed with pre- and postsimulation surveys using Likert scales. Five simulation exercises were held from June to October 2019, with 2 pharmacists participating in each simulation. Within the problem solving/decision making and communication domains, pharmacists were concise/prompt 66% of the time, while they were concise/prompt for 88.8% and 92.5% of tasks in the teamwork/organization and pharmacotherapy domains, respectively. Surveys of self-perceived knowledge revealed that while only 10% of pharmacists felt "moderately prepared" prior to the simulation exercise, 80% of pharmacists felt moderately prepared to care for patients during a disaster event after the simulation exercise. This report describes a unique approach of including emergency department-trained pharmacists in disaster simulation exercises to enhance their professional development, improve team dynamics in a mass casualty scenario, and increase their own reported level of preparedness to effectively manage a surge in critically ill pediatric patients.

178 Upstream Immersion: Preparing Allied Health Students with Foundational Placement Skills through a Multi-Disciplinary Simulation Week

The COVID-19 pandemic has led to an increased demand for clinical placements for Allied Health Professional (AHP) students. Consequently, we have needed to be creative to explore other ways to ensure students complete their 1,000 hours of clinical experience across the programme. A potential option is to use simulation to replace a portion of clinical hours. Evidence confirms that up to 25% of authentic physical practice with standardized simulated patients results in comparable student competency as assessed by an educator and that a 1-week period of simulation is effective in building students’ confidence before continuing with a placement in the clinical setting Our aim was to design, develop, implement and evaluate a multi-disciplinary simulation programme to prepare students with foundational placement skills. We sought to therefore reduce the burden on NHS staff. We also sought to determine the effect of the programme on student readiness for placement, student confidence, investigate stakeholder perceptions of the programme and determine the suitability of simulation in contributing to clinical hours.Simulation-based educational (SBE) pedagogy and principles guided the programme design and included: pre-brief, simulation with regular time outs to enable rehearsal of an activity and debriefing for reflection. We employed actor role players to act as the patient, relative or carer and clinical educators to guide the students as they would on a traditional placement. We developed three generic patient case studies designed specifically to focus on the development of the key programme learning outcomes: developing patient-centred communication skills and professional behaviours. We adopted a mixed-methods approach in our research design, collecting quantitative data from student self-report pre–post questionnaires, clinical educator questionnaires and qualitative data from focus groups to address our research questions and aims.A total of 29 Allied Health Professional students (from physiotherapy, occupational therapy and podiatry) completed a 5-day intensive simulation programme. The programme included an inter-professional ‘fishbowl simulation’ followed by 3 days of profession-specific clinical scenarios with profession-specific learning outcomes ending on the final day in six simulated multi-disciplinary team meetings. The sessions were interactive with simulated patients and their relative/carers giving authentic patient feedback from a patient perspective. We observed rich transformational learning observing students improve their communication skills and becoming more patient-centred in their approach. Preliminary student feedback indicates that they found the simulation programme challenging but extremely rewarding. Formal data analysis is continuing.

Correlation between medical performance and teamwork in multidisciplinary high fidelity obstetrics simulations

Teamwork and communication gaps are consistently cited as contributors to adverse outcomes in Obstetrics. The Critical Care in Obstetrics Course provides an innovative experience by combining brief interactive didactics with hands-on simulation. Most participants have never worked together, which creates a unique environment to evaluate the importance of teamwork and communication. The objective of this study is to evaluate the association between teamwork and medical performance in high-fidelity critical care simulations. Participants were separated into multidisciplinary teams and taken through simulations including placental abruption, eclampsia, sepsis, cardiac arrest, venous thromboembolism, diabetic ketoacidosis (DKA) and thyroid storm. Facilitators completed a validated checklist assessment for each group's performance in medical care and teamwork. Each element was rated on a scale from 1 to 5, with 1 being unacceptable and 5 being perfect. We evaluated 5 communication measures, including use of closed-loop communication and orientation of new team members A spearman correlation was used to evaluate the relationship between total medical performance and total teamwork scores as well as specific measures of team communication. ROC curves were created for total teamwork score as a predictor of good or perfect medical performance. A total of 354 multidisciplinary teams participated in 1,564 high-fidelity simulations. There was a significant correlation between medical performance and teamwork/communication scores for all scenarios (Table 1). The strongest correlation was for total teamwork score for all simulations. Teamwork scores were highly predictive of medical performance with an AUC of at least 0.88 for all simulations, although this was not significant for DKA (Fig.1). The quality of teamwork and communication correlated with the quality of clinical performance in newly formed multidisciplinary teams. This demonstrates the importance of teamwork training among medical providers to optimize management of complex and emergent obstetric conditions.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

64 360 Simulation: Assessing Baby Robin

Within a rural county, student placement locations are geographically scattered. Student feedback revealed that only students in one placement were able to benefit from the high-fidelity simulation suite resources situated at the lead hospital. Research shows students value co-created and personalized resources. Working with our practice partners we identified a cost-effective, accessible and inclusive solution, using 360 videos. Clinical simulation has been found to be effective To use 360 videos accessed via low-cost VR headsets to scale the clinical simulation experience for paediatric nursing students.Working with our local hospital and our second-year paediatric nursing students, we used agile design methods and co-creation to develop two ABCDE assessment clinical simulations (sepsis and acute respiratory illness), using a 360 camera. These videos were accessed using low-cost virtual reality headsets, Oculus Quest™, mobile devices and Microsoft HoloLens™. Qualitative evaluation sought views of students, nursing staff/academics and simulation technicians through focus groups (n = 10). Thematic analysis revealed emergent themes of flexibility of access, repetition of learning opportunity and strengthening or the practice-theory link. Challenges included user familiarity with the technology and time investment. The main impact of this project was wider and longer-lasting learning compared with traditional methods.Bite size learning chunks embedded strategically into our new nursing curriculum, for 300 student nurses studying at level 5. Harnessing the full potential of the clinical simulated experience permits students and staff to learn at a time and place of their own choosing. The ABCDE assessment will be expertly demonstrated through 360 videos, which will better prepare students for in-person simulations, saving face-to-face time explaining how to carry out the simulation. Learning from this project will feedforward to a faculty-wide multi-disciplinary clinical simulation event, informing guidelines.

59 Rapid Training During A Pandemic: An Evaluation of a Covid-19 Video E-Learning Package

As COVID-19 hospital admissions rose in 2020, there was a requirement to prepare wards and staff to care for COVID-19 patients, especially given the rapidly emerging and frequently evolving guidance, and high levels of re-deployment (GMC, 2020). In one London Trust, this need for educational material geared towards ward staff resulted in a multi-disciplinary simulation education team being commissioned to produce an e-learning resource. We measured the effectiveness of the resource for ward staff as well as any improvement in learners’ COVID-19 knowledge.The aim of the study was to quantify the effectiveness of an e-learning package in improving learners’ COVID-19 knowledge.In November 2020, an e-learning package was created, comprising a video series documenting the journey of a patient with COVID-19 covering admission to discharge (filmed from the patient perspective). This was integrated with content highlighting key aspects of COVID-19 care, ending with a mandatory assessment with an 80% pass mark. The e-learning was disseminated to hospital staff (doctors, nurses and allied healthcare professionals) with data collection via SurveyMonkey® from November 2020 for 3 months. Pre- and post-surveys were included to investigate the average improvement of learners and the impact of the resource on learner self-efficacy through self-rating on six learning outcomes. Free-text options in the post-survey allowed qualitative feedback, aiding continual resource development.In total, 108 learners, about half of whom were doctors, completed both surveys, with a significant difference (p &lt; 0.01) between the pre- and post-learning results and an overall improvement in learners’ knowledge after completion of the e-learning (Average pre- and post-learning scores of learners’ self-reported knowledge and percentage improvement*Treatment escalation plans.E-learning can rapidly disseminate learning, at a time when most feel the pandemic has had a mixed or negative impact on learning opportunities (Dean E, 2020; GMC, 2020). The e-learning is continually updated with new evidence, with plans to expand access across London. An iterative process was undertaken with updates in response to learner feedback due to the speed at which the resource needed to be developed, for example, turning resources into PDFs for home access. The e-learning remains live given rising COVID-19 cases. Further work is required to investigate the effectiveness of this resource across London and how beneficial it has been for clinical work.

The Role of Multidisciplinary Team Training in Teaching Emergency Skills for Healthcare Workers in Atypical Conditions

The experience of conducting multidisciplinary training on the basis of the Multidisciplinary Accreditation and Simulation Center of the Perm State Medical University named after academician E.A. Wagner for employees of perinatal centers and maternity hospitals in the Perm Territory. Teamwork in the provision of emergency care is a priority in the training of doctors of various specialties. The developed model of multidisciplinary training in atypical working conditions allows not only to identify and improve the technical skills necessary for employees of prenatal centers in the development of emergency conditions, but also allows to consolidate such non-technical skills as working communication of doctors of various specialties and teamwork in providing emergency care to patients.

Operationalizing the emergent management of psychiatric patients during the COVID-19 pandemic at an academic public hospital

Background: While the volume of Emergency Department (ED) visits has declined during the 2019 novel coronavirus disease or COVID-19, the opposite has been observed with mental-health related visits. The need to screen and manage potential COVID-19 symptoms in parallel with psychiatric complaints have imposed new challenges in the ED at an academic public hospital.Objective: The objective is to share operational modifications in addressing the challenges related to the influx of ED mentalhealth related complaints at the departmental, hospital-wide, and city-wide level within an academic, public hospital.Methods: At the departmental level, a triage algorithm for screening patients with concerning symptoms was developed. A dedicated Respiratory Decision Unit with psychiatrically safe rooms that adhered to infection prevention protocol was also created. All staff were trained to utilize personal protective equipment through lectures, asynchronous learning, and multidisciplinary simulations. The ED team worked with hospital leadership to increase inpatient medical psychiatric bed capacity and to develop testing protocols for patients being admitted to allow for cohorting of symptomatic patients. At the city level, leadership within the three main organizations that provide mental health services to the city met regularly to address operational issues.Conclusions: The COVID-19 pandemic has imposed new challenges in terms of increased psychosocial needs while limiting transmission risks. Based on the experiences shared, a multitier approach is necessary. At all levels, the goals were to screen appropriately, decrease transmission risk, and maintain throughput. The purpose of this descriptive manuscript is to encourage dialogue and to raise awareness about the unique needs of the mental health system.

52 AUDIT CYCLE EXAMINING QUALITY IMPROVEMENT POST EMERGENCY DEPARTMENT MULTI-DISCIPLINARY SIMULATION BASED MEDICAL EDUCATION TRAINING ON HIP FRACTURE CARE

Abstract Background The care of patients with hip fractures is a surrogate marker of trauma care. Irish hip Fracture Standard 1 involves patients with a hip fracture being admitted to an orthopaedic ward bed within 4 hours of attending the ED. We wanted to audit our current practice and introduce a quality improvement project to improve the timeliness and efficiency of care of our hip fracture patients compared with the gold standard IHFS 1. We introduced a 90 minute multidisciplinary simulation training programme on the hip fracture pathway to our ED in February 2021. All key stakeholders were represented; from Emergency Medicine, Orthopaedics, Nursing (EM and Orthopaedic), Radiology, Radiography, Porters (32 people overall). Because of COVID-19, the training was available in person and online via Zoom. Methods We performed a retrospective audit of patients presenting to TUH ED with a proximal third of femur fracture between 4th February and 31st March inclusive in 2020 and 2021, pre and post introduction of multidisciplinary simulation based medical education on the hip fracture pathway. Data was collected from the electronic record database (Symphony). We recorded the following data; Results 2020 n = 31. Average time to ward—8 hrs 29 mins. 26% patients reached ward &amp;lt;4 hours. (8/31). 2021 n = 25. Average time to ward—5 hrs 58 mins (32% reduction vs 2020). 72% patients reached ward &amp;lt;4 hours. (18/25) (46% increase vs 2020). Conclusion Simulation based medical education is a successful intervention to improve compliance with our hip fracture pathway, time from presentation to transfer to an orthopaedic ward bed and achieve IHFS 1.

An Assessment of Pediatric Resident Disaster Preparedness for the Neonatal Intensive Care Unit.

To assess the level of neonatal intensive care unit (NICU) disaster preparedness among pediatric residents. A mixed-methods study including qualitative interviews and quantitative surveys was used. Interviews guided survey development. Surveys were distributed to residents who rotated through Children's National NICU. Questions assessed residents' background in disaster preparedness, disaster protocol knowledge, NICU preparedness, roles during surge and evacuation, and views on training and education. Survey response was 62.5% (n = 80) with 51.3% of invited residents completing it. Pediatric residents (PGY-2 and PGY-3) (n = 41) had low levels of individual disaster preparedness, particularly evacuations (86%). None were aware of specific NICU disaster protocols. Patient acuity, role ambiguity, knowledge, and training deficits were major contributors to unpreparedness. Residents viewed their role as system facilitators (eg, performing duties assigned, recruiting other residents, and clerical work like documentation). Resident training requests included disaster preparedness training every NICU rotation (48%) using multidisciplinary simulations (66%), role definition (56%), and written protocols (50%). Despite their unpreparedness, residents (84%) were willing to respond. Pediatric residents lacked knowledge of NICU disaster response but were willing to respond to disasters. Training should include multi-disciplinary simulations that can be refined iteratively to clarify roles, and residents should be involved in planning and execution.

Aeroelastic simulations of a delta wing with a Chimera approach for deflected control surfaces

A numerical tool for the computation of aircraft control surface aerodynamics with flexibility effects is presented. The solution is based on coupled Computational Fluid Dynamics (CFD) and Computational Structural Mechanics (CSM) simulations embedded in the multidisciplinary simulation environment SimServer. In SimServer, the DLR-TAU Code is utilized to obtain the CFD solution by solving the Reynolds-Averaged Navier–Stokes (RANS) equations. Structural displacements are computed with a modal solver. The Chimera implementation of SimServer, suited for hybrid grids, is applied to model the control surfaces. Numerical simulations with the flexible Chimera method are performed for the Model53 wing configuration, which is a generic delta wing with a deployed slat as well as an inboard and outboard trailing edge flap. Aerodynamic and aeroelastic simulations at high dynamic pressure q=45 kPa and transonic speed {text {Ma}} = 0.8 are performed for several angles of attack 10^circ le alpha le 25^circ and flap deflection angles -30^circ le delta le 30^circ. The effect of structural deformations on the flow field and control surface effectiveness are analyzed and compared to computations of components treated fully rigid. At the targeted freestream condition M=0.8 and {text {Re}}=15.1 times 10^7, the flow field around the Model53 configuration is characterized by the interaction of vortices and shock waves. The results of the lift and pitching moment coefficient for the rigid and flexible configuration revealed the importance of taking the structural flexibility into account in order to obtain more accurate results for the considered range of flap deflections. Furthermore, the computational effort of the aerodynamic and aeroelastic simulations are evaluated. The increase in computational effort is shown to be adequate for the given increase in accuracy.

Research on Integrated Simulation Design Method of Performance and Reliability for Aerospace Electromechanical Products

This paper proposes an integrated simulation method of the performance and reliability for aerospace electromechanical products, which can obtain the reliability parameters of the product through digital simulation, so as to guide the design of the product, taking into account the factors that affect the reliability in the design stage. This method is based on a multidisciplinary performance simulation model, comprehensively considers the failure mode and failure mechanism of the product. Through the method of DESIGN OF EXPERIMENT(DOE), the key design parameters and disturbance factors are combined and designed as input, the performance response surface model, the performance and reliability integrated simulation model are constructed in turn. Taking a typical aerospace electromechanical product solar wing drive mechanism as an example, the engineering application verification is carried out, and the response surface has a high matching degree with the sampling point, which can meet the engineering application.

SP10.1.7 The Important Role of In-Situ Simulation in Preparing Surgeons for the COVID-19 Pandemic

Abstract Background Effective training is vital when facing viral outbreaks such as the SARS Coronavirus 2 (SARS-CoV-2) outbreak of 2019. The objective of this study was to measure the impact of in-situ simulation on the confidence of the surgical teams of two hospitals in assessing and managing acutely unwell surgical patients who are high-risk or confirmed to have COVID-19. Methods This was a quasi-experimental study with a pretest-posttest design. The surgical teams at each hospital participated in multi-disciplinary simulation sessions to explore the assessment and management of a patient requiring emergency surgery who is high risk for COVID-19. The participants were surveyed before and after receiving simulation training to determine their level of confidence on a Visual Analog Scale (VAS) for the premise stated in each of the nine questions in the survey, which represented multiple aspects of the care of these patients. Results 27 participants responded the pre-simulation survey and 24 the one post-simulation. The level of confidence (VAS score) were statistically significantly higher for all nine questions after the simulation. Specific themes were identified for further training and changes in policy. Conclusion In-situ simulation is an effective training method. Its versatility allows it to be set up quickly as rapid-response training in the face of an imminent threat. In this study, it improved the preparedness of two surgical teams for the challenges of the COVID-19 pandemic.

Multidisciplinary Team Simulation Training for Successful Outcomes in Robotic Cardiac Surgery

Multidisciplinary Team Simulation Training for Successful Outcomes in Robotic Cardiac Surgery