Comparing traditional, immersive simulation with Rapid Cycle Deliberate Practice in postgraduate year 2 anesthesiology residents

Abstract

Background Rapid Cycle Deliberate Practice (RCDP) is an increasingly popular simulation technique that allows learners to achieve mastery of skills through repetition, feedback, and increasing difficulty. This manuscript describes the implementation and assessment of RCDP in an anesthesia residency curriculum. Methods Researchers describe the comparison of RCDP with traditional instructional methods for anesthesiology residents' application of Emergency Cardiovascular Care (ECC) and communication principles in a simulated environment. Residents (n = 21) were randomly assigned to either Traditional or RCDP education groups, with each resident attending 2 days of bootcamp. On their first day, the Traditional group received a lecture, then participated in a group, immersive simulation with reflective debriefing. The RCDP group received education through an RCDP simulation session. On their second bootcamp day, all participants individually engaged in an immersive simulation, then completed the “Satisfaction and Self-Confidence in Learning” survey. Application of ECC and communication principles during the simulation was scored by a blinded reviewer through video review. Participants ended the bootcamp by ranking the experiences they found most valuable. Results No significant differences were found in the different group members’ individual performances during the immersive simulation, nor in the experiences they deemed most valuable. However, the Traditional education group reported higher levels of satisfaction and self-confidence in learning in 5 areas (p = 0.004–0.04). Conclusions Regardless of RCDP or Traditional education grouping, anesthesia residents demonstrated no difference in ECC skill level or perceived value of interventions. However, members of the Traditional education group reported higher levels of satisfaction and self-confidence in numerous areas. Additional RCDP opportunities in the anesthesia residency program should be considered prior to excluding it as an educational method in our program.

Simulation in contemporary medical education: Current practices and the way forward

“…However, in another study, Blanchard and Riesenberg et al . [ 31 ] compared traditional, immersive simulation, and rapid cycle deliberate practice in anaesthesiology postgraduate second-year residents and found no difference between the three groups regarding emergency cardiovascular care skills or perceived value of interventions. On the contrary, residents in the group receiving traditional training expressed greater contentment and self-assurance in various domains.…”

Práctica deliberada en ciclos rápidos en residencia multiprofesional: un estudio observacional

“…Por eso es una herramienta que merece ser destacada en estos escenarios. [18][19][20] En cuanto a la percepción de los participantes sobre la estrategia de enseñanza utilizada, el resultado fue positivo, corroborando los resultados de una revisión sistemática sobre el tema y mostró la satisfacción de los estudiantes con la metodología de enseñanza, manifestando una mayor seguridad para realizar el procedimiento en pacientes reales, así como la realización de la actividad en un entorno controlado, con posibilidad de repetición. 21 En otro estudio de formación realizado con médicos residentes de anestesiología, en el que se comparó la simulación tradicional con la estrategia de simulación por PDCR, no se encontraron diferencias significativas en cuanto al aprendizaje práctico, pero el nivel de satisfacción del grupo que utilizó PDCR fue mayor.…”

“…21 En otro estudio de formación realizado con médicos residentes de anestesiología, en el que se comparó la simulación tradicional con la estrategia de simulación por PDCR, no se encontraron diferencias significativas en cuanto al aprendizaje práctico, pero el nivel de satisfacción del grupo que utilizó PDCR fue mayor. 18,22…”

Development and Effectiveness of a Rapid Cycle Deliberate Practice Neonatal Resuscitation Simulation Program: A Quasi-Experimental Study

“…Rapid Cycle Deliberate Practice (RCDP), however, was developed for emergency clinical training at Johns Hopkins University; this mastery learning method uses within-event debriefing. RCDP utilizes a training method that pauses the simulation when a learner’s error is discovered during the scenario and immediately provides directive and personalized evidence-based feedback (solution-oriented debriefing, directing appropriate methods and techniques) for each step; thereafter, the simulation restarts the scenario from the beginning, and the problem situation is progressively expanded [ 9 , 10 ]. RCDP is repetitive training, and, therefore, offers a continuous improvement process, as well as the advantage of enabling the trainee to correct mistakes and promoting muscle and long-term memory through continuous practice [ 8 ].…”

“…The use of the RCDP in-event feedback in resuscitation training helped achieve the goal of mastery learning by familiarizing students with resuscitation guidelines and enhancing their skills and competency [ 10 ]. Furthermore, Blanchard et al [ 9 ] found RCDP to be suitable for training algorithmic, time-sensitive, team-based procedural interventions. Some studies provided RCDP neonatal resuscitation training to experts (physicians) and demonstrated significant effectiveness; however, these previous studies focused mainly on resuscitation techniques and skill evaluation, and it was difficult to find studies that included intervention strategies to improve the decision-making ability for each stage of resuscitation and evaluate their effectiveness [ 9 , 12 , 13 ].…”