Simulation: it’s a start

Davies, Jan M.; Helmreich, Robert L.

doi:10.1007/bf03018100

Cited by 13 publications

(5 citation statements)

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“…Sixth, formal training should be provided in threat and error management, with programs such as crew resource management (CRM) adapted to medicine and based on local data. 13,14 Training topics in CRM should include human limitations as sources of error; the nature of error and error management; culture and communications; expert decision-making; training in using specific behaviours and procedures as countermeasures against threat and error. Examples of these countermeasures are briefings, inquiry, sharing mental models, conflict resolution, and fatigue and alertness management.…”

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confidence: 99%

Culture, threat, and error: lessons from aviation

Helmreich

Davies

2004

Can J Anesth/J Can Anesth

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LTHOUGH different modes of transport, such as aviation and rail, have become increasingly safer over the past 20 years, accidents still occur. 1 Similarly, adverse outcomes occur in healthcare, despite numerous improvements in areas such as, for example, selection and training of personnel, design and maintenance of equipment, and greater availability and reduced side effects of many drugs. 2 However, the proportional gains in aviation have been larger than those in healthcare, and, if for this reason alone, the Institute of Medicine Report, 'To Err is Human,' 3 recommended that medicine adopt aviation's approaches to safety and error management. 4 S Si im mi il la ar ri it ti ie es s b be et tw we ee en n a av vi ia at ti io on n a an nd d h he ea al lt th hc ca ar re e There are similarities in the ongoing struggle for safety in both healthcare and aviation. First, although safety is the primary goal, cost drives decisions. Second, both domains have, in part, become safer because of technological innovation. Third, there are multiple sources of threats to safety in both systems-technological, human, and environmental. Fourth, disasters are always followed by furious bouts of second-guessing. Fifth, teamwork is essential in reducing, trapping and mitigating or treating errors. 5-7 This last point demands further elaboration. Most endeavors in healthcare, science, and industry require groups to work together effectively-this is the essence of teamwork. Failures of teamwork in complex organizations can have deadly effects. More than twothirds of air crashes involve human or pilot error as a primary factor, in contrast to the decreasing number of crashes related to primary mechanical failure. When human error is cited as a major contributor in an air crash, this occurs most often in the form of failures in teamwork, in such areas as communication and shared mental models. 8 Historically, however, professional training has focused on technical, rather than on interpersonal, skills. Aviation has mandated that the flight and cabin

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confidence: 99%

Culture, threat, and error: lessons from aviation

Helmreich

Davies

2004

Can J Anesth/J Can Anesth

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“…O uso de simuladores teve sua origem em outros ramos de atividade como a indústria da aviação e nuclear, em que os operadores devem estar atentos e treinados para enfrentar qualquer intercorrência. A reprodutibilidade dessas intercorrências, sem trazer conseqüências catastróficas, só é possível com o uso da simulação 10,[14][15][16][17][18] . A Anestesiologia é uma das especialidades médicas em que se observa grande semelhança com esses ramos de atividade.…”

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Importância do treinamento de residentes em eventos adversos durante anestesia: experiência com o uso do simulador computadorizado

Cicarelli¹,

Coelho²,

Benseñor³

et al. 2005

Rev. Bras. Anestesiol.

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“…3 Perhaps this result reflects the relative limitations of perioperative communication skills possessed by healthcare providers. According to Davies and Helmreich, 9 recurrent practice of effective communication is essential to integrate and augment the obligatory human factors that influence outcomes in healthcare. Indeed, improved communication skills among operating room team members have been shown through simulation.…”

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“…3 Ce résultat reflète peut-être les limites relatives des compétences de communication périopératoire des divers fournisseurs de soins de santé. Selon Davies et Helmreich, 9 la pratique récurrente d'une communication efficace est essentielle si l'on souhaite intégrer et étendre les facteurs humains incontournables qui influencent les devenirs des patients dans les soins de santé. En effet, une amélioration des compétences de communication entre les membres de l'équipe de la salle d'opération a été démontrée grâce à la simulation.…”

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