State-of-the-art usage of simulation in anesthesia

Krage, Ralf; Erwteman, M.

doi:10.1097/aco.0000000000000257

Cited by 40 publications

(27 citation statements)

References 80 publications

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“…Although simulation training has found a permanent place in daily anesthesiology practice and training programs and trainees seem to benefit from it (eg, in training complex team scenarios), there is an ongoing discussion about the validity and reliability of airway skill simulators). 3 , 23 , 24 As an alternative to manikin simulators, cadavers can be used to train airway management techniques. Fresh frozen cadaver models have been found useful to train airway management techniques.…”

Section: Discussionmentioning

confidence: 99%

Comparison of a Novel Cadaver Model (Fix for Life) With the Formalin-Fixed Cadaver and Manikin Model for Suitability and Realism in Airway Management Training

Emden

Geurts

Schober

et al. 2018

Anesthesia &Amp; Analgesia

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BACKGROUND:Manikins are widely used in airway management training; however, simulation of realism and interpatient variability remains a challenge. We investigated whether cadavers embalmed with the novel Fix for Life (F4L) embalmment method are a suitable and realistic model for teaching 3 basic airway skills: facemask ventilation, tracheal intubation, and laryngeal mask insertion compared to a manikin (SimMan 3G) and formalin-fixed cadavers.METHODS:Thirty anesthesiologists and experienced residents (“operators”) were instructed to perform the 3 airway techniques in 10 F4L, 10 formalin-fixed cadavers, and 1 manikin. The order of the model type was randomized per operator. Primary outcomes were the operators’ ranking of each model type as a teaching model (total rank), ranking of the model types per technique, and an operator’s average verbal rating score for suitability and realism of learning the technique on the model. Secondary outcomes were the percentages of successfully performed procedures per technique and per model (success rates in completing the respective airway maneuvers). For each of the airway techniques, the Friedman analysis of variance was used to compare the 3 models on mean operator ranking and mean verbal rating scores.RESULTS:Twenty-seven of 30 operators (90%) performed all airway techniques on all of the available models, whereas 3 operators performed the majority but not all of the airway maneuvers on all models for logistical reasons. The total number of attempts for each technique was 30 on the manikin, 292 in the F4L, and 282 on the formalin-fixed cadavers. The operators’ median total ranking of each model type as a teaching model was 1 for F4L, 2 for the manikin and, 3 for the formalin-fixed cadavers (P < .001). F4L was considered the best model for mask ventilation (P = .029) and had a higher mean verbal rating score for realism in laryngeal mask airway insertion (P = .043). The F4L and manikin did not differ significantly in other scores for suitability and realism. The formalin-fixed cadaver was ranked last and received lowest scores in all procedures (all P < .001). Success rates of the procedures were highest in the manikin.CONCLUSIONS:F4L cadavers were ranked highest for mask ventilation and were considered the most realistic model for training laryngeal mask insertion. Formalin-fixed cadavers are inappropriate for airway management training.

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Section: Discussionmentioning

confidence: 99%

Comparison of a Novel Cadaver Model (Fix for Life) With the Formalin-Fixed Cadaver and Manikin Model for Suitability and Realism in Airway Management Training

Emden

Geurts

Schober

et al. 2018

Anesthesia &Amp; Analgesia

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“…The definition and simulation of key tasks and learning objectives are considered as being more important than fidelity in simulation [ 37 , 38 ]. The systematic combination of structured observations and expert interviews generates reliable information of the surgical procedure’s key tasks through minimizing biases and sources of unreliable information that are inherent to each of the individual methods.…”

Section: Discussionmentioning

confidence: 99%

Stepwise development of a simulation environment for operating room teams: the example of vertebroplasty

et al. 2018

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BackgroundDespite the growing importance of medical simulation in education, there is limited guidance available on how to develop medical simulation environments, particularly with regard to technical and non-technical skills as well as to multidisciplinary operating room (OR) team training. We introduce a cognitive task analysis (CTA) approach consisting of interviews, structured observations, and expert consensus to systematically elicit information for medical simulator development. Specifically, our objective was to introduce a guideline for development and application of a modified CTA to obtain task demands of surgical procedures for all three OR professions with comprehensive definitions of OR teams’ technical and non-technical skills.MethodsTo demonstrate our methodological approach, we applied it in vertebroplasty, a minimally invasive spine procedure. We used a CTA consisting of document reviews, in situ OR observations, expert interviews, and an expert consensus panel. Interviews included five surgeons, four OR nurses, and four anesthetists. Ten procedures were observed. Data collection was carried out in five OR theaters in Germany.ResultsAfter compiling data from interviews and observations, we identified 6 procedural steps with 21 sub-steps for surgeons, 20 sub-steps for nurses, and 22 sub-steps for anesthetists. Additionally, we obtained information on 16 predefined categories of intra-operative skills and requirements for all three OR professions. Finally, simulation requirements for intra-operative demands were derived and specified in the expert panel.ConclusionsOur CTA approach is a feasible and effective way to elicit information on intra-operative demands and to define requirements of medical team simulation. Our approach contributes as a guideline to future endeavors developing simulation training of technical and non-technical skills for multidisciplinary OR teams.Electronic supplementary materialThe online version of this article (10.1186/s41077-018-0077-2) contains supplementary material, which is available to authorized users.

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“…Further integration of simulation into learning occurred in the aviation industry in the early 1970's, and simulated learning continues to be utilised for assessment of competency using flight simulators (Krage & Erwteman, 2015;Topping, Bøje, Rekola, Hartvigsen, Prescott, Bland, & Hannula, 2015). Simulated learning approaches were used to prepare pilots for potentially difficult and rare occurrences, which led to it being adopted by a range of high risk industries including the military, engineering, nuclear power and medicine (Kneebone, 2016).…”

Section: The Historical Development Of Simulated Learningmentioning

confidence: 99%

“…The success of SL was recognised as an accepted teaching strategy by the Institute of Medicine in 2003, specifically in preparation for management of critical events and identification of errors (Krage & Erwteman, 2015;Booth, Sinclair, Strudwick, Brennan, Tong, Relouw & Vlasic, 2017). Anaesthesiology was one of the first medical specialisations to pioneer the structured use of simulation in health professional education (Krage & Erwteman, 2015).…”

Section: The Historical Development Of Simulated Learningmentioning

confidence: 99%

Simulation based education and expansive learning in health professional education: A discussion

Burton¹,

Hope²

2018

JALT

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State-of-the-art usage of simulation in anesthesia

Abstract: Simulation for skill and team training should be a mandatory component for anesthesia residency programs and continuous medical education. The 'see one, do one, teach one' approach is obsolete and should be abandoned.

Cited by 40 publications

References 80 publications

Comparison of a Novel Cadaver Model (Fix for Life) With the Formalin-Fixed Cadaver and Manikin Model for Suitability and Realism in Airway Management Training

Comparison of a Novel Cadaver Model (Fix for Life) With the Formalin-Fixed Cadaver and Manikin Model for Suitability and Realism in Airway Management Training

Stepwise development of a simulation environment for operating room teams: the example of vertebroplasty

Simulation based education and expansive learning in health professional education: A discussion

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