PS3-05: IN-SITU OR BASED TEAMSTEPPS TRAINING LEADS TO AN IMPROVEMENT IN NON-TECHNICAL SKILLS DESPITE A VARIABLE INCREASE IN CONFIDENCE AMONG DIFFERENT PERIOPERATIVE TEAMS
D F Sigmon, MD, S Torres Landa, MD, V M Zoghbi, MD, J H Atkins, MD, PhD, M McCauley, R Branca, N N Williams, MD, A D Brooks, MD, K R Dumon, MD, R C Caskey, MD; University of Pennsylvania

Introduction: OR crises are rare events; successful patient outcomes are dependent upon the non-technical skills (NTS) possessed by the perioperative team. For the past year, we have instituted TeamSTEPPS® training to perioperative teams using our established in-situ OR Simulation program.

Methods: 9 surgical residents, 18 anesthesia residents, and 26 OR nurses were formed into 9 teams. Teams underwent two simulated crisis scenarios, with a debrief following each scenario.  The crises simulated included myocardial infarction (MI), massive bleed, and malignant hyperthermia (MH). Pre- and post- surveys were administered to gauge participant confidence and perceptions regarding simulation. A senior surgeon, anesthesiologist, and nurse evaluated each team using TeamSTEPPS® and each specialty using NOTSS®.

Results: Surgery participants reported significantly improved confidence for all scenarios: MI (2.7± 0.2 to 3.6±0.3; p=0.02), massive bleed (3.1±0.2 to 3.9±0.2; p=0.01), and MH (2.7±0.2 to 4±0.2; p=0.02). Nursing reported similar improvements: MI (2.7± 0.2 to 3.6±0.2; p<0.01), massive bleed (3.6±0.1 to 4.1±0.2; p=0.01), and MH (2.7±0.2 to 4.2±0.4; p<0.01). Anesthesia participants only reported significant improved confidence for malignant hyperthermia (3.2±0.3 to 4.7±0.2; p<0.01).  All teams demonstrated a high baseline opinion regarding simulation training which improved following the training (4.1±0.1 to 4.5±0.1; p=0.02). Average TeamSTEPPS® score improved between scenarios (38.6±1.6 to 44.8±2.2; p=0.03). Combined average NOTSS® score also improved between scenarios (10.3±0.4 to 12±0.5; p<0.01). We found a strong correlation between the increase in TeamSTEPPS® score and NOTSS® score (r=0.8).

Conclusion: This data demonstrates successful improvement in NTS in participants undergoing team based in-situ OR simulation training as determined by TeamSTEPPS® and NOTSS® scores. There was a strong correlation between these two scores, further validating utilizing TeamSTEPPS® training to improve NTS. Surprisingly, the gain in NTS was independent of the increase in confidence which varied among the separate specialties.