PS8-02: ARRESTS IN THE OPERATING ROOM: THE EFFECT OF INTERDEPARTMENTAL SIMULATION TRAINING ON RESIDENTâS PERCEIVED SELF-EFFICACY
Brendan F Scully, MD1, Allison Lee, MD2, Jake Prigoff, MD1, C. Randall Cooper, MD1, Woo-Jin Shim2, Nell Maloney-Patel, MD3, Vivek Moitra, MD2, Beth Hochman, MD1; 1Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons, 2Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, 3Department of Surgery, Rutgers Robert Wood Johnson Medical School
Background: Cardiac arrests in the operating room are rare events associated with high morbidity and mortality. Intraoperative cardiac arrests are different than those in other scenarios and have a shorter list of probable causes that can focus resuscitative efforts. High-fidelity simulation (HFS) has emerged as a successful tool to improve technical skills, team dynamics and communication in a safe environment, particularly for rare or challenging events.
Methods: Eight simulations of an operating room arrest were conducted. Each hour-long simulation consisted of an HFS scenario, followed by a structured debriefing. One junior and senior from both the anesthesia and surgery departments participated in each scenario. Prior to the simulation and after debriefing, participants completed an anonymous survey consisting of 5-point Likert scale statements and a self-efficacy questionnaire on a 10-point scale. The self-efficacy items encompassed 22 statements on five broad domains: situational awareness, communication/teamwork, shared mental models, leadership and technical skills.
Results: A total of 32 residents participated in eight simulation sessions. All participants completed the surveys. Statistically significant gains from mean pre- to post-training scores occurred in 17 of the 22 individual self-efficacy statements, and across all five domains. There was no significant difference between anesthesia and surgery residents and no significant difference in gains between junior and senior residents. All participants agreed with the following statements: their communication and teamwork skills improved as a result of the simulation (mean 4.5/5.0); they would like to participate in this type of simulation again (mean 4.87/5.0); these simulations should be incorporated into the housestaff curriculum on a regular basis (mean 4.81/5.0).
Conclusions: Interdepartmental, high-fidelity simulation of operating room arrests positively impacts resident’s perceived self-efficacy and ability to perform and communicate in these high stress situations. Housestaff reported a strong desire to incorporate these simulations into their educational curriculum.