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Tay YX, Ng GYH, Xue M, Lim CXY, Hsiao CW, Wei YM, Ong CCP. 'Gear up and get ready': Collaborative curriculum for radiographers supporting percutaneous nephrolithotomy in the operating theatre. Radiography (Lond) 2024; 30:178-184. [PMID: 38035431 DOI: 10.1016/j.radi.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/04/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION Newly qualified radiographers often find working in the operating theatre (OT) challenging and intimidating. These perceptions, which inhibit confidence, may hinder their effectiveness in interprofessional teamwork, which may in turn adversely affect patient outcomes. A collaborative education programme was designed, building upon the foundations of competency-based education (CBE) and simulation-based mastery learning (SBML) to examine its potential in mitigating these perceptions. The objective of this research was to assess participants' experience and level of competency after attending the curated collaborative educational programme. METHODS The programme was developed based on the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model and comprises two teaching and learning phases: educational session and simulation. A collaborative approach was undertaken to develop an assessment checklist for the interprofessional simulation. Requirements for the simulation, such as scenario design, information and storyboard, task trainer, logistics, and learners' briefing, debrief, and feedback, were identified and assembled. The radiographers' performance was recorded using a practical skills assessment checklist and a theory assessment. RESULTS Twelve radiographers participated and showed improvement in their self-rating of learning objectives before and after the programme. The median (interquartile range) score achieved in the theory assessment, out of a possible of 11, was 9.00 (7.75-9.50). The median (interquartile range) score achieved in the simulation component, out of a possible of 16, was 15.00 (14.00-15.00). There was statistically significant difference in self-perceived performance in all learning objective domains. CONCLUSION The findings from the programme were promising. The use of simulation and an assessment checklist proved to be useful learning tools in preparing newly qualified radiographers for work in the OT. IMPLICATIONS FOR PRACTICE Assessment checklists are valuable tools that should be considered to facilitate teaching and learning. The use of interprofessional simulation activities can support radiographers in developing knowledge, professional skills, and clinical competency. It should be conducted in a timely manner to facilitate the introduction to role understanding and effective communication.
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Affiliation(s)
- Y X Tay
- Radiography Department, Allied Health Division, Singapore General Hospital, Singapore.
| | - G Y H Ng
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | - M Xue
- Radiography Department, Allied Health Division, Singapore General Hospital, Singapore
| | - C X Y Lim
- Radiography Department, Allied Health Division, Singapore General Hospital, Singapore
| | - C-W Hsiao
- Radiography Department, Allied Health Division, Singapore General Hospital, Singapore
| | - Y-M Wei
- Radiography Department, Allied Health Division, Singapore General Hospital, Singapore
| | - C C-P Ong
- Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore; SingHealth Duke-NUS Academic Medical Centre, Singapore
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2
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Pulcinelli M, Pinnelli M, Massaroni C, Lo Presti D, Fortino G, Schena E. Wearable Systems for Unveiling Collective Intelligence in Clinical Settings. SENSORS (BASEL, SWITZERLAND) 2023; 23:9777. [PMID: 38139623 PMCID: PMC10747409 DOI: 10.3390/s23249777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
Nowadays, there is an ever-growing interest in assessing the collective intelligence (CI) of a team in a wide range of scenarios, thanks to its potential in enhancing teamwork and group performance. Recently, special attention has been devoted on the clinical setting, where breakdowns in teamwork, leadership, and communication can lead to adverse events, compromising patient safety. So far, researchers have mostly relied on surveys to study human behavior and group dynamics; however, this method is ineffective. In contrast, a promising solution to monitor behavioral and individual features that are reflective of CI is represented by wearable technologies. To date, the field of CI assessment still appears unstructured; therefore, the aim of this narrative review is to provide a detailed overview of the main group and individual parameters that can be monitored to evaluate CI in clinical settings, together with the wearables either already used to assess them or that have the potential to be applied in this scenario. The working principles, advantages, and disadvantages of each device are introduced in order to try to bring order in this field and provide a guide for future CI investigations in medical contexts.
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Affiliation(s)
- Martina Pulcinelli
- Research Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy; (M.P.); (M.P.); (C.M.); (E.S.)
| | - Mariangela Pinnelli
- Research Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy; (M.P.); (M.P.); (C.M.); (E.S.)
| | - Carlo Massaroni
- Research Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy; (M.P.); (M.P.); (C.M.); (E.S.)
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
| | - Daniela Lo Presti
- Research Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy; (M.P.); (M.P.); (C.M.); (E.S.)
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
| | - Giancarlo Fortino
- DIMES, University of Calabria, Via P. Bucci 41C, 87036 Rende, Italy;
| | - Emiliano Schena
- Research Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Roma, Italy; (M.P.); (M.P.); (C.M.); (E.S.)
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
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Chamely EA, Stulberg JJ. Measuring Quality at the Surgeon Level. Clin Colon Rectal Surg 2023; 36:233-239. [PMID: 37223225 PMCID: PMC10202541 DOI: 10.1055/s-0043-1761421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Patients expect high-quality surgical care and increasingly are looking for ways to assess the quality of the surgeon they are seeing, but quality measurement is often more complicated than one might expect. Measurement of individual surgeon quality in a manner that allows for comparison among surgeons is particularly difficult. While the concept of measuring individual surgeon quality has a long history, technology now allows for new and innovative ways to measure and achieve surgical excellence. However, some recent efforts to make surgeon-level quality data publicly available have highlighted the challenges of this work. Through this chapter, the reader will be introduced to a brief history of surgical quality measurement, learn about the current state of quality measurement, and get a glimpse into what the future holds.
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Affiliation(s)
- Elias A. Chamely
- Department of Surgery, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
| | - Jonah J. Stulberg
- Department of Surgery, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas
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4
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Stefan P, Pfandler M, Kullmann A, Eck U, Koch A, Mehren C, von der Heide A, Weidert S, Fürmetz J, Euler E, Lazarovici M, Navab N, Weigl M. Computer-assisted simulated workplace-based assessment in surgery: application of the universal framework of intraoperative performance within a mixed-reality simulation. BMJ SURGERY, INTERVENTIONS, & HEALTH TECHNOLOGIES 2023; 5:e000135. [PMID: 36687799 PMCID: PMC9853221 DOI: 10.1136/bmjsit-2022-000135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 08/24/2022] [Indexed: 01/20/2023] Open
Abstract
Objectives Workplace-based assessment (WBA) is a key requirement of competency-based medical education in postgraduate surgical education. Although simulated workplace-based assessment (SWBA) has been proposed to complement WBA, it is insufficiently adopted in surgical education. In particular, approaches to criterion-referenced and automated assessment of intraoperative surgical competency in contextualized SWBA settings are missing.Main objectives were (1) application of the universal framework of intraoperative performance and exemplary adaptation to spine surgery (vertebroplasty); (2) development of computer-assisted assessment based on criterion-referenced metrics; and (3) implementation in contextualized, team-based operating room (OR) simulation, and evaluation of validity. Design Multistage development and assessment study: (1) expert-based definition of performance indicators based on framework's performance domains; (2) development of respective assessment metrics based on preoperative planning and intraoperative performance data; (3) implementation in mixed-reality OR simulation and assessment of surgeons operating in a confederate team. Statistical analyses included internal consistency and interdomain associations, correlations with experience, and technical and non-technical performances. Setting Surgical simulation center. Full surgical team set-up within mixed-reality OR simulation. Participants Eleven surgeons were recruited from two teaching hospitals. Eligibility criteria included surgical specialists in orthopedic, trauma, or neurosurgery with prior VP or kyphoplasty experience. Main outcome measures Computer-assisted assessment of surgeons' intraoperative performance. Results Performance scores were associated with surgeons' experience, observational assessment (Objective Structured Assessment of Technical Skill) scores and overall pass/fail ratings. Results provide strong evidence for validity of our computer-assisted SWBA approach. Diverse indicators of surgeons' technical and non-technical performances could be quantified and captured. Conclusions This study is the first to investigate computer-assisted assessment based on a competency framework in authentic, contextualized team-based OR simulation. Our approach discriminates surgical competency across the domains of intraoperative performance. It advances previous automated assessment based on the use of current surgical simulators in decontextualized settings. Our findings inform future use of computer-assisted multidomain competency assessments of surgeons using SWBA approaches.
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Affiliation(s)
- Philipp Stefan
- Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Informatics, Technical University of Munich, München, Germany
| | - Michael Pfandler
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, University Hospital, Ludwig Maximilians University Munich, München, Germany
| | - Aljoscha Kullmann
- Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Informatics, Technical University of Munich, München, Germany
| | - Ulrich Eck
- Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Informatics, Technical University of Munich, München, Germany
| | - Amelie Koch
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, University Hospital, Ludwig Maximilians University Munich, München, Germany
| | - Christoph Mehren
- Spine Center, Schön Klinik München Harlaching, München, Germany,Academic Teaching Hospital and Spine Research Institute, Paracelsus Medical University, Salzburg, Austria
| | - Anna von der Heide
- Department of General, Trauma and Reconstructive Surgery, University Hospital, Campus Grosshadern, Ludwig Maximilians University Munich, München, Germany
| | - Simon Weidert
- Department of General, Trauma and Reconstructive Surgery, University Hospital, Campus Grosshadern, Ludwig Maximilians University Munich, München, Germany
| | - Julian Fürmetz
- Department of General, Trauma and Reconstructive Surgery, University Hospital, Campus Innenstadt, Ludwig Maximilians University Munich, München, Germany
| | - Ekkehard Euler
- Department of General, Trauma and Reconstructive Surgery, University Hospital, Campus Innenstadt, Ludwig Maximilians University Munich, München, Germany
| | - Marc Lazarovici
- Institute for Emergency Medicine and Management in Medicine (INM), University Hospital, Ludwig Maximilians University Munich, München, Germany
| | - Nassir Navab
- Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Informatics, Technical University of Munich, München, Germany
| | - Matthias Weigl
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, University Hospital, Ludwig Maximilians University Munich, München, Germany,Institute for Patient Safety, University of Bonn, Bonn, Germany
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5
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Managing a Team in the Operating Room: The Science of Teamwork and Non-Technical Skills for Surgeons. Curr Probl Surg 2022; 59:101172. [DOI: 10.1016/j.cpsurg.2022.101172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 11/19/2022]
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6
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Buljac-Samardžić M, Dekker-van Doorn CM, Maynard MT. What Do We Really Know About Crew Resource Management in Healthcare?: An Umbrella Review on Crew Resource Management and Its Effectiveness. J Patient Saf 2021; 17:e929-e958. [PMID: 34852415 PMCID: PMC8612906 DOI: 10.1097/pts.0000000000000816] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this article was to present an overview of the crew resource management (CRM) literature in healthcare. The first aim was to conduct an umbrella review on CRM literature reviews. The second aim was to conduct a new literature review that aims to address the gaps that were identified through the umbrella review. METHODS First, we conducted an umbrella review to identify all reviews that have focused on CRM within the healthcare context. This step resulted in 16 literature reviews. Second, we conducted a comprehensive literature review that resulted in 106 articles. RESULTS The 16 literature reviews showed a high level of heterogeneity, which resulted in discussing 3 ambiguities: definition, outcome, and information ambiguity. As a result of these ambiguities, a new comprehensive review of the CRM literature was conducted. This review showed that CRM seems to have a positive effect on outcomes at Kirkpatrick's level 1, 2, and 3. In contrast, whether CRM has a positive effect on level 4 outcomes and how level 4 should be measured remains undetermined. Recommendations on how to implement and embed CRM training into an organization to achieve the desired effects have not been adequately considered. CONCLUSIONS The extensive nature of this review demonstrates the popularity of CRM in healthcare, but at the same time, it highlights that research tends to be situated within certain settings, focuses on particular outcomes, and has failed to address the full scope of CRM as a team intervention and a management concept.
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Affiliation(s)
| | | | - M. Travis Maynard
- Department of Management, College of Business, Colorado State University, Fort Collins, Colorado
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7
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Ashokcoomar† P, Bhagwan R. The neonatal transfer process through the lens of neonatologists at public hospitals in South Africa. Health SA 2021. [DOI: 10.4102/hsag.v26i0.1617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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8
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Small C, Nwafor D, Patel D, Dawoud F, Dagra A, Ciporen J, Lucke-Wold B. Crisis Management Simulation: Review of Current Experience. SUNTEXT REVIEW OF NEUROSCIENCE & PSYCHOLOGY 2021; 2:126. [PMID: 33928268 PMCID: PMC8081329 DOI: 10.51737/2766-4503.2021.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Crisis management simulation is important in training the next generation of surgeons. In this review, we highlight our experiences with the cavernous carotid injury model. We then delve into other crisis simulation models available for the neurosurgical specialty. The discussion focuses upon how these trainings can continue to evolve. Much work is yet to be done in this exciting arena and we present several avenues for future discovery. Simulation continues to be an important training tool for the surgical learner.
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Affiliation(s)
| | | | - Devan Patel
- College of Medicine, Florida State University
| | - Fakhry Dawoud
- College of Medicine, East Tennessee State University
| | | | - Jeremy Ciporen
- Department of Neurosurgery, Oregon Health and Science University
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9
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Vigo F, Egg R, Schoetzau A, Montavon C, Brezak M, Heinzelmann-Schwarz V, Kavvadias T. An interdisciplinary team-training protocol for robotic gynecologic surgery improves operating time and costs: analysis of a 4-year experience in a university hospital setting. J Robot Surg 2021; 16:89-96. [PMID: 33606159 PMCID: PMC8863701 DOI: 10.1007/s11701-021-01209-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/02/2021] [Indexed: 12/03/2022]
Abstract
Main aim of this study is to assess the effect of a structured, interdisciplinary, surgical, team-training protocol in robotic gynecologic surgery, with the gradual integration of an advanced nurse practitioner. Data from all robotic surgical procedures were prospectively acquired. The surgical team consisted of one experienced surgeon and two surgical fellows and the scrub nurse team from three advance nurse practitioners, specialized in robotic surgery. The training was performed in a four-phase manner over 4 years and included theoretical training, hands-on training and team-communication skills enhancement. Scrub nurses increasingly adopted an active role during surgery. For a period of 4 years, 175 patients could be included in the analysis. All of them underwent a robotic gynecologic procedure. Mean docking time decreased from 45.3 to 27.3 min (p < 0.001), mean operating time from 235 to 179 min (p = 0.0071) and costs per case from 17,891 to 14,731 Swiss Francs (p = 0.035). There were no statistically significant changes in perioperative complications and conversions to laparotomy. An interdisciplinary long-term training protocol for high specialized robotic surgery within a “fixed” team with the gradually addition of an advanced study nurse improves the efficacy of the procedure in terms of time and costs. Although the surgery is performed quicker, the same performance and quality of surgical care could be reached.
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Affiliation(s)
- Francesco Vigo
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Rosalind Egg
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Adreas Schoetzau
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Celine Montavon
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Midhat Brezak
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Viola Heinzelmann-Schwarz
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Tilemachos Kavvadias
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
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10
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Truong H, Sullivan AM, Abu-Nuwar MR, Therrien S, Jones SB, Pawlowski J, Parra JM, Jones DB. Operating room team training using simulation: Hope or hype? Am J Surg 2021; 222:1146-1153. [PMID: 33933207 DOI: 10.1016/j.amjsurg.2021.01.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 01/20/2021] [Accepted: 01/31/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND This study sought to determine the long-term impact of multidisciplinary simulated operating room (OR) team training. METHOD Two-wave survey study (immediate post-training survey 2010-2017, follow-up 2018). Differences across time, specialty, and experience with adverse events were assessed using chi-square and t -tests. RESULTS Immediately after training, more than 90% of respondents found simulation scenarios realistic and reported team training would provide safer patient care. However, follow-up participants reported less enthusiasm toward training, with 58% stating they would like to take similar training again. A majority of participants (77%) experienced adverse events after training; those reporting adverse events reported more positive long-term evaluations. CONCLUSIONS Simulated OR team training is initially highly valued by participants and is perceived as contributing to patient safety. Diminution of participant enthusiasm over time suggests that repeat training requirements be reconsidered, and less costly, alternative methods (such as asynchronous learning or virtual reality) should be explored.
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Affiliation(s)
- Hung Truong
- Beth Israel Deaconess Medical Center Division of Bariatric and Minimally Invasive Surgery, United States.
| | - Amy M Sullivan
- Carl J. Shapiro Institute for Research and Education, Beth Israel Deaconess Medical Center, United States; Beth Israel Deaconess Medical Center Department of Medicine, United States.
| | - Mohamad Rassoul Abu-Nuwar
- Beth Israel Deaconess Medical Center Division of Bariatric and Minimally Invasive Surgery, United States.
| | - Stephanie Therrien
- Beth Israel Deaconess Medical Center Division of Bariatric and Minimally Invasive Surgery, United States.
| | | | - John Pawlowski
- Beth Israel Deaconess Medical Center Department of Anesthesia, Critical Care and Pain Medicine, United States.
| | - Jose M Parra
- Carl J. Shapiro Institute for Research and Education, Beth Israel Deaconess Medical Center, United States.
| | - Daniel B Jones
- Beth Israel Deaconess Medical Center Division of Bariatric and Minimally Invasive Surgery, United States.
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11
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Cant R, Levett-Jones T. Umbrella review: Impact of registered nurses' continuing professional education informed by contemporary reviews of literature. Nurse Educ Pract 2020; 50:102945. [PMID: 33321270 DOI: 10.1016/j.nepr.2020.102945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 09/17/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
This paper aims to explore and classify studies of the impact and effectiveness of continuing professional education for registered nurses, using existing reviews of literature. Four healthcare databases were searched for publications from 2010 to July 2019 and electronic keywords searches were conducted. Umbrella review methodology was applied and Kirkpatrick's Four-Level Model of training evaluation was used to synthesise results and explicate the levels of educational impact. Of 16 included reviews, 13 were of simulation-based education activities. Three reviews of experimental studies demonstrated strong positive evidence of education impact on nurses' learning. Objective evidence of transfer of knowledge and skills into practice included improved interprofessional team performance and less time taken to complete clinical tasks. Reports of practice improvements and intention to change practice provided further evidence of impact. A small number of individual studies measured impact on service delivery, reporting positive and neutral results. We conclude that nurses learn and newly acquired knowledge and skills are often transferred into practice. Collection of robust evaluative data after completion of education is limited by practical considerations such as access to learners, resources and time constraints. Further studies of translational impact are needed, specifically, of the impact on patient care.
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Affiliation(s)
- Robyn Cant
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Victoria, Australia.
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12
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Carstensen K, Jensen EK, Madsen ML, Thomsen AML, Løvschall C, Tayyari Dehbarez N, Risør BW. Implementation of integrated operating rooms: how much time is saved and how do medical staff experience the upgrading? A mixed methods study in Denmark. BMJ Open 2020; 10:e034459. [PMID: 32727737 PMCID: PMC7394299 DOI: 10.1136/bmjopen-2019-034459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate staff experiences of the implementation and use of integrated operating rooms (IORs) in comparison to conventional operating rooms (CORs) in Denmark. DESIGN This study used a mixed methods approach by combining quantitative (registry-based analysis of surgical time) and qualitative (interviews with experienced surgical staff) perspectives. SETTING Hospitals in Denmark. METHODS The quantitative component compared the time consumption of patients between the integrated and CORs in two hospital departments at Aarhus University Hospital. Data were extracted from the administrative system in the hospital. Independent t-tests were used to estimate the statistical differences in the mean time spent on patients between the two operating rooms (ORs), and linear regression was applied to adjust for the potential influence of the surgeon. The explorative qualitative research component involved interviews with 20 informants from 10 hospital departments across seven Danish hospitals, all of whom participated between February and April 2019. Data were analysed using thematic analysis. RESULTS The quantitative analyses showed that preparation time for lobectomy was significantly lower and completion time for cholecystectomy significantly higher in the integrated compared with CORs. No other statistically significant differences were found. The qualitative analysis showed that some nurses experienced better cooperation with the surgeon and that non-sterile nurses experienced an improved working environment in the integrated compared with CORs. Surgical staff experienced that the IORs led to improved workflow during surgery. CONCLUSIONS This study identified no disadvantages regarding the use of IORs compared with CORs. The quantitative component of the research did not identify convincing statistically significant differences in the time consumption per patient between the ORs and according to the qualitative analyses IORs were not experienced by study participants to lead to major improvements among staff.
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Affiliation(s)
| | | | - Mads Lænsø Madsen
- Department of Procurement & Clinical Engineering, Central Denmark Region, Aarhus, Denmark
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13
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Forbes R, Irving P, Copley J. Development and evaluation of interprofessional patient simulation activity for physiotherapy and occupational therapy students to assess and manage patients with chronic pain. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2020. [DOI: 10.12968/ijtr.2019.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims Opportunities for interprofessional learning are a priority to prepare health professionals for the effective interprofessional assessment and management of patients with chronic pain, yet finding effective and sustainable approaches are a challenge for health professional programmes. The aim of this study was to develop and evaluate an ‘interprofessional management of pain’ learning activity using simulation for physiotherapy and occupational therapy students. Methods A total of 40 physiotherapy and 20 occupational therapy students undertook the interprofessional management of pain learning activity. Chronic pain attitudes and beliefs (HC-PAIRS) and perception of interprofessional practice (SPICE-R) were assessed before and following the intervention. A survey relating to content and format of the activity was completed following the intervention. Results There was a significant improvement in total HC-PAIRS and SPICE-R scores for both student groups. Both groups demonstrated satisfaction with the activity. Conclusions These findings support the use of an interprofessional simulated learning activity with facilitated planning and debriefing to enhance students’ attitudes to chronic pain and interprofessional practice.
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Affiliation(s)
- Roma Forbes
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Peter Irving
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Jodie Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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14
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Buljac-Samardzic M, Doekhie KD, van Wijngaarden JDH. Interventions to improve team effectiveness within health care: a systematic review of the past decade. HUMAN RESOURCES FOR HEALTH 2020; 18:2. [PMID: 31915007 PMCID: PMC6950792 DOI: 10.1186/s12960-019-0411-3] [Citation(s) in RCA: 148] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 09/05/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND A high variety of team interventions aims to improve team performance outcomes. In 2008, we conducted a systematic review to provide an overview of the scientific studies focused on these interventions. However, over the past decade, the literature on team interventions has rapidly evolved. An updated overview is therefore required, and it will focus on all possible team interventions without restrictions to a type of intervention, setting, or research design. OBJECTIVES To review the literature from the past decade on interventions with the goal of improving team effectiveness within healthcare organizations and identify the "evidence base" levels of the research. METHODS Seven major databases were systematically searched for relevant articles published between 2008 and July 2018. Of the original search yield of 6025 studies, 297 studies met the inclusion criteria according to three independent authors and were subsequently included for analysis. The Grading of Recommendations, Assessment, Development, and Evaluation Scale was used to assess the level of empirical evidence. RESULTS Three types of interventions were distinguished: (1) Training, which is sub-divided into training that is based on predefined principles (i.e. CRM: crew resource management and TeamSTEPPS: Team Strategies and Tools to Enhance Performance and Patient Safety), on a specific method (i.e. simulation), or on general team training. (2) Tools covers tools that structure (i.e. SBAR: Situation, Background, Assessment, and Recommendation, (de)briefing checklists, and rounds), facilitate (through communication technology), or trigger (through monitoring and feedback) teamwork. (3) Organizational (re)design is about (re)designing structures to stimulate team processes and team functioning. (4) A programme is a combination of the previous types. The majority of studies evaluated a training focused on the (acute) hospital care setting. Most of the evaluated interventions focused on improving non-technical skills and provided evidence of improvements. CONCLUSION Over the last decade, the number of studies on team interventions has increased exponentially. At the same time, research tends to focus on certain interventions, settings, and/or outcomes. Principle-based training (i.e. CRM and TeamSTEPPS) and simulation-based training seem to provide the greatest opportunities for reaching the improvement goals in team functioning.
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Affiliation(s)
- Martina Buljac-Samardzic
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Bayle building, p.o. box 1738, 3000 DR Rotterdam, The Netherlands
| | - Kirti D. Doekhie
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Bayle building, p.o. box 1738, 3000 DR Rotterdam, The Netherlands
| | - Jeroen D. H. van Wijngaarden
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Bayle building, p.o. box 1738, 3000 DR Rotterdam, The Netherlands
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Colvin D, Gallagher S, Marcus S, Fitzpatrick G, Milliken I, Thompson A, Bourke T. Theatre LISTS: Learning from Incidents, finding Safety Threats with Simulation. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2019; 6:308-309. [DOI: 10.1136/bmjstel-2019-000538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/23/2019] [Indexed: 11/04/2022]
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Attending Surgeons Differ From Other Team Members in Their Perceptions of Operating Room Communication. J Surg Res 2019; 235:105-112. [DOI: 10.1016/j.jss.2018.09.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/31/2018] [Accepted: 09/11/2018] [Indexed: 11/22/2022]
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Parsons SM, Kuszajewski ML, Merritt DR, Muckler VC. High-Fidelity Simulation Training for Nurse Anesthetists Managing Malignant Hyperthermia: A Quality Improvement Project. Clin Simul Nurs 2019. [DOI: 10.1016/j.ecns.2018.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Implementing Medical Technological Equipment in the OR: Factors for Successful Implementations. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2018:8502187. [PMID: 30245784 PMCID: PMC6136550 DOI: 10.1155/2018/8502187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/29/2018] [Indexed: 11/28/2022]
Abstract
Operating rooms (ORs) more and more evolve into high-tech environments with increasing pressure on finances, logistics, and a not be neglected impact on patient safety. Safe and cost-effective implementation of technological equipment in ORs is notoriously difficult to manage, specifically as generic implementation activities omit as hospitals have implemented local policies for implementations of technological equipment. The purpose of this study is to identify success factors for effective implementations of new technologies and technological equipment in ORs, based on a systematic literature review. We accessed ten databases and reviewed included articles. The search resulted in 1592 titles for review, and finally 37 articles were included in this review. We distinguish influencing factors and resulting factors based on the outcomes of this research. Six main categories of influencing factors on successful implementations of medical equipment in ORs were identified: “processes and activities,” “staff,” “communication,” “project management,” “technology,” and “training.” We identified a seventh category “performance” referring to resulting factors during implementations. We argue that aligning the identified influencing factors during implementation impacts the success, adaptation, and safe use of new technological equipment in the OR and thus the outcome of an implementation. The identified categories in literature are considered to be a baseline, to identify factors as elements of a generic holistic implementation model or protocol for new technological equipment in ORs.
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Roche F. Human factors and non-technical skills: Teamwork. J Perioper Pract 2018; 26:285-288. [PMID: 29328768 DOI: 10.1177/175045891602601205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 09/15/2016] [Indexed: 01/04/2023]
Abstract
Making mistakes is part of being human and human error is normal in all areas of life (Bromiley and Mitchell 2009). In some contexts this is of little consequence, but in environments where human safety and well-being are at stake it is vital that such error is minimised. The operating theatre is one such safety critical environment. Research suggests, however, that certain factors predispose to human error. Some or all of these factors may be present in the operating theatre and, therefore, have the potential to compromise patient safety.
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Affiliation(s)
- Fiona Roche
- Queen Elizabeth University Hospital, Glasgow, UK
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Armenia S, Thangamathesvaran L, Caine AD, King N, Kunac A, Merchant AM. The Role of High-Fidelity Team-Based Simulation in Acute Care Settings: A Systematic Review. Surg J (N Y) 2018; 4:e136-e151. [PMID: 30109273 PMCID: PMC6089798 DOI: 10.1055/s-0038-1667315] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/29/2018] [Indexed: 11/04/2022] Open
Abstract
Introduction
High-fidelity team-based simulation has been identified as an effective way of teaching and evaluating both technical and nontechnical skills. Several studies have described the benefits of this modality in a variety of acute care settings, but a lack of standardized methodologies has resulted in heterogeneous findings. Few studies have characterized high fidelity simulation across a broad range of acute care settings and integrated the latest evidence on its educational and patient impact.
Methods
The MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were searched for empirical studies from the last 10 years, investigating high fidelity team-based simulation in surgical, trauma, and critical care training curricula.
Results
Seventeen studies were included. Interventions and evaluations were comprehensively characterized for each study and were discussed in the context of four overarching acute care settings: the emergency department/trauma bay, the operating room, the intensive care unit, and inpatient ad hoc resuscitation teams.
Conclusions
The use of high-fidelity team-based simulation has expanded in acute care and is feasible and effective in a wide variety of specialized acute settings, including the emergency department/trauma bay, the operating room, the intensive care unit, and inpatient ad hoc resuscitation teams. Training programs have evolved to emphasize team-based, multidisciplinary education models and are often conducted in situ to maximize authenticity. In situ simulations have also provided the opportunity for system-level improvement and discussions of complex topics such as social hierarchy. There is limited evidence supporting the impact of simulation on patient outcomes, sustainability of simulation efforts, or cost-effectiveness of training programs. These areas warrant further research now that the scope of utilization across acute care settings has been characterized.
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Affiliation(s)
- Sarah Armenia
- Division of General Surgery, Department of Surgery, Rutgers University, New Jersey Medical School, Newark, New Jersey
| | - Loka Thangamathesvaran
- Division of General Surgery, Department of Surgery, Rutgers University, New Jersey Medical School, Newark, New Jersey
| | - Akia D Caine
- Division of General Surgery, Department of Surgery, Rutgers University, New Jersey Medical School, Newark, New Jersey
| | - Neil King
- Division of General Surgery, Department of Surgery, Rutgers University, New Jersey Medical School, Newark, New Jersey
| | - Anastasia Kunac
- Division of Trauma and Surgical Critical Care, Department of Surgery, Rutgers University, New Jersey Medical School, Newark, New Jersey
| | - Aziz M Merchant
- Division of General Surgery, Department of Surgery, Rutgers University, New Jersey Medical School, Newark, New Jersey
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Gillespie BM, Steel C, Kang E, Harbeck E, Nikolic K, Fairweather N, Chaboyer W. Evaluation of a Brief Team Training Intervention in Surgery: A Mixed-Methods Study. AORN J 2018; 106:513-522. [PMID: 29173376 DOI: 10.1016/j.aorn.2017.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/16/2017] [Accepted: 09/29/2017] [Indexed: 11/25/2022]
Abstract
The aim of this study was to evaluate a brief team training program in relation to teams' observed nontechnical skills (NTSs) in surgery, teams' perceptions of safety culture, and the training implementation. We used mixed methods to analyze structured observations of 179 surgeries, semistructured interviews with surgical team members from four selected surgical specialties, and a survey. There were significant (P < .001) improvements in surgical teams' observed NTSs and in the use of the World Health Organization's Surgical Safety Checklist after participation in the training program. Nonsignificant results included increased perceived safety climate and decreased perceived teamwork climate. From participant interviews, we identified that production pressure and time constraints were the biggest barriers to implementation and the greatest enabler was the organization's support for staff education initiatives. Most participants perceived the content of the program to be useful. These results highlight the complexities inherent in the development and evaluation of interdisciplinary patient safety interventions.
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Calcagno HE, Lucke-Wold B, Noles M, Dillman D, Baskerville M, Spight D, Ciporen JN. Integrated Otolaryngology and Anesthesia Simulation Model for Crisis Management of Cavernous Carotid Artery Injury. ARCHIVES OF NEUROLOGY AND NEURO DISORDERS 2018; 1:30-41. [PMID: 30135961 PMCID: PMC6100789 DOI: pmid/30135961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Simulation training is emerging as a cost-effective way to train residents on the skill sets necessary to excel as fully functioning physicians. Until recently, the simulated resident training environments have primarily focused on handling a medical crisis with learners from the same specialty. A dual otolaryngology and anesthesiology simulation was established to improve teamwork and communication skills between specialties. One otolaryngology resident was paired with one anesthesia resident per trial in our study. The multispecialty team addressed three clinical simulation scenarios to manage a cavernous carotid artery-bleeding crisis with an endoscopic endonasal approach. An independent reviewer evaluated each individual based on situation awareness, decision-making, communications and teamwork, as well as leadership. Residents improved on blood loss, pre and post anatomical exam scores, and communication measures through the course of the scenarios. Residents from both specialties rated the simulation highly and wanted further simulation training in the future. Multidisciplinary simulation training is a novel approach for improving communication skills between specialties prior to entering the wards, clinic, or operative arena. The lessons learned from this multidisciplinary simulation transcend the individual experience by allowing trainees to develop algorithms for crisis management and to improve on aspects of teamwork, leadership, and communication skills that can be applied throughout their careers.
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Affiliation(s)
- Haley E Calcagno
- Department of Neurological Surgery, Oregon Health & Science University, Portland, OR
- Corresponding Author: Jeremy Ciporen, MD, Department of Neurosurgery, Oregon Health & Science University, Portland, OR.
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL
- Corresponding Author: Jeremy Ciporen, MD, Department of Neurosurgery, Oregon Health & Science University, Portland, OR.
| | - Michele Noles
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR
| | - Dawn Dillman
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR
| | - Mark Baskerville
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR
| | - Donn Spight
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR
| | - Jeremy N Ciporen
- Department of Neurological Surgery, Oregon Health & Science University, Portland, OR
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Who is on the primary care team? Professionals' perceptions of the conceptualization of teams and the underlying factors: a mixed-methods study. BMC FAMILY PRACTICE 2017; 18:111. [PMID: 29281980 PMCID: PMC5745958 DOI: 10.1186/s12875-017-0685-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 12/08/2017] [Indexed: 01/28/2023]
Abstract
Background Due to the growing prevalence of elderly patients with multi-morbidity living at home, there is an increasing need for primary care professionals from different disciplinary backgrounds to collaborate as primary care teams. However, it is unclear how primary care professionals conceptualize teams and what underlying factors influence their perception of being part of a team. Our research question is: What are primary care professionals’ perceptions of teams and team membership among primary care disciplines and what factors influence their perceptions? Methods We conducted a mixed-methods study in the Dutch primary care setting. First, a survey study of 152 professionals representing 12 primary care disciplines was conducted, focusing on their perceptions of which disciplines are part of the team and the degree of relational coordination between professionals from different disciplinary backgrounds. Subsequently, we conducted semi-structured interviews with 32 professionals representing 5 primary care disciplines to gain a deeper understanding of the underlying factors influencing their perceptions and the (mis)alignment between these perceptions. Results Misalignments were found between perceptions regarding which disciplines are members of the team and the relational coordination between disciplines. For example, general practitioners were viewed as part of the team by helping assistants, (district) nurses, occupational therapists and geriatric specialized practice nurses, whereas the general practitioners themselves only considered geriatric specialized practice nurses to be part of their team. Professionals perceive multidisciplinary primary care teams as having multiple inner and outer layers. Three factors influence their perception of being part of a team and acting accordingly: a) knowing the people you work with, b) the necessity for knowledge exchange and c) sharing a holistic view of caregiving. Conclusion Research and practice should take into account the misalignment between primary care professionals’ perceptions of primary care teams, as our study notes variations in the conceptualization of primary care teams. To enhance teamwork between professionals from different disciplinary backgrounds, professionals acknowledge the importance of three underlying conditions: team familiarity, regular and structured knowledge exchange between all professionals involved in the care process and realizing and believing in the added value for patients of working as a team. Electronic supplementary material The online version of this article (10.1186/s12875-017-0685-2) contains supplementary material, which is available to authorized users.
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Robertson JM, Dias RD, Yule S, Smink DS. Operating Room Team Training with Simulation: A Systematic Review. J Laparoendosc Adv Surg Tech A 2017; 27:475-480. [DOI: 10.1089/lap.2017.0043] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jamie M. Robertson
- STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Roger D. Dias
- STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts
| | - Steven Yule
- STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Boston, Massachusetts
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts
| | - Douglas S. Smink
- STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Surgery, Harvard Medical School, Boston, Massachusetts
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts
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New dimensions in surgical training: immersive virtual reality laparoscopic simulation exhilarates surgical staff. Surg Endosc 2017; 31:4472-4477. [PMID: 28378077 DOI: 10.1007/s00464-017-5500-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/08/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Virtual reality (VR) and head mount displays (HMDs) have been advanced for multimedia and information technologies but have scarcely been used in surgical training. Motion sickness and individual psychological changes have been associated with VR. The goal was to observe first experiences and performance scores using a new combined highly immersive virtual reality (IVR) laparoscopy setup. METHODS During the study, 10 members of the surgical department performed three tasks (fine dissection, peg transfer, and cholecystectomy) on a VR simulator. We then combined a VR HMD with the VR laparoscopic simulator and displayed the simulation on a 360° video of a laparoscopic operation to create an IVR laparoscopic simulation. The tasks were then repeated. Validated questionnaires on immersion and motion sickness were used for the study. RESULTS Participants' times for fine dissection were significantly longer during the IVR session (regular: 86.51 s [62.57 s; 119.62 s] vs. IVR: 112.35 s [82.08 s; 179.40 s]; p = 0.022). The cholecystectomy task had higher error rates during IVR. Motion sickness did not occur at any time for any participant. Participants experienced a high level of exhilaration, rarely thought about others in the room, and had a high impression of presence in the generated IVR world. CONCLUSION This is the first clinical and technical feasibility study using the full IVR laparoscopy setup combined with the latest laparoscopic simulator in a 360° surrounding. Participants were exhilarated by the high level of immersion. The setup enables a completely new generation of surgical training.
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Non-technical skills in minimally invasive surgery teams: a systematic review. Surg Endosc 2016; 30:5185-5199. [PMID: 27066972 DOI: 10.1007/s00464-016-4890-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/23/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Root cause analyses show that up to 70 % of adverse events are caused by human error. Strong non-technical skills (NTS) can prevent or reduce these errors, considerable numbers of which occur in the operating theatre. Minimally invasive surgery (MIS) requires manipulation of more complex equipment than open procedures, likely requiring a different set of NTS for each kind of team. The aims of this study were to identify the MIS teams' key NTS and investigate the effect of training and assessment of NTS on MIS teams. METHODS The databases of PubMed, Cochrane Library, Embase, PsycINFO, and Scopus were systematically searched according to Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles containing outcome measures related to MIS teams' key NTS, training, or assessment of NTS were included. RESULTS The search yielded 1984 articles, 11 of which were included. All were observational studies without blinding, and they differed in aims, types of evaluation, and outcomes. Only two studies evaluated patient outcomes other than operative time, and overall, the studies' quality of evidence was low. Different communication types were encountered in MIS compared to open surgery, mainly due to equipment- and patient-related challenges. Fixed teams improved teamwork and safety levels, while deficient planning and poor teamwork were found to obstruct workflow and increase errors. Training NTS mitigates these issues and improves staff attitudes towards NTS. CONCLUSIONS MIS teams' NTS are important for workflow and prevention of errors and can be enhanced by working in fixed teams. In the technological complex sphere of MIS, communication revolves around equipment- and patient-related topics, much more so than in open surgery. In all, only a few heterogeneous-design studies have examined this. In the future, the focus should shift to systematically identifying key NTS and developing effective, evidence-based team training programmes in MIS.
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Heidenreich MJ, Musonza T, Pawlina W, Lachman N. Can a teaching assistant experience in a surgical anatomy course influence the learning curve for nontechnical skill development for surgical residents? ANATOMICAL SCIENCES EDUCATION 2016; 9:97-100. [PMID: 26126886 DOI: 10.1002/ase.1558] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/05/2015] [Accepted: 06/11/2015] [Indexed: 06/04/2023]
Abstract
The foundation upon which surgical residents are trained to work comprises more than just critical cognitive, clinical, and technical skill. In an environment where the synchronous application of expertise is vital to patient outcomes, the expectation for optimal functioning within a multidisciplinary team is extremely high. Studies have shown that for most residents, one of the most difficult milestones in the path to achieving professional expertise in a surgical career is overcoming the learning curve. This view point commentary provides a reflection from the two senior medical students who have participated in the Student-as-Teacher program developed by the Department of Anatomy at Mayo Clinic, designed to prepare students for their teaching assistant (TA) role in anatomy courses. Both students participated as TAs in a six week surgical anatomy course for surgical first assistant students offered by the School of Health Sciences at Mayo Clinic. Development of teaching skills, nontechnical leadership, communication, and assessment skills, are discussed in relation to their benefits in preparing senior medical students for surgical residency.
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Affiliation(s)
- Mark J Heidenreich
- Mayo Medical School, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Tashinga Musonza
- Mayo Medical School, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Wojciech Pawlina
- Department of Anatomy, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Nirusha Lachman
- Department of Anatomy, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota
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Rashid P, Gianduzzo TR. Urology technical and non-technical skills development: the emerging role of simulation. BJU Int 2015; 117 Suppl 4:9-16. [DOI: 10.1111/bju.13259] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Prem Rashid
- Department of Urology; Rural Clinical School; The University of New South Wales; Port Macquarie Base Hospital; Port Macquarie NSW Australia
| | - Troy R.J. Gianduzzo
- Department of Urology; School of Medicine; The University of Queensland; Royal Brisbane and Women's Hospital; Brisbane Qld Australia
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Wang R, Shi N, Bai J, Zheng Y, Zhao Y. Implementation and evaluation of an interprofessional simulation-based education program for undergraduate nursing students in operating room nursing education: a randomized controlled trial. BMC MEDICAL EDUCATION 2015; 15:115. [PMID: 26155839 PMCID: PMC4496846 DOI: 10.1186/s12909-015-0400-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 06/29/2015] [Indexed: 05/29/2023]
Abstract
BACKGROUND The present study was designed to implement an interprofessional simulation-based education program for nursing students and evaluate the influence of this program on nursing students' attitudes toward interprofessional education and knowledge about operating room nursing. METHODS Nursing students were randomly assigned to either the interprofessional simulation-based education or traditional course group. A before-and-after study of nursing students' attitudes toward the program was conducted using the Readiness for Interprofessional Learning Scale. Responses to an open-ended question were categorized using thematic content analysis. Nursing students' knowledge about operating room nursing was measured. RESULTS Nursing students from the interprofessional simulation-based education group showed statistically different responses to four of the nineteen questions in the Readiness for Interprofessional Learning Scale, reflecting a more positive attitude toward interprofessional learning. This was also supported by thematic content analysis of the open-ended responses. Furthermore, nursing students in the simulation-based education group had a significant improvement in knowledge about operating room nursing. CONCLUSIONS The integrated course with interprofessional education and simulation provided a positive impact on undergraduate nursing students' perceptions toward interprofessional learning and knowledge about operating room nursing. Our study demonstrated that this course may be a valuable elective option for undergraduate nursing students in operating room nursing education.
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Affiliation(s)
- Rongmei Wang
- School of Nursing, Tianjin Medical University, Tianjin, China.
| | - Nianke Shi
- School of Basic Medicine, Tianjin Medical University, Tianjin, China.
| | - Jinbing Bai
- School of Nursing, Tianjin Medical University, Tianjin, China.
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA.
| | - Yaguang Zheng
- School of Nursing, Tianjin Medical University, Tianjin, China.
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China.
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