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Benhamou D, Tant S, Gille B, Bornemann Y, Ruscio L, Kamel K, Dunyach C, Jeannin B, Bouilliant-Linet M, Blanié A. An observer tool to enhance learning of incoming anesthesia residents' skills during simulation training of central venous catheter insertion: a randomized controlled trial. BMC Med Educ 2023; 23:942. [PMID: 38082446 PMCID: PMC10714635 DOI: 10.1186/s12909-023-04915-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Central venous catheter (CVC) insertion using simulation is an essential skill for anesthesiologists. Simulation training is an effective mean to master this skill. Given the large number of residents and the limited duration of training sessions, the active practice time is limited and residents remain observers of their colleagues for much of the session. To improve learning during observation periods, the use of an observer tool (OT) has been advocated but its educational effectiveness is not well defined. METHODS Incoming anesthesia residents were randomized to use an OT (i.e. procedural skill-based checklist) (OT+) or not (OT-) when observing other residents during a simulation bootcamp. The primary outcome was a composite score (total 60 points) evaluating CVC procedural skills rated immediately after the training. This score covers theoretical knowledge explored by multiple choice questions (MCQs) (/20), perceived improvement in knowledge and skills (/20), perceived impact on future professional life (/10) and satisfaction (/10). Measurements were repeated 1 month later. Residents in each group recorded the number of CVCs placed and their clinical outcomes (attempts, complications) during the first month of their clinical rotation using a logbook. RESULTS Immediately after training, the composite score was similar between the two groups: 45.3 ± 4.2 (OT+, n = 49) and 44.4 ± 4.8 (OT-, n = 42) (p = 0.323). Analysis of sub-items also showed no difference. Results at 1 month were not different between groups. Analysis of the logbook showed no difference between groups. No serious complications were reported. CONCLUSIONS The use of a procedural task-based OT by incoming anesthesia residents and used during CVC insertion simulation training was not associated with better learning outcomes, neither immediately after the session nor when re-evaluated 1 month later. The training at least once on simulator of all residents could limit the impact of OT. Further studies are necessary to define the place of OT in simulation training.
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Affiliation(s)
- Dan Benhamou
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
- CIAMS, Univ. Paris-Saclay, Université Paris-Saclay, Orsay Cedex, 91405, France
- CIAMS, Université d'Orléans, Orléans, 45067, France
| | - Sarah Tant
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Benoit Gille
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Yannis Bornemann
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Laura Ruscio
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Karl Kamel
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Chloé Dunyach
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Bénédicte Jeannin
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Maxime Bouilliant-Linet
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France
| | - Antonia Blanié
- Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France.
- Département d'Anesthésie-Réanimation et Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France.
- CIAMS, Univ. Paris-Saclay, Université Paris-Saclay, Orsay Cedex, 91405, France.
- CIAMS, Université d'Orléans, Orléans, 45067, France.
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Buléon C, Minehart RD, Rudolph JW, Blanié A, Lilot M, Picard J, Plaud B, Pottecher J, Benhamou D. Strategy to Develop a Common Simulation Training Program: Illustration with Anesthesia and Intensive Care Residency in France. Teach Learn Med 2023; 35:537-549. [PMID: 36251797 DOI: 10.1080/10401334.2022.2127730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/03/2022] [Indexed: 06/16/2023]
Abstract
Phenomenon: The urgency of having fair and trustworthy competency-based assessment in medical training is growing. Simulation is increasingly recognized as a potent method for building and assessing applied competencies. The growing use of simulation and its application in summative assessment calls for comprehensive and rigorously designed programs. Defining the current baseline of what is available and feasible is a crucial first step. This paper uses anesthesia and intensive care (AIC) in France as a case study in how to document this baseline. Approach: An IRB-approved, online anonymous closed survey was submitted to AIC residency program directors and AIC simulation program directors in France from January to February 2021. The researcher-developed survey consisted of 65 questions across five sections: centers' characteristics, curricular characteristics, courses' characteristics, instructors' characteristics, and simulation perceptions and perspectives. Findings: The participation rate was 31/31 (100%) with 29 centers affiliated with a university hospital. All centers had AIC simulation activities. Resident training was structured in 94% of centers. Simulation uses were training (100%), research and development (61%), procedural or organizational testing (42%), and summative assessment (13%). Interprofessional full-scale simulation training existed in 90% of centers. Procedural training on simulators prior to clinical patients' care was performed "always" in 16%, "most often" in 45%, "sometimes" in 29% and "rarely" or "not" in 10% of centers. Simulated patients were used in 61% of centers. Main themes were identified for procedural skills, full-scale and simulated patient simulation training. Simulation activity was perceived as increasing in 68% of centers. Centers expressed a desire to participate in developing and using a national common AIC simulation program. Insights: Based on our findings in AIC, we demonstrated a baseline description of nationwide simulation activities. We now have a clearer perspective on a decentralized approach in which individual institutions or regional consortia conduct simulation for a discipline in a relatively homogeneous way, suggesting the feasibility for national guidelines. This approach provides useful clues for AIC and other disciplines to develop a comprehensive and meaningful program matching existing expectations and closing the identified gaps.
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Affiliation(s)
- Clément Buléon
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Caen Normandy University Hospital, Caen, France
- Medical School, University of Caen Normandy, Caen, France
- Center for Medical Simulation, Boston, MA, USA
| | - Rebecca D Minehart
- Center for Medical Simulation, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jenny W Rudolph
- Center for Medical Simulation, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Antonia Blanié
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
| | - Marc Lilot
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Edouard Herriot University Hospital, HCL, Lyon, France
| | - Julien Picard
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Grenoble University Hospital, Grenoble, France
| | - Benoît Plaud
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Saint-Louis University Hospital, APHP, Paris, France
| | - Julien Pottecher
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Dan Benhamou
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
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Bijok B, Jaulin F, Picard J, Michelet D, Fuzier R, Arzalier-Daret S, Basquin C, Blanié A, Chauveau L, Cros J, Delmas V, Dupanloup D, Gauss T, Hamada S, Le Guen Y, Lopes T, Robinson N, Vacher A, Valot C, Pasquier P, Blet A. Guidelines on human factors in critical situations 2023. Anaesth Crit Care Pain Med 2023; 42:101262. [PMID: 37290697 DOI: 10.1016/j.accpm.2023.101262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To provide guidelines to define the place of human factors in the management of critical situations in anaesthesia and critical care. DESIGN A committee of nineteen experts from the SFAR and GFHS learned societies was set up. A policy of declaration of links of interest was applied and respected throughout the guideline-producing process. Likewise, the committee did not benefit from any funding from a company marketing a health product (drug or medical device). The committee followed the GRADE® method (Grading of Recommendations Assessment, Development and Evaluation) to assess the quality of the evidence on which the recommendations were based. METHODS We aimed to formulate recommendations according to the GRADE® methodology for four different fields: 1/ communication, 2/ organisation, 3/ working environment and 4/ training. Each question was formulated according to the PICO format (Patients, Intervention, Comparison, Outcome). The literature review and recommendations were formulated according to the GRADE® methodology. RESULTS The experts' synthesis work and application of the GRADE® method resulted in 21 recommendations. Since the GRADE® method could not be applied in its entirety to all the questions, the guidelines used the SFAR "Recommendations for Professional Practice" A means of secured communication (RPP) format and the recommendations were formulated as expert opinions. CONCLUSION Based on strong agreement between experts, we were able to produce 21 recommendations to guide human factors in critical situations.
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Affiliation(s)
- Benjamin Bijok
- Pôle Anesthésie-Réanimation, Bloc des Urgences/Déchocage, CHU de Lille, Lille, France; Pôle de l'Urgence, Bloc des Urgences/Déchocage, CHU de Lille, Lille, France.
| | - François Jaulin
- Président du Groupe Facteurs Humains en Santé, France; Directeur Général et Cofondateur Patient Safety Database, France; Directeur Général et Cofondateur Safe Team Academy, France.
| | - Julien Picard
- Pôle Anesthésie-Réanimation, Réanimation Chirurgicale Polyvalente - CHU Grenoble Alpes, Grenoble, France; Centre d'Evaluation et Simulation Alpes Recherche (CESAR) - ThEMAS, TIMC, UMR, CNRS 5525, Université Grenoble Alpes, Grenoble, France; Comité Analyse et Maîtrise du Risque (CAMR) de la Société Française d'Anesthésie Réanimation (SFAR), France
| | - Daphné Michelet
- Département d'Anesthésie-Réanimation du CHU de Reims, France; Laboratoire Cognition, Santé, Société - Université Reims-Champagne Ardenne, France
| | - Régis Fuzier
- Unité d'Anesthésiologie, Institut Claudius Regaud. IUCT-Oncopole de Toulouse, France
| | - Ségolène Arzalier-Daret
- Département d'Anesthésie-Réanimation, CHU de Caen Normandie, Avenue de la Côte de Nacre, 14000 Caen, France; Comité Vie Professionnelle-Santé au Travail (CVP-ST) de la Société Française d'Anesthésie-Réanimation (SFAR), France
| | - Cédric Basquin
- Département Anesthésie-Réanimation, CHU de Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France; CHP Saint-Grégoire, Groupe Vivalto-Santé, 6 Bd de la Boutière CS 56816, 35760 Saint-Grégoire, France
| | - Antonia Blanié
- Département d'Anesthésie-Réanimation Médecine Périopératoire, CHU Bicêtre, 78 Rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France; Laboratoire de Formation par la Simulation et l'Image en Médecine et en Santé (LabForSIMS) - Faculté de Médecine Paris Saclay - UR CIAMS - Université Paris Saclay, France
| | - Lucille Chauveau
- Service des Urgences, SMUR et EVASAN, Centre Hospitalier de la Polynésie Française, France; Maison des Sciences de l'Homme du Pacifique, C9FV+855, Puna'auia, Polynésie Française, France
| | - Jérôme Cros
- Service d'Anesthésie et Réanimation, Polyclinique de Limoges Site Emailleurs Colombier, 1 Rue Victor-Schoelcher, 87038 Limoges Cedex 1, France; Membre Co-Fondateur Groupe Facteurs Humains en Santé, France
| | - Véronique Delmas
- Service d'Accueil des Urgences, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72037 Le Mans, France; CAp'Sim, Centre d'Apprentissage par la Simulation, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72037 Le Mans, France
| | - Danièle Dupanloup
- IADE, Cadre de Bloc, CHU de Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, 54000 Nancy, France; Comité IADE de la Société Française d'Anesthésie Réanimation (SFAR), France
| | - Tobias Gauss
- Pôle Anesthésie-Réanimation, Bloc des Urgences/Déchocage, CHU Grenoble Alpes, Grenoble, France
| | - Sophie Hamada
- Université Paris Cité, APHP, Hôpital Européen Georges Pompidou, Service d'Anesthésie Réanimation, F-75015, Paris, France; CESP, INSERM U 10-18, Université Paris-Saclay, France
| | - Yann Le Guen
- Pôle Anesthésie-Réanimation, CHU Grenoble Alpes, Grenoble, France
| | - Thomas Lopes
- Service d'Anesthésie-Réanimation, Hôpital Privé de Versailles, 78000 Versailles, France
| | | | - Anthony Vacher
- Unité Recherche et Expertise Aéromédicales, Institut de Recherche Biomédicale des Armées, Brétigny Sur Orge, France
| | | | - Pierre Pasquier
- 1ère Chefferie du Service de Santé, Villacoublay, France; Département d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées Percy, Clamart, France; École du Val-de-Grâce, Paris, France
| | - Alice Blet
- Lyon University Hospital, Department of Anaesthesiology and Critical Care, Croix Rousse University Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1052, Cancer Research Center of Lyon, Lyon, France
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Calmettes M, Denoyel L, Duclos A, Lejus-Bourdeau C, Blanié A, Forestier C, Ciceron F, Mattatia L, Buleon C, Damm C, Mahoudeau G, Lehot JJ, Rimmelé T, Lilot M. Change in Sleep Quality of Residents the Night Before High-Fidelity Simulation: Results From a Prospective 1-Year National Survey. Turk J Anaesthesiol Reanim 2022; 50:295-302. [PMID: 35979977 PMCID: PMC9524411 DOI: 10.5152/tjar.2022.21235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: The stress level of participants in high-fidelity simulation stems from various factors but may result in anticipatory anxiety causing sleep disturbances during the night prior to simulation. The objective of this survey was to determine the change in sleep quality of residents during the night prior to the simulation. Methods: The survey was proposed for 1 year to all residents at the beginning of the simulation, in 10 simulation centres. The questionnaire combined demographics and the Leeds Sleep Evaluation Questionnaire using visual analogue scales divided into 4 sleep qualitative domains. The primary outcome was the prevalence of sleep disturbance (>10 mm on 1 domain). Secondary outcomes were the prevalence of severe sleep disturbance (>25 mm), as well as qualitatively and quantitatively reported explanatory sleep parameters. Results: Among respondents, 66% [95% CI: 63 to 69] of residents had more than 10 mm and 27% [95% CI: 24 to 30] had more than 25 mm of sleep disturbance. Residents with a sleep disturbance of more than 10 mm had fewer hours of sleep (6.4 [standard deviation = 1.8] vs 7.3 [standard deviation = 1.3], difference: −0.9 [95% CI: −1.1 to −0.7]; P < .0001), with a higher number of night-time awakenings (1.3 [standard deviation = 1.5] vs 0.7 [standard deviation = 0.9], difference: 0.6 [95% CI: 0.4 to 0.8]; P < .0001). Conclusion: Among residents participating in the simulation, a high prevalence of change in sleep quality during the night before the simulation was noted. Strategies to help residents achieve better sleep prior to simulation should be explored.
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Affiliation(s)
- Marion Calmettes
- Department of Anaesthesiology and Reanimation, Hospices Civils de Lyon, Lyon, France
| | - Lucas Denoyel
- Lyonnais Center for Education by Simulation in Health, Claude Bernard Lyon 1 University, SAMSEI, Lyon, France
| | - Antoine Duclos
- Department of Health Data, Hospices Civils de Lyon, Lyon, France
- Research on Healthcare Performance (RESHAPE), Claude Bernard Lyon 1 University, Lyon, France
| | - Corinne Lejus-Bourdeau
- Department of Anaesthesia and Surgical Resuscitation, Hôtel Dieu, Nantes University Hospital, Nantes, France
| | - Antonia Blanié
- Department of Anaesthesiology and Surgical Resuscitation, CHU Bicêtre LabForSIMS Faculty of Medicine, Paris-Sud, Le Kremlin Bicêtre, France
| | - Caroline Forestier
- CEnSIM Savoie Emergency Care - Savoie Simulation Education Center, Savoie Metropole Hospital Center, France
| | | | - Laurent Mattatia
- Department of Anaesthesia, Reanimation and Pain Emergency, SIMHU-Nîmes Medical Simulation Center, Carémeau Hospital Group, Nîmes University Hospital, France
| | - Clément Buleon
- Normandy Health Simulation Center (NorSimS), Caen University Hospital, France
| | - Cédric Damm
- Emergency Care Teaching Center, CESU, University Hospital Center of Rouen, France
| | - Gilles Mahoudeau
- UNISIMES European Health Simulation Unit, Strasbourg University Faculty of Medicine, France
| | - Jean-Jacques Lehot
- Department of Anaesthesiology and Reanimation, Hospices Civils de Lyon, Lyon, France
- Lyonnais Center for Education by Simulation in Health, Claude Bernard Lyon 1 University, SAMSEI, Lyon, France
- Research on Healthcare Performance (RESHAPE), Claude Bernard Lyon 1 University, Lyon, France
| | - Thomas Rimmelé
- Department of Anaesthesiology and Reanimation, Hospices Civils de Lyon, Lyon, France
- Lyonnais Center for Education by Simulation in Health, Claude Bernard Lyon 1 University, SAMSEI, Lyon, France
- University of Claude Bernard Lyon 1-Bio mericux-Hospices Civils de Lyon, Lyon, France
| | - Marc Lilot
- Department of Anaesthesiology and Reanimation, Hospices Civils de Lyon, Lyon, France
- Lyonnais Center for Education by Simulation in Health, Claude Bernard Lyon 1 University, SAMSEI, Lyon, France
- Research on Healthcare Performance (RESHAPE), Claude Bernard Lyon 1 University, Lyon, France
- Corresponding author: Marc Lilot, e-mail:
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Godon A, Gabin M, Levy JH, Huet O, Chapalain X, David JS, Tacquard C, Sattler L, Minville V, Mémier V, Blanié A, Godet T, Leone M, De Maistre E, Gruel Y, Roullet S, Vermorel C, Samama CM, Bosson JL, Albaladejo P. Management of urgent invasive procedures in patients treated with direct oral anticoagulants: An observational registry analysis. Thromb Res 2022; 216:106-112. [DOI: 10.1016/j.thromres.2022.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 01/21/2023]
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Wildenberg L, Blanié A, Benhamou D. [Local, locoregional and general anesthesia]. Rev Prat 2020; 70:e335-e341. [PMID: 33739667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Lucille Wildenberg
- Service d'anesthésie-réanimation médecine péri-opératoire ; AP-HP, université Paris-Saclay ; hôpital Bicêtre, 94275 Le Kremlin-Bicêtre Cedex, France
| | - Antonia Blanié
- Service d'anesthésie-réanimation médecine péri-opératoire ; AP-HP, université Paris-Saclay ; hôpital Bicêtre, 94275 Le Kremlin-Bicêtre Cedex, France
| | - Dan Benhamou
- Service d'anesthésie-réanimation médecine péri-opératoire ; AP-HP, université Paris-Saclay ; hôpital Bicêtre, 94275 Le Kremlin-Bicêtre Cedex, France
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Blanié A, Amorim MA, Meffert A, Perrot C, Dondelli L, Benhamou D. Assessing validity evidence for a serious game dedicated to patient clinical deterioration and communication. Adv Simul (Lond) 2020; 5:4. [PMID: 32514382 PMCID: PMC7251894 DOI: 10.1186/s41077-020-00123-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 05/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background A serious game (SG) is a useful tool for nurse training. The objectives of this study were to assess validity evidence of a new SG designed to improve nurses’ ability to detect patient clinical deterioration. Methods The SG (LabForGames Warning) was developed through interaction between clinical and pedagogical experts and one developer. For the game study, consenting nurses were divided into three groups: nursing students (pre-graduate) (group S), recently graduated nurses (graduated < 2 years before the study) (group R) and expert nurses (graduated > 4 years before the study and working in an ICU) (group E). Each volunteer played three cases of the game (haemorrhage, brain trauma and obstructed intestinal tract). The validity evidence was assessed following Messick’s framework: content, response process (questionnaire, observational analysis), internal structure, relations to other variables (by scoring each case and measuring playing time) and consequences (a posteriori analysis). Results The content validity was supported by the game design produced by clinical, pedagogical and interprofessional experts in accordance with the French nurse training curriculum, literature review and pilot testing. Seventy-one nurses participated in the study: S (n = 25), R (n = 25) and E (n = 21). The content validity in all three cases was highly valued by group E. The response process evidence was supported by good security control. There was no significant difference in the three groups’ high rating of the game’s realism, satisfaction and educational value. All participants stated that their knowledge of the different steps of the clinical reasoning process had improved. Regarding the internal structure, the factor analysis showed a common source of variance between the steps of the clinical reasoning process and communication or the situational awareness errors made predominantly by students. No statistical difference was observed between groups regarding scores and playing time. A posteriori analysis of the results of final examinations assessing study-related topics found no significant difference between group S participants and students who did not participate in the study. Conclusion While it appears that this SG cannot be used for summative assessment (score validity undemonstrated), it is positively valued as an educational tool. Trial registration ClinicalTrials.gov ID: NCT03092440
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Affiliation(s)
- Antonia Blanié
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275 Le Kremlin Bicêtre, France.,Département d'Anesthésie-Réanimation chirurgicale, CHU Bicêtre, 94275 Le Kremlin Bicêtre, France.,CIAMS, Université Paris-Saclay, 91405 Orsay Cedex, France.,CIAMS, Université d'Orléans, 45067 Orléans, France
| | - Michel-Ange Amorim
- CIAMS, Université Paris-Saclay, 91405 Orsay Cedex, France.,CIAMS, Université d'Orléans, 45067 Orléans, France
| | - Arnaud Meffert
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275 Le Kremlin Bicêtre, France.,Département d'Anesthésie-Réanimation chirurgicale, CHU Bicêtre, 94275 Le Kremlin Bicêtre, France
| | | | | | - Dan Benhamou
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275 Le Kremlin Bicêtre, France.,Département d'Anesthésie-Réanimation chirurgicale, CHU Bicêtre, 94275 Le Kremlin Bicêtre, France.,CIAMS, Université Paris-Saclay, 91405 Orsay Cedex, France.,CIAMS, Université d'Orléans, 45067 Orléans, France
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Meffert A, Baudrier D, Benhamou D, Mattatia L, Blanié A. Use of cognitive aids in anaesthesia crisis scenarios: Observational analysis from video recording during simulation. Anaesth Crit Care Pain Med 2020; 39:251-252. [PMID: 32092402 DOI: 10.1016/j.accpm.2019.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Arnaud Meffert
- Département d'anesthésie-réanimation-médecine périopératoire, groupe hospitalo-universitaire, Paris-Saclay, AP-HP, Paris, France; Centre de simulation LabForSIMS de la faculté de médecine Paris Sud, unité de recherche CIAMS, EA4532, UFR STAPS Paris-Sud, Orsay, France
| | - Dimitri Baudrier
- Département d'anesthésie-réanimation-médecine périopératoire, groupe hospitalo-universitaire, Paris-Saclay, AP-HP, Paris, France; Centre de simulation LabForSIMS de la faculté de médecine Paris Sud, unité de recherche CIAMS, EA4532, UFR STAPS Paris-Sud, Orsay, France
| | - Dan Benhamou
- Département d'anesthésie-réanimation-médecine périopératoire, groupe hospitalo-universitaire, Paris-Saclay, AP-HP, Paris, France; Centre de simulation LabForSIMS de la faculté de médecine Paris Sud, unité de recherche CIAMS, EA4532, UFR STAPS Paris-Sud, Orsay, France
| | - Laurent Mattatia
- Division anesthésie réanimation urgences douleur, centre de simulation médicale SIMHU-Nîmes, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, Nîmes, France
| | - Antonia Blanié
- Département d'anesthésie-réanimation-médecine périopératoire, groupe hospitalo-universitaire, Paris-Saclay, AP-HP, Paris, France; Centre de simulation LabForSIMS de la faculté de médecine Paris Sud, unité de recherche CIAMS, EA4532, UFR STAPS Paris-Sud, Orsay, France.
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L'Her E, Geeraerts T, Desclefs JP, Benhamou D, Blanié A, Cerf C, Delmas V, Jourdain M, Lecomte F, Ouanes I, Garnier M, Mossadegh C. Simulation-based teaching in critical care, anaesthesia and emergency medicine. Anaesth Crit Care Pain Med 2020; 39:311-326. [PMID: 32223994 DOI: 10.1016/j.accpm.2020.03.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Erwan L'Her
- Centre Hospitalier Régional Universitaire de Brest, La Cavale-Blanche, Médecine Intensive et Réanimation, LATIM, INSERM, UMR 1101, boulevard Tanguy-Prigent, 29609 Brest cedex, France.
| | - Thomas Geeraerts
- Anesthésie-Réanimation, CHU de Toulouse, Hôpital Pierre-Paul-Riquet, Institut Toulousain de Simulation en Santé (ItSimS), Université Toulouse 3-Paul-Sabatier, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France
| | - Jean-Philippe Desclefs
- Samu 91, Smur de Corbeil-Essonnes, Centre Hospitalier Sud-Francilien, 91100 Corbeil-Essonnes, France
| | - Dan Benhamou
- Service d'Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, AP-HP, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France
| | - Antonia Blanié
- Département d'anesthésie-réanimation-médecine périopératoire, groupe hospitalo-universitaire, Paris-Saclay, AP-HP, Paris, France; Centre de simulation LabForSIMS, faculté de médecine Paris-Sud, unité de recherche CIAMS, EA4532, UFR STAPS Paris-Sud, Orsay, France
| | - Charles Cerf
- Réanimation Polyvalente, Hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - Véronique Delmas
- Urgences, CHU Le Mans, 194, avenue Rubillard, 72000 Le Mans, France
| | - Mercedes Jourdain
- Réanimation médicale, Hôpital Salengro, rue Émile-Laine, 59037 Lille, France
| | - François Lecomte
- Urgences, Hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - Islem Ouanes
- Réanimation Médicale, Hôpital Fattouma-Bourguiba, avenue Farhat-Hached, Monastir, Tunisia
| | - Marc Garnier
- Département d'anesthésie et réanimation, Pôle Thorax-Voies Aériennes-Anesthésie-Réanimation, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France; INSERM, UMR1152, Faculté de médecine X.-Bichat, 16, rue Henri-Huchard, 75018 Paris, France
| | - Chirine Mossadegh
- Hôpital Universitaire La Pitié-Salpêtrière, Service de Réanimation Médicale, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
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Blanié A, Amorim MA, Benhamou D. Comparative value of a simulation by gaming and a traditional teaching method to improve clinical reasoning skills necessary to detect patient deterioration: a randomized study in nursing students. BMC Med Educ 2020; 20:53. [PMID: 32075641 PMCID: PMC7031947 DOI: 10.1186/s12909-020-1939-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/16/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Early detection and response to patient deterioration influence patient prognosis. Nursing education is therefore essential. The objective of this randomized controlled trial was to compare the respective educational value of simulation by gaming (SG) and a traditional teaching (TT) method to improve clinical reasoning (CR) skills necessary to detect patient deterioration. METHODS In a prospective multicenter study, and after consent, 2nd year nursing students were randomized into two groups: Simulation by gaming "SG": the student played individually with a serious game consisting of 2 cases followed by a common debriefing with an instructor;Traditional Teaching "TT": the student worked on the same cases in text paper format followed by a traditional teaching course with a PowerPoint presentation by an instructor. CR skill was measured by script concordance tests (80 SCTs, score 0-100) immediately after the session (primary outcome) and on month later. Other outcomes included students' satisfaction, motivation and professional impact. RESULTS One hundred forty-six students were randomized. Immediately after training, the SCTs scores were 59 ± 9 in SG group (n = 73) and 58 ± 8 in TT group (n = 73) (p = 0.43). One month later, the SCTs scores were 59 ± 10 in SG group (n = 65) and 58 ± 8 in TT group (n = 54) (p = 0.77). Global satisfaction and motivation were highly valued in both groups although significantly greater in the SG group (p < 0.05). The students declared that the training course would have a positive professional impact, with no difference between groups. CONCLUSIONS In this study assessing nursing student CR to detect patient deterioration, no significant educational difference (SCT), neither immediate nor 1 month later, was observed between training by SG and the TT course. However, satisfaction and motivation were found to be greater with the use of SG. TRIAL REGISTRATION ClinicalTrials.gov; NCT03428269. Registered 30 january 2018.
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Affiliation(s)
- Antonia Blanié
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275, Le Kremlin Bicêtre, France.
- Département d'Anesthésie-Réanimation, CHU Bicêtre, 78, rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France.
- CIAMS, Université d'Orléans, 45067, Orléans, France.
| | - Michel-Ange Amorim
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
| | - Dan Benhamou
- Centre de simulation LabForSIMS, Faculté de médecine Paris Saclay, 94275, Le Kremlin Bicêtre, France
- Département d'Anesthésie-Réanimation, CHU Bicêtre, 78, rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, 91405, Orsay, Cedex, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
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Beloeil H, Albaladejo P, Sion A, Durand M, Martinez V, Lasocki S, Futier E, Verzili D, Minville V, Fessenmeyer C, Belbachir A, Aubrun F, Renault A, Bellissant E, Bedague D, Blanié A, Casez M, Chanques G, Chaize C, Dessertaine G, Ferré F, Gaide Chevronnay L, Hébrard A, Hespel A, Jaber S, de Jong A, Lahjaouzi A, Marino M, Moury P, Neau A, Protar D, Rhem D, Rineau E, Robin S, Rossignol E, Soucemarianadin M, Veaceslav S. Multicentre, prospective, double-blind, randomised controlled clinical trial comparing different non-opioid analgesic combinations with morphine for postoperative analgesia: the OCTOPUS study. Br J Anaesth 2019; 122:e98-e106. [DOI: 10.1016/j.bja.2018.10.058] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 09/14/2018] [Accepted: 10/22/2018] [Indexed: 10/27/2022] Open
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13
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Blanié A, Gorse S, Roulleau P, Figueiredo S, Benhamou D. Impact of learners’ role (active participant-observer or observer only) on learning outcomes during high-fidelity simulation sessions in anaesthesia: A single center, prospective and randomised study. Anaesth Crit Care Pain Med 2018; 37:417-422. [DOI: 10.1016/j.accpm.2017.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/23/2017] [Accepted: 11/06/2017] [Indexed: 12/28/2022]
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Fessenmeyer C, Ruscio L, Blanié A, De Montblanc J, Benhamou D. Epidural Analgesia after Colorectal Surgery Within an Enhanced Recovery Program. J Am Coll Surg 2018; 226:337-338. [PMID: 29478475 DOI: 10.1016/j.jamcollsurg.2018.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/08/2018] [Indexed: 11/28/2022]
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Blanié A, Soued M, Benhamou D, Mazoit JX, Duranteau J. A Comparison of Photoplethysmography Versus Esophageal Doppler for the Assessment of Cardiac Index During Major Noncardiac Surgery. Anesth Analg 2016; 122:430-6. [DOI: 10.1213/ane.0000000000001113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Blanié A, Rosencher N, Godier A. Antifibrinolytic thereapy. Thromb Res 2013; 133:127. [PMID: 24112752 DOI: 10.1016/j.thromres.2013.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 09/19/2013] [Accepted: 09/18/2013] [Indexed: 11/20/2022]
Affiliation(s)
- Antonia Blanié
- Bicêtre University Hospital, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, France.
| | - Nadia Rosencher
- Cochin-Hôtel Dieu University Hospital, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, France
| | - Anne Godier
- Cochin-Hôtel Dieu University Hospital, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, France
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Blanié A, Vigué B, Benhamou D, Duranteau J, Geeraerts T. The Frontal Lobe and Thalamus Have Different Sensitivities to Hypoxia-Hypotension after Traumatic Brain Injury: A Microdialysis Study in Rats. J Neurotrauma 2012; 29:2782-90. [DOI: 10.1089/neu.2012.2381] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Antonia Blanié
- Département d'Anesthésie-Réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Bernard Vigué
- Département d'Anesthésie-Réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Dan Benhamou
- Département d'Anesthésie-Réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Jacques Duranteau
- Département d'Anesthésie-Réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Thomas Geeraerts
- Département d'Anesthésie-Réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Blanié A, Ract C, Leblanc PE, Cheisson G, Huet O, Laplace C, Lopes T, Pottecher J, Duranteau J, Vigué B. The limits of succinylcholine for critically ill patients. Anesth Analg 2012; 115:873-9. [PMID: 22763904 DOI: 10.1213/ane.0b013e31825f829d] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Urgent tracheal intubations are common in intensive care units (ICU), and succinylcholine is one of the first-line neuromuscular blocking drugs used in these situations. Critically ill patients could be at high risk of hyperkalemia after receiving succinylcholine because one or more etiologic factors of nicotinic receptor upregulation can be present, but there are few data on its real risk. Our objectives in this study were to determine the factors associated with arterial potassium increase (ΔK) and to assess the occurrence of acute hyperkalemia ≥6.5 mmol/L after succinylcholine injection for intubation in the ICU. METHODS In a prospective, observational study, all critically ill patients intubated with succinylcholine in an ICU were screened. Only intubations with arterial blood gases and potassium measurements before and after (K(after)) a succinylcholine injection were studied. RESULTS During 18 months, 131 critically ill patients were intubated after receiving succinylcholine with arterial potassium before and after intubation (K(after)) for a total of 153 intubations. After multivariate analysis, the only factor associated with ΔK was the length of ICU stay before intubation (ρ = 0.561, P < 0.001). The factors associated with K(after) ≥6.5 mmol/L (n = 11) were the length of ICU stay (P < 0.001) and the presence of acute cerebral pathology (P = 0.047). The threshold of 16 days was found highly predictive of acute hyperkalemia ≥6.5 with 37% (95% confidence interval: 19%-58%) of K(after) ≥6.5 after the 16th day compared with only 1% (95% confidence interval: 0%-4%) of K(after) ≥6.5 when succinylcholine was injected during the first 16 days. CONCLUSIONS This study shows that the risk of ΔK after succinylcholine injection is strongly associated with the length of ICU stay. The risk of acute hyperkalemia ≥6.5 mmol/L is highly significant after 16 days.
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Affiliation(s)
- Antonia Blanié
- Département d'Anesthésie-Réanimation, Centre Hospitalier Universitaire Bicêtre, Le Kremlin-Bicêtre, France
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Blanié A, Fadel E, Duranteau J. Left pulmonary artery transection after penetrating thoracic trauma. J Trauma 2011; 71:1479. [PMID: 22071942 DOI: 10.1097/ta.0b013e31822b57f5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Antonia Blanié
- Département d'Anesthésie Réanimation, APHP, Centre Hospitalier, Universitaire de Bicêtre, Le Kremlin Bicêtre, France.
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