Portal de Periódicos da CAPES

High Fidelity Simulation Based Team Training in Urology: A Preliminary Interdisciplinary Study of Technical and Nontechnical Skills in Laparoscopic Complications Management

2012; Lippincott Williams & Wilkins; Volume: 187; Issue: 4 Linguagem: Inglês

10.1016/j.juro.2011.11.106

1527-3792

Jason Y. Lee, Phillip Mucksavage, Cecilia Canales, Elspeth M. McDougall, Sharon Lin,

Cardiac, Anesthesia and Surgical Outcomes

No AccessJournal of UrologyAdult Urology1 Apr 2012High Fidelity Simulation Based Team Training in Urology: A Preliminary Interdisciplinary Study of Technical and Nontechnical Skills in Laparoscopic Complications Management Jason Y. Lee, Phillip Mucksavage, Cecilia Canales, Elspeth M. McDougall, and Sharon Lin Jason Y. LeeJason Y. Lee Division of Urology, St. Michael's Hospital, Toronto, Ontario, Canada , Phillip MucksavagePhillip Mucksavage Department of Urology, University of California Irvine Medical Center, Orange, California , Cecilia CanalesCecilia Canales Department of Anesthesiology and Perioperative Care, University of California Irvine Medical Center, Orange, California , Elspeth M. McDougallElspeth M. McDougall Department of Urology, University of California Irvine Medical Center, Orange, California , and Sharon LinSharon Lin Department of Anesthesiology and Perioperative Care, University of California Irvine Medical Center, Orange, California View All Author Informationhttps://doi.org/10.1016/j.juro.2011.11.106AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Simulation based team training provides an opportunity to develop interdisciplinary communication skills and address potential medical errors in a high fidelity, low stakes environment. We evaluated the implementation of a novel simulation based team training scenario and assessed the technical and nontechnical performance of urology and anesthesiology residents. Materials and Methods: Urology residents were randomly paired with anesthesiology residents to participate in a simulation based team training scenario involving the management of 2 scripted critical events during laparoscopic radical nephrectomy, including the vasovagal response to pneumoperitoneum and renal vein injury during hilar dissection. A novel kidney surgical model and a high fidelity mannequin simulator were used for the simulation. A debriefing session followed each simulation based team training scenario. Assessments of technical and nontechnical performance were made using task specific checklists and global rating scales. Results: A total of 16 residents participated, of whom 94% rated the simulation based team training scenario as useful for communication skill training. Also, 88% of urology residents believed that the kidney surgical model was useful for technical skill training. Urology resident training level correlated with technical performance (p = 0.004) and blood loss during renal vein injury management (p = 0.022) but not with nontechnical performance. Anesthesia resident training level correlated with nontechnical performance (p = 0.036). Urology residents consistently rated themselves higher on nontechnical performance than did faculty (p = 0.033). Anesthesia residents did not differ in the self-assessment of nontechnical performance compared to faculty assessments. Conclusions: Residents rated the simulation based team training scenario as useful for interdisciplinary communication skill training. Urology resident training level correlated with technical performance but not with nontechnical performance. Urology residents consistently overestimated their nontechnical performance. References 1 : Simulation technology for health care professional skills training and assessment. JAMA1999; 282: 861. Google Scholar 2 : Review of effective advanced cardiac life support training using experiential learning. J Clin Nurs2007; 16: 58. Google Scholar 3 : Lessons from the surgical experience with simulators: incorporation into training and utilization in determining competency. Gastrointest Endoscopy Clin N Am2006; 16: 425. Google Scholar 4 : Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg2004; 91: 146. Google Scholar 5 : Assessing the skills of surgical residents using simulation. J Surg Ed2008; 65: 77. Google Scholar 6 : Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Serv Res2002; 37: 1553. Google Scholar 7 : A method for measuring the effectiveness of simulation-based team training for improving communication skills. Anesth Analg2005; 100: 1375. Google Scholar 8 : Use of simulation based team training for obstetric crises in resident education. Simul Healthc2008; 3: 154. Google Scholar 9 : Use of high fidelity operating room simulation to assess and teach communication, teamwork and laparoscopic skills: initial experience. J Urol2009; 181: 1289. Link, Google Scholar 10 : Template for Simulation Patient Design, 2003. Simulation Support: Duke University Human Simulation and Patient Safety Center. http://simcenter.duke.edu/support.html. Accessed August 2011. Google Scholar 11 : The Delphi Method: Techniques and Applications. Reading, Massachusetts: Addison-Wesley1975. Google Scholar 12 : Surgeons' non-technical skills in the operating room: reliability testing of the NOTSS behavior rating system. World J Surg2008; 32: 548. Google Scholar 13 : Anaesthetists' Non-Technical Skills (ANTS): evaluation of a behavioural marker system. Br J Anaesth2003; 90: 580. Google Scholar 14 : Communication failure in the operating room. Surgery2011; 149: 305. Google Scholar 15 : A prospective study of patient safety in the operating room. Surgery2006; 139: 159. Google Scholar 16 : Medical errors involving trainees. Arch Intern Med2007; 167: 2030. Google Scholar 17 : Teamwork training for patient safety: best practices and guiding principles. In: Handbook of Human Factors and Ergonomics in Health Care and Patient Safety (803–822). Edited by . Mahwah, New Jersey: Lawrence Erlbaum Associates2007. Google Scholar 18 : The Mobile Mock Operating Room: Bringing Team Training to the Point of Care. In: Advances in Patient Safety: New Directions and Alternative Approaches (1–17). Edited by . Rockville: Agency for Healthcare Research and Quality2008. Google Scholar 19 : The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre. Qual Saf Health Care2009; 18: 109. Google Scholar 20 : Bridging the communication gap in the operating room with medical team training. Am J Surg2005; 190: 770. Google Scholar 21 : Surgical crisis management skills training and assessment: a stimulation-based approach to enhancing operating room performance. Ann Surg2006; 244: 139. Google Scholar 22 : Association between implementation of a medical team training program and surgical mortality. JAMA2010; 304: 1693. Google Scholar 23 : Teamwork training improves the clinical care of trauma patients. J Surg Educ2010; 67: 439. Google Scholar 24 : Improving neonatal outcome through practical shoulder dystocia training. Obstet Gynecol2008; 112: 14. Google Scholar 25 : The efficacy of medical team training: improved team performance and decreased operating room delays (a detailed analysis of 4863 cases). Ann Surg2010; 252: 477. Google Scholar 26 : Teamwork and communication in surgical teams: implications for patient safety. J Am Coll Surg2008; 206: 107. Google Scholar 27 : Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach2005; 27: 10. Google Scholar 28 : Does team training work?: Principles for health care. Acad Emerg Med2008; 15: 1002. Google Scholar 29 : Evaluating clinical simulations for learning procedural skills: a theory-based approach. Acad Med2005; 80: 549. Google Scholar 30 : Comparison of postsimulation debriefing versus in-simulation debriefing in medical simulation. Simul Healthc2010; 5: 91. Google Scholar © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByAydin A, Shafi A, Shamim Khan M, Dasgupta P and Ahmed K (2018) Current Status of Simulation and Training Models in Urological Surgery: A Systematic ReviewJournal of Urology, VOL. 196, NO. 2, (312-320), Online publication date: 1-Aug-2016. Volume 187Issue 4April 2012Page: 1385-1391 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordsnephrectomyinterdisciplinary communicationinternship and residencykidneyanesthesiologyMetricsAuthor Information Jason Y. Lee Division of Urology, St. Michael's Hospital, Toronto, Ontario, Canada More articles by this author Phillip Mucksavage Department of Urology, University of California Irvine Medical Center, Orange, California More articles by this author Cecilia Canales Department of Anesthesiology and Perioperative Care, University of California Irvine Medical Center, Orange, California More articles by this author Elspeth M. McDougall Department of Urology, University of California Irvine Medical Center, Orange, California Financial interest and/or other relationship with Karl Storz, Intuitive Surgical, Simbionix and Ethicon Endo-Surgical. More articles by this author Sharon Lin Department of Anesthesiology and Perioperative Care, University of California Irvine Medical Center, Orange, California More articles by this author Expand All Advertisement PDF DownloadLoading ...