Age and its impact on crisis management performance and learning after simulation-based education by acute care physicians: a multicentre prospective cohort study.

ageing anaesthesiologist continuing professional development crisis resource management emergency physician intensivist simulation-based education

Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
12 Dec 2023
Historique:
received: 14 04 2023
revised: 18 10 2023
accepted: 19 10 2023
medline: 13 12 2023
pubmed: 13 12 2023
entrez: 13 12 2023
Statut: aheadofprint

Résumé

Physiological changes associated with ageing could negatively impact the crisis resource management skills of acute care physicians. This study was designed to determine whether physician age impacts crisis resource management skills, and crisis resource management skills learning and retention using full-body manikin simulation training in acute care physicians. Acute care physicians at two Canadian universities participated in three 8-min simulated crisis (pulseless electrical activity) scenarios. An initial crisis scenario (pre-test) was followed by debriefing with a trained facilitator and a second crisis scenario (immediate post-test). Participants returned for a third crisis scenario 3-6 months later (retention post-test). For the 48 participants included in the final analysis, age negatively correlated with baseline Global Rating Scale (GRS; r=-0.30, P<0.05) and technical checklist scores (r=-0.44, P<0.01). However, only years in practice and prior simulation experience, but not age, were significant in a subsequent stepwise regression analysis. Learning from simulation-based education was shown with a mean difference in scores from pre-test to immediate post-test of 2.28 for GRS score (P<0.001) and 1.69 for technical checklist correct score (P<0.001); learning was retained for 3-6 months. Only prior simulation experience was significantly correlated with a decreased change in learning (r=-0.30, P<0.05). A reduced amount of prior simulation training and increased years in practice, but not age on its own, were significant predictors of low baseline crisis resource management performance. Simulation-based education leads to crisis resource management learning that is well retained for 3-6 months, regardless of age or years in practice.

Sections du résumé

BACKGROUND BACKGROUND
Physiological changes associated with ageing could negatively impact the crisis resource management skills of acute care physicians. This study was designed to determine whether physician age impacts crisis resource management skills, and crisis resource management skills learning and retention using full-body manikin simulation training in acute care physicians.
METHODS METHODS
Acute care physicians at two Canadian universities participated in three 8-min simulated crisis (pulseless electrical activity) scenarios. An initial crisis scenario (pre-test) was followed by debriefing with a trained facilitator and a second crisis scenario (immediate post-test). Participants returned for a third crisis scenario 3-6 months later (retention post-test).
RESULTS RESULTS
For the 48 participants included in the final analysis, age negatively correlated with baseline Global Rating Scale (GRS; r=-0.30, P<0.05) and technical checklist scores (r=-0.44, P<0.01). However, only years in practice and prior simulation experience, but not age, were significant in a subsequent stepwise regression analysis. Learning from simulation-based education was shown with a mean difference in scores from pre-test to immediate post-test of 2.28 for GRS score (P<0.001) and 1.69 for technical checklist correct score (P<0.001); learning was retained for 3-6 months. Only prior simulation experience was significantly correlated with a decreased change in learning (r=-0.30, P<0.05).
CONCLUSIONS CONCLUSIONS
A reduced amount of prior simulation training and increased years in practice, but not age on its own, were significant predictors of low baseline crisis resource management performance. Simulation-based education leads to crisis resource management learning that is well retained for 3-6 months, regardless of age or years in practice.

Identifiants

DOI: 10.1016/j.bja.2023.10.040 PMID: 38087740
pubmed: 38087740
pii: S0007-0912(23)00634-7
doi: 10.1016/j.bja.2023.10.040
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Auteurs

Fahad Alam (F)

Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Anesthesiology & Pain Medicine University of Toronto, Toronto, ON, Canada. Electronic address: fahad.alam@sunnybrook.ca.

Vicki R LeBlanc (VR)

Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada; University of Ottawa Simulation & Skills Centre, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Alan Baxter (A)

Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Jordan Tarshis (J)

Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Anesthesiology & Pain Medicine University of Toronto, Toronto, ON, Canada.

Dominique Piquette (D)

Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Yuqi Gu (Y)

Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Caroline Filipowska (C)

Department of Emergency Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Ashley Krywenky (A)

Department of Emergency Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Nicole Kester-Greene (N)

Department of Emergency Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Pierre Cardinal (P)

Department of Critical Care Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Meghan Andrews (M)

Department of Anesthesiology and Pain Medicine, Montfort Hospital, University of Ottawa, Ottawa, ON, Canada.

Francois Chartier (F)

Le Centre Hospitalier Affilié Universitaire Régional (CHAUR), Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec (CIUSSS MCQ), Trois-Rivière, QC, Canada.

Claire Burrows (C)

Department of Anaesthesia, Western Health, Melbourne, VIC, Australia; Western Health Anaesthesia and Critical Care Simulation, Melbourne, VIC, Australia.

Charles-Henri Houzé-Cerfon (CH)

Department of Emergency Medicine, Toulouse University Hospital, Toulouse, France; Toulouse Institute of Simulation Healthcare, Toulouse University Hospital, Toulouse, France.

Joseph K Burns (JK)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.

Lilia Kaustov (L)

Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Shelly Au (S)

Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Sandy Lam (S)

Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Susan DeSousa (S)

Sunnybrook Canadian Simulation Centre, Toronto, ON, Canada.

Sylvain Boet (S)

Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada; Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Classifications MeSH