Best practice & research. Clinical anaesthesiology
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Best Pract Res Clin Anaesthesiol · Mar 2015
ReviewBasic concepts for crew resource management and non-technical skills.
In this paper, we explain the conceptual background to non-technical skills and show how they can influence job performance in anaesthesia. We then describe the taxonomy of anaesthetists' non-technical skills (ANTS) and related systems, such as ANTS-AP for anaesthetic practitioners. We discuss the training courses that have been designed to teach these non-technical skills, which are called crew resource management (CRM), crisis resource management (CRM) or crisis avoidance resource management (CARMA). Finally, we discuss the application of non-technical skills assessment systems.
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Best Pract Res Clin Anaesthesiol · Mar 2015
ReviewBriefing and debriefing during simulation-based training and beyond: Content, structure, attitude and setting.
In this article, we review the debriefing literature and point to the dilemma that although debriefings especially intend to enhance team (rather than individual) learning, it is particularly this team setting that poses risks for debriefing effectiveness (e.g., preference-consistent information sharing, lack of psychological safety inhibiting structured information sharing, ineffective debriefing models). These risks can be managed with a mindful approach with respect to content (e.g., specific learning objectives), structure (e.g., reactions phase, analysis phase, summary phase), attitude (e.g., honesty, curiosity, holding the trainee in positive regard) and setting (e.g., briefings to provide orientation and establish psychological safety). We point to the potential of integrating systemic methods such as circular questions into debriefings, discuss the empirical evidence for debriefing effectiveness and highlight the importance of faculty development.
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Simulation has become a significant training tool in the operating room (OR). It can be used in both simple task training and complex scenarios. The challenge for simulation in the OR is how to translate that which is learned, and perceived to beneficial, into behavioral change and improved patient outcomes. Simulation in the developing world is progressing, but is still hampered by a shortage of material, personnel funding.
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About 10 years ago, the first human patient simulators were introduced to intensive care units (ICUs). Since then, there has been a rapid development of both technical and non-technical aspects in medical education. ⋯ Furthermore, a practical example describes how a simulation curriculum can be designed, which challenges might need to be faced and which steps need to be taken to make the most out of the training. Human patient simulation is an effective tool in the education of health-care professionals and will surely become an important part in the training of ICU physicians as well.
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Best Pract Res Clin Anaesthesiol · Mar 2015
ReviewThe matter of 'fidelity': Keep it simple or complex?
Simulation often relies on a case-based learning approach and is used as a teaching tool for a variety of audiences. The knowledge transmission goes beyond the mere exchange of soft skills and practical abilities, including practical knowledge and decision-making behaviour as well. As it seems, simulation requirements largely depend on the skills, abilities or competences to be conveyed. ⋯ For simulation-based learning, learning outcomes depend not only on knowledge, practical skills and motivational variables, but also on the onset of negative emotions, perception of own ability and personality profile. 'Simulation' training alone does not appear to guarantee learning success. Rather, it seems necessary to establish a simulation setting suitable for the education level, needs and personality characteristics of the students. Thus, it is fair to conclude that there is no evidence correlating the realism of a simulation scenario with the learning success of students.