Impact of Acute Care Physician's Age on Crisis Management Performance and Learning After Simulation-based Education
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 48
- 试验地点
- 2
- 主要终点
- CRM Performance During First Sim Scenario Assessed by Ottawa Global Rating Scale (GRS)
研究概览
简要总结
The proportion of older acute care physicians (ACPs) has been increasing. Ageing is associated with physiological changes and research investigating how such age-related physiological changes affect clinical performance is lacking. Specifically, Crisis Resource Management (CRM) consists of essential clinical skills in acute care specialties which when absent, can significantly impact patient safety. As such, the goals of this study are to investigate whether ageing has a correlation with baseline CRM skills of ACPs and whether ageing influences learning from high fidelity simulation.
详细描述
The proportion of older acute care physicians (ACP), emergency, critical care & anesthesia, has been steadily increasing. Ageing is associated with physiological changes, which in turn can influence a physician's clinical abilities and decision-making. The litigation and physician disciplinary data suggests that incidents involving all physicians are likely to occur later in practice, with degree of injury identified in the claims being of greater severity. However research, investigating how age-related physiological changes affect clinical performance and patient safety, is lacking.
CRM skills are essential skills within acute care specialties, and are vital for patient safety. CRM encompasses technical skills, as well as a rapid and organized approach to non-technical, cognitive skills such as decision-making, task management, situational awareness and team management. High-fidelity full body mannequin simulation-based education is effective for learning CRM, including transfer of skills from the simulated setting to the clinical setting and improving patient outcome. However, there is a gap in the literature on whether physicians' age influences baseline CRM performance and also learning from simulation-based education.
Although the effectiveness of high-fidelity simulation-based education has been studied extensively in junior learner populations (students, residents, fellows), there are a limited number of studies investigating its effectiveness in teaching CRM in the ageing physician population. In fact, a recent systematic review looking at the role of simulation in continuing medical education (CME) in ACPs supported that there is limited evidence supporting improved learning. Despite not knowing whether simulation is the correct tool in an ageing population, it is being recommended as a training, regulation and assessment tool for practicing physicians.
Objectives:
The goals of this study are to:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Emergency physicians
- •Critical care physicians
- •Anesthesiologists
- •minimum 5 years of practice post-residency
排除标准
- •Post-call day of participation
结局指标
主要结局
CRM Performance During First Sim Scenario Assessed by Ottawa Global Rating Scale (GRS)
时间窗: After managing first simulation scenario - Day 1
Ottawa GRS score correlated with chronological age. The Ottawa GRS assesses non-technical CRM skills on a 7-point scale (minimum 1, maximum 7), with higher scores indicating better performance.
CRM Performance During First Sim Scenario Assessed by ACLS Checklist
时间窗: After managing first simulation scenario - Day 1
ACLS (Advanced Cardiac Life Support) score will be correlated with chronological age. Items on the checklist were separated into two components: 1) the ACLS correct score (minimum score 0, maximum score 30), where higher scores indicate better performance, and 2) the ACLS risk score (minimum score 0, maximum score 17) where higher scores indicate worse performance.
次要结局
- Learning From High-fidelity Simulation Education Assessed by Ottawa Global Rating Scale(After managing second simulation scenario - Day 1)
- Learning From High-fidelity Simulation Education Assessed by ACLS Checklist(After managing second simulation scenario - Day 1)
研究者
Dr. Fahad Alam
Anesthesiologist
Sunnybrook Health Sciences Centre