Cardiothoracic surgical education and training
Educational program in crisis management for cardiac surgery teams including high realism simulation

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Introduction

Cardiac surgery demands effective teamwork for safe, high-quality care. The objective of this pilot study was to develop a comprehensive program to sharpen performance of experienced cardiac surgical teams in acute crisis management.

Methods

We developed and implemented an educational program for cardiac surgery based on high realism acute crisis simulation scenarios and interactive whole-unit workshop. The impact of these interventions was assessed with postintervention questionnaires, preintervention and 6-month postintervention surveys, and structured interviews.

Results

The realism of the acute crisis simulation scenarios gradually improved; most participants rated both the simulation and whole-unit workshop as very good or excellent. Repeat simulation training was recommended every 6 to 12 months by 82% of the participants. Participants of the interactive workshop identified 2 areas of highest priority: encouraging speaking up about critical information and interprofessional information sharing. They also stressed the importance of briefings, early communication of surgical plan, knowing members of the team, and continued simulation for practice. The pre/post survey response rates were 70% (55/79) and 66% (52/79), respectively. The concept of working as a team improved between surveys (P = .028), with a trend for improvement in gaining common understanding of the plan before a procedure (P = .075) and appropriate resolution of disagreements (P = .092). Interviewees reported that the training had a positive effect on their personal behaviors and patient care, including speaking up more readily and communicating more clearly.

Conclusions

Comprehensive team training using simulation and a whole-unit interactive workshop can be successfully deployed for experienced cardiac surgery teams with demonstrable benefits in participant's perception of team performance.

CTSNet classification

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41.1

Abbreviations and Acronyms

CRICO
Controlled Risk Insurance Company
CRM
crisis resource management

Cited by (0)

This study was supported by an unrestricted grant from CRICO/Risk Management Foundation of the Harvard Medical Institutions. Salary support (to L.M.S.) was provided by a fellowship award from the Canadian Institutes of Health Research's Clinical Research Initiative and the Rossetti Fund (Massachusetts General Hospital, Boston, Massachusetts).

Disclosures: J.B.C. and D.B.R. are faculty and derive salary support from the nonprofit Center for Medical Simulation, which receives income for conducting teamwork training programs for hospital teams such as those involved in this study. All other authors have nothing to disclose with regard to commercial support.