A crisis of faith? A review of simulation in teaching team-based, crisis management skills to surgical trainees.
Publication/Presentation Date
1-1-2012
Abstract
BACKGROUND: Team-based training using crisis resource management (CRM) has gained popularity as a strategy to minimize the impact of medical error during critical events. The purpose of this review was to appraise and summarize the design, implementation, and efficacy of peer-reviewed, simulation-based CRM training programs for postgraduate trainees (residents).
METHODS: Two independent reviewers conducted a structured literature review, querying multiple medical and allied health databases from 1950 to May 2010 (MEDLINE, EMBASE, CINAHL, EBM, and PsycINFO). We included articles that (1) were written in English, (2) were published in peer-reviewed journals, (3) included residents, (4) contained a simulation component, and (5) included a team-based component. Peer-reviewed articles describing the implementation of CRM instruction were critically appraised using the Kirkpatrick framework for evaluating training programs.
RESULTS: Fifteen studies involving a total of 404 residents met inclusion criteria; most studies reported high resident satisfaction for CRM training. In several CRM domains, residents demonstrated significant improvements after training, which did not decay over time. With regard to design, oral feedback may be equivalent to video feedback and single-day interventions may be as efficacious as multiple-day interventions for residents. No studies demonstrated a link between simulation-based CRM training and performance during real-life critical events.
CONCLUSIONS: The findings support the utility of CRM programs for residents. A high degree of satisfaction and perceived value reflect robust resident engagement. The iteration of themes from our review provides the basis for the development of best practices in curricula design. A dearth of well-designed, randomized studies preclude the quantification of impact of simulation-based training in the clinical environment.
Volume
69
Issue
3
First Page
274
Last Page
281
ISSN
1878-7452
Published In/Presented At
Doumouras, A. G., Keshet, I., Nathens, A. B., Ahmed, N., & Hicks, C. M. (2012). A crisis of faith? A review of simulation in teaching team-based, crisis management skills to surgical trainees. Journal of surgical education, 69(3), 274–281. https://doi.org/10.1016/j.jsurg.2011.11.004
Disciplines
Medicine and Health Sciences
PubMedID
22483124
Department(s)
Fellows and Residents
Document Type
Article