Crisis resource management training for an anaesthesia faculty: a new approach to continuing education

被引:103
作者
Blum, RH
Raemer, DB
Carroll, JS
Sunder, N
Felstein, DM
Cooper, JB
机构
[1] Childrens Hosp, Dept Anesthesia Perioperat & Pain Med, Boston, MA 02115 USA
[2] Massachusetts Gen Hosp, Dept Anesthesia & Crit Care, Boston, MA 02114 USA
[3] MIT, Alfred P Sloan Sch Management, Cambridge, MA 02139 USA
[4] Beth Israel Deaconess Med Ctr, Dept Anesthesia & Crit Care, Boston, MA 02215 USA
关键词
education; medical; undergraduate; methods; standards; anesthesia; patient care; safety; curriculum; clinical competence; standardst anaesthesia crisis resource management; anaesthesia faculty; behavioural skills; critical events; non-technical skills; patient safety; performance; teamwork;
D O I
10.1046/j.1365-2923.2004.01696.x
中图分类号
G40 [教育学];
学科分类号
040101 ; 120403 ;
摘要
Background Human error and system failures continue to play a substantial role in adverse outcomes in health care. Anaesthesia crisis resource management addresses many patient safety issues by teaching behavioural skills for critical events but it has not been systematically utilized to teach experienced faculty. Methods An anaesthesia crisis resource management course was created for the faculty of our medical school's anaesthesia teaching programmes. The course objectives were to understand and improve participants' proficiency in crisis resource management (CRM) skills and to learn skills for debriefing residents after critical events. Through surveys, measurement objectives assessed acceptance, utility and need for recurrent training immediately post-course. These were measured again approximately 1 year later along with self-perceived changes in the management of difficult or critical events. Results The highly rated course was well received in terms of overall course quality, realism, debriefings and didactic presentation. Course usefulness, CRM principles, debriefing skills and communication were highly rated immediately post-course and 1 year later. Approximately half of the faculty staff reported a difficult or critical event following the course; of nine self-reported CRM performance criteria surveyed all claimed improvement in their CRM non-technical skills. Conclusions A unique and highly rated anaesthesia faculty course was created; participation made the faculty staff eligible for malpractice premium reductions. Self-reported CRM behaviours in participants' most significant difficult or critical events indicated an improvement in performance. These data provide indirect evidence supporting the contention that this type of training should be more widely promoted, although more definitive measures of improved outcomes are needed.
引用
收藏
页码:45 / 55
页数:11
相关论文
共 20 条
[1]  
[Anonymous], HUMAN ERROR MED
[2]  
BLUM RH, 1996, 2 ROCH C SIM AN ED
[3]  
CARROLL JS, 2000, NATURALISTIC DECISIO
[4]   AN ANALYSIS OF MAJOR ERRORS AND EQUIPMENT FAILURES IN ANESTHESIA MANAGEMENT - CONSIDERATIONS FOR PREVENTION AND DETECTION [J].
COOPER, JB ;
NEWBOWER, RS ;
KITZ, RJ .
ANESTHESIOLOGY, 1984, 60 (01) :34-42
[5]  
DEKEYSER V, 1990, SYSTEMS RELIABILITY
[6]   Understanding self-report bias in organizational behavior research [J].
Donaldson, SI ;
Grant-Vallone, EJ .
JOURNAL OF BUSINESS AND PSYCHOLOGY, 2002, 17 (02) :245-260
[7]   Disrupted routines: Team learning and new technology implementation in hospitals [J].
Edmondson, AC ;
Bohmer, RM ;
Pisano, GP .
ADMINISTRATIVE SCIENCE QUARTERLY, 2001, 46 (04) :685-716
[8]   The role of non-technical skills in anaesthesia: a review of current literature [J].
Fletcher, GCL ;
McGeorge, P ;
Flin, RH ;
Glavin, RJ ;
Maran, NJ .
BRITISH JOURNAL OF ANAESTHESIA, 2002, 88 (03) :418-429
[9]   A COMPREHENSIVE ANESTHESIA SIMULATION ENVIRONMENT - RECREATING THE OPERATING-ROOM FOR RESEARCH AND TRAINING [J].
GABA, DM ;
DEANDA, A .
ANESTHESIOLOGY, 1988, 69 (03) :387-394
[10]  
Gaba DM, 1994, Crisis management in anesthesiology