THE POWER OF TEAMWORK & SIM EFFICIENCY
By Dr. Niranjan Sathivel
Multidisciplinary team simulations have several benefits for the parties involved; learners, educators and the simulation centre staff.
In these scenarios learners have the unique opportunity to tackle problems using a team approach, which in many ways mimic real life settings. Communicating, learning and understanding the perspective of each team member is a vital aspect for patient safety, which can be built into training scenarios.
I understand that it's challenging for educators to collaborate and integrate goals and objectives for their individual teams, in-order to create simulation scenarios for team training. By making this happen they are able to add a whole new domain which could enhance the simulation education experience for learners.
There are three benefits to the simulation centre and the staff: The first being the optimum use of the centre's space and equipment. From my experience in the industry, I have observed that in many simulation centres, the training equipment often remain under-utilized. Bringing a multidisciplinary team for training, into one simulation theatre, sometimes provides the context for putting such equipment to use, by hybridizing simulation platforms. At this point you probably might have guessed the other two benefits. There is a positive impact on staff work flow efficiency and operational costs. Running the sessions in one simulation theatre as opposed to multiple simulation theatres can save you money and time.
When it comes to designing scenarios and running team training sessions, I can provide an example that clinical educators from the respective departments and I had put together, for the orthopedic surgery residents, anesthesiology residents and O.R. nursing staff. It was a total knee arthroplasty (TKA) case with an intraop complication. It was in an O.R. simulation theatre which included a mannequin (set-up for a left knee TKA), common orthopedic instruments used for TKA, anesthesia gas machine (AGM), drapes, O.R. tables, IV lines, etc. The three teams were assessed on their performance on technical skills and non-technical skills. The intraop complication was introduced after about 15 minutes into the procedure. The vital signs of the computer controlled mannequin were made to deteriorate gradually, setting off the alarms in the AGM and the vitals monitor. The teams were then assessed on their ability to recognize that there is an intraop complication, communicate with the O.R. team members, identify the aetiology, then manage and call for help. I found that adding intraop complications in the scenarios was a good test for medical knowledge and clinical skills. It also prompted the team members to be more engaged in communication and decision making.
Developing and running simulation sessions are definitely dependent on your goals and objectives. When team training is an option, it does let you get the most from a simulation session.
Based on your experience let us know what worked and what were some of your challenges with team training in a surgical setting.
Niranjan Sathivel, Hon. BSc., M.D.