Skip to main content
Top
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 6/2014

Open Access 01-06-2014 | Review Article/Brief Review

Transfer of learning and patient outcome in simulated crisis resource management: a systematic review

Authors: Sylvain Boet, MD, M. Dylan Bould, MBChB, Lillia Fung, MD, Haytham Qosa, MD, Laure Perrier, MLIS, Walter Tavares, PhD(c), Scott Reeves, PhD, Andrea C. Tricco, PhD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 6/2014

Login to get access

Abstract

Purpose

Simulation-based learning is increasingly used by healthcare professionals as a safe method to learn and practice non-technical skills, such as communication and leadership, required for effective crisis resource management (CRM). This systematic review was conducted to gain a better understanding of the impact of simulation-based CRM teaching on transfer of learning to the workplace and subsequent changes in patient outcomes.

Source

Studies on CRM, crisis management, crew resource management, teamwork, and simulation published up to September 2012 were searched in MEDLINE®, EMBASE™, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC. All studies that used simulation-based CRM teaching with outcomes measured at Kirkpatrick Level 3 (transfer of learning to the workplace) or 4 (patient outcome) were included. Studies measuring only learners’ reactions or simple learning (Kirkpatrick Level 1 or 2, respectively) were excluded. Two authors independently reviewed all identified titles and abstracts for eligibility.

Principal findings

Nine articles were identified as meeting the inclusion criteria. Four studies measured transfer of simulation-based CRM learning into the clinical setting (Kirkpatrick Level 3). In three of these studies, simulation-enhanced CRM training was found significantly more effective than no intervention or didactic teaching. Five studies measured patient outcomes (Kirkpatrick Level 4). Only one of these studies found that simulation-based CRM training made a clearly significant impact on patient mortality.

Conclusions

Based on a small number of studies, this systematic review found that CRM skills learned at the simulation centre are transferred to clinical settings, and the acquired CRM skills may translate to improved patient outcomes, including a decrease in mortality.
Appendix
Available only for authorised users
Literature
1.
go back to reference Cook DA, Hatala R, Brydges R, et al. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA 2011; 306: 978-88.PubMed Cook DA, Hatala R, Brydges R, et al. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA 2011; 306: 978-88.PubMed
2.
go back to reference Gurusamy KS, Aggarwal R, Palanivelu L, Davidson BR. Virtual reality training for surgical trainees in laparoscopic surgery. Cochrane Database Syst Rev 2009; 1: CD006575.PubMed Gurusamy KS, Aggarwal R, Palanivelu L, Davidson BR. Virtual reality training for surgical trainees in laparoscopic surgery. Cochrane Database Syst Rev 2009; 1: CD006575.PubMed
3.
go back to reference Haycock A, Koch AD, Familiari P, et al. Training and transfer of colonoscopy skills: a multinational, randomized, blinded, controlled trial of simulator versus bedside training. Gastrointest Endosc 2010; 71: 298-307.PubMedCrossRef Haycock A, Koch AD, Familiari P, et al. Training and transfer of colonoscopy skills: a multinational, randomized, blinded, controlled trial of simulator versus bedside training. Gastrointest Endosc 2010; 71: 298-307.PubMedCrossRef
4.
go back to reference Boet S, Bould MD, Sharma B, et al. Within-team debriefing versus instructor-led debriefing for simulation-based education: a randomized controlled trial. Ann Surg 2013; 258: 53-8.PubMedCrossRef Boet S, Bould MD, Sharma B, et al. Within-team debriefing versus instructor-led debriefing for simulation-based education: a randomized controlled trial. Ann Surg 2013; 258: 53-8.PubMedCrossRef
5.
go back to reference Savoldelli GL, Naik VN, Park J, Joo HS, Chow R, Hamstra SJ. Value of debriefing during simulated crisis management: oral versus video-assisted oral feedback. Anesthesiology 2006; 105: 279-85.PubMedCrossRef Savoldelli GL, Naik VN, Park J, Joo HS, Chow R, Hamstra SJ. Value of debriefing during simulated crisis management: oral versus video-assisted oral feedback. Anesthesiology 2006; 105: 279-85.PubMedCrossRef
6.
go back to reference Boet S, Bould MD, Bruppacher HR, Desjardins F, Chandra DB, Naik VN. Looking in the mirror: self-debriefing versus instructor debriefing for simulated crises. Crit Care Med 2011; 39: 1377-81.PubMedCrossRef Boet S, Bould MD, Bruppacher HR, Desjardins F, Chandra DB, Naik VN. Looking in the mirror: self-debriefing versus instructor debriefing for simulated crises. Crit Care Med 2011; 39: 1377-81.PubMedCrossRef
7.
go back to reference Boet S, Bould MD, Schaeffer R, et al. Learning fibreoptic intubation with a virtual computer program transfers to ‘hands on’ improvement. Eur J Anaesthesiol 2010; 27: 31-5.PubMedCrossRef Boet S, Bould MD, Schaeffer R, et al. Learning fibreoptic intubation with a virtual computer program transfers to ‘hands on’ improvement. Eur J Anaesthesiol 2010; 27: 31-5.PubMedCrossRef
8.
go back to reference Borges BC, Boet S, Siu LW, et al. Incomplete adherence to the ASA difficult airway algorithm is unchanged after a high-fidelity simulation session. Can J Anesth 2010; 57: 644-9.PubMedCrossRef Borges BC, Boet S, Siu LW, et al. Incomplete adherence to the ASA difficult airway algorithm is unchanged after a high-fidelity simulation session. Can J Anesth 2010; 57: 644-9.PubMedCrossRef
9.
go back to reference Gaba DM, Howard SK, Fish KJ, Smith BE, Sowb YA. Simulation-Based Training in Anesthesia Crisis Resource Management (ACRM): A Decade of Experience. Simulation Gaming 2001; 32: 175-93.CrossRef Gaba DM, Howard SK, Fish KJ, Smith BE, Sowb YA. Simulation-Based Training in Anesthesia Crisis Resource Management (ACRM): A Decade of Experience. Simulation Gaming 2001; 32: 175-93.CrossRef
10.
go back to reference Gordon M, Darbyshire D, Baker P. Non-technical skills training to enhance patient safety: a systematic review. Med Educ 2012; 46: 1042-54.PubMedCrossRef Gordon M, Darbyshire D, Baker P. Non-technical skills training to enhance patient safety: a systematic review. Med Educ 2012; 46: 1042-54.PubMedCrossRef
11.
go back to reference Doumouras AG, Keshet I, Nathens AB, Ahmed N, Hicks CM. A crisis of faith? A review of simulation in teaching team-based, crisis management skills to surgical trainees. J Surg Educ 2012; 69: 274-81.PubMedCrossRef Doumouras AG, Keshet I, Nathens AB, Ahmed N, Hicks CM. A crisis of faith? A review of simulation in teaching team-based, crisis management skills to surgical trainees. J Surg Educ 2012; 69: 274-81.PubMedCrossRef
12.
go back to reference Kirkpatrick DL, Kirkpatrick JD. Evaluating Training Programs: the Four Levels. 3rd ed. San Francisco, CA: Berrett-Koehler; 2006 . Kirkpatrick DL, Kirkpatrick JD. Evaluating Training Programs: the Four Levels. 3rd ed. San Francisco, CA: Berrett-Koehler; 2006 .
13.
go back to reference Boet S, Sharma S, Goldman J, Reeves S. Review article: Medical education research: an overview of methods. Can J Anesth 2012; 59: 159-70.PubMedCrossRef Boet S, Sharma S, Goldman J, Reeves S. Review article: Medical education research: an overview of methods. Can J Anesth 2012; 59: 159-70.PubMedCrossRef
14.
go back to reference Hammick M, Freeth D, Koppel I, Reeves S, Barr H. A best evidence systematic review of interprofessional education: BEME Guide no. 9. Med Teach 2007; 29: 735-51.PubMedCrossRef Hammick M, Freeth D, Koppel I, Reeves S, Barr H. A best evidence systematic review of interprofessional education: BEME Guide no. 9. Med Teach 2007; 29: 735-51.PubMedCrossRef
15.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151: 264-9.PubMedCrossRef Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151: 264-9.PubMedCrossRef
16.
go back to reference Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005; 27: 10-28.PubMedCrossRef Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005; 27: 10-28.PubMedCrossRef
17.
go back to reference Ward M, Gruppen L, Regehr G. Measuring self-assessment: current state of the art. Adv Health Sci Educ Theory Pract 2002; 7: 63-80.PubMedCrossRef Ward M, Gruppen L, Regehr G. Measuring self-assessment: current state of the art. Adv Health Sci Educ Theory Pract 2002; 7: 63-80.PubMedCrossRef
18.
go back to reference Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA 2006; 296: 1094-102.PubMedCrossRef Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA 2006; 296: 1094-102.PubMedCrossRef
21.
go back to reference Shapiro MJ, Morey JC, Small SD. Simulation based teamwork training for emergency department staff: does it improve clinical team performance when added to an existing didactic teamwork curriculum? Qual Saf in Health Care 2004; 13: 417-21.CrossRef Shapiro MJ, Morey JC, Small SD. Simulation based teamwork training for emergency department staff: does it improve clinical team performance when added to an existing didactic teamwork curriculum? Qual Saf in Health Care 2004; 13: 417-21.CrossRef
22.
go back to reference Knudson MM, Khaw L, Bullard MK, et al. Trauma training in simulation: translating skills from SIM time to real time. J Trauma 2008; 64: 255-64.PubMedCrossRef Knudson MM, Khaw L, Bullard MK, et al. Trauma training in simulation: translating skills from SIM time to real time. J Trauma 2008; 64: 255-64.PubMedCrossRef
23.
go back to reference Capella J, Smith S, Philp A, et al. Teamwork training improves the clinical care of trauma patients. J Surg Educ 2010; 67: 439-43.PubMedCrossRef Capella J, Smith S, Philp A, et al. Teamwork training improves the clinical care of trauma patients. J Surg Educ 2010; 67: 439-43.PubMedCrossRef
24.
go back to reference Riley W, Davis S, Miller K, Hansen H, Sainfort F, Sweet R. Didactic and simulation nontechnical skills team training to improve perinatal patient outcomes in a community hospital. Jt Comm J Qual Patient Saf 2011; 37: 357-64.PubMed Riley W, Davis S, Miller K, Hansen H, Sainfort F, Sweet R. Didactic and simulation nontechnical skills team training to improve perinatal patient outcomes in a community hospital. Jt Comm J Qual Patient Saf 2011; 37: 357-64.PubMed
25.
go back to reference Miller D, Crandall C, Washington C 3rd, McLaughlin S. Improving teamwork and communication in trauma care through in situ simulations. Acad Emerg Med 2012; 19: 608-12.PubMedCrossRef Miller D, Crandall C, Washington C 3rd, McLaughlin S. Improving teamwork and communication in trauma care through in situ simulations. Acad Emerg Med 2012; 19: 608-12.PubMedCrossRef
26.
go back to reference Phipps MG, Lindquist DG, McConaughey E, O’Brien JA, Raker CA, Paglia MJ. Outcomes from a labor and delivery team training program with simulation component. Am J Obstet Gynecol 2012; 206: 3-9.PubMedCrossRef Phipps MG, Lindquist DG, McConaughey E, O’Brien JA, Raker CA, Paglia MJ. Outcomes from a labor and delivery team training program with simulation component. Am J Obstet Gynecol 2012; 206: 3-9.PubMedCrossRef
27.
go back to reference Bruppacher HR, Alam SK, LeBlanc VR, et al. Simulation-based training improves physicians’ performance in patient care in high-stakes clinical setting of cardiac surgery. Anesthesiology 2010; 112: 985-92.PubMedCrossRef Bruppacher HR, Alam SK, LeBlanc VR, et al. Simulation-based training improves physicians’ performance in patient care in high-stakes clinical setting of cardiac surgery. Anesthesiology 2010; 112: 985-92.PubMedCrossRef
28.
go back to reference Steinemann S, Berg B, Skinner A, et al. In situ, multidisciplinary, simulation-based teamwork training improves early trauma care. J Surg Educ 2011; 68: 472-7.PubMedCrossRef Steinemann S, Berg B, Skinner A, et al. In situ, multidisciplinary, simulation-based teamwork training improves early trauma care. J Surg Educ 2011; 68: 472-7.PubMedCrossRef
29.
go back to reference Andreatta P, Saxton E, Thompson M, Annich G. Simulation-based mock codes significantly correlate with improved pediatric patient cardiopulmonary arrest survival rates. Pediatr Crit Care Med 2011; 12: 33-8.PubMedCrossRef Andreatta P, Saxton E, Thompson M, Annich G. Simulation-based mock codes significantly correlate with improved pediatric patient cardiopulmonary arrest survival rates. Pediatr Crit Care Med 2011; 12: 33-8.PubMedCrossRef
30.
go back to reference DeVita MA, Schaefer J, Lutz J, Wang H, Dongilli T. Improving medical emergency team (MET) performance using a novel curriculum and a computerized human patient simulator. Qual Saf Health Care 2005; 14: 326-31.PubMedCentralPubMedCrossRef DeVita MA, Schaefer J, Lutz J, Wang H, Dongilli T. Improving medical emergency team (MET) performance using a novel curriculum and a computerized human patient simulator. Qual Saf Health Care 2005; 14: 326-31.PubMedCentralPubMedCrossRef
31.
go back to reference Yardley S, Dornan T. Kirkpatrick’s levels and education ‘evidence’. Med Educ 2012; 46: 97-106.PubMedCrossRef Yardley S, Dornan T. Kirkpatrick’s levels and education ‘evidence’. Med Educ 2012; 46: 97-106.PubMedCrossRef
32.
go back to reference Neily J, Mills PD, Young-Xu Y, et al. Association between implementation of a medical team training program and surgical mortality. JAMA 2010; 304: 1693-700.PubMedCrossRef Neily J, Mills PD, Young-Xu Y, et al. Association between implementation of a medical team training program and surgical mortality. JAMA 2010; 304: 1693-700.PubMedCrossRef
33.
go back to reference Salas E, Burke CS, Bowers CA, Wilson KA. Team training in the skies: does crew resource management (CRM) training work? Hum Factors 2001; 43: 641-74.PubMedCrossRef Salas E, Burke CS, Bowers CA, Wilson KA. Team training in the skies: does crew resource management (CRM) training work? Hum Factors 2001; 43: 641-74.PubMedCrossRef
34.
go back to reference Eva KW, Cunnington JP, Reiter HI, Keane DR, Norman GR. How can I know what I don’t know? Poor self assessment in a well-defined domain. Adv Health Sci Educ Theory Pract 2004; 9: 211-24.PubMedCrossRef Eva KW, Cunnington JP, Reiter HI, Keane DR, Norman GR. How can I know what I don’t know? Poor self assessment in a well-defined domain. Adv Health Sci Educ Theory Pract 2004; 9: 211-24.PubMedCrossRef
Metadata
Title
Transfer of learning and patient outcome in simulated crisis resource management: a systematic review
Authors
Sylvain Boet, MD
M. Dylan Bould, MBChB
Lillia Fung, MD
Haytham Qosa, MD
Laure Perrier, MLIS
Walter Tavares, PhD(c)
Scott Reeves, PhD
Andrea C. Tricco, PhD
Publication date
01-06-2014
Publisher
Springer US
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 6/2014
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-014-0143-8

Other articles of this Issue 6/2014

Canadian Journal of Anesthesia/Journal canadien d'anesthésie 6/2014 Go to the issue