Implementation of Pit Crew Resuscitation Model on the Training of Advanced Life Support: a Randomized Controlled Study
NCT ID: NCT04364529
Last Updated: 2021-11-12
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
104 participants
INTERVENTIONAL
2017-08-14
2020-01-30
Brief Summary
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Detailed Description
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Technical skills (TS) and non-technical skills (NTS) are two sets of skills required by Crisis resource management (CRM). Sudden cardiac arrest is a time-critical emergency situation in which both skills are needed - it's handled by a team rather than by individual health-care workers.
Because of the relatively rare nature of cardiac arrests in many wards and clinics, regular resuscitation training is necessary. However, the main part of the training is traditionally emphasized to technical skills. The recent research findings of the authors suggest that the TS and NTS seem to associate in a real life resuscitation. The authors wanted to investigate if pre-allocated tasks and positions (a pit crew model) helps to perform better ALS performance and helps to maintain the skills in simulated ALS situations.
Simulation-based education (SBE) is a key tool for teaching CPR. It has demonstrated its effectiveness in promoting skill acquisition and has been suggested as an ideal tool for teaching medical skills allowing learners to engage actively in their learning process while doing no harm to their patients but its effectiveness on improving anesthesiologists NTS is unclear as the matter has not been studied. SBE is particularly good method to create trainees a realistic medical crisis situation (scenario) created within a physical space (simulator) replicating the real environment where trainees goal is to solve the problem, do the diagnose and treat the patient. Afterwards, the simulation debriefing is an crucial part of the whole letting trainees and the instructor to finish the learning process. Traditionally such training has been a standard in professions characterized by high risk caused by 'human factor' such as in aviation and other high risk industries. On the other hand the benefit for maintaining resuscitation skills learned after single SBE is modest thus short - only a few minutes a week - but frequent SBE appears to facilitate transfer of new knowledge and skills into clinical practice. SBE has been shown to improve the satisfaction of learners and skill performance in the simulated environment but it's still unclear whether it improves the patient outcome. Simulation training is expensive though so other teaching methods like mental practice and e-learning could be useful alongside it.
Catchpole and colleagues aimed to improve the quality and safety of handover of pediatric patients from surgery to intensive care using the analogy of a Formula 1 pit stop and expertise from aviation. They introduced a new handover protocol which led to improvements in all aspects of the critical situation. Based on he same idea, a novel resuscitation tactic model (a pit crew model) was developed which predetermines the roles and responsibilities of each resuscitation team members.
Purpose and hypothesis
In this study, advanced life support (ALS) skills are trained to medical students (26 persons), student nurses (52 persons) and student paramedics (26 persons). A pit crew model is taught for every other four-person resuscitation team (intervention group) and for every other group not (control group). The hypothesis is that the pit crew model could improve the quality of advanced life support immidiately after the ALS education (primary outcome) and help to maintain the ALS metrics during the follow-up period (secondary outcome). Additionally, we analyze if the pit-crew model help team physician to take hands free earlier.
Methods
The students are divided into 26 four-person resuscitation teams: one medical student, one student paramedic and two student nurses. Each resuscitation team participates on an ALS course which is based on the 2015 European (the test group) Guidelines for Resuscitation. The participants are randomized in two study arms: intervention and control. The intervention group receives ALS education according the pit crew model while the control Group received traditional ALS training. In the end of the ALS course, the resuscitation team performs a simulated resuscitation situation which is video-recorded. The TS and NTS are later analyzed by the medical professionals using detailed instrument. The hands-on ratio and the time when the team physician takes hands-free analyzed visually from the videos. Later, after six months of the ALS course, the participants will run through a simulated CPR-situation again and the data will be collected as the the same way.
The primary outcome was the difference in the total assessment score between the intervention and control groups after 6-months follow-up. The secondary outcome was the difference in ALS skills after 6-months follow-up.
Ethics The study protocol was approved by the Ethics Committee of Turku University (31/2016).
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
TRIPLE
Two senior anesthetists analyse the ALS-performance of the video recordings. They are unaware of the study design. They analyze the videos independently and in random order.
Study Groups
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Intervention (pit crew model group)
13 groups being taught the pit crew model
The pit crew model
The pit crew model
control (traditional ALS education)
13 groups being taught along traditional ALS education
No interventions assigned to this group
Interventions
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The pit crew model
The pit crew model
Eligibility Criteria
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Inclusion Criteria
* paramedic student (third or fourth year)
* nurse student (third or fourth year)
* participated simulated ALS-situations e.g. in school before
Exclusion Criteria
ALL
No
Sponsors
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Turku University of Applied Sciences
UNKNOWN
Turku University Hospital
OTHER_GOV
Responsible Party
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Locations
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Turku University
Turku, , Finland
Countries
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References
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Cheng A, Auerbach M, Hunt EA, Chang TP, Pusic M, Nadkarni V, Kessler D. Designing and conducting simulation-based research. Pediatrics. 2014 Jun;133(6):1091-101. doi: 10.1542/peds.2013-3267. Epub 2014 May 12.
Rovamo L, Nurmi E, Mattila MM, Suominen P, Silvennoinen M. Effect of a simulation-based workshop on multidisplinary teamwork of newborn emergencies: an intervention study. BMC Res Notes. 2015 Nov 12;8:671. doi: 10.1186/s13104-015-1654-2.
Cheng A, Lang TR, Starr SR, Pusic M, Cook DA. Technology-enhanced simulation and pediatric education: a meta-analysis. Pediatrics. 2014 May;133(5):e1313-23. doi: 10.1542/peds.2013-2139. Epub 2014 Apr 14.
Eppich WJ, Nypaver MM, Mahajan P, Denmark KT, Kennedy C, Joseph MM, Kim I. The role of high-fidelity simulation in training pediatric emergency medicine fellows in the United States and Canada. Pediatr Emerg Care. 2013 Jan;29(1):1-7. doi: 10.1097/PEC.0b013e31827b20d0.
Asarbakhsh M, Sandars J. E-learning: the essential usability perspective. Clin Teach. 2013 Feb;10(1):47-50. doi: 10.1111/j.1743-498X.2012.00627.x.
Didwania A, McGaghie WC, Cohen ER, Butter J, Barsuk JH, Wade LD, Chester R, Wayne DB. Progress toward improving the quality of cardiac arrest medical team responses at an academic teaching hospital. J Grad Med Educ. 2011 Jun;3(2):211-6. doi: 10.4300/JGME-D-10-00144.1.
Wayne DB, Didwania A, Feinglass J, Fudala MJ, Barsuk JH, McGaghie WC. Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case-control study. Chest. 2008 Jan;133(1):56-61. doi: 10.1378/chest.07-0131. Epub 2007 Jun 15.
Lorello GR, Hicks CM, Ahmed SA, Unger Z, Chandra D, Hayter MA. Mental practice: a simple tool to enhance team-based trauma resuscitation. CJEM. 2016 Mar;18(2):136-42. doi: 10.1017/cem.2015.4. Epub 2015 Apr 10.
Nicastro E, Lo Vecchio A, Liguoro I, Chmielewska A, De Bruyn C, Dolinsek J, Doroshina E, Fessatou S, Pop TL, Prell C, Tabbers MM, Tavares M, Urenden-Elicin P, Bruzzese D, Zakharova I, Sandhu B, Guarino A. The Impact of E-Learning on Adherence to Guidelines for Acute Gastroenteritis: A Single-Arm Intervention Study. PLoS One. 2015 Jul 6;10(7):e0132213. doi: 10.1371/journal.pone.0132213. eCollection 2015.
Catchpole K, Mishra A, Handa A, McCulloch P. Teamwork and error in the operating room: analysis of skills and roles. Ann Surg. 2008 Apr;247(4):699-706. doi: 10.1097/SLA.0b013e3181642ec8.
Mduma E, Ersdal H, Svensen E, Kidanto H, Auestad B, Perlman J. Frequent brief on-site simulation training and reduction in 24-h neonatal mortality--an educational intervention study. Resuscitation. 2015 Aug;93:1-7. doi: 10.1016/j.resuscitation.2015.04.019. Epub 2015 May 6.
Gjeraa K, Moller TP, Ostergaard D. Efficacy of simulation-based trauma team training of non-technical skills. A systematic review. Acta Anaesthesiol Scand. 2014 Aug;58(7):775-87. doi: 10.1111/aas.12336. Epub 2014 May 14.
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 Jan;27(1):10-28. doi: 10.1080/01421590500046924.
Other Identifiers
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T212/2016
Identifier Type: -
Identifier Source: org_study_id