Significance of debriefing methods in simulation-based sedation training courses for medical safety improvement in Japan

Nobuyasu Komasawa, Takuro Sanuki, Shunsuke Fujiwara, Masanori Haba, Ryusuke Ueki, Yoshiroh Kaminoh, Toshiaki Minami, Nobuyasu Komasawa, Takuro Sanuki, Shunsuke Fujiwara, Masanori Haba, Ryusuke Ueki, Yoshiroh Kaminoh, Toshiaki Minami

Abstract

Based on the American Society of Anesthesiologists' Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists (ASA-SED), a sedation training course aimed at improving medical safety was developed by the Japanese Association for Medical Simulation in 2011. This study evaluated the effect of debriefing on participants' perceptions of the essential points of the ASA-SED. A total of 38 novice doctors participated in the sedation training course during the research period. Of these doctors, 18 participated in the debriefing group, and 20 participated in non-debriefing group. Scoring of participants' guideline perceptions was conducted using an evaluation sheet (nine items, 16 points) created based on the ASA-SED. The debriefing group showed a greater perception of the ASA-SED, as reflected in the significantly higher scores on the evaluation sheet (median, 16 points) than the control group (median, 13 points; p < 0.05). No significant differences were identified before or during sedation, but the difference after sedation was significant (p < 0.05). Debriefing after sedation training courses may contribute to better perception of the ASA-SED, and may lead to enhanced attitudes toward medical safety during sedation and analgesia.

Keywords: Debriefing; Medical safety; Sedation and analgesia; Simulation training.

References

    1. Abdelshehid CS, Quach S, Nelson C, Graversen J, Lusch A, Zarraga J, Alipanah R, Landman J, McDougall EM. High-fidelity simulation-based team training in urology: evaluation of technical and nontechnical skills of urology residents during laparoscopic partial nephrectomy. J Surg Educ. 2013;70:588–595. doi: 10.1016/j.jsurg.2013.04.009.
    1. Allen LC. Role of a quality management system in improving patient safety - Laboratory aspects. Clin Biochem. 2013;46:1187–1193. doi: 10.1016/j.clinbiochem.2013.04.028.
    1. Aronson L. Twelve tips for teaching reflection at all levels of medical education. Med Teach. 2011;33:200–205. doi: 10.3109/0142159X.2010.507714.
    1. Chung HS, Dieckmann P, Issenberg SB. It is time to consider cultural differences in debriefing. SB. Simul Healthc. 2013;8:166–170. doi: 10.1097/SIH.0b013e318291d9ef.
    1. Daniels K, Auguste T. Moving forward in patient safety: multidisciplinary team training. Semin Perinatol. 2013;37:146–150. doi: 10.1053/j.semperi.2013.02.004.
    1. Desai MS. Office-based anesthesia: new frontiers, better outcomes, and emphasis on safety. Curr Opin Anaesthesiol. 2008;21:699–703. doi: 10.1097/ACO.0b013e328313e879.
    1. 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. doi: 10.1080/01421590500046924.
    1. Kiersma ME, Plake KS, Darbishire P. Patient safety instruction in US health professions education. Am J Pharm Educ. 2011;75:162. doi: 10.5688/ajpe758162.
    1. Komasawa N, Fujiwara S, Atagi K, Ueki R, Haba M, Ueshima H, Kaminoh Y, Minami T. Effects of a simulation-based sedation training course on non-anesthesiologists’ attitudes toward sedation and analgesia. J Anesth. 2014;28:785–789. doi: 10.1007/s00540-014-1787-9.
    1. Lichtenstein DR, Jagannath S, Baron TH, Anderson MA, Banerjee S, Dominitz JA, Fanelli RD, Gan SI, Harrison ME, Ikenberry SO, Shen B, Stewart L, Khan K, Vargo JJ. Sedation and anesthesia in GI endoscopy. Gastrointest Endosc. 2008;68:815–826. doi: 10.1016/j.gie.2008.09.029.
    1. Lorello GR, Cook DA, Johnson RL, Brydges R. Simulation-based training in anesthesiology: a systematic review and meta-analysis. Br J Anaesth. 2014;112:231–245. doi: 10.1093/bja/aet414.
    1. McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010;44:50–63. doi: 10.1111/j.1365-2923.2009.03547.x.
    1. Moran TC, Kaye AD, Mai AH, Bok LR. Sedation, analgesia, and local anesthesia: a review for general and interventional radiologists. Radiographics. 2013;33:E47–E60. doi: 10.1148/rg.332125012.
    1. Naik VN, Brien SE. Review article: simulation: a means to address and improve patient safety. Can J Anaesth. 2013;60:192–200. doi: 10.1007/s12630-012-9860-z.
    1. Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists: An updated report by the American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists.Anesthesiology96:1004–1017.
    1. Sawyer Sierocka-Castaneda A, Chan D, Berg B, Lustik M, Thompson M. The effectiveness of video-assisted debriefing versus oral debriefing alone at improving neonatal resuscitation performance: a randomized trial. Simul Healthc. 2012;7:213–221. doi: 10.1097/SIH.0b013e3182578eae.
    1. Sawyer TL, Deering S. Adaptation of the US Army's After-Action Review for Simulation Debriefing in Healthcare. Simul Healthc. 2013;8:388–397. doi: 10.1097/SIH.0b013e31829ac85c.
    1. Schmidt E, Goldhaber-Fiebert SN, Ho LA, McDonald KM. Simulation exercises as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158:426–432. doi: 10.7326/0003-4819-158-5-201303051-00010.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren