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

Sylvain Boet, M Dylan Bould, Lillia Fung, Haytham Qosa, Laure Perrier, Walter Tavares, Scott Reeves, Andrea C Tricco, Sylvain Boet, M Dylan Bould, Lillia Fung, Haytham Qosa, Laure Perrier, Walter Tavares, Scott Reeves, Andrea C Tricco

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.

Figures

Fig. 1
Fig. 1
Search and selection of included studies. *Languages other than English or French considered as Foreign Language
Fig. 2
Fig. 2
Risk of bias summary. Other biases include large inter-rater reliability of 0.2 for part II outcome assessments and sampling bias. Green = low risk; yellow = intermediate risk or unclear; red = high risk

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Source: PubMed

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