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Identifying intraoperative events in a simulated laparotomy video: a multinational study of inattentional blindness among anesthesiologists.
Mizubuti, Glenio B; E Lima, Lais H N; E Lima, Rodrigo M; Ho, Adrienne K; de Cássia Rodrigues, Rita; Cagnolati, Daniel Carlos; Dos Santos Júnior, Victório; Belfiore, Elio B R; Santos, Filipe N C; Lam, Wai Shun Vincent; Chu, Mandy; Korz, Linda T C; Szulewski, Adam; McMullen, Michael; Burjorjee, Jessica; Sydor, Devin; Carten, Kathleen; Wang, Louie; Phelan, Rachel; Smethurst, Bethany; Cheng, Camilyn; Hopman, Wilma M; Ho, Anthony M-H.
Afiliação
  • Mizubuti GB; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada. gleniomizubuti@hotmail.com.
  • E Lima LHN; Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston General Hospital site, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada. gleniomizubuti@hotmail.com.
  • E Lima RM; Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada.
  • Ho AK; Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada.
  • de Cássia Rodrigues R; Department of Public Health Sciences (Epidemiology), Queen's University School of Medicine, Kingston, ON, Canada.
  • Cagnolati DC; Department of Anesthesiology, São Paulo Federal University, São Paulo, Brazil.
  • Dos Santos Júnior V; Santa Casa de Misericórdia de Ribeirão Preto Hospital, Ribeirão Preto, São Paulo, Brazil.
  • Belfiore EBR; Department of Anesthesiology, Faculty of Medicine of Marília, Marília, São Paulo, Brazil.
  • Santos FNC; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
  • Lam WSV; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
  • Chu M; Department of Anaesthesia, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
  • Korz LTC; Department of Anaesthesia, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
  • Szulewski A; Department of Anesthesia, McMaster University, Hamilton, ON, Canada.
  • McMullen M; Department of Emergency Medicine, Queen's University, Kingston, ON, Canada.
  • Burjorjee J; Department of Psychology, Queen's University, Kingston, ON, Canada.
  • Sydor D; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada.
  • Carten K; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada.
  • Wang L; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada.
  • Phelan R; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada.
  • Smethurst B; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada.
  • Cheng C; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada.
  • Hopman WM; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada.
  • Ho AM; Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada.
Can J Anaesth ; 71(9): 1229-1237, 2024 Sep.
Article em En | MEDLINE | ID: mdl-38918271
ABSTRACT

PURPOSE:

Medical errors may be occasionally explained by inattentional blindness (IB), i.e., failing to notice an event/object that is in plain sight. We aimed to determine whether age/experience, restfulness/fatigue, and previous exposure to simulation education may affect IB in the anesthetic/surgical setting.

METHODS:

In this multicentre/multinational study, a convenience sample of 280 anesthesiologists watched an attention-demanding video of a simulated trauma patient undergoing laparotomy and (independently/anonymously) recorded the abnormalities they noticed. The video contained four expected/common abnormalities (hypotension, tachycardia, hypoxia, hypothermia) and two prominently displayed unexpected/rare events (patient's head movement, leaky central venous line). We analyzed the participants' ability to notice the expected/unexpected events (primary outcome) and the proportion of expected/unexpected events according to age group and prior exposure to simulation education (secondary outcomes).

RESULTS:

Anesthesiologists across all ages noticed fewer unexpected/rare events than expected/common ones. Overall, younger anesthesiologists missed fewer common events than older participants did (P = 0.02). There was no consistent association between age and perception of unexpected/rare events (P = 0.28), although the youngest cohort (< 30 yr) outperformed the other age groups. Prior simulation education did not affect the proportion of misses for the unexpected/rare events but was associated with fewer misses for the expected/common events. Self-perceived restfulness did not impact perception of events.

CONCLUSION:

Anesthesiologists noticed fewer unexpected/rare clinical events than expected/common ones in an attention-demanding video of a simulated trauma patient, in keeping with IB. Prior simulation training was associated with an improved ability to notice anticipated/expected events, but did not reduce IB. Our findings may have implications for understanding medical mishaps, and efforts to improve situational awareness, especially in acute perioperative and critical care settings.
RéSUMé OBJECTIF Les erreurs médicales peuvent parfois s'expliquer par la cécité d'inattention, soit le fait de ne pas remarquer un événement/objet qui est à la vue de tous et toutes. Notre objectif était de déterminer si l'âge/l'expérience, le repos/la fatigue et l'exposition antérieure à l'enseignement par simulation pouvaient affecter la cécité d'inattention dans le cadre de l'anesthésie/chirurgie. MéTHODE Dans cette étude multicentrique/multinationale, un échantillon de convenance de 280 anesthésiologistes ont visionné une vidéo exigeant l'attention portant sur un patient de trauma simulé bénéficiant d'une laparotomie et ont enregistré (de manière indépendante/anonyme) les anomalies qu'ils et elles ont remarquées. La vidéo contenait quatre anomalies attendues/courantes (hypotension, tachycardie, hypoxie, hypothermie) et deux événements inattendus/rares bien en vue (mouvement de la tête du patient, fuite du cathéter veineux central). Nous avons analysé la capacité des participant·es à remarquer les événements attendus/inattendus (critère d'évaluation principal) et la proportion d'événements attendus/inattendus selon le groupe d'âge et l'exposition antérieure à l'enseignement par simulation (critères d'évaluation secondaires). RéSULTATS Les anesthésiologistes de tous âges ont remarqué moins d'événements inattendus/rares que d'événements attendus/courants. Globalement, les anesthésiologistes plus jeunes ont manqué moins d'événements courants que leurs congénères plus âgé·es (P = 0,02). Il n'y avait pas d'association constante entre l'âge et la perception d'événements inattendus ou rares (P = 0,28), bien que la cohorte la plus jeune (< 30 ans) ait surpassé les autres groupes d'âge. La formation antérieure par simulation n'a pas eu d'incidence sur la proportion d'inobservation des événements inattendus ou rares, mais a été associée à moins de cécité d'inattention envers les événements attendus ou courants. Le repos perçu n'a pas eu d'impact sur la perception des événements.

CONCLUSION:

Les anesthésiologistes ont remarqué moins d'événements cliniques inattendus/rares que d'événements attendus/courants dans une vidéo exigeant l'attention portant sur la simulation d'un patient traumatisé, ce qui s'inscrit dans la cécité d'inattention. La formation préalable par simulation était associée à une meilleure capacité à remarquer les événements anticipés/attendus, mais ne réduisait pas la cécité d'inattention. Nos résultats peuvent avoir des implications pour la compréhension des accidents médicaux et les efforts visant à améliorer la conscience situationnelle, en particulier dans les contextes de soins périopératoires aigus et de soins intensifs.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção / Gravação em Vídeo / Anestesiologistas / Laparotomia Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Can J Anaesth Assunto da revista: ANESTESIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Canadá

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção / Gravação em Vídeo / Anestesiologistas / Laparotomia Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Can J Anaesth Assunto da revista: ANESTESIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Canadá