Comparative Analysis of the Impact of Training through Simulation Using the Crisis Resource Management Tool for Primary Care Professionals.

This was a prospective observational study based on clinical simulation courses taught in 2017 at the IDEhA Simulation Center of Alcorcón Foundation University Hospital. Two courses in metabolic emergencies (MEs) and respiratory emergencies (REs) were offered to primary care physicians all over Spain. The main objective was to teach nontechnical skills (crisis resource management). Using a modified five-level Kirkpatrick-Phillips education evaluation model, level I (reaction, K1), level II (learning, K2) and level III (behavioral change, K3) changes were evaluated through surveys at the end of the courses and one year later. Thirty courses were held (15 ME courses and 15 RE courses) with 283 primary care physicians. The overall satisfaction (K1) was high: ME courses, 9.5/10; RE courses, 9.6/10. More than 80% of the participants rated the organization, resources, content, debriefing and scenarios as excellent, with no significant differences between the two courses. After one year (156 responses), the respondents for both courses reported that they would repeat the training annually (K2), encourage debriefing with colleagues (K3) and have modified some aspects of their workplace (K3), citing improvements in procedures and in the organization of the health team as the most important. After the ME course, few participants, i.e., 5 (6%), reported providing improved care to patients; after the RE course, 15 (19%) participants reported providing improved care; the difference between groups was significant (p < 0.05). Compared with the ME course, the RE course imparted greater knowledge about patient safety (K2) (38 (49%) vs. 24 (31%) (p < 0.05)) and more useful tools for daily clinical practice (K3) (67% vs. 56.4%) and resulted in participants paying more attention to personal performance and to colleagues when working as a team (K2) (64% vs. 50%). Clinical simulation courses are highly valued and potentially effective for training primary care physicians in patient safety and CRM tools. Future studies with objective measures of long-term impact, behavior in the workplace (K3) and benefits to patients (K4) are needed. Based on the results of our study, the areas that are important are those aimed at improving procedures and the organization of health teams.

Percepción de los residentes sobre el impacto de la pandemia COVID 19 en la formación en profesionalismo / Residents ́perspective of the impact of the COVID 19 pandemic on professional competency training

Introducción: el profesionalismo es clave para construir la identidad de los profesionales sanitarios. El objetivo de este trabajo ha sido conocer en un colectivo de residentes, la influencia de la primera ola de la pandemia por SARS-CoV2 en sus competencias del profesionalismo. Materiales y métodos: estudio descriptivo transversal mediante cuestionario electrónico, remitido a 167 residentes, para medir su percepción sobre el impacto de la pandemia COVID-19 en el profesionalismo, con una escala verbal de cuatro niveles: excelente, por encima de lo esperado, lo esperado, por debajo de lo esperado. Se realizó, además, una pregunta abierta de "reflexión personal" analizada cualitativamente mediante un proceso de triangulación. La encuesta se hizo en el Hospital Universitario Fundación Alcorcón en los dos meses siguientes a la primera ola pandémica. Resultados: respondieron 59 residentes (35,3%) de 21 especialidades. Sus lugares de trabajo fueron muy variados. Los atributos del profesionalismo valorados por encima de esperado o excelente fueron: trabajo en equipo (74,6%), empatía (71,2%) y responder a las necesidades del paciente por encima de las propias (69,5%). Se encontró por debajo de lo esperado la gestión de las emociones (22%). Discusión: la pandemia COVID-19 ha contribuido a reforzar la identidad profesional de los residentes, manifestándose a través de muchas dimensiones del profesionalismo. La gestión de las emociones fue la que obtuvo menor valoración.

Introduction: Professionalism is essential to build the identity of health professionals. The aim in this study was to determine, in a group of residents, the influence of the first wave of SARS-CoV2 pandemic on their professionalism competencies. Methods: Cross-sectional descriptive study with an electronic survey sent to 167 residents of Hospital Universitario Fundación Alcorcón to assess their perception of the impact of COVID-19 pandemic on professionalism, with a four-level verbal scale: excellent, above expected, expected, below expected. In addition, an open-ended "personal reflection" question was qualitatively analyzed through a triangulation process. The survey was completed immediately after the first pandemic wave. Results: The questionnaire was answered by 59 residents (35.3%) of 21 specialties from different workplaces. The attributes of professionalism rated above expected or excellent were: teamwork (74.6%), empathy (71.2%) and responding to patient's needs above their own (69.5%). Management of emotions (21%) was found to be below expectations. Discussion: COVID-19 pandemic has contributed to reinforce the professional identity of the residents, expressing itself through many dimensions of professionalism. Emotional management was the lowest rated.

Una estrategia para la formación en seguridad del paciente durante la residencia: desde el incidente crítico a la simulación. Parte 2 / A strategy for training in patient safety during residency programme: From critical incident to simulation. Part 2

La formación en seguridad del paciente durante la residencia contribuye a la cultura de la seguridad y a la calidad asistencial. Un currículum para formar en seguridad incorpora distintas actividades formativas a lo largo de la especialidad y adecuadas a cada momento: cursos, talleres, sesiones de incidente crítico, rondas de seguridad, que se han descrito anteriormente, y simulación. La simulación permite el entrenamiento seguro de situaciones clínicas complejas en equipos multiprofesionales. Estructurar el aprendizaje de factor humano mediante el manejo de recursos en las crisis, y proporcionar feedback en el debriefing mejora la competencia. La simulación puede formar parte de la evaluación formativa objetiva de los residentes. Se ha demostrado que tiene resultados en el desempeño de los profesionales sanitarios, mejora la calidad de la asistencia y tiene efectos sobre los pacientes

Patient safety training during residency contributes to the culture of safety and quality of care. Patient safety curriculum incorporates different activities throughout the specialty and appropriate to each moment: courses, workshops, critical incident sessions, safety rounds, which have been described above, and simulation. The simulation allows the safe training of complex clinical situations in multiprofessional teams. Structure the learning of human factor through the management of resources in crises, and provide feedback in debriefing improves competition. The simulation can be part of the objective formative evaluation of the residents. It has been shown to have results in the performance of health professionals, improves the quality of care and has effects on patients

Una estrategia para la formación en seguridad del paciente durante la residencia: desde el incidente crítico hasta la simulación. Parte 1 / A strategy for training in patient safety during residency programme: From critical incident to simulation. Part 1

La formación en seguridad del paciente durante la residencia contribuye a la cultura de la seguridad y a la calidad asistencial. Un currículum para formar en seguridad incorpora distintas actividades formativas a realizar a lo largo de la especialidad y adecuadas a cada momento formativo. Desde la incorporación del residente, los cursos de seguridad, comunicación, ética, los talleres de lavado de manos, de técnicas, junto con los recursos de Internet, lo van dotando de diferentes competencias. Adquiere la competencia en seguridad con la integración en la actividad asistencial diaria de la valoración de los riesgos, la detección y la comunicación de incidentes, y el análisis de eventos adversos. Acelera el aprendizaje reflexionando de forma estructurada y aprendiendo del error con los incidentes críticos y la simulación

Patient safety training during residency contributes to the culture of safety and quality of care. Patient safety curriculum incorporates different activities to be carried out throughout the residence and appropriate to each training moment. Since the incorporation of the resident the courses of security, communication, ethics, hand washing workshops, techniques, together with Internet resources are endowing him with knowledge and skills. Acquires security competence with the integration of risk assessment, detection and communication of incidents and the analysis of adverse events into the daily assistance activity. Accelerates learning by reflecting in a structured way and learning from error with critical incidents and simulation

Ictericia obstructiva y colangitis secundaria a quiste hidatídico hepático / Obstructive jaundice and cholangitis secondary to hepatic hydatid cyst

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