Simulation in healthcare during COVID-19: An experience with residents in Anaesthesiology.

BACKGROUND: The restrictions to stop COVID-19 pandemic have had a negative impact in simulation, however, it is imperative to develop new strategies that facilitate healthcare education. OBJECTIVE: To describe a simulation in healthcare based on the learning of Non-Technical Skills (NTS) and performed under the restrictions of COVID-19 Pandemic. METHODS: Quasi-experimental study of an educational activity performed through simulation with anaesthesiology residents in November 2020. Twelve residents participated in two consecutive days. A questionnaire was filled related to the performance of NTS that encompasses leadership, teamwork and decision making. The complexity of the scenarios and the NTS results obtained between the two days were analysed. Advantages and challenges were documented when a clinical simulation is performed under COVID-19 restrictions. RESULTS: The global performance of the teams improved when comparing first and second day (79.5% vs 88.6%, p<0.01). Leadership was the worst section rated, however, was the one that showed the best improvement (70% vs 87.5%, p<0.01). The complexity of the simulation cases had no relation with the group performance in leadership and teamwork but affected task management results. General satisfaction was over 75%. The main challenges to develop the activity were the technology required to adapt virtuality to simulation and the time spent for the preparation of it. No cases of COVID-19 were reported within the first month after the activity. CONCLUSION: Clinical simulation can be done in the context of COVID-19 Pandemic, obtaining satisfactory learning results but requiring the adaptation of institutions to the new challenges it implies.

Simulación sanitaria durante la COVID-19: una experiencia con los residentes de Anestesiología / Simulation in healthcare during COVID-19: An experience with residents in Anaesthesiology

Antecedentes: Las restricciones para frenar la pandemia de COVID-19 han tenido un impacto negativo en la simulación. Sin embargo, es imperativo desarrollar nuevas estrategias para facilitar la educación sanitaria. Objetivo: Describir una simulación sanitaria basada en el aprendizaje de competencias no técnicas realizadas en el contexto de las restricciones de la pandemia de COVID-19. Métodos: Estudio cuasiexperimental de una actividad educativa realizada mediante simulación con residentes de Anestesiología en noviembre de 2020. Doce residentes participaron en 2 días consecutivos. Se completó un cuestionario relativo al desempeño de competencias no técnicas que abarcaba liderazgo, trabajo en equipo y toma de decisiones. Se analizaron la complejidad de los escenarios y los resultados de las competencias no técnicas, obtenidos entre los 2 días. Se documentaron las ventajas y dificultades de realizar una simulación clínica durante las restricciones de la COVID-19. Resultados: El desempeño global de los equipos mejoró al comparar el primero y segundo días (79,5 vs. 88,6%, p<0,01). El liderazgo fue la sección peor calificada, aunque, sin embargo, fue la que reflejó mayor mejora (70 vs. 87,5%, p<0,01). La complejidad de los casos de simulación no guardó relación con el desempeño del grupo en cuanto a liderazgo y trabajo en equipo, pero afectó a los resultados sobre gestión de tareas. La satisfacción general fue superior al 75%. Las principales dificultades para desarrollar la actividad fueron la tecnología necesaria para adaptar la virtualidad a la simulación y el tiempo empleado en su preparación. No se reportaron casos de COVID-19 durante el primer mes posterior a la actividad. Conclusión: La simulación clínica puede realizarse dentro del contexto de la pandemia de COVID-19, obteniéndose resultados satisfactorios de aprendizaje, pero requiriendo la adaptación de las instituciones a las nuevas dificultades que ello implica.(AU)

Background: The restrictions to stop COVID-19 pandemic have had a negative impact in simulation. However, it is imperative to develop new strategies that facilitate healthcare education.Objective: To describe a simulation in healthcare based on the learning of non-technical skills and performed under the restrictions of COVID-19 pandemic. Methods: Quasi-experimental study of an educational activity performed through simulation with Anaesthesiology residents in November 2020. Twelve residents participated in 2 consecutive days. A questionnaire was filled related to the performance of non-technical skills that encompasses leadership, teamwork and decision making. The complexity of the scenarios and the non-technical skills results obtained between the 2 days were analysed. Advantages and challenges were documented when a clinical simulation is performed under COVID-19 restrictions. Results: The global performance of the teams improved when comparing first and second day (79.5 vs. 88.6%, P<.01). Leadership was the worst section rated, however, was the one that showed the best improvement (70 vs. 87.5%, P<.01). The complexity of the simulation cases had no relation with the group performance in leadership and teamwork but affected task management results. General satisfaction was over 75%. The main challenges to develop the activity were the technology required to adapt virtuality to simulation and the time spent for the preparation of it. No cases of COVID-19 were reported within the first month after the activity. Conclusion: Clinical simulation can be done in the context of COVID-19 pandemic, obtaining satisfactory learning results but requiring the adaptation of institutions to the new challenges it implies.(AU)

[Simulation in healthcare during COVID-19: An experience with residents in Anaesthesiology]. / Simulación sanitaria durante la COVID-19: una experiencia con los residentes de Anestesiología.

Background: The restrictions to stop COVID-19 pandemic have had a negative impact in simulation. However, it is imperative to develop new strategies that facilitate healthcare education. Objective: To describe a simulation in healthcare based on the learning of non-technical skills and performed under the restrictions of COVID-19 pandemic. Methods: Quasi-experimental study of an educational activity performed through simulation with Anaesthesiology residents in November 2020. Twelve residents participated in 2 consecutive days. A questionnaire was filled related to the performance of non-technical skills that encompasses leadership, teamwork and decision making. The complexity of the scenarios and the non-technical skills results obtained between the 2 days were analysed. Advantages and challenges were documented when a clinical simulation is performed under COVID-19 restrictions. Results: The global performance of the teams improved when comparing first and second day (79.5 vs. 88.6%, P < .01). Leadership was the worst section rated, however, was the one that showed the best improvement (70 vs. 87.5%, P < .01). The complexity of the simulation cases had no relation with the group performance in leadership and teamwork but affected task management results. General satisfaction was over 75%. The main challenges to develop the activity were the technology required to adapt virtuality to simulation and the time spent for the preparation of it. No cases of COVID-19 were reported within the first month after the activity. Conclusion: Clinical simulation can be done in the context of COVID-19 pandemic, obtaining satisfactory learning results but requiring the adaptation of institutions to the new challenges it implies.

Current status and needs for changes in critical care training: the voice of the young cardiologists.

AIMS: The implementation of the 2013 European Society of Cardiology (ESC) Core Curriculum guidelines for acute cardiovascular care (acc) training among European countries is unknown. We aimed to evaluate the current status of acc training among cardiology trainees and young cardiologists (<40 years) from ESC countries. METHODS AND RESULTS: The survey (March-July 2019) asked about details of cardiology training, self-confidence in acc technical and non-technical skills, access to training opportunities, and needs for further training in the field. Overall 614 young doctors, 31 (26-43) years old, 55% males were surveyed. Place and duration of acc training differed between countries and between centres in the same country. Although the majority of the respondents (91%) had completed their acc training, the average self-confidence to perform invasive procedures and to manage acc clinical scenarios was low-44% (27.3-70.4). The opportunities for simulation-based learning were scarce-18% (5.8-51.3), as it was previous leadership training (32%) and knowledge about key teamwork principles was poor (48%). The need for further acc training was high-81% (61.9-94.3). Male gender, higher level of training centres, professional qualifications of respondents, longer duration of acc/intensive care training, debriefings, and previous leadership training as well as knowledge about teamwork were related to higher self-confidence in all investigated aspects. CONCLUSIONS: The current cardiology training program is burdened by deficits in acc technical/non-technical skills, substantial variability in programs across ESC countries, and a clear gender-related disparity in outcomes. The forthcoming ESC Core Curriculum for General Cardiology is expected to address these deficiencies.