Team Training in the Operative Room using Simulation for uncontrolled bleeding during Thoracic minimal invasive surgery
JP Henry | F Lourdaux
Seance of wednesday 17 may 2017 (LES NOUVEAUX OUTILS DE FORMATION EN CHIRURGIE : e-learning, simulation, Serious Games)
DOI number : 10.26299/yt12-jd04/emem.2017.4.005
Abstract
Objective. Thoracic Minimal invasive surgery is an innovative technique, which presents a high risk of severe vascular tear. Incidence of uncontrolled bleeding is rare but very stressful for the team with loss of performance. New surgical environment (non-dedicated teams, new training programs for young surgeons, innovative techniques) should improve our training strategy to maintain excellence, especially in crisis events.
Our objective was to implement a team training program in thoracic surgery for specific and rare events.
Methods. An uncontrolled bleeding scenario was set up during a minimal invasive thoracic surgery. The HAS recommendations on simulation were adopted with briefing and debriefing times. The team training was conducted with all the surgical team in a real operative room using a high-fidelity mannequin. Conventional monitoring was performed. A video recording simulated live surgical procedure. Our session was recorded by an external consultant specialized in team resource management and broadcast to our meeting room for the other members of the surgical team The debriefing was done by video analysis.
Results. Since 2014, 4 sessions with 4 different teams of in situ simulation have been performed with an uncontrolled bleeding scenario.
An external consultant (a fighter pilot) was in charge of the non-technical skills and physician trainers in charge of technical and cognitive knowledge to improve team performance in crisis events.
The debriefings highlighted necessary improvements in practices and internal recommendations were launched to increase patient safety. These recommendations were also underlined during morbi-mortality meetings.
Conclusion. Team training in crisis events in minimal invasive thoracic surgery using simulation is likely an accurate teaching tool in our new hospital environment, especially for improvements in stress management and non-technical skills. Check lists and per-operative protocols are essential tools for the entire surgical team to deal with crisis events.
Our objective was to implement a team training program in thoracic surgery for specific and rare events.
Methods. An uncontrolled bleeding scenario was set up during a minimal invasive thoracic surgery. The HAS recommendations on simulation were adopted with briefing and debriefing times. The team training was conducted with all the surgical team in a real operative room using a high-fidelity mannequin. Conventional monitoring was performed. A video recording simulated live surgical procedure. Our session was recorded by an external consultant specialized in team resource management and broadcast to our meeting room for the other members of the surgical team The debriefing was done by video analysis.
Results. Since 2014, 4 sessions with 4 different teams of in situ simulation have been performed with an uncontrolled bleeding scenario.
An external consultant (a fighter pilot) was in charge of the non-technical skills and physician trainers in charge of technical and cognitive knowledge to improve team performance in crisis events.
The debriefings highlighted necessary improvements in practices and internal recommendations were launched to increase patient safety. These recommendations were also underlined during morbi-mortality meetings.
Conclusion. Team training in crisis events in minimal invasive thoracic surgery using simulation is likely an accurate teaching tool in our new hospital environment, especially for improvements in stress management and non-technical skills. Check lists and per-operative protocols are essential tools for the entire surgical team to deal with crisis events.