Funding for this project was provided by an unrestricted research grant from the Canadian Association of Emergency Physicians.
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Building a Simulation-based Crisis Resource Management Course for Emergency Medicine, Phase 1: Results from an Interdisciplinary Needs Assessment Survey
Article first published online: 14 JUL 2008
DOI: 10.1111/j.1553-2712.2008.00185.x
© 2008 by the Society for Academic Emergency Medicine
Issue
Academic Emergency Medicine
Special Issue: Proceedings of The 2008 AEM Consensus Conference: The Science of Simulation in Healthcare: Defining and Developing Clinical Expertise Guest Editors:Amy Kaji, MD, PhD David C. Cone, MD
Volume 15, Issue 11, pages 1136–1143, November 2008
Additional Information
How to Cite
Hicks, C. M., Bandiera, G. W. and Denny, C. J. (2008), Building a Simulation-based Crisis Resource Management Course for Emergency Medicine, Phase 1: Results from an Interdisciplinary Needs Assessment Survey. Academic Emergency Medicine, 15: 1136–1143. doi: 10.1111/j.1553-2712.2008.00185.x
Publication History
- Issue published online: 3 NOV 2008
- Article first published online: 14 JUL 2008
- Received March 3, 2008; revision received April 10, 2008; accepted April 15, 2008.
Keywords:
- emergency medicine;
- education;
- simulation;
- crisis resource management
Abstract
Introduction: Emergency department (ED) resuscitation requires the coordinated efforts of an interdisciplinary team. Human errors are common and have a negative impact on patient safety. Although crisis resource management (CRM) skills are utilized in other clinical domains, most emergency medicine (EM) caregivers currently receive no formal CRM training.
Objectives: The objectives were to compile and compare attitudes toward CRM training among EM staff physicians, nurses, and residents at two Canadian academic teaching hospitals.
Methods: Emergency physicians (EPs), residents, and nurses were asked to complete a Web survey that included Likert scales and short answer questions. Focus groups and pilot testing were used to inform survey development. Thematic content analysis was performed on the qualitative data set and compared to quantitative results.
Results: The response rate was 75.7% (N = 84). There was strong consensus regarding the importance of core CRM principles (i.e., effective communication, team leadership, resource utilization, problem-solving, situational awareness) in ED resuscitation. Problems with coordinating team actions (58.8%), communication (69.6%), and establishing priorities (41.3%) were among factors implicated in adverse events. Interdisciplinary collaboration (95.1%), efficiency of patient care (83.9%), and decreased medical error (82.6%) were proposed benefits of CRM training. Communication between disciplines is a barrier to effective ED resuscitation for 94.4% of nurses and 59.7% of EPs (p = 0.008). Residents reported a lack of exposure to (64.3%), yet had interest in (96.4%) formal CRM education using human patient simulation.
Conclusions: Nurses rate communication as a barrier to teamwork more frequently than physicians. EM residents are keen to learn CRM skills. An opportunity exists to create a novel interdisciplinary CRM curriculum to improve EM team performance and mitigate human error.