Efficacy of simulation-based trauma team training of non-technical skills. A systematic review
Corresponding Author
K. GJERAA
Danish Institute for Medical Simulation, Herlev Hospital, Capital Region of Denmark and Copenhagen University, Copenhagen, Denmark
Address:
Kirsten Gjeraa
Danish Institute for Medical Simulation
Herlev Hospital
25th floor, Herlev Ringvej 75
2730 Herlev
Denmark
e-mail: [email protected]
Search for more papers by this authorT. P. MØLLER
Danish Institute for Medical Simulation, Herlev Hospital, Capital Region of Denmark and Copenhagen University, Copenhagen, Denmark
Search for more papers by this authorD. ØSTERGAARD
Danish Institute for Medical Simulation, Herlev Hospital, Capital Region of Denmark and Copenhagen University, Copenhagen, Denmark
Search for more papers by this authorCorresponding Author
K. GJERAA
Danish Institute for Medical Simulation, Herlev Hospital, Capital Region of Denmark and Copenhagen University, Copenhagen, Denmark
Address:
Kirsten Gjeraa
Danish Institute for Medical Simulation
Herlev Hospital
25th floor, Herlev Ringvej 75
2730 Herlev
Denmark
e-mail: [email protected]
Search for more papers by this authorT. P. MØLLER
Danish Institute for Medical Simulation, Herlev Hospital, Capital Region of Denmark and Copenhagen University, Copenhagen, Denmark
Search for more papers by this authorD. ØSTERGAARD
Danish Institute for Medical Simulation, Herlev Hospital, Capital Region of Denmark and Copenhagen University, Copenhagen, Denmark
Search for more papers by this authorAbstract
Trauma resuscitation is a complex situation, and most organisations have multi-professional trauma teams. Non-technical skills are challenged during trauma resuscitation, and they play an important role in the prevention of critical incidents. Simulation-based training of these is recommended. Our research question was: Does simulation-based trauma team training of non-technical skills have effect on reaction, learning, behaviour or patient outcome?
The authors searched PubMed, EMBASE and the Cochrane Library and found 13 studies eligible for analysis. We described and compared the educational interventions and the evaluations of effect according to the four Kirkpatrick levels: reaction, learning (knowledge, skills, attitudes), behaviour (in a clinical setting) and patient outcome.
No studies were randomised, controlled and blinded, resulting in a moderate to high risk of bias. The multi-professional trauma teams had positive reactions to simulation-based training of non-technical skills. Knowledge and skills improved in all studies evaluating the effect on learning. Three studies found improvements in team performance (behaviour) in the clinical setting. One of these found difficulties in maintaining these skills. Two studies evaluated on patient outcome, of which none showed improvements in mortality, complication rate or duration of hospitalisation.
A significant effect on learning was found after simulation-based training of the multi-professional trauma team in non-technical skills. Three studies demonstrated significantly increased clinical team performance. No effect on patient outcome was found. All studies had a moderate to high risk of bias. More comprehensive randomised studies are needed to evaluate the effect on patient outcome.
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