Decay in Blood Loss Estimation Skills After Web-Based Didactic Training

Department of Anesthesiology, Institute for Healthcare Studies, Northwestern Memorial Hospital, Chicago, IL, USA.
Simulation in healthcare: journal of the Society for Simulation in Healthcare (Impact Factor: 1.48). 02/2012; 7(1):18-21. DOI: 10.1097/SIH.0b013e318230604f
Source: PubMed


Accuracy in blood loss estimation has been shown to improve immediately after didactic training. The objective of this study was to evaluate retention of blood loss estimation skills 9 months after a didactic web-based training.
Forty-four participants were recruited from a cohort that had undergone web-based training and testing in blood loss estimation. The web-based posttraining test, consisting of pictures of simulated blood loss, was repeated 9 months after the initial training and testing. The primary outcome was the difference in accuracy of estimated blood loss (percent error) at 9 months compared with immediately posttraining.
At the 9-month follow-up, the median error in estimation worsened to -34.6%. Although better than the pretraining error of -47.8% (P = 0.003), the 9-month error was significantly less accurate than the immediate posttraining error of -13.5% (P = 0.01).
Decay in blood loss estimation skills occurs by 9 months after didactic training.

21 Reads
  • Source
    • "There are four broad uses of simulation in obstetric anesthesia: improvement of technical skills, nontechnical or teamwork skills, individual clinical competence, and the safety of the clinical environment [69, 70] . Technical skills such as epidural anesthesia and estimating volume of blood loss [71, 72] can be effectively taught via the use of simulation. Similarly videotaped simulation sessions can be used to teach team communication skills [73]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: There have been colossal technological advances in the use of simulation in anesthesiology in the past 2 decades. Over the years, the use of simulation has gone from low fidelity to high fidelity models that mimic human responses in a startlingly realistic manner, extremely life-like mannequin that breathes, generates E.K.G, and has pulses, heart sounds, and an airway that can be programmed for different degrees of obstruction. Simulation in anesthesiology is no longer a research fascination but an integral part of resident education and one of ACGME requirements for resident graduation. Simulation training has been objectively shown to increase the skill-set of anesthesiologists. Anesthesiology is leading the movement in patient safety. It is rational to assume a relationship between simulation training and patient safety. Nevertheless there has not been a demonstrable improvement in patient outcomes with simulation training. Larger prospective studies that evaluate the improvement in patient outcomes are needed to justify the integration of simulation training in resident education but ample number of studies in the past 5 years do show a definite benefit of using simulation in anesthesiology training. This paper gives a brief overview of the history and evolution of use of simulation in anesthesiology and highlights some of the more recent studies that have advanced simulation-based training.
    Full-text · Article · Feb 2016 · Anesthesiology Research and Practice
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The use of simulation in medicine has grown significantly over the past 2 decades. Simulation in obstetric anesthesia can be divided into four broad uses: technical skills, nontechnical or teamwork skills, individual clinical competence, and the safety of the clinical environment. This review will describe recent trends in the use of simulation in several of these categories. Simulation continues to be an important part of skills (technical and cognitive) and teamwork training in obstetric anesthesia. The acquisition of simple and complex technical skills appears to be improved with the use of simulation. However, the assessment of these skills is currently done in the simulated environment. Simulation is also important in assessing and enhancing the safety of a labor unit. Two simulation trends have recently evolved. Instructional articles describing how to best perform simulation have begun to appear. In addition, several review articles have been published that demonstrate the maturation of the body of research in this field. As the use of simulation continues to grow, research should concentrate on whether anesthesia or teamwork skills learned in the simulated environment change behavior and improve outcomes in the clinical setting. More instructional publications would also facilitate the growth into more clinical environments.
    Full-text · Article · Apr 2012 · Current opinion in anaesthesiology
  • [Show abstract] [Hide abstract]
    ABSTRACT: A culture of safety is a growing movement in obstetrical healthcare quality and management. Patient-centered and safe care is a primary priority for all healthcare workers, with communication and teamwork central to achieving optimal maternal health outcomes. A mandatory educational program was developed and implemented by physicians and nurses to sustain awareness and compliance to current protocols within a large university-based hospital. A didactic portion reviewing shoulder dystocia, operative vaginal delivery, obstetric hemorrhage, and fetal monitoring escalation was combined with a simulation session. The simulation was a fetal bradycardia activating the decision to perform an operative vaginal delivery complicated by a shoulder dystocia. More than 370 members of the healthcare team participated including obstetricians, midwives, the anesthesia team, and nurses. Success of the program was measured by an evaluation tool and comparing results from a prior safety questionnaire. Ninety-seven percent rated the program as excellent, and the response to a question on perception of overall grade on patient safety measured by the Agency for Healthcare Research and Quality safety survey demonstrated a significant improvement in the score (P = .003) following the program.
    No preview · Article · Apr 2013 · The Journal of perinatal & neonatal nursing
Show more