A comparative study on the frequency of simulation-based training and assessment of non-technical skills in the Norwegian ground ambulance services and helicopter emergency medical services

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Abstract

Background

Inadequate non-technical skills (NTSs) among employees in the Norwegian prehospital emergency medical services (EMSs) are a risk for patient and operational safety. Simulation-based training and assessment is promising with respect to improving NTSs. The frequency of simulation-based training in and assessment of NTSs among crewmembers in the Norwegian helicopter emergency medical service (HEMS) has gained increased attention over recent years, whereas there has been much less focus on the Norwegian ground emergency medical service (GEMS). The aim of the study was to compare and document the frequencies of simulation-based training in and assessment of seven NTSs between the Norwegian HEMS and GEMS, conditional on workplace and occupation.

Method

A comparative study of the results from cross-sectional questionnaires responded to by employees in the Norwegian prehospital EMSs in 2016 regarding training in and assessment of NTSs during 2015, with a focus on the Norwegian GEMS and HEMS. Professional groups of interest are: pilots, HEMS crew members (HCMs), physicians, paramedics, emergency medical technicians (EMTs), EMT apprentices, nurses and nurses with an EMT licence.

Results

The frequency of simulation-based training in and assessment of seven generic NTSs was statistically significantly greater for HEMS than for GEMS during 2015. Compared with pilots and HCMs, other health care providers in GEMS and HEMS undergo statistically significantly less frequent simulation-based training in and assessment of NTSs. Physicians working in the HEMS appear to be undergoing training and assessment more frequently than the rest of the health trust employees. The study indicates a tendency for lesser focus on the assessment of NTSs compared to simulation-based training.

Conclusion

HEMS has become superior to GEMS, in terms of frequency of training in and assessment of NTSs. The low frequency of training in and assessment of NTSs in GEMS suggests that there is a great potential to learn from HEMS and to strengthen the focus on NTSs. Increased frequency of assessment of NTSs in both HEMS and GEMS is called for.

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Most cited references 29

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Teamwork and patient safety in dynamic domains of healthcare: a review of the literature.

T. Manser (2009)

This review examines current research on teamwork in highly dynamic domains of healthcare such as operating rooms, intensive care, emergency medicine, or trauma and resuscitation teams with a focus on aspects relevant to the quality and safety of patient care. Evidence from three main areas of research supports the relationship between teamwork and patient safety: (1) Studies investigating the factors contributing to critical incidents and adverse events have shown that teamwork plays an important role in the causation and prevention of adverse events. (2) Research focusing on healthcare providers' perceptions of teamwork demonstrated that (a) staff's perceptions of teamwork and attitudes toward safety-relevant team behavior were related to the quality and safety of patient care and (b) perceptions of teamwork and leadership style are associated with staff well-being, which may impact clinician' ability to provide safe patient care. (3) Observational studies on teamwork behaviors related to high clinical performance have identified patterns of communication, coordination, and leadership that support effective teamwork. In recent years, research using diverse methodological approaches has led to significant progress in team research in healthcare. The challenge for future research is to further develop and validate instruments for team performance assessment and to develop sound theoretical models of team performance in dynamic medical domains integrating evidence from all three areas of team research identified in this review. This will help to improve team training efforts and aid the design of clinical work systems supporting effective teamwork and safe patient care.

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Error, stress, and teamwork in medicine and aviation: cross sectional surveys.

Timothy J. Sexton, J. Thomas-Wilsker, Robert Helmreich (2000)

To survey operating theatre and intensive care unit staff about attitudes concerning error, stress, and teamwork and to compare these attitudes with those of airline cockpit crew. : Cross sectional surveys. : Urban teaching and non-teaching hospitals in the United States, Israel, Germany, Switzerland, and Italy. Major airlines around the world. : 1033 doctors, nurses, fellows, and residents working in operating theatres and intensive care units and over 30 000 cockpit crew members (captains, first officers, and second officers). : Perceptions of error, stress, and teamwork. : Pilots were least likely to deny the effects of fatigue on performance (26% v 70% of consultant surgeons and 47% of consultant anaesthetists). Most pilots (97%) and intensive care staff (94%) rejected steep hierarchies (in which senior team members are not open to input from junior members), but only 55% of consultant surgeons rejected such hierarchies. High levels of teamwork with consultant surgeons were reported by 73% of surgical residents, 64% of consultant surgeons, 39% of anaesthesia consultants, 28% of surgical nurses, 25% of anaesthetic nurses, and 10% of anaesthetic residents. Only a third of staff reported that errors are handled appropriately at their hospital. A third of intensive care staff did not acknowledge that they make errors. Over half of intensive care staff reported that they find it difficult to discuss mistakes. Medical staff reported that error is important but difficult to discuss and not handled well in their hospital. Barriers to discussing error are more important since medical staff seem to deny the effect of stress and fatigue on performance. Further problems include differing perceptions of teamwork among team members and reluctance of senior theatre staff to accept input from junior members.

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Is Open Access

Simulation-based medical teaching and learning

Abdulmohsen H. Al Elq (2010)

One of the most important steps in curriculum development is the introduction of simulation- based medical teaching and learning. Simulation is a generic term that refers to an artificial representation of a real world process to achieve educational goals through experiential learning. Simulation based medical education is defined as any educational activity that utilizes simulation aides to replicate clinical scenarios. Although medical simulation is relatively new, simulation has been used for a long time in other high risk professions such as aviation. Medical simulation allows the acquisition of clinical skills through deliberate practice rather than an apprentice style of learning. Simulation tools serve as an alternative to real patients. A trainee can make mistakes and learn from them without the fear of harming the patient. There are different types and classification of simulators and their cost vary according to the degree of their resemblance to the reality, or ‘fidelity’. Simulation- based learning is expensive. However, it is cost-effective if utilized properly. Medical simulation has been found to enhance clinical competence at the undergraduate and postgraduate levels. It has also been found to have many advantages that can improve patient safety and reduce health care costs through the improvement of the medical provider's competencies. The objective of this narrative review article is to highlight the importance of simulation as a new teaching method in undergraduate and postgraduate education.

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Author and article information

Contributors

Henrik Langdalen:

ORCID: http://orcid.org/0000-0001-5716-3431

(0047) 98877527 , henrik.langdalen@uis.no

Eirik B. Abrahamsen: eirik.b.abrahamsen@uis.no

Stephen J. M. Sollid: stephen.j.sollid@uis.no

Leif Inge K. Sørskår: leif.i.sorskar@uis.no

Håkon B. Abrahamsen: hakon.b.abrahamsen@uis.no

Journal

Journal ID (nlm-ta): BMC Health Serv Res

Journal ID (iso-abbrev): BMC Health Serv Res

Title: BMC Health Services Research

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6963

Publication date (Electronic): 3 July 2018

Publication date PMC-release: 3 July 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 509

Affiliations

[1 ]ISNI 0000 0004 0627 2891, GRID grid.412835.9, Department of Safety, Economics and Planning, , University of Stavanger, Faculty of Science and Technology, ; Stavanger, Norway

[2 ]ISNI 0000 0004 0627 2891, GRID grid.412835.9, Department of Quality and Health Technology, , University of Stavanger, Faculty of Health Sciences, ; Stavanger, Norway

[3 ]ISNI 0000 0004 0627 2891, GRID grid.412835.9, Prehospital Division, , Stavanger University Hospital, ; Stavanger, Norway

[4 ]ISNI 0000 0004 0627 2891, GRID grid.412835.9, Department of Anaesthesiology and Intensive Care, , Stavanger University Hospital, ; Stavanger, Norway

Author information

Henrik Langdalen http://orcid.org/0000-0001-5716-3431

Article

Publisher ID: 3325

DOI: 10.1186/s12913-018-3325-1

PMC ID: 6029269

PubMed ID: 29970079

SO-VID: 39ee2e95-6a98-47f1-87b7-3ad686a5996a

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 6 March 2018

Date accepted : 25 June 2018

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: non-technical skills,helicopter,ambulance,emergency medical service,simulation-based training,assessment,learning

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ScienceOpen disciplines: Health & Social care

Keywords: non-technical skills, helicopter, ambulance, emergency medical service, simulation-based training, assessment, learning

A comparative study on the frequency of simulation-based training and assessment of non-technical skills in the Norwegian ground ambulance services and helicopter emergency medical services

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International Journal of Applied Technology in Medical Sciences

Most cited references 29

Teamwork and patient safety in dynamic domains of healthcare: a review of the literature.

Error, stress, and teamwork in medicine and aviation: cross sectional surveys.

Simulation-based medical teaching and learning

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