ABSTRACT
Purpose: This study conducted a simulation needs assessment on diverse ongoing residency training programs supervised by the Saudi Commission for Health Specialties (SCFHS) in Saudi Arabia. The goal was to develop a standardized methodological approach to integrate simulation as a teaching tool for any ongoing training program. Methods: A mixed-methods approach is used in four steps to focus on top educational needs and integrate simulation into the curriculum. The first step was the selection of 38 residency training programs based on the scoring criteria tool. Of these, nine were selected as target programs. The next step was champion recruitment, where two faculty representatives from each specialty were trained to become specialty champions. The third step was a targeted audience needs assessment, consisting of four phases: curriculum review; a targeted audience survey; stakeholders' interview; and selection of top educational requirements generated by the first three phases. Lastly, the fourth step used an integration simulation sheet to build common themes for incorporating simulation into the program curriculum. Results: Out of 38 programs, the nine selected top-ranked specialties completed the process, and roadmaps were developed. Using the combined list of all skills and behaviors, the final score proportion was calculated and then ranked. A list of the top needed skills and behaviors was compiled as follows: Obstetrics and Gynecology 10/84, Emergency Medicine (ER) 80/242, Intensive Care Unit 20/139, Internal Medicine (IM) 37/102, Pediatric 82/135, Ear, Nose, and Throat (ENT) 49/125, General Surgery (GS) 55/114, Plastic Surgery 24/165, and Family Medicine (FM) 59/168. Conclusion: Findings from this process could be used by the supervisory bodies at a country level and assist decision-makers to determine which criteria to use in the needs assessment to integrate simulation into any ongoing residency training program.
ABSTRACT
Background: Healthcare providers performing aerosol-generating procedures like airway management are at the highest risk for contamination with coronavirus disease 2019 (COVID-19). We developed an in-situ simulation (ISS) airway management training in confirmed or suspected COVID-19 patients for emergency and anesthesiology staff, evaluated participants' reactions, and identified perceived challenges. Methods: We used a cross-sectional study design incorporating a quantitative questionnaire to describe participants' reaction to the ISS and a qualitative group interview using the plus-delta debriefing modality to explore participants' challenges in acquiring the knowledge and skills required for each learning objective. Data were analyzed using descriptive statistics and deductive content analysis. Results: Two hundred and ninety-nine healthcare providers participated in 62 ISS training sessions. Over 90% of our study participants agreed or strongly agreed that: they understood the learning objectives; the training material appropriately challenged them; the course content was relevant, easy to navigate, and essential; the facilitators' knowledge, teaching, and style were appropriate; the simulation facilities were suitable; and they had ample opportunities to practice the learned skills. The main challenges identified were anticipating difficult airways, preparing intubation equipment, minimizing the number of personnel inside the room, adhering to the proper doffing sequence, preparing needed equipment outside the intubation room, speaking up, and ensuring closed-loop communication. Conclusion: The newly developed ISS training was feasible for busy healthcare practitioners to safely perform airway management procedures for suspected or confirmed COVID-19 patients without affecting bedside care. Anticipation of difficult airways and speaking up were the most frequent challenges identified across all specialties in this study.
ABSTRACT
BACKGROUND: COVID-19 pandemic was declared a worldwide crisis, as a response the community established new protocols and clinical pathways to prepare the health system in adapting to the expected surge of cases. OBJECTIVES: In this study, we aim to assess the effect of the pandemic on the anesthesia training program residents from their own view. Identification of gaps in training programs will help to overcome the challenge like pandemic in order to have competent anesthesia practitioners. METHODS: We deployed an online survey in early May 2020 targeting the anesthesia residents in Saudi Arabia. We used mixed methods, containing both quantitative and qualitative questions. Our survey had 3 main sections: demographics, pandemic effect on the training, and pandemic effect on the trainees. RESULTS: Our survey showed that in the first 2 months of the pandemic there was a vast decrease in educational activities and clinical activities. However, after that both the Saudi Commission for Health Speciality (SCFHS) and local hospitals employed alternative education methods like electronic learning and simulation to adopt these changes. We also found the average stress level among residents was 6.5 out of 10 with number one stressor is transmitting Covid-19 to family or self. Finally, Wellbeing resources were available to residents however were not used sufficiently by residents. CONCLUSION: During times of pandemic, assessment and gap identification in postgraduate training programs are necessary to help overcome challenges of training anesthesiologists. Other than the clinical competency residents' wellbeing needs to be monitored and make available resources easy to reach for the residents.
ABSTRACT
Objective: To evaluate the effectiveness of a preoperative tour to a simulated anaesthesia induction at operating theatre on reducing children's and parents' preoperative anxiety. Design: A pragmatic, single-centre, assessor-blinded, randomised controlled trial. Setting: In preoperative anaesthesia clinic and the operating room at a tertiary care centre in Saudi Arabia. Participants: One hundred and sixteen children-parents dyads (pairs) (n=57) intervention group (IG); (n=59) control group (CG) with children aged 4-14 years who were planned for day case procedures under general anaesthesia. Interventions: Participants' dyads were randomly allocated through a computer to receive either a preoperative tour to a real operating theatre and simulate anaesthesia induction or standard of care. Main outcome measure: The primary study outcome was children's anxiety levels as measured by the modified-Yale Preoperative Anxiety Scale (m-YPAS), and the parent's anxiety level as assessed by the Beck Anxiety Inventory Scale. The children's anxiety levels were measured at two time points, the preoperative holding area (T0) and before the anaesthesia induction (T1), and the parents' anxiety level was measured after the anaesthesia induction. The secondary outcomes were the prevalence of preoperative anxiety and children's somatic signs of anxiety including heart rate and systolic blood pressure. Results: The Mann-Whitney U test of m-YPAS scores showed significant differences in the children's anxiety levels between the CG and IG at T0 (Z -5.009); p<0.01) and T1 (Z -6.599); p<0.01). BIAS analysis revealed a significant difference in the parents' anxiety level between the CG and IG (Z -4.353); p<0.01). The prevalence of children's anxiety was reported by 55 (93.2%) in the CG compared with 25 (43.9%) in the IG, with a statistically significant difference (p<0.001). Conclusion: The preoperative simulated anaesthesia induction was effective in reducing preoperative anxiety in children and their parents.
ABSTRACT
Background: COVID-19 pandemic is presenting serious challenges to the world's healthcare systems. The high communicability of the COVID-19 necessitates robust medical preparedness and vigilance. Objective: To report on the simulation-based training and test preparedness activities to prepare healthcare workers (HCWs) for effective and safe handling of patients with COVID-19. Methodology: Two activities were conducted: simulation-based training to all HCWs and a full-scale unannounced simulation-based disaster exercise at King Fahad Medical City (KFMC). The online module was designed to enhance the knowledge on COVID-19. This module was available to all KFMC staff. The five hands-on practical part of the course was available to frontliner HCWs. The unannounced undercover simulated patients' full-scale COVID-19 simulation-based disaster exercise took place in the emergency department over 3 hours. Six scenarios were executed to test the existing plan in providing care of suspected COVID-19 cases. Results: 2620 HCWs took the online module, 17 courses were conducted and 337 frontliner HCWs were trained. 94% of learners were satisfied and recommended the activity to others. The overall compliance rate of the full-scale COVID-19 disaster drill with infection control guidelines was 90%. Post-drill debriefing sessions recommended reinforcing PPE training, ensuring availability of different sizes of PPEs and developing an algorithm to transfer patients to designated quarantine areas. Conclusion: Simulation-based training and preparedness testing activities are vital in identifying gaps to apply corrective actions immediately. In the presence of a highly hazardous contagious disease like COVID-19, such exercises are a necessity to any healthcare institution.
ABSTRACT
The educational programs in the Saudi Commission for Health Specialties are developing rapidly in the fields of technical development. Such development is witnessed, particularly in the scientific areas related to what is commonly known as evidence-based medicine. This review highlights the critical need and importance of integrating simulation into anesthesia training and assessment. Furthermore, it describes the current utilization of simulation in anesthesia and critical care assessment process.
