Simulation training in the operating room improves competency for the entire operating room team

Research Activities, March 2010, No. 355

Hospital operating rooms (ORs) are highly intense work environments that require the OR team to function as a well-honed unit under stressful conditions. Ongoing training opportunities are critical to improving the competency and cooperation of these OR teams. Training on patient simulators of various OR crisis scenarios improves OR team-based competencies such as communication, role clarity, and mutual support, concludes a new study.

For the study, patient simulators were set up in ORs at a 157-bed hospital. Seven crisis scenarios were duplicated, including cardiac arrhythmia, shock, and problems with anesthesia. OR personnel participated in two separate training sessions lasting up to 3 hours. Following each training session, participants were asked about their experience and how it affected team-related competency. A total of 45 team members participated, representing surgical residents, nurse anesthetists, circulating nurses, and surgical technicians.

Post-training scores improved significantly compared with pretraining scores. The scores increased from 4 out of 15 items related to teamwork competencies after the first training (Module 1) to 9 out of 15 items after the second training (Module 2). Competency areas that showed improvement after completion of the two trainings included role clarity, team orientation, open communication, and mutual support and backup behavior. Observers who were placed in the OR during the high-fidelity simulations witnessed distinct improvements in teamwork abilities from one module to the next.

The researchers conclude that such competency improvements can then be adopted in actual clinical practice in the OR. The study was supported in part by the Agency for Healthcare Research and Quality (HS16680).

See "Attitudinal changes resulting from repetitive training of operating room personnel using high-fidelity simulation at the point of care," by John T. Paige, M.D., Valeriy Kozmenko, M.D., Tong Yang, M.D., M.S., and others, in The American Surgeon 75(7), pp. 584-591, 2009.

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