Department of Anesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan.
SimTiki Simulation Center, John A Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, United States of America.
PLoS One. 2018 Nov 19;13(11):e0207594. doi: 10.1371/journal.pone.0207594. eCollection 2018.
Senior anesthesia residents must acquire competency in crisis management for operating room (OR) emergencies. We conducted problem based learning (PBL) OR emergency scenarios for anesthesia residents, focused on emergencies in 'Airway', 'Circulation', 'Central venous catheter', and 'Pain management complications'. Non-technical skills are an integral component of team-based OR emergency management.
Prior to integrated OR emergency clinical and non-technical skills PBL training, participating 35 anesthesia residents completed two 5-point scale surveys regarding frequency of emergency experiences in the operating room, and self-confidence for anesthesia-related crisis management. Repeat administration of the self-confidence survey was completed immediately following PBL training.
Post-PBL resident clinical management self- confidence improved (P<0.05) in all scenarios on Circulation, Central venous catheter, and Pain treatment related complication topics. Impossible intubation, impossible oxygenation, and awake intubation did not show significant difference following PBL.
Our findings suggest that PBL for OR emergency management can improve resident self- confidence in anesthesia residents.
高级麻醉住院医师必须具备处理手术室（OR）紧急情况的危机管理能力。我们为麻醉住院医师开展了基于问题的学习（PBL）OR 紧急情况场景，重点关注“气道”、“循环”、“中心静脉导管”和“疼痛管理并发症”中的紧急情况。非技术技能是基于团队的 OR 紧急情况管理的一个组成部分。
在进行综合 OR 紧急情况临床和非技术技能 PBL 培训之前，参与的 35 名麻醉住院医师完成了两项 5 分制调查，内容是他们在手术室中遇到紧急情况的频率，以及他们对麻醉相关危机管理的信心。在 PBL 培训后立即重复进行自信调查。
PBL 后，住院医师在循环、中心静脉导管和疼痛处理相关并发症主题的所有场景中的临床管理自信心都有所提高（P<0.05）。在 PBL 后，无法插管、无法给氧和清醒插管没有显示出显著差异。
我们的研究结果表明，OR 紧急情况管理的 PBL 可以提高麻醉住院医师的自我信心。
