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Record: 1
Title:Improving medical emergency team (MET) performance using a novel
curriculum and a computerized human patient simulator.Authors:DeVita MA;
Schaefer J; Lutz J; Wang H; Dongilli TAuthor's Address:Department of Critical
Care Medicine, University of Pittsburgh School of Medicine and UPMC Health
System, Pittsburgh, PA 15212, USA. devitam@msx.upmc.eduSource:Quality & Safety
In Health Care [Qual Saf Health Care] 2005 Oct; Vol. 14 (5), pp. 326-31.
Publication Type:Evaluation Studies; Journal ArticleLanguage:EnglishJournal
Information:Country of Publication: England NLM ID: 101136980 Publication
Model: Print Cited Medium: Internet ISSN: 1475-3901 (Electronic) Linking ISSN:
14753898 NLM ISO Abbreviation: Qual Saf Health Care Subsets: Health
AdministrationMeSH Terms:Computer Simulation*
Patient Care Team*
Safety Management*
Emergency Medicine/*education
Resuscitation/*education
Curriculum; Data Interpretation, Statistical; Heart Arrest/therapy; Humans;
Internet; Medical Errors; Nurses; Physicians; Respiratory Therapy; Time
FactorsAbstract:PROBLEM: Advance cardiac life support (ACLS) training does not
address coordination of team resources to improve the ability of teams to
deliver needed treatments reliably and rapidly. Our objective was to use a
human simulation training educational environment to develop multidisciplinary
team skills and improve medical emergency team (MET) performance. We report
findings of a crisis team training course that is focused on organization.
SETTING: Large center for human simulation training at a university affiliated
tertiary care hospital. PARTICIPANTS: Ten courses were delivered and 138
clinically experienced individuals were trained (69 critical care nurses, 48
physicians, and 21 respiratory therapists). All participants were ACLS trained
and experienced in responding to cardiac arrest situations. COURSE DESIGN:
Each course had four components: (1) a web based presentation and pretest
before the course; (2) a brief reinforcing didactic session on the day of the
course; (3) three of five different simulated scenarios; each followed by (4)
debriefing and analysis with the team. Three of five simulator scenarios were
used; scenario selection and order was random. Trainees did not repeat any
scenario or role during the training. Participants were video recorded to
assist debriefing. Debriefing focused on reinforcing organizational aspects of
team performance: assuming designated roles independently, completing goals
(tasks) assigned to each role, and directed communication. MEASURES FOR
 IMPROVEMENT: Participants graded their performance of specific organizational
and treatment tasks within specified time intervals by consensus. Simulator
"survival" depended on supporting oxygenation, ventilation, circulation within
60 seconds, and delivering the definitive treatment within 3 minutes. EFFECTS
OF CHANGE: Simulated survival (following predetermined criteria for death)
increased from 0% to 89%. The initial team task completion rate was 10-45% and
rose to 80-95% during the third session. LESSONS LEARNT: Training
multidisciplinary teams to organize using simulation technology is feasible.
This preliminary report warrants more detailed inquiry.Comments:Cites: JAMA.
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Cites: J Crit Care. 2003 Jun;18(2):87-94. (PMID: 12800118)
Cites: Crit Care Med. 2003 Oct;31(10):2437-43. (PMID: 14530748)
Cites: Qual Saf Health Care. 2004 Aug;13(4):251-4. (PMID: 15289626)
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Cites: BMJ. 1994 Nov 26;309(6966):1408-9. (PMID: 7819848)
Cites: Anesthesiology. 1998 Jul;89(1):8-18. (PMID: 9667288)
Cites: Acad Emerg Med. 2003 Apr;10(4):386-9. (PMID: 12670855)Entry Dates:Date
Created: 20050930 Date Completed: 20060302 Latest Revision: 20091118Update
Code:20091202PubMed Central ID:PMC1744065PMID:16195564Persistent link to this
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computerized human patient simulator.</A>Database: MEDLINE
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