Participation in anesthesiology simulation program boosts practice improvements

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In 2010, the American Society of Anesthesiologists® (ASA®) introduced a mannequin-based simulation program to satisfy the American Board of Anesthesiology requirements for Maintenance of Certification in Anesthesiology (MOCA®). According to a study published in the Online First edition of Anesthesiology, the official medical journal of ASA, an overwhelming majority of physician anesthesiologists who participated in the simulation program successfully implemented their practice improvements.

The study examined 634 participants and found that, after participating in the simulation program and making a commitment to change, 94 percent of physician anesthesiologists implemented practice improvements.

"The participants' acceptance rate of the simulation program was extremely encouraging," said Randolph H. Steadman, M.D., M.S., professor and vice chair, Department of Anesthesiology, David Geffen School of Medicine at UCLA. "Many physician anesthesiologists went above and beyond expectations, using the opportunity to improve their knowledge, enhance their work environment and implement teamwork skills."

Dr. Steadman and his colleagues studied simulation course data from January 2010 to December 2012. Course participants listed at least three practice improvement plans they would implement after the course, such as enhancing communication among care team members, improving care transitions of medically complex cases and adopting useful cognitive aids such as checklists. After the course was completed, participants were contacted on a monthly basis to report the completion level of their improvement plans. Researchers found that 94 percent of participants described successfully implementing at least one improvement plan within three months after the course, and 79 percent reported implementing three or more practice improvements within the same period.

The American Board of Medical Specialties requires all disciplines to complete a Practice Performance Assessment and Improvement (PPAI) program. While many specialties can complete the requirement with measurements such as improvements based on chart review, physician anesthesiologists require a more realistic setting because they often care for patients in complex cases. Simulation allows physician anesthesiologists to experience and reflect on their performance during crisis situations when patient care is most critical. On a daily basis physician anesthesiologists use their extensive knowledge, years of training and management skills to make crucial decisions in challenging situations.

"Simulation experiences encourage active learning and motivate personal and team improvement," continued Dr. Steadman. "Further research on this topic can help us further refine the program."

Source: American Society of Anesthesiologists (ASA)

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