Promoting leadership and communication skills in emergency medicine residents: the role of High-Fidelity Simulation

Submitted: 16 July 2024
Accepted: 27 August 2024
Published: 25 September 2024
Abstract Views: 22
PDF: 4
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The residency program in Emergency Medicine should include formal training in Non-Technical Skills (NTS). We evaluated the effectiveness of a program based on High-Fidelity Simulation (HFS) to improve the leadership and communication skills of residents in Emergency Medicine. In this prospective observational study, we performed 6 simulation sessions, each with 3 scenarios about the management of the critically ill. In the second to the fifth session, participants received specific training about: the ABCDE (Airway, Breathing, Circulation, Disability, Exposure) approach, leadership, communication, and situation awareness, one topic per session. Technical Skills (TS) were measured as the percentage of critical actions correctly performed by participants during the primary examination. NTS were rated by the Leadership Behavior Description Questionnaire (LBDQ), Communication Competence Questionnaire (CCP), and Clinical Teamwork Scale (CTS). The trend over the following sessions was evaluated. We examined 90 scenarios, 15 scenarios per session (three scenarios repeated 5 times). The LBDQ score reached in the fifth and sixth sessions (fifth: 25 [20-30]; sixth: 25 [22-29]), was significantly higher than that obtained in the first, second, and third ones (first: 23 [18-24]; second: 22 [16-26]; third: 20 [14-26], all p<0.05). The percentage of correctly performed actions during ABCDE assessment (10 [7-14] vs. 17 [15-19]), as well as CCQ scores (46 [42-48] vs. 51 [47-52]) and CTS scores (82 [64-88] vs. 94 [91-101], all p<0.01), increased significantly between the first and the last session. HFS confirmed to be an effective instrument to allow Emergency Medicine residents to acquire NTS skills in a safe environment.

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Savioli G, Ceresa IF, Gri N, et al. Emergency Department overcrowding: understanding the factors to find corresponding solutions. J Pers Med 2022;12:279. DOI: https://doi.org/10.3390/jpm12020279
Wu L, Chen X, Khalemsky A, et al. The association between Emergency Department length of stay and in-hospital mortality in older patients using machine learning: an observational cohort study. J Clin Med 2023;12:4750. DOI: https://doi.org/10.3390/jcm12144750
Peterson SM, Harbertson CA, Scheulen JJ, Kelen GD. Trends and characterization of academic Emergency Department patient visits: a five-year review. Acad Emerg Med 2019;26:410-9. DOI: https://doi.org/10.1111/acem.13550
Rusiecki D, Walker M, Douglas SL, et al. Multiprofessional perspectives on the identification of latent safety threats via in situ simulation: a prospective cohort pilot study. Bmj Simul Technol En 2021;7:102-7. DOI: https://doi.org/10.1136/bmjstel-2020-000621
Salas E, Rosen MA, King, H. Managing teams managing crises: principles of teamwork to improve patient safety in the emergency room and beyond. Theoretical Issues Ergon Sci 2007;8: 381-94. DOI: https://doi.org/10.1080/14639220701317764
Yeung JH, Ong GJ, Davies RP, et al. Factors affecting team leadership skills and their relationship with quality of cardiopulmonary resuscitation. Crit Care Med 2012;40:2617-21. DOI: https://doi.org/10.1097/CCM.0b013e3182591fda
Lateef F. Grace under pressure: leadership in Emergency Medicine. J Emerg Trauma Shock 2018;11:73-9. DOI: https://doi.org/10.4103/JETS.JETS_18_18
Parsons JR, Crichlow A, Ponnuru S, et al. Filling the gap: simulation-based crisis resource management training for Emergency Medicine residents. West J Emerg Med 2018;19:205-10. DOI: https://doi.org/10.5811/westjem.2017.10.35284
Zimmermann K, Holzinger IB, Ganassi L, et al. Inter-professional in-situ simulated team and resuscitation training for patient safety: description and impact of a programmatic approach. BMC Med Educ 2015;15:189. DOI: https://doi.org/10.1186/s12909-015-0472-5
Kurup V, Matei V, Ray J. Role of in-situ simulation for training in healthcare: opportunities and challenges. Curr Opin Anaesthesiol 2017;30:755-60. DOI: https://doi.org/10.1097/ACO.0000000000000514
Innocenti F, Tassinari I, Ralli ML, et al. Improving technical and non-technical skills of emergency medicine residents through a program based on high-fidelity simulation. Intern Emerg Med 2022;17:1471-80. DOI: https://doi.org/10.1007/s11739-022-02940-y
Goldshtein D, Krensky C, Doshi S, Perelman VS. In situ simulation and its effects on patient outcomes: a systematic review. BMJ Simul Technol Enhanc Learn 2020;6:3-9. DOI: https://doi.org/10.1136/bmjstel-2018-000387
Rudolph JW, Simon R, Raemer DB, Eppich WJ. Debriefing as formative assessment: closing performance gaps in medical education. Acad Emerg Med 2008;15:1010-6. DOI: https://doi.org/10.1111/j.1553-2712.2008.00248.x
Carne B, Kennedy M, Gray T. Review article: crisis resource management in Emergency Medicine. Emerg Med Australas 2012;24:7-13. DOI: https://doi.org/10.1111/j.1742-6723.2011.01495.x
Flin R, Maran N. Identifying and training non-technical skills for teams in acute medicine. Qual Saf Health Care 2004;13:i80-4. DOI: https://doi.org/10.1136/qhc.13.suppl_1.i80
Innocenti F, Spiteri A, Butt A, et al. Using high-fidelity simulation for testing purposes: the experience of the European Board Examination in Emergency Medicine. Eur J Emerg Med 2023;30:135-7. DOI: https://doi.org/10.1097/MEJ.0000000000000987
Olgers TJ, Dijkstra RS, Drost-de Klerck AM, Ter Maaten JC. The ABCDE primary assessment in the Emergency Department in medically ill patients: an observational pilot study. Neth J Med 2017;75:106-11.
Cooper S, Wakelam A. Leadership of resuscitation teams: "Lighthouse Leadership'. Resuscitation 1999;42:27-45. DOI: https://doi.org/10.1016/S0300-9572(99)00080-5
Madlock P. The link between leadership style‚ communicator competence‚ and employee satisfaction. J Business Comm 2008;45:61-78. DOI: https://doi.org/10.1177/0021943607309351
Guise JM, Deering SH, Kanki BG, et al. Validation of a tool to measure and promote clinical teamwork. Simul Healthc 2008;3:217-23. DOI: https://doi.org/10.1097/SIH.0b013e31816fdd0a
Harper J. Clinical leadership-bridging theory and practice. Nurse Educ 1995;20:11-2. DOI: https://doi.org/10.1097/00006223-199505000-00011
Cook MJ. The attributes of effective clinical nurse leaders. Nurs Stand 2001;15:33-6. DOI: https://doi.org/10.1097/00002800-200101000-00014
Lett M. The concept of clinical leadership. Contemp Nurse 2002;12:16-21. DOI: https://doi.org/10.5172/conu.12.1.16
Stanley D, Stanley K. Clinical leadership and nursing explored: a literature search. J Clin Nurs 2018;27:1730-43. DOI: https://doi.org/10.1111/jocn.14145
Brindley PG. I. Improving teamwork in anaesthesia and critical care: many lessons still to learn. Br J Anaesth 2014;112:399-401. DOI: https://doi.org/10.1093/bja/aet334
Lewis R, Strachan A, Smith MM. Is high fidelity simulation the most effective method for the development of non-technical skills in nursing? A review of the current evidence. Open Nurs J 2012;6:82-9. DOI: https://doi.org/10.2174/1874434601206010082
Lee CW, Liu CY, Chen CH, et al. Simulation-based education can help resident's readiness in critical care and medical ethical issues. Int J Gerontol 2021;15:138-44.
Kalnow A, Davis A, Hampton Z, Gable BD. In Situ Simulation to Promote Residents as Resuscitation Leaders. Cureus 2021;13:e14449. DOI: https://doi.org/10.7759/cureus.14449
Riem N, Boet S, Bould MD, et al. Do technical skills correlate with non-technical skills in crisis resource management: a simulation study. Br J Anaesth 2012;109:723-8. DOI: https://doi.org/10.1093/bja/aes256

How to Cite

Maiorano, L., Capretti, E., De Paris, A., Prota, A., Paolucci, E., Marchetti, R., Coppa, A., Savinelli, C., Pini, R., & Innocenti, F. (2024). Promoting leadership and communication skills in emergency medicine residents: the role of High-Fidelity Simulation. Emergency Care Journal. https://doi.org/10.4081/ecj.2024.12816