Florent Sigwalt1, Guillaume Petit, Jean-Noel Evain, Damien Claverie, Monique Bui, Angélique Guinet-Lebreton, Marion Trousselard, Frédéric Canini, Dominique Chassard, Antoine Duclos, Jean-Jacques Lehot, Thomas Rimmelé, Marc Lilot. 1. From the Departments of Anesthesia and Intensive Care, Hospices Civils of Lyon, Lyon, France (F.S., G.P., D.C., J.-J.L., T.R., M.L.) Departments of Anesthesia and Intensive Care, Grenoble Alpes University Hospital, Grenoble, France (J.-N.E.) Institute of Biomedical Research, Armies' Health Service, Bretigny sur Orge, France (D.C., M.T., F.C.) Desgenettes Hospital, Armies' Health Service, Lyon, France (M.B.) Seventh Medical Center of the Armies of Lyon, 76th Medical Antenna of Varces, Varces, France (A.G.-L.) Claude Bernard Lyon 1 University, high fidelity medical simulation center (CLESS; Centre Lyonnais d'Enseignement par Simulation en Santé), SAMSEI, Lyon, France (D.C., J.-J.L., T.R., M.L.) Health Data Department, Hospices Civils of Lyon, Lyon, France (A.D.) Claude Bernard Lyon 1 University, Health Services and Performance Research Lab (EA 7425 HESPER), Lyon, France (A.D., J.-J.L., M.L.) EA 7426 "Pathophysiology of Injury-Induced Immunosuppression" (Pi3), Claude Bernard Lyon 1 University-Biomérieux-Hospices Civils of Lyon, Lyon, France (T.R.) Val-de-Grâce School, Paris, France (M.T., F.C.).
Abstract
BACKGROUND: High-fidelity simulation improves participant learning through immersive participation in a stressful situation. Stress management training might help participants to improve performance. The hypothesis of this work was that Tactics to Optimize the Potential, a stress management program, could improve resident performance during simulation. METHODS:Residents participating in high-fidelity simulation were randomized into two parallel arms (Tactics to Optimize the Potential or control) and actively participated in one scenario. Only residents from the Tactics to Optimize the Potential group received specific training a few weeks before simulation and a 5-min reactivation just before beginning the scenario. The primary endpoint was the overall performance during simulation measured as a composite score (from 0 to 100) combining a specific clinical score with two nontechnical scores (the Ottawa Global Rating Scale and the Team Emergency Assessment Measure scores) rated for each resident by four blinded independent investigators. Secondary endpoints included stress level, as assessed by the Visual Analogue Scale during simulation. RESULTS: Of the 134 residents randomized, 128 were included in the analysis. The overall performance (mean ± SD) was higher in the Tactics to Optimize the Potential group (59 ± 10) as compared with controls ([54 ± 10], difference, 5 [95% CI, 1 to 9]; P = 0.010; effect size, 0.50 [95% CI, 0.16 to 0.91]). After specific preparation, the median Visual Analogue Scale was 17% lower in the Tactics to Optimize the Potential group (52 [42 to 64]) than in the control group (63 [50 to 73]; difference, -10 [95% CI, -16 to -3]; P = 0.005; effect size, 0.44 [95% CI, 0.26 to 0.59]. CONCLUSIONS: Residents coping with simulated critical situations who have been trained with Tactics to Optimize the Potential showed better overall performance and a decrease in stress level during high-fidelity simulation. The benefits of this stress management training may be explored in actual clinical settings, where a 5-min Tactics to Optimize the Potential reactivation is feasible prior to delivering a specific intervention.
RCT Entities:
BACKGROUND: High-fidelity simulation improves participant learning through immersive participation in a stressful situation. Stress management training might help participants to improve performance. The hypothesis of this work was that Tactics to Optimize the Potential, a stress management program, could improve resident performance during simulation. METHODS: Residents participating in high-fidelity simulation were randomized into two parallel arms (Tactics to Optimize the Potential or control) and actively participated in one scenario. Only residents from the Tactics to Optimize the Potential group received specific training a few weeks before simulation and a 5-min reactivation just before beginning the scenario. The primary endpoint was the overall performance during simulation measured as a composite score (from 0 to 100) combining a specific clinical score with two nontechnical scores (the Ottawa Global Rating Scale and the Team Emergency Assessment Measure scores) rated for each resident by four blinded independent investigators. Secondary endpoints included stress level, as assessed by the Visual Analogue Scale during simulation. RESULTS: Of the 134 residents randomized, 128 were included in the analysis. The overall performance (mean ± SD) was higher in the Tactics to Optimize the Potential group (59 ± 10) as compared with controls ([54 ± 10], difference, 5 [95% CI, 1 to 9]; P = 0.010; effect size, 0.50 [95% CI, 0.16 to 0.91]). After specific preparation, the median Visual Analogue Scale was 17% lower in the Tactics to Optimize the Potential group (52 [42 to 64]) than in the control group (63 [50 to 73]; difference, -10 [95% CI, -16 to -3]; P = 0.005; effect size, 0.44 [95% CI, 0.26 to 0.59]. CONCLUSIONS: Residents coping with simulated critical situations who have been trained with Tactics to Optimize the Potential showed better overall performance and a decrease in stress level during high-fidelity simulation. The benefits of this stress management training may be explored in actual clinical settings, where a 5-min Tactics to Optimize the Potential reactivation is feasible prior to delivering a specific intervention.
Authors: Sophie T Schlatter; Corentin C Thérond; Aymeric Guillot; Simon P Louisy; Antoine Duclos; Jean-Jacques Lehot; Thomas Rimmelé; Ursula S Debarnot; Marc E Lilot Journal: BMC Med Educ Date: 2022-06-02 Impact factor: 3.263
Authors: Jérémy Favre-Félix; Mikhail Dziadzko; Christian Bauer; Antoine Duclos; Jean-Jacques Lehot; Thomas Rimmelé; Marc Lilot Journal: Turk J Anaesthesiol Reanim Date: 2022-08