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Simulatorgestütztes, modulares Human Factors Training in der Anästhesie

Konzept und Ergebnisse des Trainingsmoduls „Kommunikation und Kooperation im Team“

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Zusammenfassung

Fragestellung

Human Factors (HF) sind maßgeblich an der Entstehung und der Bewältigung von Zwischenfällen in der Anästhesie beteiligt. Mit einem Simulatortraining können HF-Aspekte des Krisenmanagements trainiert werden. Es wurde ein modulares Trainingskonzept mit psychologischem Intensivbriefing entwickelt. Ziel der Studie war die Frage, ob sich beim Thema „Kommunikation und Kooperation im Team“ das Lernen und die Verhaltensänderungen der Treatmentgruppe (TG) von der Kontrollgruppe (KG) ohne Intensivbriefing unterscheidet.

Methodik

Es bewältigten 34 Assistenzärzte (TG: n=20, KG: n=14) je 1 von 3 Krisenszenarien. Kommunikation und medizinisches Management wurden anhand von Videoaufzeichnungen bewertet. Am Kursende wurden Fragebögen ausgefüllt. Verhaltensänderungen und erinnerte Lerninhalte wurden nach 2 Monaten erfasst.

Ergebnisse

Kommunikationsverhalten und medizinisches Management korrelierten hochsignifikant (r=0,57, p=0,001). Die TG kommunizierte häufiger initiativ (p=0,001) und kam häufiger in Konflikte mit dem Operateur (p=0,06). Nach 2 Monaten berichtete die TG öfter über Verhaltensveränderungen als die KG. Der Trainingsnutzen bestand für die KG im Üben seltener Komplikationen, in der TG in Erkenntnissen zu Kommunikation und Kooperation (p=0,001).

Schlussfolgerungen

Ein Trainingskonzept mit psychologischem Intensivbriefing kann HF-Aspekte nachhaltiger vermitteln als ein „klassisches“ Simulatortraining.

Abstract

Background

Human factors (HF) play a major role in crisis development and management and simulator training can help to train HF aspects. We developed a modular training concept with psychological intensive briefing. The aim of the study was to see whether learning and transfer in the treatment group (TG) with the module “communication and team-cooperation” differed from that in the control group (CG) without psychological briefing (“anaesthesia crisis resource management type course”).

Methods

A total of 34 residents (TG: n=20, CG: n=14) managed 1 out of 3 scenarios and communication patterns and management were evaluated using video recordings. A questionnaire was answered at the end of the course and 2 months later participants were asked for lessons learnt and behavioral changes.

Results

Good communication and medical management showed a significant correlation (r=0.57, p=0.001). The TG showed greater initiative (p=0.001) and came more often in conflict with the surgeon (p=0.06). The TG also reported more behavioral changes than the CG 2 months later. The reported benefit of the simulation was training for rare events in the CG, whereas in the TG it was issues of communication and cooperation (p=0.001).

Conclusions

A training concept with psychological intensive briefing may enhance the transfer of HF aspects more than classical ACRM.

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Authors and Affiliations

  1. Klinik für Anästhesiologie, Friedrich-Alexander-Universität, Erlangen

    M. St.Pierre D.E.A.A., G. Breuer & J. Schüttler

  2. Institut für Theoretische Psychologie, Otto-Friedrich-Universität, Bamberg

    G. Hofinger, C. Buerschaper & H. Harms

  3. Academisch Ziekenhuis, Groningen

    M. Grapengeter

  4. Klinik für Anästhesiologie, Krankenhausstrasse 12, 91054 , Erlangen

    M. St.Pierre D.E.A.A.

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  1. M. St.Pierre D.E.A.A.
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  2. G. Hofinger
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  3. C. Buerschaper
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  4. M. Grapengeter
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  5. H. Harms
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  6. G. Breuer
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  7. J. Schüttler
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Correspondence to M. St.Pierre D.E.A.A..

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St.Pierre, M., Hofinger, G., Buerschaper, C. et al. Simulatorgestütztes, modulares Human Factors Training in der Anästhesie. Anaesthesist 53, 144–152 (2004). https://doi.org/10.1007/s00101-003-0623-7

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  • DOI: https://doi.org/10.1007/s00101-003-0623-7

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