Elsevier

Air Medical Journal

Volume 35, Issue 5, September–October 2016, Pages 301-304
Air Medical Journal

Feature
Original Research
Simulation-Based Training in Mountain Helicopter Emergency Medical Service: A Multidisciplinary Team Training Concept

https://doi.org/10.1016/j.amj.2016.05.006Get rights and content

Highlights

  • Most fatal events in aviation as well as in medicine are derived from human factors.

  • Multidisciplinary systems, like helicopter emergency medical services (HEMS), are particularly susceptible to human error.

  • Simulation-based training is a suitable tool to detect latent safety errors. If they had occurred in real life, such errors could have contributed in harm occurring to patient or rescue team.

  • Multidisciplinary simulation-based educational training is feasible and improves self-estimated competence and awareness of crisis resource management and human factors in a medical complex setting like mountain rescue HEMS.

Abstract

Objective

Mountain helicopter rescue operations often confront crews with unique challenges in which even minor errors can result in dangerous situations. Simulation training provides a promising tool to train the management of complex multidisciplinary settings, thus reducing the occurrence of fatal errors and increasing the safety for both the patient and the helicopter emergency medical service (HEMS) crew.

Methods

A simulation-based training, dedicated to mountain helicopter emergency medicine service, was developed and executed. We evaluated the impact of this training by the means of a pre- and posttraining self-assessment of 40 HEMS crewmembers.

Results

Multidisciplinary simulation-based educational training in HEMS is feasible. There was a significant increase in self-assessed competence in safety-related items of human factors and team resource management. The highest gain of competence was demonstrated by a trend in the domain of structured decision making.

Conclusions

Interprofessional simulation-based team training could have the potential to impact patient outcomes and improve rescuer safety. Simulation trainings lead to a subjective increase of self-assuredness in the management of complex situations in a difficult working environment.

Section snippets

Setting

Simulation took place at the newly built mountain rescue training center (Bergwacht - Zentrum für Sicherheit und Ausbildung, BW-ZSA) in Bad Tölz, Germany.6 Dedicated education and training facilities were adapted to the field of mountain rescue for the first time worldwide. The centerpiece of BW-ZSA is a helicopter rescue simulation unit; a specially developed crane unit suspends a full-scale mock-up helicopter fuselage (Eurocopter, BK117), allowing it to “fly” within the approximately

Results

Forty questionnaires (questionnaire response rate = 100%) were evaluated regarding pre- and posttraining self-evaluation. On a scale ranging from 1 (best) to 6 (worst), the overall rating of the training was 1.04. Also, the multidisciplinary approach was highly esteemed, with a gradual rating of 1.3 ± 0.64.

The results of the self-evaluation show that participants felt they could improve their skills in all safety-related attitudes (Table 2). Accordingly, improved self-perception of competence

Discussion

This is the first study reporting data of multidisciplinary simulation-based team training in mountain HEMS based on prospective self-assessment. We demonstrated the feasibility of dedicated mountain HEMS simulation and the improvement in self-estimated competence and awareness in HF/TRM items.

The demand for training in complex environments is commonly underestimated.8 Attention to nontechnical skills in acute care medicine, especially in anesthesiology, arose in the 1990s,9 some 20 years after

Conclusion

Simulation-based training can contribute to real-life patient safety, as indicated by different studies demonstrating improved morbidity and mortality after the initiation of in situ simulation training. Even in a multidisciplinary setting such as alpine HEMS, simulation-based training is feasible and improves self-estimated competence and awareness of HFs and TRM regarding a complex medical setting. Thus, simulation-based training in mountain HEMS might ameliorate patient outcome and improve

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