Effect of Interprofessional Crisis Simulation Training in a Non-Operating Room Anesthesia Setting on Team Coordination: A Mixed Methods Study.

Abstract

Background: Crisis resource management in non-operating room anesthesia (NORA) locations is challenging but can potentially be improved through interprofessional crisis simulation training (ICST). This mixed methods study aimed to evaluate the effect of a one-time training on team coordination in diagnostic and interventional magnetic resonance imaging locations.

Methods: Personnel from anesthesia, radiology, and perioperative services (n = 87) underwent ICST over eight months. Team coordination among participants was assessed and compared at baseline, immediately after, and at three months after ICST using a validated instrument-the relational coordination index (RCI)-and a questionnaire on role perceptions and task confidence. Open-ended interviews on a purposive sample of participants were conducted before and after training and analyzed for recurring themes.

Results: Response rates for the RCI were 71.3% at baseline, 65.5% immediately after, and 36.8% three months after training. For subjects responding at baseline and at the respective post-training time point, there were no statistically significant differences in composite RCI scores immediately after or at three months after ICST. However, some individual RCI domain scores increased from baseline to three months after training. For instance, mutual respect increased from (mean ± standard deviation) 3.67 ± 0.49 to 4.42 ± 0.67 (p = 0.003) among non-anesthesia personnel rating anesthesia personnel; and shared knowledge rose from 3.58 ± 0.79 to 4.08 ± 0.51 (p = 0.010) among non-anesthesia personnel rating anesthesia personnel. Thematic analysis from 15 interviews revealed increased familiarity with roles and crisis procedures after ICST as well as improved communication.

Conclusion: A single interprofessional crisis simulation training in a NORA setting, though it did not change overall relational coordination scores, had positive effects on some aspects of team coordination by improving role clarity, task confidence, trust, and communication.