To Determine the Change in Demonstrated Anesthesia Non-technical Skills After Delivery of the VAST Course Clinical Trial
Official title:
Can we Make a VAST Improvement? Promoting Anaesthetists' Non-technical Skills Through the Vital Anaesthesia Simulation Training Course in a Low-resource Setting
Rationale: The World Health Assembly resolution 68.15 identified surgical and anesthesia care
as core components of universal health coverage. However, about 5 billion people worldwide
lack access to essential surgical and anesthesia services. Of the 313 million procedures
undertaken each year only 6% occur in the poorest countries with an estimated 30% of all
deaths globally associated with common surgical conditions. Patient safety in low-resource
settings is hindered by severe workforce shortages, lack of essential resources, hierarchical
culture and few opportunities for professional development.
Non-technical skills (NTS), such as communication, team working, and task coordination, are
vital to patient safety. Up to 70-80% of untoward events in health care are associated with
errors in NTS8. The Anaesthetists' Non-Technical Skills framework (ANTS) describes behaviour
markers for NTS in anesthesia. This framework has been found applicable in low-resource
settings.
Simulation-based education is widespread for NTS training in well-resourced countries.
Traditionally, high costs have prohibited this modality in low-resource settings.
Foundational work in Rwanda and at Dalhousie University has demonstrated that effective
training in ANTS can be achieved through simple low-cost simulation. The Vital Anaesthesia
Simulation Training (VAST) Course is a three-day simulation-based program designed de-novo to
focus on core clinical practices and NTS that promote safe perioperative care in low-resource
settings. The course uses low-cost materials in an immersive simulated environment to
replicate common cases managed in district hospitals in low-resource settings. Realism is
created with simple mannequins, iPads with the SimMon App functioning as monitoring, basic
props (e.g., airway equipment, syringes, drapes), photographs of pathology, and briefing
cards for scenario role-play.
Purpose: To assess the impact of the VAST Course on ANTS and explore factors that influence
long-term retention of ANTS amongst anesthesia providers in a low-resource setting.
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