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
| NCT number | NCT04521101 |
| Other study ID # | 2018-4474 |
| Secondary ID | |
| Status | Completed |
| Phase | N/A |
| First received | |
| Last updated | |
| Start date | August 24, 2018 |
| Est. completion date | June 30, 2019 |
| Verified date | August 2020 |
| Source | Dalhousie University |
| Contact | n/a |
| Is FDA regulated | No |
| Health authority | |
| Study type | Interventional |
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.
| Status | Completed |
| Enrollment | 32 |
| Est. completion date | June 30, 2019 |
| Est. primary completion date | January 30, 2019 |
| Accepts healthy volunteers | Accepts Healthy Volunteers |
| Gender | All |
| Age group | N/A and older |
| Eligibility |
Inclusion Criteria: - All anesthesia (anesthesiologists, anesthesia residents and non-physician anesthetists) VAST Course participants during the study period. Exclusion Criteria: - VAST Course participants who do not practice anesthesia (surgeons, nurses, midwives etc.) |
| Country | Name | City | State |
|---|---|---|---|
| Rwanda | University of Rwanda | Butare | |
| Rwanda | Rwanda Military Hospital | Kigali |
| Lead Sponsor | Collaborator |
|---|---|
| Dalhousie University |
Rwanda,
| Type | Measure | Description | Time frame | Safety issue |
|---|---|---|---|---|
| Primary | Total Anesthesia NonTechnical Skills (ANTS) Score | Baseline ANTS Score | Day 1 (pre-course test) | |
| Primary | Total Anesthesia NonTechnical Skills (ANTS) Score | The change from baseline ANTS score to post-course (day 3) | Day 3 (post-course test) | |
| Primary | Total Anesthesia NonTechnical Skills (ANTS) Score | The change from baseline ANTS score to follow-up (4 months) | 4 months (follow-up score) | |
| Secondary | Category Anesthesia NonTechnical Skills (ANTS) Score | Baseline category ANTS scores (team working, task management, situation awareness, decision making) | Day 1 (pre-course) | |
| Secondary | Category Anesthesia NonTechnical Skills (ANTS) Score | The change in category ANTS scores (team working, task management, situation awareness, decision making) | Day 3 (post-course) | |
| Secondary | Category Anesthesia NonTechnical Skills (ANTS) Score | The change in category ANTS scores (team working, task management, situation awareness, decision making) | 4 months (post-course) |