Simulation-Based Education of Endovascular Scrub Nurses Reduces Stress and Improves Team Performance
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Simulation-Based Education of Endovascular Scrub Nurses Reduces Stress and Improves Team Performance. / Skov, Rebecca Andrea Conradsen; Lawaetz, Jonathan; Konge, Lars; Westerlin, Lise; Aasvang, Eske Kvanner; Meyhoff, Christian Sylvest; Vogt, Katja; Ohrlander, Tomas; Resch, Timothy Andrew; Eiberg, Jonas Peter.
I: Journal of Surgical Research, Bind 280, 2022, s. 209-217.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Simulation-Based Education of Endovascular Scrub Nurses Reduces Stress and Improves Team Performance
AU - Skov, Rebecca Andrea Conradsen
AU - Lawaetz, Jonathan
AU - Konge, Lars
AU - Westerlin, Lise
AU - Aasvang, Eske Kvanner
AU - Meyhoff, Christian Sylvest
AU - Vogt, Katja
AU - Ohrlander, Tomas
AU - Resch, Timothy Andrew
AU - Eiberg, Jonas Peter
N1 - Publisher Copyright: © 2022 The Author(s)
PY - 2022
Y1 - 2022
N2 - Introduction: Endovascular procedures have become commonplace in vascular surgery. This development calls for new training strategies for future specialists. Most simulation-based education (SBE) programs have a monodisciplinary focus on physicians, although successful surgery is a multidisciplinary team effort. Mental stress impairs the learning process and surgical performance and heart rate variability (HRV) can be measured as a proxy for both mental and physical stress. This study aims to assess how SBE of endovascular scrub nurses affects team performance and HRV during endovascular aneurysm repair (EVAR). Materials and methods: Prospective interventional study in which EVAR-inexperienced scrub nurses followed a focused SBE EVAR program. During real-life EVAR procedures, HRV was continuously recorded with a wireless electrocardiogram patch and multidisciplinary team performance was assessed with the Imperial College Error CAPture (ICECAP) tool, before and after the SBE program, allowing each scrub nurse to serve as their own control. Eight scrub nurses with experience in lower limb endovascular procedures, but not EVAR, were invited to participate. Results: Seven participants completed the study. In five of seven scrub nurses, HRV-derived stress levels during real-time EVAR procedures were lower after SBE compared to before SBE. Mean HRV increased from 24 msec to 35 msec (P < 0.001), indicating stress level reduction. Before SBE, the mean number of errors/hour was 7.3 (standard deviation ± 1.8) compared to 3.6 (standard deviation ± 2.7) after SBE. Most errors were categorized as technical (58 %) and communicative (23 %). Conclusions: SBE of scrub nurses may improve team performance and may lower mental stress during EVAR procedures. In this small study, we suggest using mental stress, as evaluated with HRV, and multidisciplinary team performance, as evaluated with ICECAP, to assess SBE effectiveness in real-case EVAR procedures. This SBE program and live ICECAP observations and electrocardiogram patches was well-accepted by scrub nurses and the entire team.
AB - Introduction: Endovascular procedures have become commonplace in vascular surgery. This development calls for new training strategies for future specialists. Most simulation-based education (SBE) programs have a monodisciplinary focus on physicians, although successful surgery is a multidisciplinary team effort. Mental stress impairs the learning process and surgical performance and heart rate variability (HRV) can be measured as a proxy for both mental and physical stress. This study aims to assess how SBE of endovascular scrub nurses affects team performance and HRV during endovascular aneurysm repair (EVAR). Materials and methods: Prospective interventional study in which EVAR-inexperienced scrub nurses followed a focused SBE EVAR program. During real-life EVAR procedures, HRV was continuously recorded with a wireless electrocardiogram patch and multidisciplinary team performance was assessed with the Imperial College Error CAPture (ICECAP) tool, before and after the SBE program, allowing each scrub nurse to serve as their own control. Eight scrub nurses with experience in lower limb endovascular procedures, but not EVAR, were invited to participate. Results: Seven participants completed the study. In five of seven scrub nurses, HRV-derived stress levels during real-time EVAR procedures were lower after SBE compared to before SBE. Mean HRV increased from 24 msec to 35 msec (P < 0.001), indicating stress level reduction. Before SBE, the mean number of errors/hour was 7.3 (standard deviation ± 1.8) compared to 3.6 (standard deviation ± 2.7) after SBE. Most errors were categorized as technical (58 %) and communicative (23 %). Conclusions: SBE of scrub nurses may improve team performance and may lower mental stress during EVAR procedures. In this small study, we suggest using mental stress, as evaluated with HRV, and multidisciplinary team performance, as evaluated with ICECAP, to assess SBE effectiveness in real-case EVAR procedures. This SBE program and live ICECAP observations and electrocardiogram patches was well-accepted by scrub nurses and the entire team.
KW - Endovascular aneurysm repair
KW - Error-capture
KW - Heart-rate-variability
KW - Simulation-based education
KW - Stress-level
KW - Team performance
U2 - 10.1016/j.jss.2022.07.030
DO - 10.1016/j.jss.2022.07.030
M3 - Journal article
C2 - 35994983
AN - SCOPUS:85136168916
VL - 280
SP - 209
EP - 217
JO - Journal of Surgical Research
JF - Journal of Surgical Research
SN - 0022-4804
ER -
ID: 319780998