title: The use of high-fidelity human patient simulation and the introduction of new anesthesia delivery systems.
abstract: New anesthesia delivery systems are becoming increasingly complex. Although equipment is involved in a large proportion of intraoperative anesthesia problems (most also involving human error), the current methods of introducing new equipment into clinical practice have not been well studied. We designed a randomized, controlled, prospective study to investigate an alternative method of introducing new anesthesia equipment. Fifteen anesthesiology trainees were randomized to either the standard introduction to a Drager Fabius GS anesthesia delivery machine plus simulated clinical use of the new machine in a high-fidelity human patient simulator (HPS) (Group 1) or to the standard introduction alone (Group 2). We used a questionnaire to seek their opinion on the new equipment, and responses showed that both groups were comparable in their reported confidence to use the new equipment safely. All trainees were then tested in two simulated anesthetic crises with the new machine. Performance was analyzed in terms of time to resolve the emergency, by using analysis of videos by an independent rater. Group 1 resolved both crises significantly faster. HPS allowed us to detect design features that were common sources of error.
authors.affiliation: *Department of Anaesthesia and Pain Manaement, Wellington Hospital, †National Patient Simulation Training Centre, Wellington Hospital, and ‡Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
authors.forename: Paul
authors.initials: P
authors.lastname: Dalley
authors.forename: Brian
authors.initials: B
authors.lastname: Robinson
authors.forename: Jennifer
authors.initials: J
authors.lastname: Weller
authors.forename: Catherine
authors.initials: C
authors.lastname: Caldwell
mesh_terms: D000758:Anesthesia; D000776:Anesthesiology / Q000295:instrumentation*; D002983:Clinical Competence; D004868:Equipment Failure; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000628:therapy; D016544:Patient Simulation; D011446:Prospective Studies; D011795:Surveys and Questionnaires