title: Using medical simulation to teach crisis resource management and decision-making skills to otolaryngology housestaff.
abstract: OBJECTIVE
  Develop a course to use in situ high-fidelity medical simulation (HFS) in an actual operating room (OR) to (1) teach teamwork and crisis resource management (CRM) skills simultaneously to otolaryngology and anesthesia trainees and OR nurses and (2) provide decision-making experience to ear, nose, and throat residents and OR teams in simulated high-risk, low-frequency airway emergencies.
  
  
  METHODS
  A simulation-based, in situ CRM course was developed to teach airway management and CRM in the OR. Upon completion of each course, the participants were surveyed using questions with (1-5) scale answers.
  
  
  METHODS
  The simulated clinical scenarios took place in the intensive care unit and OR at Children's Hospital Boston.
  
  
  METHODS
  The participants consisted of pediatric otolaryngology fellows, otolaryngology residents, anesthesiology residents, fellows, and certified registered nurse anesthetists as well as OR nurses. Fifty-nine individuals participated in 9 simulation-based courses given between October 2008 and May 2010. The team members participated together in 3 simulated medical crises that centered on airway and anesthesia issues. Each simulated crisis was followed by a structured debriefing session conducted by trained debriefers. Embedded within the course were didactics on CRM principles.
  
  
  RESULTS
  The participants' responses on the survey included General Course Organization, Realism, Debriefing, and Relevance to Future Practice. Ninety percent of the responses were favorable or very favorable.
  
  
  CONCLUSIONS
  Using a newly developed, in situ HFS-based course, clinical decision-making skills and teamwork can be effectively taught concurrently to members of an OR team.
authors.affiliation: Department of Otolaryngology and Communication Disorders, Children's Hospital, Boston, Massachusetts, USA. mark.volk@childrens.harvard.edu
authors.forename: Mark S
authors.initials: MS
authors.lastname: Volk
authors.forename: Jessica
authors.initials: J
authors.lastname: Ward
authors.forename: Noel
authors.initials: N
authors.lastname: Irias
authors.forename: Andres
authors.initials: A
authors.lastname: Navedo
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pollart
authors.forename: Peter H
authors.initials: PH
authors.lastname: Weinstock
mesh_terms: D058109:Airway Management; D000402:Airway Obstruction / Q000628:therapy*; D001900:Boston; D002983:Clinical Competence; D003198:Computer Simulation; D003299:Cooperative Behavior; D003479:Curriculum; D003661:Decision Support Techniques; D004630:Emergencies; D006295:Health Resources; D006801:Humans; D007318:Inservice Training; D033183:Interdisciplinary Communication; D007396:Internship and Residency; D008348:Manikins; D010036:Otolaryngology / Q000193:education*; D010348:Patient Care Team; D014741:Video Recording