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Transfer of learning and patient outcome in simulated crisis resource management: a systematic review |
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| Authors: | Sylvain Boet MD M. Dylan Bould MBChB Lillia Fung MD Haytham Qosa MD Laure Perrier MLIS Walter Tavares PhD Scott Reeves PhD Andrea C. Tricco PhD |
| Affiliation: | 1. Department of Anesthesiology, The Ottawa Hospital, University of Ottawa, General Campus, 501 Smyth Rd, Critical Care Wing 1401, Ottawa, ON, Canada 2. The Ottawa Hospital Research Institute, University of Ottawa Skills and Simulation Centre (uOSSC), University of Ottawa, ON, Canada 3. The Academy for Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada 4. Department of Anesthesiology, The Children’s Hospital of Eastern Ontario Research Institute, The Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada 5. Li Ka Shing Knowledge Institute of St Michael’s Hospital, Toronto, ON, Canada 6. Continuing Education & Professional Development, Faculty of Medicine, University of Toronto, Toronto, ON, Canada 7. Wilson Centre and Centennial College, Toronto, ON, Canada 8. Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, London, UK |
| Abstract: | PurposeSimulation-based learning is increasingly used by healthcare professionals as a safe method to learn and practice non-technical skills, such as communication and leadership, required for effective crisis resource management (CRM). This systematic review was conducted to gain a better understanding of the impact of simulation-based CRM teaching on transfer of learning to the workplace and subsequent changes in patient outcomes.SourceStudies on CRM, crisis management, crew resource management, teamwork, and simulation published up to September 2012 were searched in MEDLINE®, EMBASE?, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC. All studies that used simulation-based CRM teaching with outcomes measured at Kirkpatrick Level 3 (transfer of learning to the workplace) or 4 (patient outcome) were included. Studies measuring only learners’ reactions or simple learning (Kirkpatrick Level 1 or 2, respectively) were excluded. Two authors independently reviewed all identified titles and abstracts for eligibility.Principal findingsNine articles were identified as meeting the inclusion criteria. Four studies measured transfer of simulation-based CRM learning into the clinical setting (Kirkpatrick Level 3). In three of these studies, simulation-enhanced CRM training was found significantly more effective than no intervention or didactic teaching. Five studies measured patient outcomes (Kirkpatrick Level 4). Only one of these studies found that simulation-based CRM training made a clearly significant impact on patient mortality.ConclusionsBased on a small number of studies, this systematic review found that CRM skills learned at the simulation centre are transferred to clinical settings, and the acquired CRM skills may translate to improved patient outcomes, including a decrease in mortality. |
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