Non-technical skills progression during anesthesiology residency in Portugal: the impact of a National Pedagogical Plan

ABSTRACT

Background

Simulation is known as an important tool for the learning of technical and non-technical skills without endangering patient safety. In Portugal, a National Pedagogical Plan for Anesthesiology Residents was created based on simulation training. This plan was designed according to the objectives set forth by the Portuguese Board of Anesthesiology. This study aimed to evaluate the impact of simulation training courses on the non-technical skills of medical residents in Anesthesiology.

Methods

Confidential questionnaires, pre- and post-course, were answered by all the residents that attended the different modules of the simulation training program at Centro Hospitalar e Universitário de Coimbra Biomedical Simulation Centre, Portugal, from February 2011 to March 2018.

Results

A total of 344 questionnaires were answered. In the group of questions regarding the need for help, mistakes, and self-efficacy over time, students recognized an increase over time in the need for support and the self-assessment of the number of mistakes (p < 0.001). Regarding the self-evaluation of safety culture and communication skills, at the end of the residency, almost all the students recognized that they did not feel bad when asking for help or expressing their opinion, even when they disagreed with the consultant anesthesiologist. This was significantly different from the values of the self-assessment at the beginning of residency (p < 0.001). The evolution of preparation, knowledge, and training also showed a positive evolution over the simulation modules (p < 0.001). Finally, the evaluation of the behavioral component in the clinical setting showed a significant positive evolution over time (p < 0.001): in the end, all the students strongly agreed that behavioral competencies are crucial.

Conclusions

The impact of simulation on anesthesiology non-technical skills during residency is positive and recognized by the students. Moreover, simulation also helps in the recognition of error, enriching the value of self-confidence and the crucial role of behavioral skills.

ABBREVIATIONS

BSC-CHUC: Biomedical Simulation Centre from Centro Hospitalar e Universitário de Coimbra

KEYWORDS:

• Anesthesiology
• simulation
• behavior
• residency
• pedagogical plan
• self-assessment
• non-technical skills

Acknowledgement

The Authors want to thank to the Portuguese Society of Anesthesiology for scientific advice and dissemination of the simulation courses.

Author contributions

Francisco Maio Matos: helped on study design, data collection, statistical analysis, interpretation of data, preparation of the manuscript, and critical review of the manuscript.

Mafalda Ramos Martins: helped on study design, data collection, statistical analysis, interpretation of data, preparation of the manuscript, and critical review of the manuscript.

Inês Martins: helped on data collection, statistical analysis, interpretation of data, and critical review of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval and consent to participate

Ethical approval for this study (Ethical Committee Nº 171/CES) was provided, retrospectively, by the Ethical Committee from CHUC, Coimbra, Portugal (Chairperson Prof. Doutor João Pedroso de Lima) on 18 July 2019. Written informed consent has been waived by the Ethical Committee.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Supplementary material

Supplemental data for this article can be accessed here.