Comparison of anaesthetists' activity patterns in the operating room and during simulation

Abstract

This study investigated the behavioural aspects of ecological validity of anaesthesia simulation environments using a task analysis approach. Six anaesthesists were observed during two cases performed in the operating room (OR), one routine and two critical incident simulation scenarios. A two-way MANOVA for repeated measures was performed with the independent variables Case (OR/SIM-R/SIM-CI) and Phase Induction/Maintenance (Emergence), the latter being a repeated measure. Dependent variables were the proportion of each phase spent on each of the observation categories. Statistically significant main effects for Phase concerning communication, monitoring, manual tasks and documentation, for Case concerning communication and documentation, and a significant interaction effect for Phase × Case concerning manual tasks and other were found. Increased action density (i.e. amount of co-occurring activities) was observed during Induction, Emergence and the Management of simulated critical events. The similarities and differences in anaesthetists' activity patterns identified in this study will help to further improve the ecological validity of simulation environments as research settings.

Keywords:

• Anaesthesiology
• Behavioural realism
• Ecological validity
• Operating room
• Simulation environments
• Task analysis

Acknowledgements

We thank the staff of the Center for Patient Safety and Simulation (TuPASS), Tuebingen, Germany, for their dedication, and the residents for their participation in this study. This research was funded by a grant from the Swiss National Science Foundation (Project-No. 11 – 65296.01) to the Center for Organizational and Occupational Sciences, Swiss Federal Institute of Technology (ETH) Zurich, Switzerland, and a grant from the University Tuebingen (fortuene Project-No. 844 – 0-0) to the Department of Anaesthesiology, University Hospital Tuebingen, Germany.