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Simulation in Anaesthesia at the Royal Adelaide Hospital PowerPoint Presentation
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Simulation in Anaesthesia at the Royal Adelaide Hospital

Simulation in Anaesthesia at the Royal Adelaide Hospital

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Simulation in Anaesthesia at the Royal Adelaide Hospital

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  1. Simulation in Anaesthesiaat the Royal Adelaide Hospital Dr Graham Lowry FANZCA

  2. The Royal Adelaide Hospital • Adult Tertiary Teaching Hospital • Affiliated with the University of Adelaide • 680 beds • 23 operating theatres • 24 ICU / 10 HDU/ICU beds • Major trauma referral centre for SthAustralia • Receives 800 retrievals/year

  3. Department of Anaesthesia • Branch of Critical Care • Anaesthesia/Pain/Hyperbaric medicine • 52 FTE Consultants • 32 Registrars

  4. Simulation Unit • Operational since 2003 • Teaching/education role • Interns • Registrars/trainees • Consultant anaesthetists • Technical and non-technical skills • Relatively low budget

  5. Specialty of Anaesthesia • Five years of postgraduate training • Major focus of training on developing technical skills • Conflict of decreased working hours versus need for clinical experience • Aging population • More complex surgery • Increased emphasis from ANZCA for training in non-technical skills.

  6. Why Consultant Anaesthetists? • Historically, a lack of training in this area • Often seen as leaders during a crisis in theatre BUT: • No leadership training • Often poor followers • Crisis Resource Management training is not mandatory

  7. The Scenarios • Clearly defined goals important • Simple clinical scenarios • Diagnostic uncertainty useful for teaching human factors • Team dynamics create complexity • Level of fidelity always a challenge • Self reflection and evaluation important learning component

  8. Challenges……1 • Changing the culture • Stressful for • for participants • facilitators • Labourintensive • maintaining service commitment versus patient safety and quality of care.

  9. Challenges……2 • Availability of relevant, validated outcome measures. • Adequate funding and resource allocation • Managing participants’ expectations and comfort levels

  10. Advantages ……1 • Allows training/experience in rare (but catastrophic) events • Breaks down the “silos” • Work as a team, train as a team even if the “team” is constantly changing

  11. Advantages ……2 • Training/practicing in context • Issues of access to facilities • Moving beyond the operating theatre…