Traditional Poster Round
Background: : Scoliosis is the most common pediatric spinal disorder (Konieczny et al., 2012). Spinal fusion surgery, an extensive and invasive procedure, is the recommended treatment for severe scoliosis cases (Asher & Burton, 2006) and is associated with high levels of stress and anxiety for patients and their caregivers (Starkweather et al., 2006; Kathol, 1984; Shirley et al., 1998, Thompson et al., 1996). Preparation for surgery has been found to reduce anxiety prior to and after the procedure (Kain et al., 2007; Aranha et al., 2017); however, many preparation methods are insufficient to achieve full and successful knowledge/skill transfer if they do not include opportunities to learn through active practice and realistic exposure and rehearsal of what patients might experience before, during, and after a procedure. Simulation in training medical professionals allows a clinician to practice skills and rehearse scenarios that replicate real experiences, resulting in improved knowledge, performance, and confidence (Cook, 2011; Allan, 2010). Thus, simulation applied to patients and caregivers in preparation for a procedure offers a unique method of practice and rehearsal which may similarly result in improved outcomes following the intervention.
As part of our patient and caregiver facing service-line, we developed SimDiscovery, a module-based program simulating the entire peri-operative process for patients and caregivers. This has been piloted successfully 3 times for the spinal fusion patient population resulting in positive feedback from patients and caregivers.
Research Question: : Study aims to examine the effectiveness of a multi-faceted preparation program using simulation techniques to reduce anxiety and increase preparedness among patients who will undergo spinal fusion surgery and their families. We hypothesize that after participating in SIMDiscovery, patients and parents will report fewer symptoms of anxiety and increased feelings of preparedness regarding the child’s spinal fusion surgery than before their participation in the simulation program.
Methodology: : SIMDiscovery will be held on three dates. We anticipate 10 patient-caregiver dyads to participate in the SIMDiscovery at each date, for a total of 30 patient-caregiver dyads. We will assess child and parent anxiety, preparedness, and knowledge about the spinal fusion surgery before and after simulation using self-report measures (e.g. STAI, Caregiver Preparedness Scale and Pre-Post Simulation Anxiety ). Participants will also complete a brief interview at their 4-6 week follow-up appointment post-surgery. Initial descriptive statistics will be calculated for demographic and medical variables as well as anxiety, preparedness, and knowledge variables. Differences between pre and post-simulation anxiety, preparedness, and knowledge will be calculated with paired t-tests.
Results: : At the time of the conference, we will have preliminary data which will include 10 patient-caregiver dyads. Anecdotally, families who have participated in the initial trials of this program have found it helpful in preparing them for their child’s spinal fusion surgery.
Discussion/Conclusions: : If successful at increasing preparedness and decreasing anxiety this approach could be expanded for use with other patient populations undergoing invasive medical procedures. Future aims include a control group, inclusion of additional variables that may contribute to anxiety and preparedness, and assessment of impact on medical outcomes.