Oral Themed Presentation
Context: : Crisis resource management (CRM) training, adopted from the aviation industry, has been shown to be effective in improving team performance in both high-fidelity simulation and real-life clinical emergencies(1-3). Resuscitation courses and healthcare professional training have adapted their teaching to focus not only on technical skills but also to incorporate non-technical, or CRM skills. Despite this, the ability to lead in a clinical emergency, a key CRM principle, continues to be suboptimal(4). Effective leadership skills are known to improve team performance and studies have shown that leadership skills can be taught successfully to healthcare professionals(5-6). Current leadership courses focus on managerial issues, yet there is growing need to train professionals in clinical emergencies(5-8). Therefore, we implemented a course focusing on leadership in clinical emergencies aiming to improve healthcare professionals’ confidence and ability to lead.
Description: : A focused, practical one-day leadership course was developed and delivered by interprofessional trained facilitators. It consisted of interactive CRM teaching in the morning, emphasising expert clinical leadership qualities based on literature and expert opinions. This was followed by 2 streams of high-fidelity simulation training scenarios each, with one participant acting as team leader each time. Structured debrief after each scenario using advocacy & inquiry questions provided immediate formative feedback to learners, emphasising leadership and followership skills. A pre- and post-course questionnaire including 8 performance questions using a 0-100% level of confidence scale assessed the effectiveness of our course, based on the Kilpatrick model of learning. Overall course feedback was also obtained.
Observation/Evaluation: : 10 participants underwent the course of which 8 were doctors (2 anaesthetic and 2 paediatric consultants, 4 paediatric trainees) and 2 were charge nurses in paediatric intensive care units. All participants practised being team leader at least once, with 4 participants leading twice. Knowledge, skills and level of confidence in being a good leader improved by 24% overall with consultants improving by 16%, trainees by 31% and nurses by 34%. The improvement observed on level of confidence for CRM overall, announcing yourself as leader and each individual aspect of CRM was highly significant (table 1). Participants felt the training was enjoyable, engaging and relevant, with mean overall course rating 97%. One of the participants quoting it was a “very useful course to improve fluency with non clinical skills, especially leadership and followership in clinical emergencies”.
Discussion: : Our leadership course was highly effective in improving participants’ confidence, knowledge and skills in leading a clinical emergency. We intend to investigate if the knowledge and skills gained are sustained and applied in real-life scenarios, by sending out a questionnaire to participants 4 months after the course date. Our results support the evidence that leadership skills are teachable and important aspects of CRM principles(2-6,8). Further studies are required to assess if a focused leadership course, including non-technical skills, improves team performance and patient outcomes.