1. Proceedings
  2. I3M
  3. 2021
  4. IWISH
  5. 10.46354/i3m.2021.iwish.006

Crisis Resource Management in Emergency Medicine: an Italian medical students’ experience

  • a Andrea Calandrino , 
  • b Alessio Riitano , 
  • c Serena Ricci , 
  • d Silvia Dibenedetto , 
  • e Fabio Vento ,  
  • f Giancarlo Torre , 
  • g Marco Chirico , 
  • h Giacomo Borgonovo 
  • a,b,c,d,e,f,g,h Simulation and Advanced Education Center (SimAv), University of Genova, Via Pastore 3, 16132, Genova, Italy
  • a IRCCS Giannina Gaslini Children’s Hospital, Via Gerolamo Gaslini 5, 16147, Genova, Italy
  • c Department of Informatics, Bioengineering, Robotics, and Systems Engineering, University of Genova, Via all’Opera Pia 13, 16145, Genova, Italy
  • h Department of Surgical Sciences and Integrated Diagnostics, University of Genova Viale Benedetto XV 6, 16132 Genova, Italy
Cite as
Calandrino A., Riitano A., Ricci S., Dibenedetto S., Vento F., Torre G., Chirico M., Borgonovo G. (2021). Crisis Resource Management in Emergency Medicine: an Italian medical students’ experience. Proceedings of the 10th International Workshop on Innovative Simulation for Healthcare (IWISH 2021), pp. 36-40. DOI: https://doi.org/10.46354/i3m.2021.iwish.006

Abstract

Crisis Resource Management (CRM) is a training technique which follows the procedures used for improving aviation safety. CRM can be used in many contexts, including emergency medicine training. This technique includes three steps: presentation of the problem, high fidelity simulation and debriefing. In particular, CRM carefully analyzes behavioral factors related to the management of critical events. This way, trainees and instructors can discuss and improve management and leadership. In fact, key factors of CRM are communication, roles management and priority definition. In order to apply CRM in Emergency Medicine, the Italian Medical Students’ Secretariat organized the Emergency Medicine Simulation Seminary (EMSS). At the end of EMSS, we asked the 26 participants to give their feedback on the acceptance level of such medical training to assess the possibility of proposing CRM to other institutions as a method for emergency medicine training. Results show that Italian students have less simulation experience than international attendees. Also, CRM is a powerful training tool to rapidly improve knowledge on critical cases management; particularly if simulations are presented in high-fidelity settings by experienced instructors and with a proper training time to investigate, rehearse and fully understand the concepts.

References

  1. Adobor, Henry, and Alireza Daneshfar. 2006.  “Management Simulations: Determining Their
    Effectiveness.” Journal of Management Development 25: 151–68.
  2. Arias-Aranda, Daniel. 2007. “Simulating Reality for Teaching Strategic Management.” Innovations in Education and Teaching International 44(3): 273–86.
  3. Bagnasco, Annamaria et al. 2014. “The Role of Simulation in Developing Communication and
    Gestural Skills in Medical Students.” BMC medical education 14(1): 1–7.
  4. Bracco, Fabrizio et al. 2017. “Adaptation of Non-Technical Skills Behavioural Markers for Delivery Room Simulation.” BMC pregnancy and childbirth 17(1): 1–7.
  5. Calandrino, Andrea et al. 2020. “Peer Collaboration in Italy during COVID-19 Pandemic: The Experience of an Online Bottom-up Backed Platform Designed for Medical Students.”
  6. Foushee, H Clayton, J K Lauber, M M Baetge, and D B Acomb. 1986. “Crew Factors in Flight Operations: 111. The Operational Significance of Exposure to Short-Haul Air Transport Operations.” NASA Technical Memorandum 88322: 99–136.
  7. Frascio, Marco et al. 2009. “New Teaching Models for the Medical School of Medicine: Comparison between Oral an Online Classes. The Experience of the Genoa School of Medicine.” Journal of e-Learning and Knowledge Society 5(3): 43–48.
  8. Gaba, David M et al. 2001. “Simulation-Based Training in Anesthesia Crisis Resource Management (ACRM): A Decade of Experience.” Simulation & Gaming 32(2): 175–93.
    https://doi.org/10.1177/104687810103200206.
  9. Girau, Elisa et al. 2019. “A Mixed Reality System for the Simulation of Emergency and First-Aid Scenarios.” Conference proceedings : 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2019: 5690–95.
  10. Groen, G J, and Vimla L Patel. 1985. “Medical Problemsolving: Some Questionable Assumptions.” Medical education 19(2): 95–100.
  11. Gross B, et al. 2019. “Crew resource management training in healthcare: a systematic review of intervention design, training conditions and evaluation.” BMJ Open 9(2):e025247.
  12. Gunz, Hugh. 1994. “Learning from a Realistic Simulation: A Case Study.” Journal of Management Education 18: 45–60.
  13. Howard, S K et al. 1992. “Anesthesia Crisis Resource Management Training: Teaching Anesthesiologists to Handle Critical Incidents.” Aviation, space, and environmental medicine 63(9): 763–70.
  14. Klein, Gary A, Judith Orasanu, Roberta Calderwood, and Caroline E Zsambok. 1993. Decision Making in Action: Models and Methods. Ablex Norwood, NJ.
  15. Levine, Adam I, Samuel DeMaria Jr, Andrew D Schwartz, and Alan J Sim. 2013. The Comprehensive Textbook of Healthcare Simulation. Springer Science & Business Media.
  16. Mcdonnell, Lori, Kimberly Jobe, and Key Dismukes. 1997. “Facilitating LOS Debriefings: A Training Manual.”
  17. Orasanu, Judith, and Terry Connolly. 1993. “The Reinvention of Decision Making.” Decision
    making in action: Models and methods 1: 3–20.
  18. Parsons JR, et al. Filling the Gap: Simulation-based Crisis Resource Management Training for Emergency Medicine Residents. West J Emerg Med. 2018 Jan;19(1):205-210. doi:
    10.5811/westjem.2017.10.35284. Epub 2017 Dec 14. PMID: 29383082; PMCID: PMC5785195.
  19. Patel, V L, D A Evans, and D R Kaufman. 1990. “Reasoning Strategies and the Use of Biomedical Knowledge by Medical Students.” Medical education 24(2): 129–36.
  20. Ricci, Serena et al. 2019. “Design and Implementation of a Low-Cost Birth Simulator.” In 41st
    Engineering in Medicine and Biology Conference.
  21. Salas, E, C A Bowers, and L Rhodenizer. 1998. “It Is Not How Much You Have but How You Use It: Toward a Rational Use of Simulation to Support Aviation Training.” The International journal of aviation psychology 8(3): 197–208.
  22. Wiener, Earl L, Barbara G Kanki, and Robert L Helmreich. 1995. Cockpit Resource Management. Gulf Professional Publishing.