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Comparing Resource Management Skills in a High- versus Low-Resource Simulation Scenario: A Pilot Study

Published online by Cambridge University Press:  06 December 2019

Alba Ripoll Gallardo ,
Grazia Meneghetti ,
Jeffrey M. Franc ,
Alessandro Costa ,
Luca Ragazzoni ,
Moran Bodas Open the ORCID record for Moran Bodas [Opens in a new window] ,
Vaclav Jordan  and
Francesco Della Corte Open the ORCID record for Francesco Della Corte [Opens in a new window]
Alba Ripoll Gallardo
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
Grazia Meneghetti
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
Jeffrey M. Franc
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
Alessandro Costa
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
Luca Ragazzoni
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
Moran Bodas
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
Vaclav Jordan
Affiliation:
Department Gynaecology and Obstetrics, Schiers Hospital, Switzerland
Francesco Della Corte*
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
*
Correspondence: Francesco Della Corte, MD Via Lanino 1, 28100, Novara, NO, Italy E-mail: francesco.dellacorte@med.uniupo.it
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Abstract

Background:

Low-resource environments, such as those found in humanitarian crises, pose significant challenges to the provision of proper medical treatment. While the lack of training of health providers to such settings has been well-acknowledged in literature, there has yet to be any scientific evidence for this phenomenon.

Methods:

This pilot study utilized a randomized crossover experimental design to examine the effects of high- versus low-resource simulated scenarios of a resuscitation of a critically ill obstetric patient on a medical doctors’ performance and inter-personal skills. Ten senior residents (fifth-year post-graduate) of the Maggiore Hospital School of Medicine (Novara, NO, Italy) were included in the study.

Results:

Overall performance score for the high-resource setting was 5.2, as opposed to only 2.3 for the low-resource setting. The mean effect size for the overall score was 2.9 (95% CI, 1.7–4.0; P <.001). The results suggest a significant decrease in both technical (medical) and non-technical skills, such as leadership, problem solving, situation awareness, resource utilization, and communication in the low-resource environment setting. The latter finding is of special important since it was yet to be reported.

Conclusions:

This pilot study suggests that untrained physicians in low-resource environments may experience a considerable setback not only to their professional performance, but also to their interpersonal skills, when deployed ill-prepared to humanitarian missions. Consequently, this may endanger the health of local populations.

Keywords

humanitarian crisislow-resource environmentspostpartum hemorrhageresource management
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 1 , February 2020 , pp. 83 - 87
Copyright
© World Association for Disaster and Emergency Medicine 2019

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References

World Health Organization. Global health emergency workforce. Report by the Director- General. May 15, 2015. http://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_27-en.pdf?ua=1. Accessed May 3, 2017.Google Scholar
Van Hoving, DJ, Wallis, LA, Docrat, F, De Vries, S.Haiti disaster tourism--a medical shame. Prehosp Disaster Med. 2010;25(3):201–202.CrossRefGoogle Scholar
Burkle, FM.Conversations in disaster medicine and public health: the profession. Disaster Med Public Health Prep. 2014;8(1):5–11.CrossRefGoogle Scholar
Nuland, SB. After the Deluge: A Report from a Relief Mission. New Republic. April 11, 2005. http://www.tnr.com/article/after-the-deluge. Accessed May 9, 2017.Google Scholar
Iserson, KV, Biros, MH, James Holliman, C.Challenges in international medicine: ethical dilemmas, unanticipated consequences, and accepting limitations. Acad Emerg Med. 2012;19(6):683–692.CrossRefGoogle ScholarPubMed
Birch, M, Miller, S.Humanitarian assistance: standards, skills, training, and experience. BMJ. 2005;330(7501):1199–1201.CrossRefGoogle ScholarPubMed
Slepski, LA.Emergency preparedness and professional competency among health care providers during hurricanes Katrina and Rita: pilot study results. Disaster Manag Response. 2007;5(4):99–110.CrossRefGoogle ScholarPubMed
Ripoll Gallardo, A, Ingrassia, PL, Ragazzoni, L, et al. Professionalization of anesthesiologists and critical care specialists in humanitarian action: a nationwide poll among Italian residents. Prehosp Disaster Med. 2015;30(1):16–21.CrossRefGoogle ScholarPubMed
Merry, AF, Cooper, JB, Soyannwo, O, Wilson, IH, Eichhorn, JH.International standards for a safe practice of anesthesia 2010. Can J Anaesth. 2010;57(11):1027–1034CrossRefGoogle ScholarPubMed
AbouZahr, C. Global burden of maternal death and disability. Br Med Bull. 2003;67:1.CrossRefGoogle ScholarPubMed
Prata, N, Passano, P, Rowen, T, Bell, S, Walsh, J, Potts, M.Where there are (few) skilled birth attendants. J Health Popul Nutr. 2011;29(2):81–91.CrossRefGoogle ScholarPubMed
Kim, J, Neilipovitz, D, Cardinal, P, Chiu, M, Clinch, J.A pilot study using high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: The University of Ottawa Critical Care Medicine, High-Fidelity Simulation, and Crisis Resource Management I Study. Crit Care Med. 2006;34(8):2167.CrossRefGoogle ScholarPubMed
Howard, SK, Gaba, DM, Fish, KJ, Yang, G, Sarnquist, FH.Anesthesia crisis resource management training: teaching anesthesiologists to handle critical incidents. Aviat Space Environ Med. 1992;63(9):763–770.Google ScholarPubMed
Franc, JM, Verde, M, Gallardo, AR, Carenzo, L, Ingrassia, PL.An Italian version of the Ottawa Crisis Resource Management Global Rating Scale: a reliable and valid tool for assessment of simulation performance. Intern Emerg Med. 2017;12(5):651–656.CrossRefGoogle ScholarPubMed