Experienced anesthesiologists tended to react more rapidly to simulated critical incidents than trainees, but differences compared to second-year residents were not statistically significant.
Observational (n=27)
Does experience level improve response times and performance during simulated critical incidents among anesthesiologists?
Experience improves initial response times to simulated critical incidents, but adequate response routines are largely acquired by the end of the second year of residency, and vulnerability to error persists regardless of experience.
Eight experienced anesthesiologists (faculty or private practitioners) were presented with the same simulated critical incidents that had previously been presented to 19 anesthesia trainees. The detection and correction times for these incidents were measured, as was compliance with Advanced Cardiac Life Support (ACLS) guidelines during cardiac arrest, and the occurrence of unplanned incidents. Experienced personnel tended to react more rapidly than did trainees, but differences between second-year anesthesia residents (CA2) and experienced anesthesiologists were not statistically significant. There was a high variability in performance between incidents and within each group. Unplanned errors and management flaws still occurred with experience subjects. The response to incidents during anesthesia is a complex process that involves multiple levels of cognitive activity and is vulnerable to error regardless of experience. Most trainees seemed to acquire adequate response routines by the end of the CA2 year. Formal reasoning appeared to play a minor role in responding to intraoperative events, but the exact nature of the anesthesiologist's cognition remains to be thoroughly investigated.
DeAnda et al. (Fri,) conducted a observational in Simulated critical incidents during anesthesia (n=27). Clinical experience vs. Anesthesia trainees was evaluated on Detection and correction times for simulated critical incidents, compliance with ACLS guidelines, and occurrence of unplanned incidents. Experienced anesthesiologists tended to react more rapidly to simulated critical incidents than trainees, but differences compared to second-year residents were not statistically significant.