Background Intraoperative cardiac arrest in non-standard positions, such as the sitting beach chair and prone positions, present unique challenges for surgical teams. Evidence on how to prepare teams for these rare events is limited. To evaluate whether a half-day, multi-station in situ simulation course was associated with changes in interprofessional surgical team members’ self-reported confidence and timed repositioning performance, and to describe self-reported application of course content to real patients three months afterwards. Methods Prospective single-center educational intervention at an elective orthopaedic unit. Interprofessional teams rotated through seven in situ stations during a 3.5-hour course. Anonymous questionnaires on confidence in managing cardiac arrest were distributed before, immediately after and three months after the course. Exploratory transfer drills (sitting to supine and prone to supine) were timed within session. Confidence scores were analysed with the Mann-Whitney U test (primary comparison: Before versus three months). Effect sizes were reported as r, with |r| ≈ 0.1, 0.3 and 0.5 considered small, medium and large. Results Sixty-three staff in five interprofessional teams participated. Questionnaire response rate was 74-92%, varied across domains. Self-reported confidence was higher at three months than before the course in all four domains (all p < 0.001), with medium to large effect sizes (r 0.39-0.68). The largest shift was for confidence in one’s own ability to manage cardiac arrest in the sitting beach-chair position (median 4 before versus 8 at three months). At 3 months, 48/56 (85.7%) respondents reported that course content had been of use for a real patient, including in situations other than cardiac arrest. Repositioning times showed a trend towards improvement in first-to-best transfer attempts, median ∼35 s (sitting to supine) and ∼30 s (prone to supine). Conclusion A half-day, multi-station in situ simulation course at an elective surgical unit was associated with higher self-reported confidence at three months, and self-reported application of course content to real patients. Exploratory within-session transfer drills suggested improvements that are hypothesis-generating given the small number of teams. The design may be a feasible use of planned surgical downtime. Article
Sundelin et al. (Mon,) studied this question.