Kristin Ireland, BS, RRT
Respiratory Therapist
Loma Linda University, United States
Disclosure information not submitted.
Laren Tan, MD, FCCP
Associate Professor
Loma Linda University, United States
Disclosure information not submitted.
Abdullah Alismail, PhD, RRT, , FCCP
Assistant Professor
Loma Linda University, United States
Disclosure information not submitted.
Title: Team Debrief After Real Codes During Clinical Training: Learners' Perspectives
Introduction: Team Debrief (TD) has been reported in the simulation literature to be a vital component post-Cardiopulmonary Arrest Events (CAE) for trainees learning and reflection due to the unexpected nature of the event. The purpose of this study was to evaluate the frequency of TD post-in-hospital CAE as well as possible barriers to TD from trainees’ perspectives in their current training program.
Methods: This study was approved by the Institutional Review Board. Selected program directors of residency programs (Medical Residents [MR] and respiratory therapy [RT]) in Southern California were invited to email their trainees to participate in an anonymous survey. Questions included demographics, CAE experience, perspectives on TD, cognitive load using a validated 9-point Likert scale (from very very low to very very high mental effort), emotional level using a validated 8-Likert bipolar scale, barriers, and benefits to TD in CAE.
Results: A total of N=37 trainees participated and encountered CAE during their training program with a median of 3 (min=1, max=30) CAEs. Thirty-four (91.9%) were MR, 3 (8.1%) RT, and 21 (56.7%) were females. Trainees reported rotating at mean 3±0.5 clinical sites in their current program. Only 18 (48.65%) reported ever having TD post-CAE. In their most recent CAE, they reported investing a 6.05±1.84 mental effort in the event with only 12(32.4%) reporting having TD post-event. Trainees reported being tense, nervous, stressed, and sad during these events using the emotional level scale. Interestingly, 33 (89.2%) reported preferring TD to be conducted immediately post-CAE, while 4 (10.8%) preferred delaying TD to a later, more formal session. Trainees believed that lack of time/being too busy was the biggest barrier to conducting TD, followed by being a junior trainee, and TD not being part of the institutional culture. They believed that process improvement, providing emotional support, and paying respect to human life were the top benefits to conducting TD post-CAE.
Conclusion: In this preliminary study, trainees reported infrequent TD during training, while also investing high mental effort and having negative emotions in these events. More efforts should be directed toward implementing TD post-CAE for trainees since TD provides multiple benefits to their experience.