P43 Long term follow up of self-reported confidence levels during a simulation over 12 months

• Published in: BMJ simulation & technology enhanced learning 2019-11, Vol.5 (Suppl 2), p.A78
• Main Authors: EJ, Sree Kumar, Purva, Makani
• Format: Article
• Language: English
• Subjects: Communication; Simulation
• ISSN: 2056-6697
• DOI: 10.1136/bmjstel-2019-aspihconf.144

IntroductionThe literature is sparse on the effect of repeated simulation on the confidence levels of residents in achieving non-technical skills.MethodologyTen first year anaesthesiology residents underwent a simulation scenario of difficult airway situation during general anaesthesia for Caesarean section. Pre and Post questionnaires, were collected for self-reported confidence levels on seven parameters. The residents were assessed based on a preformed check list and debriefed by two experienced anaesthesiologists. The same scenario was repeated at 6 and 12 months and confidence scores were collected.ResultsThe overall collated confidence scores showed significant increase from pre to post simulation at 0 and 12 months (p of 0.021 and 0.004 respectively) but not at 6 months. At 0 months, significant improvement between pre and post confidence scores were noted in the parameters of communication (p=0.016), recognising error at work place (p=0.031) and acknowledging limits of competence (p=0.016). At 6 months, there was no change between pre and post scores in any parameter. At 12 months, the significant improvement was noted again in communication(p=0.031) and also in ability to lead a team (p=0.031) and work as a team member (p=0.016). Up till 12 months, the two parameters where there was improvement but did not reach significance was in the confidence l to delegate and to manage a sick patient.DiscussionLearner specific training includes the understanding of the self confidence levels in the performance during a simulation scenario. The difference observed in the variables could suggest the hierarchical goals set by the residents to solve the problem.1 As per the conscious-competence model,2 acknowledging the limits of knowledge and a less complex communication skill preceded achievement of confidence in the more complex psycho-motor skill of leading a team and working as a team. Confidence in a more complex metacognitive knowledge like delegation of work would require more time.ConclusionDebriefing during simulation for resident training should factor in the stages of competency hierarchy of the resident.RecommendationDebriefing should be targeted to guide the residents through these phases of learningReferencesAnderson JR. Skill acquisition: Compilation of weak-method problem situations. Psychol Rev 1987;94:192–210. doi:10.1037/0033-295X.94.2.192Cannon H, Hale Feinstein A, Feinstein D. Managing Complexity: Applying the Conscious-Competence Model to E