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TECHNOLOGY, COMPUTING, AND SIMULATION

The Use of High-Fidelity Human Patient Simulation and the Introduction of New Anesthesia Delivery Systems

Paul Dalley, MbChB^*, Brian Robinson, PhD, Jennifer Weller, MClinEd, FANZCA, and Catherine Caldwell, MbBCh, FANZCA^*

*Department of Anaesthesia and Pain Manaement, Wellington Hospital, National Patient Simulation Training Centre, Wellington Hospital, and Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand

Address correspondence and reprint requests to Brian Robinson, PhD, National Patient Simulation Training Centre, Wellington Hospital, Private Bag 7902, Wellington South, New Zealand. Address e-mail to brian.robinson{at}ccdhb.org.nz

New anesthesia delivery systems are becoming increasingly complex. Although equipment is involved in a large proportion of intraoperative anesthesia problems (most also involving human error), the current methods of introducing new equipment into clinical practice have not been well studied. We designed a randomized, controlled, prospective study to investigate an alternative method of introducing new anesthesia equipment. Fifteen anesthesiology trainees were randomized to either the standard introduction to a Dräger Fabius GS anesthesia delivery machine plus simulated clinical use of the new machine in a high-fidelity human patient simulator (HPS) (Group 1) or to the standard introduction alone (Group 2). We used a questionnaire to seek their opinion on the new equipment, and responses showed that both groups were comparable in their reported confidence to use the new equipment safely. All trainees were then tested in two simulated anesthetic crises with the new machine. Performance was analyzed in terms of time to resolve the emergency, by using analysis of videos by an independent rater. Group 1 resolved both crises significantly faster. HPS allowed us to detect design features that were common sources of error.

IMPLICATIONS: A human patient simulator may reduce the risk of learning-curve error in anesthesiologists using new, complex equipment without subjecting patients to risk. It can be used to highlight potential design errors in new equipment through usability testing or certify practitioners before they use new equipment.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999