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Mental practice: a simple tool to enhance team-based trauma resuscitation

  • Gianni R. Lorello (a1), Christopher M. Hicks (a2), Sana-Ara Ahmed (a1), Zoe Unger (a1), Deven Chandra (a1) and Megan A. Hayter (a3)...
Abstract
Abstract Introduction

Effective trauma resuscitation requires the coordinated efforts of an interdisciplinary team. Mental practice (MP) is defined as the mental rehearsal of activity in the absence of gross muscular movements and has been demonstrated to enhance acquiring technical and procedural skills. The role of MP to promote nontechnical, team-based skills for trauma has yet to be investigated.

Methods

We randomized anaesthesiology, emergency medicine, and surgery residents to two-member teams randomly assigned to either an MP or control group. The MP group engaged in 20 minutes of MP, and the control group received 20 minutes of Advanced Trauma Life Support (ATLS) training. All teams then participated in a high-fidelity simulated adult trauma resuscitation and received debriefing on communication, leadership, and teamwork. Two blinded raters independently scored video recordings of the simulated resuscitations using the Mayo High Performance Teamwork Scale (MHPTS), a validated team-based behavioural rating scale. The Mann-Whitney U-test was used to assess for between-group differences.

Results

Seventy-eight residents provided informed written consent and were recruited. The MP group outperformed the control group with significant effect on teamwork behaviour as assessed using the MHPTS: r=0.67, p<0.01.

Conclusions

MP leads to improvement in team-based skills compared to traditional simulation-based trauma instruction. We feel that MP may be a useful and inexpensive tool for improving nontechnical skills instruction effectiveness for team-based trauma care.

Résumé Introduction

La réanimation efficace des traumatisés exige la coordination des efforts d’une équipe interdisciplinaire. La visualisation mentale (VM) se définit comme la répétition mentale d’une action, sans mouvement musculaire visible, et il a été démontré que ce type d’exercice mental améliorait l’acquisition de compétences techniques et opératoires. Toutefois, le rôle de la VM visant à faciliter l’acquisition de compétences non techniques, réalisées en équipe, dans la prestation des soins aux traumatisés reste à étudier.

Méthode

Après répartition aléatoire, des résidents en anesthésiologie, en médecine d’urgence et en chirurgie ont été divisés en équipes de deux membres, elles-mêmes dirigées au hasard vers le groupe de VM ou vers le groupe témoin. Le groupe de VM s’est concentré sur une VM de 20 minutes, tandis que le groupe témoin a reçu une formation de 20 minutes sur les principes des soins avancés de réanimation traumatologique (Advanced Trauma Life Support© [ATLS]). Par la suite, toutes les équipes ont participé à une simulation réaliste de réanimation chez des adultes traumatisés, après quoi elles ont reçu un compte rendu sur la communication, le pouvoir d’influence et le travail d’équipe. Deux examinateurs tenus dans l’ignorance des faits ont évalué, chacun de leur côté, les enregistrements vidéo des réanimations simulées, et ce, à l’aide de la Mayo High Performance Teamwork Scale (MHPTS), une échelle validée d'évaluation du comportement en équipe. Le test U de Mann-Whitney a servi à évaluer les écarts entre groupes.

Résultats

Soixante-dix-huit résidents ont donné, par écrit, leur consentement éclairé, puis ont été retenus pour l’étude. Le groupe de VM a obtenu des résultats significativement meilleurs que le groupe témoin en ce qui concerne le comportement en équipe, d’après la Mayo Team Scale (MHPTS: r=0,67; p<0,01).

Conclusions

La VM a permis d’améliorer les compétences liées au travail d’équipe comparativement à la formation classique, fondée sur la simulation, sur les soins à donner aux traumatisés. Les auteurs sont d’avis que la VM pourrait s’avérer un outil utile et économique, qui permettrait d’améliorer l’efficacité de la formation sur les compétences non techniques, dans la prestation des soins en équipe, en traumatologie.

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Copyright
Corresponding author
Correspondence to: Dr. Christopher Hicks, Department of Emergency Medicine, St. Michael’s Hospital, 30 Bond Street, 1-008e Shuter Wing, Toronto, ON M5B 1W8; Email: hicksc@smh.ca
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Canadian Journal of Emergency Medicine
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  • EISSN: 1481-8035
  • URL: /core/journals/canadian-journal-of-emergency-medicine
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