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Comparing Resource Management Skills in a High- versus Low-Resource Simulation Scenario: A Pilot Study

Published online by Cambridge University Press:  06 December 2019

Alba Ripoll Gallardo
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
Grazia Meneghetti
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
Jeffrey M. Franc
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
Alessandro Costa
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
Luca Ragazzoni
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
Moran Bodas
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
Vaclav Jordan
Affiliation:
Department Gynaecology and Obstetrics, Schiers Hospital, Switzerland
Francesco Della Corte*
Affiliation:
CRIMEDIM – Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale, Novara, Italy
*
Correspondence: Francesco Della Corte, MD Via Lanino 1, 28100, Novara, NO, Italy E-mail: francesco.dellacorte@med.uniupo.it

Abstract

Background:

Low-resource environments, such as those found in humanitarian crises, pose significant challenges to the provision of proper medical treatment. While the lack of training of health providers to such settings has been well-acknowledged in literature, there has yet to be any scientific evidence for this phenomenon.

Methods:

This pilot study utilized a randomized crossover experimental design to examine the effects of high- versus low-resource simulated scenarios of a resuscitation of a critically ill obstetric patient on a medical doctors’ performance and inter-personal skills. Ten senior residents (fifth-year post-graduate) of the Maggiore Hospital School of Medicine (Novara, NO, Italy) were included in the study.

Results:

Overall performance score for the high-resource setting was 5.2, as opposed to only 2.3 for the low-resource setting. The mean effect size for the overall score was 2.9 (95% CI, 1.7–4.0; P <.001). The results suggest a significant decrease in both technical (medical) and non-technical skills, such as leadership, problem solving, situation awareness, resource utilization, and communication in the low-resource environment setting. The latter finding is of special important since it was yet to be reported.

Conclusions:

This pilot study suggests that untrained physicians in low-resource environments may experience a considerable setback not only to their professional performance, but also to their interpersonal skills, when deployed ill-prepared to humanitarian missions. Consequently, this may endanger the health of local populations.

Type
Brief Report
Copyright
© World Association for Disaster and Emergency Medicine 2019

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