Procedural Sedation

The procedural sedation project is an undertaking by the University of Illinois College of Medicine at Peoria (UICOMP) along with OSF HealthCare and Jump Simulation. The goal of the study is to analyze whether video self-assessment works as well as standard debriefing in residents' performance of simulated procedural sedation.

Background

Standard debriefing with expert physicians is common practice in medical training, including the training of resident physicians. It involves everyone who would be in the room at the time a procedure takes place. It can involve the physician, nurse, a medical student or any participant who may be in on that patient's care.

The goal of this project is to determine if using video self-assessment in the setting of sedation simulation will affect error recognition and error rate. The hypothesis is that self-assessment versus standard debriefing will not alter the rate of error detection and correction during a simulated procedural sedation. Debriefing is a time and labor intensive activity; if one could establish an equivalent process (video debriefing), it may result in less human resource utilization.

Data Collection

The sedation research study began in May 2013 with a pilot study of 10 senior residents. The full cohort study began in December 2013, and currently 28 Emergency Medicine residents have enrolled to date.

Emergency Medicine residents with one to three years of training are presented with an emergency pediatric simulated scenario in which the patient requires sedation in order to repair, or otherwise treat his/her condition. After every simulation, participants are randomized to either standard debriefing or video self-assessment to determine how they responded to the situation. A standardized assessment checklist is used by both the participant and facilitator. The checklist contains every stage of the procedure.

Residents randomized to standard debriefing are then debriefed with the facilitator and standardized participants involved in the case. Those randomized to undergo video self-assessment are immediately taken to a private room to watch themselves on video replay, and identify errors of their performances using a checklist.

Results

The procedural sedation study is still ongoing, but interim analysis has been promising. Initial results show that faculty and resident self-evaluations and standard debriefings are similar. But more data needs to be collected to provide a better statistical outcome.