Aims (1) Understand the impact of cardiopulmonary bypass (CPB), (2) Manage complications arising during CPB, Clarify roles of team members, (3) Practice team communication for coordinated patient care.
Background The cardiac anaesthesia setting is a highly dynamic environment requiring continuous processing of feedback from multiple sources. CAST is a valuable enhancement to prepare and orientate residents to the high risk environment. We report our continuing efforts to develop CAST for our first year anaesthesia residents using a high-fidelity simulator, adapted to simulate the CPB state.
Methodology The course is led by a multidisciplinary faculty, including surgeons and perfusionists. The simulation scenarios focused on management of complications during CPB, re-warming and weaning from bypass (e.g. arrhythmias, electrolyte abnormalities and protamine reactions). This is followed by facilitated debriefing. Pre-reading, pre-/post-tests and short didactics are also used to augment the learning experience.
Outcomes To date, 26 residents have undergone CAST, including 2 cardiac surgical residents, who found CAST useful in fostering inter-professional understanding and learning. 92% of the residents scored CAST ‘Excellent or Good’ for clarity of the course objectives, 84% for reinforcing knowledge, and 66.6% for‖improvement of communication. The challenges faced by faculty included getting buy-in from stake-holders from different disciplines, securing protected time for residents and faculty, and developing a comprehensive lesson plan to address different training needs of the multidisciplinary team. Recommendations and take home messages CAST scenarios with varying complexity targeted at training our advanced residents are currently in development. There is also potential to develop a separate course with an emphasis on non-technical skills (e.g. team‖communication) and inter-professional education.
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