Medical Error Recognition by Medical Students during Simulated Asystole: Benefits from Teamwork and Assertiveness Training Techniques Used in Aviation

Introduction/Purpose: Our purpose was to determine if a teamwork lecture with first-year medical students using aviation-based methods would yield a perceptible increase in error recognition and intervention.

Methods or Case Description: We recruited first-year medical students without current CPR training and provided American Heart Association certification in CPR techniques. The students were divided into a control group (n=10) and intervention group (n=11). The intervention group received a 90-minute session on aviation-based teamwork and error recognition and two role-playing exercises, including error assessment, just culture, and intervention strategies.

Outcomes: The time (in seconds) in the intervention group was lower as compared to the control group (9.56 +/-2.47, 15.86 +/- 11.19, p=0.11). Forty-two percent of intervention group participants spoke up within a critical 10 second time period, compared to 30% from the control group. We videotaped the simulated exercises, recorded the debriefing sessions, and transcribed both for analysis. Using a combination of manual and NVivo-aided coding, we aggregated the interview results into three thematic clusters: Stress, Real-Life, and Speak Up.

Conclusion: These results indicate the benefit of aviation-based team training and error recognition during simulated scenarios early in medical education.