HIGH FIDELITY SIMULATION OF CONTRAST MEDIA ADVERSE REACTIONS AS A LIFELONG LEARNING OPPORTUNITY: A PILOT STUDY

Background:
Nowadays, lifelong learning and simulation-based learning (SBL) are recognized as important teaching tools for healthcare professionals in clinical practice. SBL enables and highlight behaviours, skills and attributes and can be used to identify weakness and implement improvements in a controlled and safe environment. Adverse Contrast media reactions, namely severe ones, present a low occurrence, making management in those situations a great target for lifelong and SBL training. The main goal was to develop a SBL opportunity on adverse contrast media reactions management for all team of the radiology department. Educational objectives were to enhance and develop technical, problem-solving and interpersonal skills as well as to implement teamwork values.

Methods:
Participants were divided into 2 sessions performed in 2 different days (8 hours per session). The training program included basic life support and 2 clinical simulation scenarios. Clinical simulation scenarios (moderate and severe anaphylactic reaction) were constructed based on a Portuguese Guideline for Anaphylaxis management in healthcare institutions. In each simulation scenario, 4 phases of the learning process were accomplished: introduction to the context, briefing, clinical simulation and debriefing. In each session participants were divided in 2 independent groups that performs same scenarios alternately. At arrival, participants were introduced to the context, that they would work in a scenario of performing a CT scan with contrast media administration. Half group participated actively in the procedure while the remaining group could attend remotely through the internal video system. At the end everyone participated in the discussion of learning. All participants gave their free and informed consent to participate in the survey and for recording video images. Before and after the experience, participants fulfil a questionnaire, using a 5-point Likert scale. The first one aimed to know prior experiences and motivations and the second one was focused on learning experience, acquired knowledge, confidence to solve the scenarios in real life and simulation evaluation.

Results:
The course had a total of 37 participants (21 radiographers, 10 operational assistants, 3 radiologists and 3 nurses) of the Radiology department. Before the course participants were very motivated (Mean 4.39±0.82) but assumed that they had a small experience when leading with emergencies (Mean 2.25±1.10) and low level of Knowledge in their management (Mean 2.65±0.92). After the course, participants reported an improvement on their level of knowledge (Mean 3.71±0.65) statistically significant (p<0,05). All participants considered that their experience increased after the course and their motivation regarding new clinical simulations was very high (Mean 4.68±0.61).

Conclusions:
High fidelity SIMULAtion of Contrast Media adverse reactions improve the level of knowledge and “hands-on” experience of all participants witch can lead to the improvement of patient management in anaphylactic reactions in clinical practice. The motivation to participate in new clinical simulation scenarios was very high because they “promote efficient coordination”, “share experiences between specialties an professions” and “optimize individual and team function” during an adverse event. So, the use of a SLB can replicate day-to-day experience and empower multidisciplinary teams in a safe environment.