Simulation training improves team dynamics and performance in a low-resource cardiac intensive care unit.

Introduction : Although simulation training has been utilized quite extensively in high-income medical environments, its feasibility and effect on team performance in low-resource pediatric Cardiac Intensive Care Unit (CICU) environments has not been demonstrated. We hypothesized that low-fidelity simulation-based crisis resource management training would lead to improvements in team performance in such settings. Methods : In this prospective observational study, the effect of simulation on team dynamics and performance was assessed in 23 health-care providers in a pediatric CICU in Southeast Asia. A 5-day training program was utilized consisting of various didactic sessions and simulation training exercises. Improvements in team dynamics were assessed using participant questionnaires, expert evaluations, and video analysis of time to intervention and frequency of closed-loop communication. Results : In subjective questionnaires, participants noted significant (P < 0.05) improvement in team dynamics and performance over the training period. Video analysis revealed a decrease in time to intervention and significant (P < 0.05) increase in frequency of closed-loop communication because of simulation training. Conclusions : This study demonstrates the feasibility and effectiveness of simulation-based training in improving team dynamics and performance in low-resource pediatric CICU environments, indicating its potential role in eliminating communication barriers in these settings.