From Emergency Room to Operating Room: Multidisciplinary Simulation Training in Emergency Laparotomy for Ruptured Abdominal Aortic Aneurysm - Learning Outcomes and Costs.

BACKGROUND: Opportunities to practice emergency laparotomy (EL) and open surgical repair (OSR) for a ruptured abdominal aortic aneurysm (rAAA) are limited. While simulation-based training (SBT) is effective in educating healthcare professionals in medical emergencies, SBT specifically in EL and OSR for rAAA is scarce. It takes a team to diagnose a patient with massive abdominal bleeding, such as in rAAA, to organize primary care, and to provide definite treatment without unnecessary delays. This study investigated the effects of multidisciplinary EL simulation training in OSR for rAAA, from the emergency room (ER) to the operating room (OR), on trainees' learning outcomes and the costs of the training.

METHODS: A total of 162 healthcare professionals in 21 simulated emergency laparotomy teams participated in a structured 2-hour course consisting of an introductory lecture and a simulation scenario followed by debriefing. Data were collected using a pre-post self-assessment questionnaire and the T-NOTECHS scale. Implementation costs and the cost of education were calculated.

RESULTS: Simulation training improved knowledge, skills, and attitudes of both physicians and nurses. Most of the non-technical skills studied were significantly enhanced in both professional groups. The total cost of the simulation training was €29 415, cost per team €1,400 and cost per participant €182.

CONCLUSIONS: Multidisciplinary EL simulation training in OSR for rAAA from the ER to the OR is effective in improving knowledge, skills, and attitudes, as well as non-technical skills among both physicians and nurses. The overall costs of training seem reasonable given the significant learning outcomes.