COVID-19 Critical Care Simulations: An International Cross-Sectional Survey

  1. Mohamad-Hani Temsah
  2. Abdulkarim Alrabiaah
  3. Ayman Al-Eyadhy
  4. Fahad Al-Sohime
  5. Abdullah Al Huzaimi
  6. Nurah Alamro
  7. Khalid Alhasan
  8. Vaibhavi Upadhye
  9. Amr Jamal
  10. Fadi Aljamaan
  11. Ali Alhaboob
  12. Yaseen M. Arabi
  13. Marc Lazarovici
  14. Ali M. Somily
  15. Abdulaziz M. Boker

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Abstract

Objective: To describe the utility and patterns of COVID-19 simulation scenarios across different international healthcare centers.

Methods: This is a cross-sectional, international survey for multiple simulation centers team members, including team-leaders and healthcare workers (HCWs), based on each center's debriefing reports from 30 countries in all WHO regions. The main outcome measures were the COVID-19 simulations characteristics, facilitators, obstacles, and challenges encountered during the simulation sessions.

Results: Invitation was sent to 343 simulation team leaders and multidisciplinary HCWs who responded; 121 completed the survey. The frequency of simulation sessions was monthly (27.1%), weekly (24.8%), twice weekly (19.8%), or daily (21.5%). Regarding the themes of the simulation sessions, they were COVID-19 patient arrival to ER (69.4%), COVID-19 patient intubation due to respiratory failure (66.1%), COVID-19 patient requiring CPR (53.7%), COVID-19 transport inside the hospital (53.7%), COVID-19 elective intubation in OR (37.2%), or Delivery of COVID-19 mother and neonatal care (19%). Among participants, 55.6% reported the team's full engagement in the simulation sessions. The average session length was 30–60 min. The debriefing process was conducted by the ICU facilitator in (51%) of the sessions followed by simulation staff in 41% of the sessions. A total of 80% reported significant improvement in clinical preparedness after simulation sessions, and 70% were satisfied with the COVID-19 sessions. Most perceived issues reported were related to infection control measures, followed by team dynamics, logistics, and patient transport issues.

Conclusion: Simulation centers team leaders and HCWs reported positive feedback on COVID-19 simulation sessions with multidisciplinary personnel involvement. These drills are a valuable tool for rehearsing safe dynamics on the frontline of COVID-19. More research on COVID-19 simulation outcomes is warranted; to explore variable factors for each country and healthcare system.

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  1. Version published to 10.3389/fpubh.2021.700769
  2. ScreenIT

    SciScore for 10.1101/2020.11.17.20233262: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the institutional review board at King Saud University approved the study.
    Consent: Waiver for signed consent were obtained, since the evaluation presented no more than minimal risk to subjects and involved no procedures for which written consent is usually required outside the study context.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The data from the questionnaires were transferred into an Excel database.
    Excel
    suggested: None
    Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 21 for windows 8.1.
    Statistical Package for the Social Sciences
    suggested: (SPSS, RRID:SCR_002865)
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    Microsoft Excel V16.43.1® was used for the creation of figures and depictions.
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Moreover, this method offers a means of rapid knowledge dissemination, using very few resources and saving time, PPE, and simulation equipment, while allowing for social distancing, eliminating geography as a limitation to education delivery, and allowing use by HCWs in preparation for in situ simulation training, as more than half of them want to be prepared [(Coyne et al., 2018, Patterson et al., 2013)]. Of note, a recent COVID-19 simulation study found no significant differences between in situ and lab-based simulations for all domains of personal strengths that were assessed among their candidates [(Cheung et al., 2020)]. Study limitations: We included centers with simulation centers in order to survey institutions trained already to simulation drills, this limits our study results as this pandemic is global pandemic affecting any healthcare institution. Our questionnaire was available online worldwide, and we got replies from many countries, representing different regions of the globe. Some regions were represented more heavily, while we got few replies from others. South America was not represented in our sample, and in Europe, we received data only from Spain, the U.K., Italy, Germany, and Russia. Given the diversity of European healthcare systems and the varying degrees of impact of the COVID-19 pandemic in different European countries, the data may not represent the full bandwidth of the reality in European healthcare. Another region with representation that might le...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.11.17.20233262v1 on medRxiv