Newsletter 2023
Simulation Committee 2022 report
ESAIC and SESAM collaborate to run Simulation Instructors Training in Advanced Airway Management in Romania
Crina Burlacu
Member of the ESAIC Simulation Committee
Creating a national simulation-based education and training (SBET) curriculum for training anaesthesiology residents is no small task. Very few countries in Europe have attempted to do so, and even fewer have implemented mandatory SBET in their anaesthesiology residency programme1.
The road to developing, implementing, and standardising simulation training in anaesthesiology across Europe may appear long and scattered with obstacles, yet an important milestone has just been reached.
On October 28th – 30th 2022, a Simulation Instructors Training in Advanced Airway Management course took place in the historic city of Timişoara in south-west Romania, under the auspices of the European Society of Anaesthesiology and Intensive Care (ESAIC), the Society for Simulation in Europe (SESAM), and the Romanian Society of Anaesthesiology and Intensive Care (Societatea Română de Anestezie si Terapie Intensiva) (SRATI).
This course is part of a wider collaborative project between the ESAIC Simulation Committee and SESAM, as formally agreed in 2021. It builds on the vision of former SESAM Presidents Dr David Grant and Dr Marc Lazarovici, as also endorsed by the current SESAM President, Dr Francisco Maio Matos. During their respective tenures, they endorsed the development of national champions in simulation and national simulation development programmes. It also draws upon a recent survey conducted by the ESAIC Simulation Committee chaired by Prof. Doris Østergaard, which showed a wide variation in SBET development and utilization for anaesthesiology residents training across Europe1. The ESAIC Education Committee, chaired by Prof. Stefan De Hert, recognises the need to support European countries to achieve similar standards of SBET2.
On the other hand, the SRATI Executive showed initiative and proactivity by approaching ESAIC as early as 2020 to ask for a template for a national simulation curriculum. A successful project aimed at developing a simulation curriculum in Romania would create the foundation for other European countries to follow.
Amidst strong commitment from the 3 societies, a plan for a Simulation Instructors Training in Advanced Airway Management course emerged in late 2021 – early 2022. This would be followed by developing and rolling out a National Advanced Airway Management (NAAM) course for Romanian anaesthesiology residents. The ESAIC and SESAM would provide specialist expertise to train existing and new Romanian faculty. Faculty would practice and develop new expertise in airway management and airway teaching skills as per the Difficult Airway Society (DAS) guidelines. They would also acquire confidence in conducting high-fidelity manikin-based simulation training. SRATI would manage the planning at a national level by integrating this course (and other similar courses) into the residency programme.
A group of international experts with the participation of Prof. Doris Østergaard (Copenhagen, Denmark), Dr Marc Lazarovici (Munich, Germany) and Assoc. Clin. Prof. Crina Burlacu (Dublin, Ireland) worked together to devise a comprehensive NAAM course outline to teach technical and social and cognitive (non-technical) skills, adult education principles and debriefing techniques as anaesthesia crisis management principles related to airway crises.
The international group travelled to the beautiful city of Timişoara at the end of October to conduct simulation instructor training and develop new connections with the Romanian faculty. Dr Daniela Godoroja, a Romanian anaesthesiologist and European Airway Management Society (EAMS) committee member, also contributed to the programme with an excellent lecture on the standardisation of airway management and training as a prerequisite for patient safety.
The 2 ½ day course was attended by 25 consultant anaesthesiologists, ‘medici specialists, specialists and ‘medici primari’, senior specialists, the head of the department, teaching faculty and several residents from 5 university-affiliated simulation centres in Bucharest, Târgu Mureş, Cluj-Napoca, Iaşi and Timişoara. The course outline consisted of a mixture of pre-reading material and lectures, video-assisted learning material, airway skills training and airway simulation scenarios. There were multiple delegate opportunities to learn and practice airway skills but also to practice airway skills teaching and debriefing after the simulation, often teaching and offering constructive feedback to each other. The delegates were asked to immerse themselves in a ‘hot-seat’, confederate or debriefer role for the simulation component. They also got an insight into setting up a full-scale realistic simulation, simulator controls and operations, and scenario writing. The primary course language was English; however, every now and then, the delegates and faculty slipped into teaching and conversing in Romanian. (Drs. Lazarovici and Burlacu are both of Romanian origin and have professionally interacted with their Romanian colleagues over the years).
The course was a great success. For us, the international faculty group, the display of interest in this project, the commitment to learning in general and the proactivity and dynamism of the delegates were inspiring. There were many rewarding delegate comments, e.g. ‘excellent organization’, ‘outstanding’, ‘extraordinary experience’. ‘you made us feel safe’ and ‘thank you very much for everything’.
The course concluded with a Q&A and planning meeting to discuss the next steps towards developing and implementing this course in the Romanian residency programme. Timelines have been agreed upon, and equipment sourcing, preparation of video-assisted material and scenario writing have already started in the 5 regions.
Finally, a few acknowledgements are necessary. The course wouldn’t have been possible without the leadership of Prof. Şerban Bubenek, SRATI President, and Prof. Dorel Săndesc, SRATI Vice-President and Head of the Discipline of Anaesthesiology and Intensive Care, University of Medicine and Pharmacy, Timişoara. Special thanks go to the local co-ordinator Assist. Prof. Claudiu Bârsac, the local anaesthesiology simulation lead, worked very hard to ensure a wonderful learning and social experience for the delegates and faculty alike.
The simulation facilities available at Timişoara Simulation Centre and other regions in Romania, from the physical space to a large range of part-task trainers and simulation manikins, are all state-of-the-art. Yet, as the Romanian saying ‘omul sfinţeşte locul’ goes (the closest equivalent in English I could find would be “a good farmer makes a good farm,”), people like Dr Bârsac and his colleagues, all simulation leads from the 5 regions, are the people who are to be commended for their passion and commitment to SBET. Last but not least, this course wouldn’t have been possible without the financial support from SRATI and sponsorship from several industry partners.
References
- Savoldelli GL, Østergaard D. ittee. Eur J Anaesthesiol. 2022 Jun 1;39(6):558-561. doi: 10.1097/EJA.0000000000001667. Epub 2022 Feb 21. PMID: 35190515.
- De Hert SEur J Anaesthesiol. 2022 Jun 1;39(6):487-488. doi: 10.1097/EJA.0000000000001687. PMID: 35608875.
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