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Impact of Promoting Excellence and Reflective Learning in Simulation (PEARLS) Debriefing Training during COVID-19: Changes in Perception of Barriers, Comfort and Frequency of Hot Debriefing (1090-003879) (Developmental Research Projects: Communication, Debriefing, Faculty Training (By Invitation Only))
Start time: Thursday, February 4, 2021, 2:00 PM End time: Thursday, February 4, 2021, 3:00 PM Session Type: Research Study Development and Presentation Program Abstracts Cost: $0.00
Content Category: Researcher
Hypothesis:
Pandemics have a profound psychological impact on healthcare workers and lead to an increased burden of depression, anxiety, and Post-Traumatic Stress Disorder. (1) Debriefing decreases professional burnout, increases morale and resilience, (6) and improves clinical outcomes. (3,4) Creating and cultivating an environment where all team members feel safe expressing ideas, perspectives, concerns, and emotions is essential to team member learning and growth. (2) Our training institutions Kings County Hospital and University Hospital of Brooklyn experienced a massive surge of COVID-19 cases resulting in an unprecedented number of deaths. Concerned for the psychological health of our workforce who were being placed in chaotic clinical scenarios with high levels of moral distress, we set out to educate and empower our team using the PEARLS debriefing framework. Our hypothesis was that PEARLS would improve debriefing frequency and comfort while identifying perceived barriers to debriefing.
Methods:
This is a before-and-after study of 98 EM residents in an ACGME accredited program. Prior to intervention, surveys will assess the current debriefing frequency, comfort, and barriers. Hour-long training sessions using PEARLS are planned to teach the basics of hot debriefing in our weekly resident conference. This post-event debriefing tool emphasizes the physiological well-being and self-reflective assessment of all interprofessional providers. (5) PEARLS pocket cards will be distributed to all staff and posters placed in all clinical areas to reinforce effective debriefing. Three months post-intervention a survey will reassess frequency, comfort with debriefing, and barriers to debriefing. Interval data will be reported as medians with Interquartile ranges (IQR 25%, 75%) and frequency as percentages with 95% Confidence Intervals (95%, CI). Pre- vs. Post-survey testing will utilize Mann-Whitney U or Fishers Exact Test as appropriate with alpha set at 0.05, all tests 2-tailed.
Anticipated Results:
We plan to present the comparisons of pre- and post-intervention surveys assessing the changes in debriefing frequency, comfort, and perceived barriers after PEARLS training. We will present the identified barriers to debriefing in order of most to least common.
Co-Presenter: Dr. Richard Sinert, DO, SUNY Downstate Medical Center About the co-presenter: After completing a Nephrology Fellowship at Mount Sinai Hospital in Manhattan I returned to KCHC where I did my Internal Medicine Residency training and founded the Department of Emergency Medicine (EM) at SUNY/KCHC. The American Board of Emergency Medicine (EM) recognized my efforts in establishing EM and allowed me to become boarded in EM in addition to Internal Medicine and Nephrology. I continued my bench research from my Nephrology background by conducting animal research studying the response to uncontrolled hemorrhage in murine models of human diseases. At this time, I was chosen to be a member of the Institutional Animal Care and Use Committee (IACUC) within a few years becoming its chairman. Concurrently with my bench studies, I, with my chairman, Thomas Scalea, a world famous traumatologist began to study the trauma population at KCHC. KCHC being one of the leading trauma hospitals in the US afforded us a large sample of patients with penetrating trauma from gun shots and stab wounds. We did seminal studies in the utility of base deficit, bicarbonate and lactate as biomarkers to rapidly detect patients with uncontrolled hemorrhage even with normal vital signs. We developed a trauma database for ongoing studies which we used to mentor junior faculty in my department eventually leading to the advancement of Dr. Shahriar Zehtabchi to a tenured full Professor and Dr. Lorenzo Paladino to tenured Associate Professor. I am also mentoring Dr. Jennifer Martindale for her Masters of Clinical Science at the NYU CTSI and her K23 grant application. These studies directly led to NIH awards for murine models of uncontrolled hemorrhage, sepsis and human studies of non-convulsive seizures utilizing a novel mini-EEG machine developed at SUNY. Our department’s success in enrolling subjects in the NETT was quickly recognized by the pharmaceutical industry providing funds for over 10 sponsored studies allowing us to expand our research infrastructure to include three full-time Research Coordinators and a grants writer and administrator, expanding to ED-based cardiology, critical care, and hematology RCTs.
Disclosure: No financial relationships with ineligible companies.
Co-Presenter: Dr. Lorenzo Paladino, State University New York Downstate / Kings County Hospital
Disclosure: No financial relationships with ineligible companies.