Interdisciplinary Crisis Resource Management Training: How Do Otolaryngology Residents Compare? A Survey Study

Abstract

Objective: Emergent medical crises, such as acute airway obstruction, are often managed by interdisciplinary teams. However, resident training in crisis resource management traditionally occurs in silos. Our objective was to compare the current state of interdisciplinary crisis resource management (IDCRM) training of otolaryngology residents with other disciplines.

Methods: A survey study examining (1) the frequency with which residents are involved in interdisciplinary crises, (2) the current state of interdisciplinary training, and (3) the desired training was conducted targeting Canadian residents in the following disciplines: otolaryngology, anesthesiology, emergency medicine, general surgery, obstetrics and gynecology, internal medicine, pediatric emergency medicine, and pediatric/neonatal intensive care.

Results: A total of 474 surveys were completed (response rate, 12%). On average, residents were involved in 13 interdisciplinary crises per year. Only 8% of otolaryngology residents had access to IDCRM training, as opposed to 66% of anesthesiology residents. Otolaryngology residents reported receiving an average of 0.3 hours per year of interdisciplinary training, as compared with 5.4 hours per year for pediatric emergency medicine residents. Ninety-six percent of residents desired more IDCRM training, with 95% reporting a preference for simulation-based training.

Discussion: Residents reported participating in crises managed by interdisciplinary teams. There is strong interest in IDCRM and crisis resource management training; however, it is not uniformly available across Canadian residency programs. Despite their pivotal role in managing critical emergencies such as acute airway obstruction, otolaryngology residents received the least training.

Implication: IDCRM should be explicitly taught since it reflects reality and may positively affect patient outcomes.

Keywords: crisis resource management; interdisciplinary; medical education; multidisciplinary; patient safety/quality improvement; resident training.

Figure 1.

Percentage of residents who reported receiving formal training, presented by specialty. CRM, crisis resource management; IDCRM, interdisciplinary crisis resource management.

Figure 2.

Average reported training currently received (hours per year): (a) including average reported desired training and (b) including only those receiving training. CRM, crisis resource management; IDCRM, interdisciplinary crisis resource management.

Figure 3.

Resident self-perceived preparedness to manage interdisciplinary crisis, presented by resident specialty (percentage of residents responding to each Likert scale option).