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Does the age of acute care physicians impact their (1) crisis management performance and (2) learning after simulation-based education? A protocol for a multicentre prospective cohort study in Toronto and Ottawa, Canada
  1. Fahad Alam1,
  2. Vicki R LeBlanc2,3,
  3. Alan Baxter4,
  4. Jordan Tarshis1,
  5. Dominique Piquette5,
  6. Yuqi Gu4,
  7. Caroline Filipkowska6,
  8. Ashley Krywenky7,
  9. Nicole Kester-Greene6,
  10. Pierre Cardinal8,
  11. Shelly Au1,
  12. Sandy Lam4,
  13. Sylvain Boet2,3,4,
  14. Perioperative Anesthesia Clinical Trials Group9
  1. 1 Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
  2. 2 Department of Innovation in Medical Education and University of Ottawa Skillssy, University of Ottawa, Ottawa, Ontario, Canada
  3. 3 Simulation Centre, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
  4. 4 Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Toronto, Ontario, Canada
  5. 5 Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
  6. 6 Department of Emergency Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
  7. 7 Department of Emergency Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
  8. 8 Department of Critical Care Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
  9. 9 Department of Anesthesia, University of Manitoba, Winnipeg, Canada
  1. Correspondence to Dr Fahad Alam; fahad.alam{at}


Introduction The proportion of older acute care physicians (ACPs) has been steadily increasing. Ageing is associated with physiological changes and prospective research investigating how such age-related physiological changes affect clinical performance, including crisis resource management (CRM) skills, is lacking. There is a gap in the literature on whether physician’s age influences baseline CRM performance and also learning from simulation. We aim to investigate whether ageing is associated with baseline CRM skills of ACPs (emergency, critical care and anaesthesia) using simulated crisis scenarios and to assess whether ageing influences learning from simulation-based education.

Methods and analysis This is a prospective cohort multicentre study recruiting ACPs from the Universities of Toronto and Ottawa, Canada. Each participant will manage an advanced cardiovascular life support crisis-simulated scenario (pretest) and then be debriefed on their CRM skills. They will then manage another simulated crisis scenario (immediate post-test). Three months after, participants will return to manage a third simulated crisis scenario (retention post-test). The relationship between biological age and chronological age will be assessed by measuring the participants CRM skills and their ability to learn from high-fidelity simulation.

Ethics and dissemination This protocol was approved by Sunnybrook Health Sciences Centre Research Ethics Board (REB Number 140–2015) and the Ottawa Health Science Network Research Ethics Board (#20150173–01H). The results will be disseminated in a peer-reviewed journal and at scientific meetings.

Trial registration number NCT02683447; Pre-results.

  • adult anaesthesia

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  • Contributors FA and SB contributed to secure research funding and conceived and designed all aspects of the study protocol. AB, VRL, JT, DP, CF, NK-G, YG, AK, PC, SA and SL contributed to the study design. FA, SB and SA drafted and finalised the manuscript. All authors have approved the final manuscript. This study has been endorsed by the Perioperative Anesthesia Clinical Trials Group.

  • Funding At the time of submission, this study has received two grants from (1) Phil R. Manning Research Award, Continuing Medical Education, the Society for Academic Continuing Medical Education; and (2) Department of Innovation in Medical Education, Education Healthcare Grant, University of Ottawa. Dr Boet was supported by The Ottawa Hospital Anesthesia Alternate Funds Association.

  • Disclaimer Funders have no role in the study design, data collection, management, analysis or interpretation of the data.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethical approval was received from the Ottawa Health Science Network Research Ethics Board (#20150173–01 hour) (Ottawa, Ontario) and the Sunnybrook Health Sciences Centre, Research Ethics and Human Research Protections Program (#140–2015) (Toronto, Ontario).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data sharing is not applicable for this article as no data has been analysed during this stage. Only study investigators will have access to the final trial data set to maintain privacy of participants.

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