PURPOSE: Accurate knowledge of elapsed time during IHCPR scenarios is important. Additionally, variations in timing of behaviors during IHCPR may affect patient outcomes. We strove to assess residents’ time perception of IHCPR scenarios using a CPS and to identify factors associated with time distortion.
METHODS: The study took place over six months starting August 25th, 2006 in an urban hospital with 119 internal medicine residents. Each month, residents are led by critical care attendings and fellows in scenario-based training(SBT) with a CPS. The IHCPR team consists of 4 Post-Graduate Year 1 (PGY-1), 2 PGY-2 and 2 PGY-3 residents. Each team participates in two standardized IHCPR scenarios with PGY-3 residents alternating as leader. The scenario begins with one intern responding to a cardiac arrest. Thirty seconds after the start of the scenario, the remaining interns join. Thirty seconds later, the remaining residents enter. After completion, all subjects are independently asked how much time elapsed. An observer records the actual time.
RESULTS: The cohort consisted of 46 subjects, 27(58.7%) of whom were men. Twenty-four(52.2%) were interns and 22(47.8%) were residents. Each subject went through SBT twice, resulting in 92 responses. The mean scenario took 383.6±52.6 s. On average, a subject felt the scenario took 42.6 seconds longer than it actually had (Range -286 to 685 seconds). The mean absolute error was 163.3±153s. Men were more likely to overestimate while women were more likely to underestimate scenario time. Interns were more likely to underestimate scenario time than residents(Table 1).
CONCLUSION: Subjects experience time distortion during IHCPR simulations. On average, house staff believe that the scenario takes longer than it actually does. Women are more likely to underestimate scenario time. Interns are more likely to underestimate scenario time in comparison to residents.
CLINICAL IMPLICATIONS: An objective timekeeper may be needed for appropriate timing of interventions during IHCPR. Time distortion may have implications for assessing reports of time passage from responders such as the time that a patient remained pulseless.
DISCLOSURE: Lewis Eisen, None.