# A simulation-based role-reversal training program improves knowledge, skills, and job satisfaction of endovascular scrub nurses

## TL;DR

A simulation-based training program improved endovascular scrub nurses' skills, teamwork, and job satisfaction by having them practice as surgeons.

## Contribution

A role-reversal simulation program was adapted for endovascular scrub nurses, showing significant improvements in both technical and non-technical skills.

## Key findings

- Technical skills improved significantly, with Global Rating Scale scores increasing from 19.0 to 43.0.
- Endovascular scrub nurses reported better anticipation of surgeons' needs and improved teamwork in the operating room.
- Participants showed increased job satisfaction and a more collaborative atmosphere after the training.

## Abstract

•Role-reversal simulation-based education program enhances endovascular scrub nurses' technical skills.•Rating Scale scores increased from 19.0 to 43.0 (max 55), Checklist scores from 49.0 to 73.0 (max 85).•Improved understanding of procedures boosts teamwork and job satisfaction.•Endovascular scrub nurses reported better anticipation of surgeons' needs, fostering collaboration.•Potential for role-reversal training to improve surgical outcomes and job satisfaction.

Role-reversal simulation-based education program enhances endovascular scrub nurses' technical skills.

Rating Scale scores increased from 19.0 to 43.0 (max 55), Checklist scores from 49.0 to 73.0 (max 85).

Improved understanding of procedures boosts teamwork and job satisfaction.

Endovascular scrub nurses reported better anticipation of surgeons' needs, fostering collaboration.

Potential for role-reversal training to improve surgical outcomes and job satisfaction.

This study assessed the effectiveness of a modified simulation-based education (SBE) program, originally designed for vascular surgical trainees, adapted for endovascular scrub nurses (ESNs). The goal was to enhance their technical and non-technical skills and explore the program’s impact on operating room (OR) teamwork and workflow.

A mixed-methods design was used. Eleven experienced ESNs—each with experience from approximately 100 endovascular procedures in the past 2–3 years—participated in role-reversal simulations, practicing peripheral endovascular procedures in the role of the surgeon under the guidance of a supervisor. Quantitative assessments included the Global Rating Scale (GRS) and an Examiner’s Checklist for technical skills, while semi-structured interviews provided qualitative insights into non-technical domains such as teamwork, workflow, and job satisfaction.

The program significantly improved ESNs' technical skills, with GRS scores increasing from median [IQR] 19.0 [14.0; 24.0] to 43.0 [32.0; 44.0] (p=.004) and Examiner’s Checklist scores rising from 49.0 [45.0; 58.0] to 73.0 [65.0; 78.0] (p=.004). Qualitative findings, derived from the themes of learning potential, job satisfaction, culture, feedback, overwhelming, and COVID-19, further demonstrated improvements in non-technical domains, including understanding of procedural sequences, teamwork, workflow, and job satisfaction. Participants reported better anticipation of surgeons' needs and a more collaborative atmosphere in the operating room.

The role-reversal simulation-based education program for ESNs improved technical skills and strengthened teamwork and collaboration in the operating room. These findings highlight the potential of role-reversal training to enhance surgical performance and job satisfaction among OR staff.