Cordula M. Wetzel

High fidelity simulations within the operating theatre (OT) require physical infrastructure and a full OT team. Such teams place heavy demands on clinical service. Research and training programmes in our surgical department were often compromised by the late cancellation of anaesthetists. This paper describes and evaluates a training programme in which actors were trained as simulated anaesthetists. The training programme was developed, piloted and implemented in a surgical education programme. Evaluation consisted of interviews with actors after the series of simulations. Surgical participants were not informed that the anaesthetist was an actor until after the simulation when they completed an interview and a 10-point authenticity scale (1 = not at all to 10 = highly authentic). Three actors played the role of anaesthetists in 34 scenarios with 17 surgeons in simulations of carotid endarterectomy. Although initially anxious about their role, actors found the training programme valuable and came to feel confident. Mean ratings of anaesthetist authenticity was 8.1 (Range 2-10). Surgeons' comments showed that in most scenarios they found the anaesthetist's performance highly authentic. Although this study demonstrates the feasibility of using actors as anaesthetists in high fidelity surgical simulations, there are also limitations. Factors contributing to success included: selective actor recruitment; written training materials; formal OT orientation, audio link between the control room and the actor; the opportunity to rehearse; and, structured observations.