Background Though rare, power outages in the operating room happen, perhaps at increased frequency due to more extreme weather related to climate change. These situations are dangerous and anesthesiologists must be prepared to manage them. However, evidence suggests that anesthesiologists are insufficiently prepared to manage a power outage and 85% desire more training. This problem could be solved during residency, yet many programs overlook power outage training. Thus, the objective of this study was to fill this training gap by designing a power outage simulation for anesthesiology residents and then assess whether the simulation improved confidence in power outage management.

Methods Our team designed a high-fidelity power outage simulation for PGY-3 and PGY-4 anesthesiology residents. The simulation case involved an intraoperative power loss during an inguinal hernia repair of a patient under general anesthesia. This scenario took place within a simulated operating room at an academic simulation center and included a mannequin as the patient under general anesthesia, a surgeon actor, and a simulation specialist. After the simulation, a debriefing focused on power outage management specifics was led by an anesthesiology faculty member. Once debriefing concluded, the residents completed five-point Likert scale surveys to assess before and after confidence in several aspects of intraoperative power loss management including operating room management, monitoring vital signs, and patient disposition planning. Data were analyzed using a two-tailed paired t-test.

Results Twenty-two anesthesiology residents completed the simulation over two years. Residents' mean confidence in managing a patient in the operating room during a power outage improved by 1.23 points (p=0.001), confidence in monitoring vital signs during a power outage improved by 1.37 points (p=0.001), and confidence in planning appropriate patient disposition during a power outage improved by 0.88 points (p=0.001). After the simulation, 100% of residents strongly agreed or agreed that they could confidently manage a patient in the operating room during a power outage, compared to just 45.5% before the simulation.

Conclusion It is essential to address anesthesiologists’ desire for further power outage training and this simulation seems to fill the power outage training gap. After participating, residents felt confident in their power outage management skills. Other residency programs may consider implementing this simulation. A limitation of the study is that it relied solely on self-reported measures to ascertain simulation effectiveness; thus, future research could involve conducting objective performance assessments such as standardized tests or direct observation of clinical practice.