Armson A1, Darby L1
1Careflight Northern Operations
Biography:
Andrew Armson is an Anaesthetic Registrar in Sydney and a Fellow of the Royal College of Anaesthetists (UK). With postgraduate qualifications in Medical Education, Andrew has a strong background in human factors research and simulation-based training. He is currently Communication Lead for the Human Factors in Surgery Network. Louis Darby is a London-based Emergency Medicine Registrar with a committed interest in pre-hospital medicine. The pair worked as Retrieval Registrars with CareFlight in the Northern Territory. Here, they developed ‘Flight Deck’ — a novel, opportunistic simulation tool designed to enhance multidisciplinary team cohesion and crisis management during retrieval missions.
Abstract
Aims
CareFlight’s Northern Territory retrieval service manages clinical emergencies across vast distances with unique aeromedical challenges and ever-changing teams. ‘Flight-Deck’, a novel simulation tool, was developed to stimulate critical discussion and verbal rehearsal in this context. Through structured, in-situ scenarios, the resource aims to simulate operational and clinical crises, enhancing human factor awareness and team cohesion during flight missions.
Methods
Designed for application during operational missions, teams select a random scenario flashcard on appropriate outbound flights. Utilising the TEAM framework and SHEEP/SHELL models, the multidisciplinary crew—including doctor, nurse, and pilot—engages in five-minute collaborative discussions concerning clinical priorities, logistical challenges and team coordination. Scenarios range from equipment failures to critical events like pilot incapacitation or in-flight cardiac arrest.
Results
Flight-Deck addresses the challenge of providing consistent training in a fast-paced service with limited downtime. By integrating simulation directly into the working environment, teams identify aircraft-specific ergonomic and practical constraints. Preliminary evaluation (n=8) across all roles showed high engagement, with mean scores of 4.88/5 for resource usefulness and 4.75/5 for fostering team cohesion and managing infrequent emergencies. Qualitative feedback highlighted the tool’s success in flattening professional hierarchies and identifying overlooked operational risks. Participants valued the "shared mental models" and "interprofessional learning" facilitated between clinicians and pilots, which provide a rare opportunity for collaborative crisis rehearsal.
Conclusions
Flight-Deck demonstrates that brief, verbal simulations are a high-impact method for maintaining crisis resource management skills. The initiative successfully bridges the gap between theoretical human factors and frontline practice, ultimately enhancing team resilience and patient safety.