Gilfoyle Elaine, Gottesman Ronald, Razack Saleem
Alberta Children's Hospital, Canada.
Med Teach. 2007 Nov;29(9):e276-83. doi: 10.1080/01421590701663287.
Paediatric residency programs rarely prepare trainees to assume resuscitation team leadership roles despite the recognized need for these skills by specialty accreditation organizations. We conducted a needs-assessment survey of all residents in the McGill Pediatric Residency Program, which demonstrated that most residents had minimal or no experience at leading resuscitation events and felt unprepared to assume this role in the future.
We developed an educational intervention (workshop) and evaluated immediate and long term learning outcomes in order to determine whether residents could acquire and retain team leadership skills in pediatric advanced resuscitation.
Fifteen paediatric residents participated in a workshop that we developed to fulfill the learning needs highlighted with the needs assessment, as well as the Objectives of Training in Pediatrics from the Royal College of Physicians and Surgeons of Canada. It consisted of a plenary session followed by 2 simulated resuscitation scenarios. Team performance was evaluated by checklist. Residents were evaluated again 6 months later without prior interactive lecture. Learning was also assessed by self-reported retrospective pre/post questionnaire.
Checklist score (assigning roles, limitations of team, communication, overall team atmosphere) expressed as % correct: initial workshop scenario 1 vs. scenario 2 (63 vs. 82 p < 0.05); 6-month scenario with prior workshop exposure vs. control (74 vs. 50 p < 0.01); initial workshop scenario 2 vs. 6-month scenario control (82 vs. 50 p < 0.001). Retrospective pre/post survey (5 point Likert scale) revealed self-reported learning in knowledge of tasks, impact and components of communication, avoidance of fixation errors and overall leadership performance (p < 0.001).
Residents acquired resuscitation team leadership skills following an educational intervention as shown by both observational checklist scores and self-reported survey. The six-month follow-up evaluation demonstrated skill retention beyond the initial intervention. A control group suggested that these results were due to completion of the first workshop.
尽管专业认证组织已认识到这些技能的必要性，但儿科住院医师培训项目很少让学员承担复苏团队领导角色。我们对麦吉尔儿科住院医师培训项目的所有住院医师进行了一项需求评估调查，结果表明，大多数住院医师在领导复苏事件方面经验极少或全无，且觉得未来没有准备好承担这一角色。
我们开发了一种教育干预措施（工作坊），并评估即时和长期学习成果，以确定住院医师是否能够获得并保持儿科高级复苏中的团队领导技能。
15名儿科住院医师参加了我们开发的一个工作坊，该工作坊旨在满足需求评估中突出的学习需求，以及加拿大皇家内科医师和外科医师学院的儿科培训目标。它包括一次全体会议，随后是2个模拟复苏场景。通过检查表评估团队表现。6个月后，在没有事先互动讲座的情况下再次对住院医师进行评估。还通过自我报告的回顾性前后调查问卷评估学习情况。
检查表得分（分配角色、团队局限性、沟通、整体团队氛围）以正确百分比表示：初始工作坊场景1与场景2（63%对82%，p<0.05）；有工作坊前期接触的6个月场景与对照组（74%对50%，p<0.01）；初始工作坊场景2与6个月场景对照组（82%对50%，p<0.001）。回顾性前后调查（5点李克特量表）显示，在任务知识、沟通的影响和组成部分、避免固定错误以及整体领导表现方面有自我报告的学习（p<0.001）。
观察检查表得分和自我报告调查均显示，住院医师在接受教育干预后获得了复苏团队领导技能。6个月的随访评估表明，技能在初始干预后得以保持。一个对照组表明，这些结果是由于完成了第一个工作坊。
