Department of Surgery, Emory University School of Medicine, Grady Memorial Hospital, Glenn Memorial Building, 69 Jesse Hill Jr. Ave., Suite No. 315, Atlanta, GA 30303, USA.
J Surg Res. 2011 May 15;167(2):223-30. doi: 10.1016/j.jss.2009.08.030. Epub 2009 Sep 23.
Critical care training for medical personnel is crucial for the survival of the highest acuity patients. The Fundamental Critical Care Course (FCCS), a critical care course developed by the Society of Critical Care Medicine, permits course adaption and, thus, has potential for global dissemination. The FCCS course was provided in two Kenyan hospitals after minimal adaption. Participant knowledge and confidence gain as well as FCCS applicability to an African context were evaluated.
Questionnaires and a multiple-choice test were administered to assess knowledge, attitude, and self-reported confidence or self-efficacy. For applicability, the pre-course questionnaire assessed participant expectations and existing levels of confidence/knowledge in the care of the critically ill patient. Post-course, the participant evaluated the overall quality of the course, lectures, and skill stations along with context applicability questions.
There were 100 participants, 45 doctors, 45 nurses, and 10 clinical officers. There was a 22.7% gain in the mean test score (P < 0.0001) after the course, with 98% of participants showing improvement. Confidence to perform new skills post-course, or self-efficacy, was demonstrated by a median of 4 or greater on a Likert scale of 5 (most confident) in 10 of 12 clinical scenarios and in 11 of 14 new procedures. There was a consistency between areas reported as needed expertise, and participant evaluation of similar lecture and skill station's quality and appropriateness. The most common areas reported were mechanical ventilation, patient monitoring, and their related procedures.
The FCCS course met participant's expectations and was reported as applicable for the Kenyan context with minimal adaption. Post-course, knowledge improved and confidence increased for implementation of new skills in clinical care situations. We confirmed the effectiveness and relevancy of the FCCS course for other resource-constrained health care settings.
对医务人员进行重症监护培训对于挽救最高危患者的生命至关重要。由重症监护医学会开发的基础重症监护课程（FCCS）允许课程适应，因此具有全球传播的潜力。FCCS 课程在肯尼亚的两家医院进行了最小的调整后提供。评估了参与者的知识和信心的提高以及 FCCS 对非洲背景的适用性。
通过问卷调查和多项选择题评估知识、态度以及自我报告的信心或自我效能。为了评估适用性，在课前问卷中评估了参与者对危重病患者护理的期望和现有信心/知识水平。课后，参与者评估了课程的整体质量、讲座和技能站以及与背景适用性相关的问题。
共有 100 名参与者，其中 45 名医生、45 名护士和 10 名临床医生。课程后平均测试成绩提高了 22.7%（P < 0.0001），98%的参与者表现出提高。在 12 个临床场景中的 10 个和 14 个新程序中的 11 个中，参与者在 5 分制的 Likert 量表上以 4 或更高的中位数表示对新技能的信心，即自我效能。在报告需要的专业知识领域与参与者对类似讲座和技能站的质量和适当性的评估之间存在一致性。最常见的报告领域是机械通气、患者监测及其相关程序。
FCCS 课程满足了参与者的期望，并被报告为在肯尼亚背景下具有最小适应性。课后，知识得到了提高，参与者在临床护理环境中实施新技能的信心也得到了增强。我们证实了 FCCS 课程在其他资源有限的医疗保健环境中的有效性和相关性。
