Friedman Debbie, Zaveri Pavan, O'Connell Karen
Children's Hospital Los Angeles, Los Angeles, CA, USA.
Pediatr Emerg Care. 2010 Jul;26(7):490-4. doi: 10.1097/PEC.0b013e3181e5bf34.
Resuscitation of the acutely ill child is a necessary skill for pediatric residents. The effects of a hospital-wide mock code program on involvement, anxiety, and leadership have not been studied. We hypothesized that after 1 year of mock codes, pediatric residents would report (1) increased participation, (2) decreased anxiety and increased comfort with knowledge, and (3) increased likelihood of leading and feeling capable of running a code.
In this cross-sectional study of pediatric residents, anonymous surveys evaluated involvement, comfort, and leadership in codes before and 1 year after a monthly mock code curriculum was incorporated into the resident educational curriculum. The survey measured residents' involvement in actual and mock codes and levels of anxiety, knowledge, and leadership ability during codes.
Approximately 60 residents returned completed survey forms each year. Attendance and participation at actual codes were not significantly changed between years. For mock codes, there was a significant change (P < 0.001) in both observation and participation. After 1 year, residents reported a statistically significant increase in their comfort with knowledge during a code (odds ratio, 2.5; 95% confidence interval, 1.2-5.2). They also reported a decrease in anxiety and felt more capable of running a code, although these numbers were not statistically significant.
One year after starting a mock code program, residents attended more mock codes and reported more comfort with knowledge in codes. A continued monthly mock code program will provide residents with critical skills training and experience and may translate into active participation, increased leadership, and decreased anxiety in actual codes.
对危重症患儿进行复苏是儿科住院医师必须掌握的技能。医院范围内的模拟急救演练项目对参与度、焦虑情绪和领导能力的影响尚未得到研究。我们假设，在进行1年的模拟急救演练后，儿科住院医师会报告：（1）参与度提高；（2）焦虑感降低，对知识的掌握更有信心；（3）主导急救过程和感觉有能力主持急救的可能性增加。
在这项针对儿科住院医师的横断面研究中，通过匿名调查评估了在住院医师教育课程中纳入每月模拟急救演练课程之前及之后1年，住院医师在急救中的参与度、信心和领导能力。该调查衡量了住院医师在实际急救和模拟急救中的参与情况，以及急救过程中的焦虑水平、知识掌握情况和领导能力。
每年约有60名住院医师返回填写完整的调查问卷。不同年份间实际急救的出勤和参与情况无显著变化。对于模拟急救，观察和参与情况均有显著变化（P < 0.001）。1年后，住院医师报告在急救过程中对知识的掌握更有信心，差异有统计学意义（优势比为2.5；95%置信区间为1.2 - 5.2）。他们还报告焦虑感降低，感觉更有能力主持急救，尽管这些数字无统计学意义。
启动模拟急救演练项目1年后，住院医师参加了更多的模拟急救，并报告在急救中对知识的掌握更有信心。持续开展每月一次的模拟急救演练项目将为住院医师提供关键技能培训和经验，可能转化为在实际急救中的积极参与、领导能力增强和焦虑感降低。
