Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Crit Care Med. 2010 Sep;38(9):1899-903. doi: 10.1097/CCM.0b013e3181eb3ca9.
The purpose of this study was to describe the essential elements of in hospital resuscitation knowledge and skills for senior internal medicine resident physicians and to evaluate a low-fidelity simulation course that incorporates these elements.
In part 1, attending physicians were electronically surveyed using a modified Dillman method. A broad list of knowledge skills sets was gathered from recent resuscitation guidelines. In part 2, a 2-day, low-fidelity simulation, case-based curriculum was designed based on the results of part 1. Course participants were surveyed 1 month before and 1 month after the course.
Four academic teaching hospitals.
Attending physicians in cardiology, critical care, and internal medicine responded to the needs assessment survey. A convenience sample of internal medicine residents responded to the surveys before and after the course.
Respondents ranked items on a 6-point Likert scale for all surveys. Responses were collated using descriptive statistics. This study met the requirements of the Research Ethics Board.
In part 1, the response rate was 75% (n = 93), with the majority (52%) of respondents being internal medicine attending physicians. The top five knowledge sets were cardiac rhythm assessment, discussion of code status, delivery of bad news, management of wide complex tachycardia, and management of bradycardia. The top five skills were defibrillation, airway assessment, bag-mask ventilation, central venous access, and cardioversion. In part 2, the response rate was 93% (n = 27) before and 85% (n = 23) after course. Only 28% of residents felt prepared to lead resuscitations before the course. After the course, 45% of participants reporting using the knowledge and skills during a resuscitation. Significant changes in median confidence scores before to after the course occurred in important domains.
The results of the needs assessment should be used to tailor resuscitation education for residents. An educational need exists for resident physicians. This low-fidelity simulation course improves self-reported confidence in resuscitation knowledge and skills.
本研究旨在描述高级内科住院医师院内复苏知识和技能的基本要素，并评估包含这些要素的低保真模拟课程。
在第 1 部分中，主治医生通过修改后的 Dillman 方法进行电子调查。从最近的复苏指南中收集了广泛的知识技能集列表。在第 2 部分中，根据第 1 部分的结果设计了为期 2 天的基于案例的低保真模拟课程。课程参与者在课程前后进行了调查。
四家学术教学医院。
心内科、危重病科和内科的主治医生对需求评估调查做出了回应。内科住院医师的便利样本在课程前后进行了调查。
所有调查的受访者都对 6 分制李克特量表上的项目进行了排名。使用描述性统计方法整理了答复。这项研究符合研究伦理委员会的要求。
在第 1 部分中，应答率为 75%（n=93），其中大多数（52%）受访者为内科主治医生。前五个知识集是：心搏节律评估、讨论代码状态、传递坏消息、宽复杂心动过速的管理和心动过缓的管理。前五项技能是除颤、气道评估、球囊面罩通气、中心静脉通路和电复律。在第 2 部分中，课程前的应答率为 93%（n=27），课程后的应答率为 85%（n=23）。只有 28%的住院医师在课程前觉得有能力领导复苏。在课程之后，45%的参与者报告在复苏期间使用了知识和技能。课程前后重要领域的中位数信心得分发生了显著变化。
需求评估的结果应用于调整住院医师的复苏教育。住院医师需要接受教育。这种低保真模拟课程提高了自我报告的复苏知识和技能的信心。
