Sudikoff Stephanie N, Overly Frank L, Shapiro Marc J
Rhode Island Hospital Medical Simulation Center, Providence, RI, USA.
Pediatr Emerg Care. 2009 Oct;25(10):651-6. doi: 10.1097/pec.0b013e3181bd93ea.
High-fidelity medical simulation is a technique used for training residents. Simulation is used to teach procedural skills and teamwork. There are limited data on the efficacy of this educational technique. We hypothesize that simulation is effective for teaching pediatric residents airway skills and teamwork.
We performed a randomized crossover trial with 16 postgraduate year 2 residents at the Rhode Island Hospital Medical Simulation Center. The residents were given a standard introduction to the simulation center then managed 2 scenarios, during which baseline airway and teamwork skills were assessed. The participants were divided into 2 groups. Group 1 returned for a simulation-enhanced session on pediatric airway management and teamwork, whereas group 2 received no supplemental education. Two months later, groups 1 and 2 were reassessed. Subsequently, group 2 returned for the same intervention as group 1. Both groups returned for a final assessment.
Data were collected using the Rhode Island Hospital Medical Simulation Center global competency score, critical action checklists, harmful actions lists, and the Behaviorally Anchored Rating Scale. The mean global competency score improved and showed a statistically significant relationship between the intervention and the performance. Critical actions showed a statistically insignificant trend of improvement. There was a striking reduction in the number of harmful actions. The Behaviorally Anchored Rating Scale improved at each session though statistically unrelated to the intervention.
This study supports simulation-enhanced educational strategies for improving performance and teamwork skills. This technique is effective in teaching pediatric residents airway skills and teamwork fundamentals required to efficiently manage an acute airway situation.
高保真医学模拟是一种用于培训住院医师的技术。模拟用于教授操作技能和团队协作。关于这种教育技术的效果的数据有限。我们假设模拟对于教授儿科住院医师气道技能和团队协作是有效的。
我们在罗德岛医院医学模拟中心对16名二年级住院医师进行了一项随机交叉试验。住院医师们在模拟中心接受了标准的介绍，然后处理2个场景，在此期间评估基线气道和团队协作技能。参与者被分为2组。第1组返回接受关于儿科气道管理和团队协作的模拟强化课程，而第2组没有接受补充教育。两个月后，对第1组和第2组进行重新评估。随后，第2组返回接受与第1组相同的干预。两组都返回进行最终评估。
使用罗德岛医院医学模拟中心全球能力评分、关键操作清单、有害操作清单和行为锚定评级量表收集数据。平均全球能力评分有所提高，并且干预与表现之间显示出统计学上的显著关系。关键操作显示出统计学上不显著的改善趋势。有害操作的数量有显著减少。行为锚定评级量表在每个阶段都有所改善，尽管在统计学上与干预无关。
本研究支持模拟强化教育策略以提高表现和团队协作技能。这种技术在教授儿科住院医师有效管理急性气道情况所需的气道技能和团队协作基础方面是有效的。
