Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Clin Transplant. 2012 Jul-Aug;26(4):564-70. doi: 10.1111/j.1399-0012.2011.01570.x. Epub 2011 Dec 23.
Anesthesia for liver transplantation (ALT) requires extensive preparation and rapid recognition of changing clinical conditions. Owing to the proliferation of transplant centers, greater number of anesthesia providers need training in specific skills required to treat these patients. These cases are no longer limited to few transplant centers; therefore, reduction of cases in individual centers has created a need for simulation training to prepare and supplement clinical experience. We have developed an ALT simulation course for senior anesthesia residents which combines didactic sessions with live-patient-based and mannequin-based simulation. Outcomes have been measured using pre- and post-simulation course quizzes as well as a survey given at the end of the month-long ALT rotation. Twenty-four senior anesthesiology residents (n = 24) have completed the ALT simulation course. Residents had an average score of 75% ± 10% on the pre-simulation quiz, which increased to 92% ± 6.5% on the post-simulation quiz (p < 0.001). Furthermore, survey scores indicated that residents noted that the course provided an improvement in their preparedness, confidence, anticipation, and understanding of the importance of communication skills in the care of this patient population. The ALT simulation course provided a standardized in-depth exposure to clinical issues involved in the perioperative care of liver transplant patients.
肝移植(ALT)的麻醉需要广泛的准备和对不断变化的临床状况的快速识别。由于移植中心的增多,需要更多的麻醉提供者接受治疗这些患者所需的特定技能的培训。这些病例不再仅限于少数移植中心;因此,个别中心病例的减少需要模拟培训来准备和补充临床经验。我们为高级麻醉住院医师开发了一种 ALT 模拟课程,该课程将理论课程与基于真实患者和基于模型的模拟相结合。通过在模拟课程前后进行测验以及在为期一个月的 ALT 轮训结束时进行调查来衡量结果。24 名高级麻醉住院医师(n = 24)完成了 ALT 模拟课程。住院医师在模拟前测验中的平均得分为 75% ± 10%,在模拟后测验中的平均得分为 92% ± 6.5%(p < 0.001)。此外,调查结果表明,住院医师表示该课程提高了他们对围手术期肝移植患者护理相关准备、信心、预期和沟通技巧重要性的理解。ALT 模拟课程为涉及肝移植患者围手术期护理的临床问题提供了标准化的深入接触。