Chan Soi-Yu, Figueroa Mayte, Spentzas Thomas, Powell Ashley, Holloway Ricky, Shah Samir
Division of Pediatric Cardiology, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
Pediatr Cardiol. 2013 Mar;34(3):543-52. doi: 10.1007/s00246-012-0490-6. Epub 2012 Aug 26.
This study aimed to assess the impact of integrating a simulation-based education module into an extracorporeal membrane oxygenation (ECMO) curriculum on novice learners and to test the duration of time that skills obtained during this training exercise were retained. The authors hypothesized that multidisciplinary, simulation-based ECMO training would improve comfort and confidence levels among participants. An ECMO training curriculum was developed that incorporated in situ simulation modules to train multidisciplinary health care professionals involved in the management of patients receiving ECMO in the pediatric cardiac intensive care unit (PCICU). During the simulation, a team was assembled similar to the one that would staff the PCICU during a routine workday. Pre- and postparticipation questionnaires were used to determine the effects on the knowledge, ability, and confidence level of the participants. The participants were required to repeat the simulation test within 6-8 months. The study enrolled 26 providers (10 fellow physicians, 12 nurses and nurse practitioners, 4 respiratory therapists). All except one had no previous training in the management of ECMO. Of the 26 participants, 24 passed the initial written and practical tests. One participant failed the written test, whereas another failed the practical test. All the responding participants scored the didactic and scenarios education as useful, at 4 or higher (5 = very useful), in improving their perception of their overall knowledge and their ability to perform the required critical performance criteria on simulated ECMO. The 20 participants who appeared for the 6 month follow-up visit to assess maintenance of competency skills demonstrated success with simulated ECMO emergencies. All four questionnaires were completed by 18 participants. Simulation-based training is an effective method of improving knowledge, ability, and confidence levels among novice ECMO specialists and physician trainees. Further research is needed to assess real-time demonstration of skills retention during ECMO emergencies.
本研究旨在评估将基于模拟的教育模块纳入体外膜肺氧合(ECMO)课程对新手学习者的影响,并测试在此培训练习中获得的技能保持的时间长度。作者假设多学科、基于模拟的ECMO培训将提高参与者的舒适度和信心水平。开发了一个ECMO培训课程,其中纳入了现场模拟模块,以培训参与小儿心脏重症监护病房(PCICU)中接受ECMO治疗患者管理的多学科医疗保健专业人员。在模拟过程中,组建了一个类似于常规工作日在PCICU工作的团队。参与前和参与后的问卷用于确定对参与者的知识、能力和信心水平的影响。参与者被要求在6至8个月内重复模拟测试。该研究招募了26名提供者(10名专科医师、12名护士和执业护士、4名呼吸治疗师)。除一人外,所有人以前都没有接受过ECMO管理方面的培训。在26名参与者中,24人通过了初始笔试和实践测试。一名参与者笔试不及格,另一名参与者实践测试不及格。所有做出回应的参与者都将理论教学和情景教育评为有用,评分为4或更高(5 = 非常有用),认为这提高了他们对整体知识的认知以及在模拟ECMO上执行所需关键绩效标准的能力。20名参加6个月随访以评估能力技能维持情况的参与者在模拟ECMO紧急情况中表现成功。18名参与者完成了所有四份问卷。基于模拟的培训是提高新手ECMO专家和医师学员的知识、能力和信心水平的有效方法。需要进一步研究以评估在ECMO紧急情况期间技能保持的实时表现。