Australian National University, Canberra, Australia ; South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka.
PLoS One. 2013 Nov 8;8(11):e79491. doi: 10.1371/journal.pone.0079491. eCollection 2013.
Sri Lankan rural doctors based in isolated peripheral hospitals routinely resuscitate critically ill patients but have difficulty accessing training. We tested a train-the-trainer model that could be utilised in isolated rural hospitals.
Eight selected rural hospital non-specialist doctors attended a 2-day instructor course. These "trained trainers" educated their colleagues in advanced cardiac life support at peripheral hospital workshops and we tested their students in resuscitation knowledge and skills pre and post training, and at 6- and 12-weeks. Knowledge was assessed through 30 multiple choice questions (MCQ), and resuscitation skills were assessed by performance in a video recorded simulated scenario of a cardiac arrest using a Resuci Anne Skill Trainer mannequin.
RESULTS/DISCUSSION/CONCLUSION: Fifty seven doctors were trained. Pre and post training assessment was possible in 51 participants, and 6-week and 12-week follow up was possible for 43, and 38 participants respectively. Mean MCQ scores significantly improved over time (p<0.001), and a significant improvement was noted in "average ventilation volume", "compression count", and "compressions with no error", "adequate depth", "average depth", and "compression rate" (p<0.01). The proportion of participants with compression depth ≥40mm increased post intervention (p<0.05) and at 12-week follow up (p<0.05), and proportion of ventilation volumes between 400-1000mls increased post intervention (p<0.001). A significant increase in the proportion of participants who "checked for responsiveness", "opened the airway", "performed a breathing check", who used the "correct compression ratio", and who used an "appropriate facemask technique" was also noted (p<0.001). A train-the-trainer model of resuscitation education was effective in improving resuscitation knowledge and skills in Sri Lankan rural peripheral hospital doctors. Improvement was sustained to 12 weeks for most components of resuscitation knowledge and skills. Further research is needed to identify which components of training are most effective in leading to sustained improvement in resuscitation.
斯里兰卡农村地区的基层医生在偏远的基层医院常规对危重症患者进行复苏抢救，但他们接受培训的机会有限。我们测试了一种可用于偏远农村医院的培训师培训模式。
8 名选定的农村医院非专科医生参加了为期 2 天的指导员课程。这些“培训培训师”在基层医院的研讨会上向同事传授高级心脏生命支持知识，我们在培训前后以及 6 周和 12 周时对他们的学生进行复苏知识和技能测试。知识通过 30 个多项选择题（MCQ）进行评估，复苏技能通过使用 Resuci Anne Skill Trainer 模拟人评估在记录的心脏骤停模拟场景中的表现进行评估。
结果/讨论/结论：共培训了 57 名医生。51 名参与者可进行培训前后评估，43 名和 38 名参与者分别可进行 6 周和 12 周随访。平均 MCQ 分数随时间显著提高（p<0.001），并且在“平均通气量”、“按压次数”、“无错误按压”、“适当深度”、“平均深度”和“按压率”方面有显著改善（p<0.01）。干预后（p<0.05）和 12 周随访时（p<0.05），参与者中具有按压深度≥40mm 的比例增加，干预后（p<0.001）通气量在 400-1000ml 之间的比例增加。还注意到，“检查反应”、“开放气道”、“进行呼吸检查”、“使用正确的按压比”和“使用适当的面罩技术”的参与者比例显著增加（p<0.001）。复苏教育的培训师培训模式有效地提高了斯里兰卡农村基层医院医生的复苏知识和技能。大多数复苏知识和技能的指标在 12 周时仍有改善。需要进一步研究确定培训的哪些内容对导致复苏的持续改善最有效。
