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模拟强化训练对复苏操作技能和团队协作的保持有影响吗?

Does simulation booster impact retention of resuscitation procedural skills and teamwork?

作者信息

Bender J, Kennally K, Shields R, Overly F

机构信息

1] Department of Pediatrics, Women & Infants' Hospital, Providence, RI, USA [2] Warren Alpert School of Medicine at Brown University, Providence, RI, USA.

Department of Pediatrics, Women & Infants' Hospital, Providence, RI, USA.

出版信息

J Perinatol. 2014 Sep;34(9):664-8. doi: 10.1038/jp.2014.72. Epub 2014 Apr 24.

Abstract

OBJECTIVE

The Neonatal Resuscitation Program (NRP) has transitioned to a simulation-based format. We hypothesized that immersive simulation differentially impacts similar trainee populations' resuscitation knowledge, procedural skill and teamwork behavior.

STUDY DESIGN

Residents from NICU and non-NICU programs were randomized to either control or a booster simulation 7 to 10 months after NRP. Procedural skill and teamwork behavior instruments were validated. Individual resident's resuscitation performance was assessed at 15 to 18 months. Three reviewers rated videos.

RESULT

Fifty residents were assessed. Inter-rater reliability was good for procedural skills (0.78) and team behavior (0.74) instruments. The intervention group demonstrated better procedural skills (71.6 versus 64.4) and teamwork behaviors (18.8 versus 16.2). The NICU program demonstrated better teamwork behaviors (18.6 versus 15.5) compared with non-NICU program.

CONCLUSION

A simulation-enhanced booster session 9 months after NRP differentiates procedural skill and teamwork behavior at 15 months. Deliberate practice with simulation enhances teamwork behaviors additively with residents' clinical resuscitation exposure.

摘要

目的

新生儿复苏项目(NRP)已转变为基于模拟的形式。我们假设沉浸式模拟对类似受训人群的复苏知识、操作技能和团队协作行为有不同影响。

研究设计

将新生儿重症监护病房(NICU)和非NICU项目的住院医师在NRP结束7至10个月后随机分为对照组或强化模拟组。对操作技能和团队协作行为工具进行了验证。在15至18个月时评估个体住院医师的复苏表现。由三名评审员对视频进行评分。

结果

对50名住院医师进行了评估。评分者间信度在操作技能工具(0.78)和团队行为工具(0.74)方面表现良好。干预组表现出更好的操作技能(71.6对64.4)和团队协作行为(18.8对16.2)。与非NICU项目相比,NICU项目表现出更好的团队协作行为(18.6对15.5)。

结论

NRP结束9个月后的模拟强化培训在15个月时可区分操作技能和团队协作行为。通过模拟进行刻意练习与住院医师的临床复苏经验相加,可增强团队协作行为。

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