Department of Pediatrics, University of Washington School of Medicine and Division of Emergency Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States.
Department of Pediatrics, University of Washington School of Medicine and Division of Emergency Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States.
Resuscitation. 2014 Aug;85(8):1099-105. doi: 10.1016/j.resuscitation.2014.05.005. Epub 2014 May 12.
Studies demonstrating the impact of resuscitation simulation curricula on performance are limited. Our objective was to create and evaluate a simulation-based resuscitation curriculum's impact on pediatric residents' performance in a simulated resuscitation.
We developed a standardized simulation-based pediatric resident resuscitation curriculum consisting of nine modules, incorporating four domains (basic skills, airway/breathing, circulation and team management) and specific topics (e.g., anaphylaxis). Each module was presented four times over the academic year. Evaluation of the curriculum consisted of pre- and post-intervention video-recorded performances of a simulated pediatric resuscitation by 10 resident resuscitation teams, scored using the Simulation Team Assessment Tool (STAT). The effectiveness of the standardized curriculum on medical (basics, airway/breathing, circulation) and team management, and on knowledge test scores was evaluated by comparing pre- and post-intervention STAT scores using unpaired two-sided T-test. The impact of group curriculum participation on team performance (STAT scores) was analyzed using linear regression.
Overall team performance STAT scores increased post-intervention (mean pre-test 0.61, post-test 0.74, p<0.001), as did management of the basics of resuscitation, airway/breathing and teamwork (mean basics: pre 0.46, post 0.62, p=0.001; mean airway/breathing: pre 0.63, post 0.76, p=0.01; mean teamwork: pre 0.61, post 0.79, p=0.003). Regression analysis provided evidence for a training "dose-response" among the post-intervention teams, with teams exposed to more training achieving higher performance scores (p=0.004).
We created a standardized simulation-based pediatric resuscitation curriculum that increased pediatric residents' scores on medical management and teamwork skills in a dose dependent relationship.
展示复苏模拟课程对表现影响的研究有限。我们的目标是创建和评估基于模拟的复苏课程对儿科住院医师在模拟复苏中的表现的影响。
我们开发了一个标准化的基于模拟的儿科住院医师复苏课程，由九个模块组成，包含四个领域（基本技能、气道/呼吸、循环和团队管理）和特定主题（例如过敏反应）。每个模块在整个学年内呈现四次。课程评估包括 10 个住院医师复苏团队进行的模拟儿科复苏的干预前后视频记录表现，使用模拟团队评估工具（STAT）进行评分。通过比较干预前后 STAT 评分的非配对双侧 T 检验，评估标准化课程对医学（基础、气道/呼吸、循环）和团队管理以及知识测试成绩的有效性。使用线性回归分析团队课程参与对团队表现（STAT 评分）的影响。
总体团队表现 STAT 评分在干预后增加（平均预测试 0.61，后测试 0.74，p<0.001），复苏基本原理、气道/呼吸和团队合作的管理也是如此（平均基础：预 0.46，后 0.62，p=0.001；平均气道/呼吸：预 0.63，后 0.76，p=0.01；平均团队合作：预 0.61，后 0.79，p=0.003）。回归分析为干预后团队提供了培训“剂量反应”的证据，接受更多培训的团队获得了更高的表现分数（p=0.004）。
我们创建了一个标准化的基于模拟的儿科复苏课程，该课程增加了儿科住院医师在医学管理和团队合作技能方面的分数，呈剂量依赖性关系。
