Griswold-Theodorson Sharon, Ponnuru Srikala, Dong Chaoyan, Szyld Demian, Reed Trent, McGaghie William C
S. Griswold-Theodorson is director, Master of Science in Medical and Healthcare Simulation Program, director, Division of Simulation, Department of Emergency Medicine, and professor of emergency medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania. S. Ponnuru is fellowship director, Division of Simulation, Department of Emergency Medicine, and assistant professor of emergency medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania. C. Dong is assistant director of medical education, National University of Singapore Yong Loo Lin School of Medicine, Singapore. D. Szyld is medical director, New York Simulation Center for the Health Sciences, and assistant professor of emergency medicine, New York University School of Medicine, New York, New York. T. Reed is assistant dean and director of clinical simulation and associate professor, Department of Emergency Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois. W.C. McGaghie is professor of medical education, Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Acad Med. 2015 Nov;90(11):1553-60. doi: 10.1097/ACM.0000000000000938.
Translational educational outcomes have been defined as starting in simulation laboratories (T1) and moving downstream to improved patient care practices (T2), patient outcomes (T3), and cost/other value outcomes (T4). The authors conducted a realist synthesis review of the literature to evaluate the translational effect of simulation-based mastery learning (SBML) principles beyond the laboratory. They also sought to address future directions in SBML to improve patient care processes and outcomes and, thus, the quality of health care delivery.
The authors searched multiple databases for simulation-based medical education (SBME) studies published through April 2013. They screened articles using the PICO method-population (P), intervention (I), control (C), outcome (O)-to answer the research question: For (P) any health care providers, does the (I) implementation of SBML training, compared with (C) other training methodologies or no extra training, result in (O) a change in patient care practices or T2-T4 outcomes? Studies implementing SBME interventions with training methodologies that met all SBML principles and reporting T2-T4 outcomes were identified.
The 14 included studies used pre/post or cohort study designs; the majority were limited to individual performance and procedural competency. They reported improvement after SBML training in procedure performance, task success, patient discomfort, procedure time, complication rates, or T4 impacts (e.g., cost reduction).
Findings suggest health professions education conducted using SBML methodology can improve patient care processes and outcomes. Further research is needed to understand the translational impact of SBML for nontechnical skills, including teamwork, and skill retention.
转化性教育成果被定义为始于模拟实验室（T1），并向下游延伸至改善患者护理实践（T2）、患者结局（T3）以及成本/其他价值成果（T4）。作者对文献进行了实证综合回顾，以评估基于模拟的掌握学习（SBML）原则在实验室之外的转化效果。他们还试图探讨SBML的未来发展方向，以改善患者护理流程和结局，从而提高医疗服务质量。
作者检索了多个数据库，查找截至2013年4月发表的基于模拟的医学教育（SBME）研究。他们使用PICO方法（人群[P]、干预措施[I]、对照[C]、结局[O]）筛选文章，以回答研究问题：对于（P）任何医疗保健提供者，与（C）其他培训方法或无额外培训相比，（I）实施SBML培训是否会导致（O）患者护理实践或T2 - T4结局发生变化？确定了采用符合所有SBML原则的培训方法并报告T2 - T4结局的SBME干预研究。
纳入的14项研究采用了前后对照或队列研究设计；大多数研究仅限于个人表现和程序能力。他们报告称，SBML培训后在程序表现、任务成功率、患者不适、程序时间、并发症发生率或T4影响（如成本降低）方面有所改善。
研究结果表明，采用SBML方法进行的卫生专业教育可改善患者护理流程和结局。需要进一步研究以了解SBML对非技术技能（包括团队合作）和技能保留的转化影响。
