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护理助产教育项目中跨专业生理分娩与产科急诊模拟的成功与挑战

Successes and Challenges of Interprofessional Physiologic Birth and Obstetric Emergency Simulations in a Nurse-Midwifery Education Program.

作者信息

Shaw-Battista Jenna, Belew Cynthia, Anderson Deborah, van Schaik Sandrijn

出版信息

J Midwifery Womens Health. 2015 Nov-Dec;60(6):735-43. doi: 10.1111/jmwh.12393. Epub 2015 Dec 1.

Abstract

This article describes childbirth simulation design and implementation within the nurse-midwifery education program at the University of California, San Francisco. Nurse-midwife and obstetrician faculty coordinators were supported by faculty from multiple professions and specialties in curriculum review and simulation development and implementation. The primary goal of the resulting technology-enhanced simulations of normal physiologic birth and obstetric emergencies was to assist learners' development of interprofessional competencies related to communication, teamwork, and patient-centered care. Trainees included nurse-midwifery students; residents in obstetrics, pediatrics, and family medicine; medical students; and advanced practice nursing students in pediatrics. The diversity of participant types and learning levels provided benefits and presented challenges to effective scenario-based simulation design among numerous other theoretical and logistical considerations. This project revealed practical solutions informed by emerging health sciences and education research literature, faculty experience, and formal course evaluations by learners. Best practices in simulation development and implementation were incorporated, including curriculum revision grounded in needs assessment, case- and event-based clinical scenarios, optimization of fidelity, and ample time for participant debriefing. Adequate preparation and attention to detail increased the immersive experience and benefits of simulation. Suggestions for fidelity enhancement are provided with examples of simulation scenarios, a timeline for preparations, and discussion topics to facilitate meaningful learning by maternity and newborn care providers and trainees in clinical and academic settings. Pre- and postsimulation measurements of knowledge, skills, and attitudes are ongoing and not reported. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.

摘要

本文介绍了加利福尼亚大学旧金山分校护士助产教育项目中的分娩模拟设计与实施。护士助产士和产科教员协调员在课程审查以及模拟开发与实施过程中得到了来自多个专业和专科的教员的支持。由此产生的正常生理分娩和产科急症的技术增强模拟的主要目标是帮助学习者培养与沟通、团队合作和以患者为中心的护理相关的跨专业能力。受训人员包括护士助产专业学生;产科、儿科和家庭医学住院医师;医学生;以及儿科高级实践护理学生。参与者类型和学习水平的多样性在众多其他理论和后勤考虑因素中,为有效的基于情景的模拟设计带来了益处,也带来了挑战。该项目揭示了基于新兴健康科学和教育研究文献、教员经验以及学习者的正式课程评估的实际解决方案。纳入了模拟开发和实施的最佳实践,包括基于需求评估的课程修订、基于病例和事件的临床情景、逼真度优化以及为参与者进行充分的汇报留出充足时间。充分的准备和对细节的关注增加了模拟的沉浸感和益处。文中提供了提高逼真度的建议,并列举了模拟情景示例、准备时间表以及讨论话题,以促进产科和新生儿护理提供者以及临床和学术环境中的受训人员进行有意义的学习。目前正在进行模拟前后知识、技能和态度的测量,但未报告结果。本文是一系列专题文章的一部分,这些文章探讨了助产在临床实践、教育、跨专业协作、卫生政策和全球卫生方面的创新。

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