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基于模拟的心脏骤停团队培训中聚焦式与纠正性反馈对比结构化与支持性汇报:一项初步随机对照研究

Focused and Corrective Feedback Versus Structured and Supported Debriefing in a Simulation-Based Cardiac Arrest Team Training: A Pilot Randomized Controlled Study.

作者信息

Kim Ji-Hoon, Kim Young-Min, Park Seong Heui, Ju Eun A, Choi Se Min, Hong Tai Yong

机构信息

From the Department of Emergency Medicine, (J.-H.K., T.Y.H.), The Catholic University of Korea Bucheon St. Mary's Hospital, Bucheon; Department of Emergency Medicine, (Y.-M.K.), The Catholic University of Korea Seoul St. Mary's Hospital; START Center for Medical Simulation (Y.-M.K., E.A.J.), College of Medicine, The Catholic University of Korea; Human Resource Team (S.H.P.), The Catholic University of Korea Seoul St. Mary's Hospital, Seoul; and Department of Emergency Medicine, (S.M.C.), The Catholic University of Korea Uijeongbu St. Mary Hospital, Uijeongbu, Republic of Korea.

出版信息

Simul Healthc. 2017 Jun;12(3):157-164. doi: 10.1097/SIH.0000000000000218.

Abstract

OBJECTIVE

The aim of the study was to compare the educational impact of two postsimulation debriefing methods-focused and corrective feedback (FCF) versus Structured and Supported Debriefing (SSD)-on team dynamics in simulation-based cardiac arrest team training.

METHODS

This was a pilot randomized controlled study conducted at a simulation center. Fourth-year medical students were randomly assigned to the FCF or SSD group, with each team composed of six students and a confederate. Each team participated in two simulations and the assigned debriefing (FCF or SSD) sessions and then underwent a test simulation. Two trained raters blindly assessed all of the recorded simulations using checklists. The primary outcome was the improvement in team dynamics scores between baseline and test simulation. The secondary outcomes were improvements before and after training in team clinical performance scores, self-assessed comprehension of and confidence in cardiac arrest management and team dynamics, as well as evaluations of the postsimulation debriefing intervention.

RESULTS

In total, 95 students participated [FCF (8 teams, n = 47) and SSD (8 teams, n = 48)]. The SSD team dynamics score during the test simulation was higher than at baseline [baseline: 74.5 (65.9-80.9), test: 85.0 (71.9-87.6), P = 0.035]. However, there were no differences in the improvement in the team dynamics or team clinical performance scores between the two groups (P = 0.328, respectively).

CONCLUSIONS

There was no significant difference in improvement in team dynamics scores during the test simulation compared with baseline between the SSD and FCF groups in a simulation-based cardiac arrest team training in fourth-year Korean medical students.

摘要

目的

本研究旨在比较两种模拟后汇报方法——聚焦式与纠正性反馈(FCF)和结构化与支持性汇报(SSD)——在基于模拟的心脏骤停团队培训中对团队动态的教育影响。

方法

这是一项在模拟中心进行的试点随机对照研究。四年级医学生被随机分配到FCF组或SSD组,每个团队由六名学生和一名协同者组成。每个团队参与两次模拟及指定的汇报(FCF或SSD)环节,然后进行一次测试模拟。两名经过培训的评估者使用清单对所有录制的模拟进行盲评。主要结局是基线与测试模拟之间团队动态得分的改善情况。次要结局包括培训前后团队临床绩效得分、自我评估的心脏骤停管理理解与信心以及团队动态的改善情况,以及对模拟后汇报干预的评估。

结果

共有95名学生参与研究[FCF组(8个团队,n = 47)和SSD组(8个团队,n = 48)]。测试模拟期间SSD组的团队动态得分高于基线[基线:74.5(65.9 - 80.9),测试:85.0(71.9 - 87.6),P = 0.035]。然而,两组之间团队动态或团队临床绩效得分的改善情况没有差异(P分别为0.328)。

结论

在韩国四年级医学生基于模拟的心脏骤停团队培训中,SSD组和FCF组在测试模拟期间与基线相比,团队动态得分的改善没有显著差异。

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