Schornack Leslie A, Baysinger Curtis L, Pian-Smith May C M
aDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee bDepartment of Anesthesia, Critical Care & Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Curr Opin Anaesthesiol. 2017 Dec;30(6):723-729. doi: 10.1097/ACO.0000000000000522.
Simulation training in obstetric anesthesia has become widespread in recent years. Simulations are used to train staff and trainees, assess and improve team performance, and evaluate the work environment. This review summarizes current research in these categories.
Simulation to improve individual technical skills has focused on induction of general anesthesia for emergent cesarean delivery, an infrequently encountered scenario by anesthesia trainees. Low- and high-fidelity simulation devices for the learning and practicing neuraxial and non-neuraxial procedures have been described, and both are equally effective. The use of checklists in obstetric emergencies has become common as and post-scenario debriefing techniques have improved. Although participant task performance improves, whether participants retain learned skills or whether simulation improves patient outcomes has not yet been established. Tools to assess teamwork during simulation have been developed, but none have been rigorously validated. In-situ vs. offsite simulations do not differ in effectiveness.
Simulation allows for practice of tasks and teamwork in a controlled manner. There is little data whether simulation improves patient outcomes and metrics to predict the long-term retention of skills by simulation participants have not been developed.
近年来，产科麻醉模拟培训已广泛开展。模拟用于培训工作人员和学员、评估和改善团队表现以及评估工作环境。本综述总结了这些方面的当前研究。
提高个体技术技能的模拟主要集中在急诊剖宫产全身麻醉诱导方面，这是麻醉学员很少遇到的情况。已描述了用于学习和练习神经轴和非神经轴操作的低保真和高保真模拟设备，二者效果相当。随着情景后汇报技术的改进，产科急诊中使用检查表已变得普遍。尽管参与者的任务表现有所提高，但参与者是否能保留所学技能以及模拟是否能改善患者结局尚未明确。已开发出模拟期间评估团队合作的工具，但均未经过严格验证。现场模拟与非现场模拟在效果上并无差异。
模拟允许以可控方式进行任务和团队合作练习。关于模拟是否能改善患者结局的数据很少，且尚未开发出预测模拟参与者长期保留技能的指标。
