Cuerva Marcos J, Piñel Carlos S, Martin Lourdes, Espinosa Jose A, Corral Octavio J, Mendoza Nicolás
a Obstetrics Department , Hospital Universitario La Paz , Madrid , Spain.
b Obstetrics Department , Hospital Quironsalud San Jose , Madrid , Spain.
J Obstet Gynaecol. 2018 Jul;38(5):607-610. doi: 10.1080/01443615.2017.1393403. Epub 2018 Feb 12.
The design of optimal courses for obstetric undergraduate teaching is a relevant question. This study evaluates two different designs of simulator-based learning activity on childbirth with regard to respect to the patient, obstetric manoeuvres, interpretation of cardiotocography tracings (CTG) and infection prevention. This randomised experimental study which differs in the content of their briefing sessions consisted of two groups of undergraduate students, who performed two simulator-based learning activities on childbirth. The first briefing session included the observations of a properly performed scenario according to Spanish clinical practice guidelines on care in normal childbirth by the teachers whereas the second group did not include the observations of a properly performed scenario, and the students observed it only after the simulation process. The group that observed a properly performed scenario after the simulation obtained worse grades during the simulation, but better grades during the debriefing and evaluation. Simulator use in childbirth may be more fruitful when the medical students observe correct performance at the completion of the scenario compared to that at the start of the scenario. Impact statement What is already known on this subject? There is a scarcity of literature about the design of optimal high-fidelity simulation training in childbirth. It is known that preparing simulator-based learning activities is a complex process. Simulator-based learning includes the following steps: briefing, simulation, debriefing and evaluation. The most important part of high-fidelity simulations is the debriefing. A good briefing and simulation are of high relevance in order to have a fruitful debriefing session. What do the results of this study add? Our study describes a full simulator-based learning activity on childbirth that can be reproduced in similar facilities. The findings of this study add that high-fidelity simulation training in childbirth is favoured by a short briefing session and an abrupt start to the scenario, rather than a long briefing session that includes direct instruction in the scenario. What are the implications of these findings for clinical practice and/or further research? The findings of this study reveal what to include in the briefing of simulator-based learning activities on childbirth. These findings have implications in medical teaching and in medical practice.
产科本科教学最佳课程设计是一个相关问题。本研究评估了两种基于模拟器的分娩学习活动设计，涉及对患者的尊重、产科操作、胎心监护图（CTG）解读以及感染预防。这项随机实验研究的简报环节内容不同，由两组本科生组成，他们进行了两次基于模拟器的分娩学习活动。第一次简报环节包括教师按照西班牙正常分娩护理临床实践指南对一个正确执行的场景进行观察，而第二组没有对正确执行的场景进行观察，学生仅在模拟过程后才观察。在模拟后观察正确执行场景的组在模拟期间成绩较差，但在汇报和评估期间成绩较好。与在场景开始时观察正确表现相比，医学生在场景结束时观察正确表现时，在分娩中使用模拟器可能更有成效。影响声明关于这个主题已知的情况是什么？关于分娩中最佳高保真模拟训练设计的文献稀缺。已知准备基于模拟器的学习活动是一个复杂过程。基于模拟器的学习包括以下步骤：简报、模拟、汇报和评估。高保真模拟最重要的部分是汇报。为了有一个富有成效的汇报环节，良好的简报和模拟非常重要。本研究的结果增加了什么？我们的研究描述了一个完整的基于模拟器的分娩学习活动，可在类似设施中重现。本研究的结果还表明，分娩中的高保真模拟训练更倾向于简短的简报环节和场景的突然开始，而不是包括场景直接指导的冗长简报环节。这些发现对临床实践和/或进一步研究有什么影响？本研究的结果揭示了分娩中基于模拟器的学习活动简报应包含的内容。这些发现对医学教学和医学实践都有影响。
