Alyousef Sawsan, Marwa Haifa, Alnojaidi Najd, Lababidi Hani, Bashir Muhammad Salman
1Specialized Children Hospital, King Fahad Medical City, Riyadh, Saudi Arabia.
2Center for Research, Education & Simulation Enhanced Training (CRESENT), King Fahad Medical City, Riyadh, Saudi Arabia.
Adv Simul (Lond). 2017 Aug 1;2:11. doi: 10.1186/s41077-017-0044-3. eCollection 2017.
To utilize cumulative evaluation data of the pediatric airway management simulation-based learning course on knowledge and practical skills of residents in the Saudi Commission for Health Speciality (SCFHS) in order to measure its efficacy and areas for improvement.
The evaluation is a retrospective cohort study that compares pre- and post-test (knowledge and skills) of a pediatric airway management simulation course. The 2-day course has been conducted four times annually at CRESENT and is comprised of interactive lectures on airway management and crew resource management, a demonstration of fundamentals of intubation, three skill stations, and six case scenarios with debriefing. Our evaluation data includes all pediatric residents who attended the course between January and December 2015.
Forty-six residents participated, of whom 30 (65.2%) are male and 16 (34.78%) are female. Overall, there is statistically significant improvement between the pre-test and post-test knowledge and practical skill scores. The pre-test scores are significantly different between the four different resident levels with values of 0.003 and <0.001 respectively. However, there are no statistically significant differences in the post-test scores among the four different resident levels with values of 0.372 and 0.133 respectively. The practical skill assessment covers four main domains. Improvements were noted in pharmacology (811%), equipment setup (250%), intubation steps (200%), and patient positioning (130%). The post-test scores are similar in all practical skill categories for the four different residency levels.
Our outcome-based evaluation strategy demonstrated that residents met the course learning objectives. The pediatric airway management simulation course at CRESENT is effective in improving the knowledge and practical skills of pediatric residents. Although the greatest improvement is noted among junior residents, learners from different residency levels have comparable knowledge and practical skills at the end of the course. Things that can be improved based on our study results include stressing more the type and dosages of the medications used in airway management and mandating the course for all junior pediatric residents. Although residents scored well, specific knowledge and skill elements still led us to targeted areas for course excellence. Similar courses need to be integrated in the pediatric residency curriculum. Further research is needed to study skill retention and more importantly its impact on patients' care. Although resource-intensive, the use of cumulative evaluation data helped to focus quality improvement in our courses.
利用沙特卫生专业委员会(SCFHS)住院医师小儿气道管理模拟学习课程在知识和实践技能方面的累积评估数据,以衡量其效果及改进方向。
该评估为一项回顾性队列研究,比较小儿气道管理模拟课程的课前和课后测试(知识和技能)。为期2天的课程每年在CRESENT举办4次,包括气道管理和机组资源管理的互动讲座、插管基础演示、三个技能站以及六个案例场景并进行汇报总结。我们的评估数据包括2015年1月至12月参加该课程的所有儿科住院医师。
46名住院医师参与,其中30名(65.2%)为男性,16名(34.78%)为女性。总体而言,课前和课后的知识及实践技能得分在统计学上有显著提高。四个不同住院医师级别之间的课前得分有显著差异,分别为0.003和<0.001。然而,四个不同住院医师级别之间的课后得分在统计学上无显著差异,分别为0.372和0.133。实践技能评估涵盖四个主要领域。药理学(811%)、设备设置(250%)、插管步骤(200%)和患者体位(130%)方面均有改善。四个不同住院医师级别的所有实践技能类别中的课后得分相似。
我们基于结果的评估策略表明住院医师达到了课程学习目标。CRESENT的小儿气道管理模拟课程在提高儿科住院医师的知识和实践技能方面是有效的。虽然初级住院医师的进步最大,但不同住院医师级别的学习者在课程结束时具有相当的知识和实践技能。根据我们的研究结果可以改进的方面包括更加强调气道管理中使用的药物类型和剂量,并要求所有初级儿科住院医师参加该课程。虽然住院医师得分不错,但特定的知识和技能要素仍使我们找到了课程的目标改进领域。类似课程需要纳入儿科住院医师培训课程。需要进一步研究以探讨技能保持情况,更重要的是其对患者护理的影响。虽然资源密集,但累积评估数据的使用有助于聚焦我们课程的质量改进。