Stellflug Stacy M, Lowe Nancy K
College of Nursing, Montana State University Bozeman, United States.
College of Nursing, University of Colorado Denver, United States.
J Pediatr Nurs. 2018 Mar-Apr;39:21-26. doi: 10.1016/j.pedn.2017.12.006. Epub 2017 Dec 28.
Rural health care providers (HCPs) care for millions of Americans despite challenges. Pediatric Advanced Life Support (PALS) provides rural HCPs training in assessment and interventions for critically ill/injured pediatric patients (American Heart Association, 2015). The purpose of this study was to determine the effects of integration of high fidelity simulators into PALS courses in a rural setting.
Participants were randomized by course to control or experimental PALS conditions where the control group received PALS with low fidelity static manikins (LFM) and the experimental group received PALS with high-fidelity simulators (HFS). Multiple level modeling (MLM) was used to examine participants time-to-task on pre-identified skills on PALS core case scenarios during testing on the last day of the course. MLM also was used to examine the differences in PALS knowledge and skills self-efficacy (SEI) between control and experimental groups at course end and six months later.
The experimental and control groups had similar scores on the PALS post course knowledge exam, however the skill performance of the experimental group on time-to-task in core case scenarios was significantly better when compared to the control group (p=0.05). A decrease in knowledge exam scores and SEI scores occurred in both groups over time, however the control group had significantly greater declines in PALS written exam (p=0.042) and SEI (p=0.003).
Integration of HFS into PALS may increase HCPs' ability to recall valuable knowledge when seconds matter most. Further research in long-term recall of knowledge and retention of skills following PALS training is needed.
尽管面临挑战,农村医疗保健提供者(HCPs)仍为数百万美国人提供医疗服务。儿科高级生命支持(PALS)为农村HCPs提供针对危重症/受伤儿科患者的评估和干预培训(美国心脏协会,2015年)。本研究的目的是确定在农村环境中将高保真模拟器整合到PALS课程中的效果。
参与者按课程随机分为对照组或实验组PALS条件,对照组接受使用低保真静态人体模型(LFM)的PALS培训,实验组接受使用高保真模拟器(HFS)的PALS培训。在课程最后一天的测试中,使用多水平建模(MLM)来检查参与者在PALS核心病例场景中预先确定技能的任务完成时间。MLM还用于检查课程结束时和六个月后对照组和实验组在PALS知识和技能自我效能感(SEI)方面的差异。
实验组和对照组在PALS课程后知识考试中的得分相似,然而,与对照组相比,实验组在核心病例场景中的任务完成时间技能表现明显更好(p=0.05)。随着时间的推移,两组的知识考试成绩和SEI分数均有所下降,然而对照组在PALS笔试(p=0.042)和SEI(p=0.003)方面的下降幅度明显更大。
将HFS整合到PALS中可能会提高HCPs在最关键的几秒钟内回忆宝贵知识的能力。需要对PALS培训后的知识长期回忆和技能保持进行进一步研究。