Emani Sivaram Subaya, Allan Catherine K, Forster Tess, Fisk Anna C, Lagrasta Christine, Zheleva Bistra, Weinstock Peter, Thiagarajan Ravi R
Simulator Program, Boston Children's Hospital, Boston, MA, USA.
Department of Cardiology, Boston Children's Hospital, Boston, MA, USA.
Ann Pediatr Cardiol. 2018 May-Aug;11(2):130-136. doi: 10.4103/apc.APC_117_17.
Although simulation training has been utilized quite extensively in highincome medical environments, its feasibility and effect on team performance in lowresource pediatric Cardiac Intensive Care Unit (CICU) environments has not been demonstrated. We hypothesized that lowfidelity simulationbased crisis resource management training would lead to improvements in team performance in such settings.
In this prospective observational study, the effect of simulation on team dynamics and performance was assessed in 23 healthcare providers in a pediatric CICU in Southeast Asia. A 5day training program was utilized consisting of various didactic sessions and simulation training exercises. Improvements in team dynamics were assessed using participant questionnaires, expert evaluations, and video analysis of time to intervention and frequency of closedloop communication.
In subjective questionnaires, participants noted significant ( < 0.05) improvement in team dynamics and performance over the training period. Video analysis revealed a decrease in time to intervention and significant ( < 0.05) increase in frequency of closedloop communication because of simulation training.
This study demonstrates the feasibility and effectiveness of simulationbased training in improving team dynamics and performance in lowresource pediatric CICU environments, indicating its potential role in eliminating communication barriers in these settings.
尽管模拟培训在高收入医疗环境中已得到广泛应用，但其在资源匮乏的儿科心脏重症监护病房（CICU）环境中的可行性及其对团队绩效的影响尚未得到证实。我们假设基于低保真模拟的危机资源管理培训将改善此类环境中的团队绩效。
在这项前瞻性观察研究中，对东南亚一家儿科CICU的23名医疗服务提供者评估了模拟对团队动态和绩效的影响。采用了一个为期5天的培训计划，包括各种理论课程和模拟培训练习。使用参与者问卷、专家评估以及干预时间和闭环沟通频率的视频分析来评估团队动态的改善情况。
在主观问卷中，参与者指出在培训期间团队动态和绩效有显著（<0.05）改善。视频分析显示，由于模拟培训，干预时间减少，闭环沟通频率显著（<0.05）增加。
本研究证明了基于模拟的培训在改善资源匮乏的儿科CICU环境中的团队动态和绩效方面的可行性和有效性，表明其在消除这些环境中的沟通障碍方面的潜在作用。
