发展中国家和资源匮乏地区的医疗保健模拟
Health Care Simulation in Developing Countries and Low-Resource Situations.
作者信息
Martinerie Laetitia, Rasoaherinomenjanahary Fanjandrainy, Ronot Maxime, Fournier Pierre, Dousset Bertrand, Tesnière Antoine, Mariette Christophe, Gaujoux Sébastien, Gronnier Caroline
机构信息
Dr. Martinerie: Department of Pediatric Endocrinology, Hopital Robert Debré, AP-HP, Paris, France, and University Paris 7 Denis Diderot, Paris, France. Dr. Rasoaherinomenjanahary: Department Surgery B, Hôpital Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar, and Antananarivo Medicine Faculty, Madagascar. Dr. Ronot: Department of Radiology, PMAD, Hopital Beaujon, AP-HP, Clichy, France. Dr. Fournier: Department of Visceral Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. Dr. Dousset: Department of Digestive and Endocrine Surgery, Cochin Hospital, APHP, Paris, France, and Paris Descartes University, Paris, France. Dr. Tesnière: Paris Descartes University, Paris, France, Surgical Intensive Care Unit, Cochin Hospital, APHP, Paris, France, and iLumens Simulation Department, Paris, France. Dr. Mariette: Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, and North of France University, Lille, France. Dr. Gaujoux: Department of Digestive and Endocrine Surgery, Cochin Hospital, APHP, Paris, France, and Paris Descartes University, Paris, France. Dr. Gronnier: Department of Digestive Surgery, University Hospital of Bordeaux, Bordeaux, France, and Bordeaux Medicine Faculty, France.
出版信息
J Contin Educ Health Prof. 2018 Summer;38(3):205-212. doi: 10.1097/CEH.0000000000000211.
INTRODUCTION
Health care simulation, as a complement to traditional learning, has spread widely and seems to benefit both students and patients. The teaching methods involved in health care simulation require substantial human, logistical, and financial investments that might preclude their spread in developing countries. The aim of this study was to analyze the health care simulation experiences in developing countries.
METHODS
A comprehensive literature search was performed from January 2000 to December 2016. Articles reporting studies on educational health care simulation in developing countries were included.
RESULTS
In total, 1161 publications were retrieved, of which 156 were considered eligible based on title and abstract screening. Thirty articles satisfied our predefined selection criteria. Most of the studies were case series; 76.7% (23/30) were prospective and comparative, and five were randomized trials. The development of dedicated task trainers and telesimulation were the primary techniques assessed. The retrieved studies showed encouraging trends in terms of trainee satisfaction with improvement after training, but the improvements were mainly tested on the training tool itself. Two of the tools have been proven to be construct valid with clinical impact.
CONCLUSION
Health care simulation in developing countries seems feasible with encouraging results. Higher-quality studies are required to assess the educational value and promote the development of health care simulation programs.
引言
医疗保健模拟作为传统学习的补充，已广泛传播，似乎对学生和患者都有益处。医疗保健模拟所涉及的教学方法需要大量的人力、后勤和资金投入，这可能会阻碍其在发展中国家的推广。本研究的目的是分析发展中国家的医疗保健模拟经验。
方法
于2000年1月至2016年12月进行了全面的文献检索。纳入了报道发展中国家教育性医疗保健模拟研究的文章。
结果
共检索到1161篇出版物，其中根据标题和摘要筛选，有156篇被认为符合条件。30篇文章满足我们预先设定的选择标准。大多数研究为病例系列；76.7%（23/30）为前瞻性和比较性研究，5篇为随机试验。专用任务训练器和远程模拟的开发是评估的主要技术。检索到的研究显示，在学员对培训后改进的满意度方面呈现出令人鼓舞的趋势，但这些改进主要是在培训工具本身进行测试的。其中两种工具已被证明具有临床影响的结构效度。
结论
发展中国家的医疗保健模拟似乎可行，结果令人鼓舞。需要更高质量的研究来评估教育价值并促进医疗保健模拟项目的发展。
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