Sachedina Ayaaz K, Blissett Sarah, Remtulla Alliya, Sridhar Kumar, Morrison Deric
From the Department of Medicine, London Health Sciences Centre (A.K.S., K.S., D.M., S.B.), Western University, Schulich School of Medicine & Dentistry, London, ON; Division of Cardiology (S.B.), Jewish General Hospital, McGill University, Montreal, QC; and Department of Health and Rehabilitation Sciences (A.R.), University of Western Ontario, London, ON, Canada.
Simul Healthc. 2019 Apr;14(2):77-81. doi: 10.1097/SIH.0000000000000343.
Despite the increasing reliance on simulation to train residents as code blue leaders, the perceived role and effectiveness of code blue simulations from the learners' perspective have not been explored. A code blue Simulation Program (CBSP), developed based on evidence-based simulation principles, was implemented at our institution. We explored the role of simulation in code blue training and the differences between real and simulated code blues from the learner perspective.
Using a thematic analysis approach and a purposeful sampling strategy, residents who participated in the CBSP were invited to participate in one of the three focus groups. Data were collected through small group discussions guided by semistructured interviews. The interviews were audio-recorded and transcribed. Interview transcripts were coded to assess underlying themes.
Thematic analysis revealed that participants believed that the CBSP enhanced preparedness by capturing aspects of real codes (eg, inclusion of precode scenarios with awake patients, lack of readily available information) and facilitating automatization of code blue processes. Despite efforts to develop a high-fidelity simulation, participants noted that they experienced more anxiety, observed more chaos in the environment, and encountered different communication challenges in real codes.
The CBSP enhanced resident preparedness to serve as code blue leaders. Learners highlighted that they valued the CBSP; however, differences remain between simulated and real codes that could be addressed to enhance the fidelity of future simulations.
尽管越来越依赖模拟培训住院医师成为急救团队领导者，但从学习者的角度对急救模拟的认知作用和效果尚未得到探讨。我们机构实施了一个基于循证模拟原则开发的急救模拟项目（CBSP）。我们从学习者的角度探讨了模拟在急救培训中的作用以及真实急救和模拟急救之间的差异。
采用主题分析方法和目的抽样策略，邀请参与CBSP的住院医师参加三个焦点小组之一。通过由半结构化访谈引导的小组讨论收集数据。访谈进行了录音和转录。对访谈转录本进行编码以评估潜在主题。
主题分析表明，参与者认为CBSP通过捕捉真实急救的各个方面（例如，纳入清醒患者的急救前场景、缺乏现成信息）并促进急救流程的自动化，提高了准备程度。尽管努力开发高保真模拟，但参与者指出，他们在真实急救中经历了更多焦虑，观察到环境中更混乱，并且遇到了不同的沟通挑战。
CBSP提高了住院医师担任急救团队领导者的准备程度。学习者强调他们重视CBSP；然而，模拟急救和真实急救之间仍然存在差异，可以加以解决以提高未来模拟的逼真度。
