Foglia Lisa M, Eubanks Allison A, Peterson Logan C, Hickey Kimberly, Hammons Crystal B, Borgia Lindsey B, Light Morgan R, Jackson Amanda, Deering Shad
Maternal Fetal Medicine, Womack Army Medical Center, Fort Bragg, USA.
Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, USA.
Cureus. 2020 Sep 9;12(9):e10324. doi: 10.7759/cureus.10324.
We evaluated a novel simulation-based cesarean section training program to teach critical techniques for cesarean section and hemorrhage management. Methods: This was a prospective educational intervention. After Institutional Review Board approval, we recruited Obstetrics and Gynecology, Family Medicine, and General Surgery residents at three hospitals. All participants received didactic education. Participants were then randomized into two arms with one group to receive task-trainer based training and the other no training. Afterwards, all residents had their performance of a complete cesarean section and management of a post-partum hemorrhage evaluated on a high-fidelity simulator. Evaluators were blinded to randomization.
Thirty-three participants were recruited between July 2017 and January 2019. There were 19 trainees in the control group and 14 in the intervention group. The intervention group scored significantly higher on performance of the cesarean delivery (p-value 0.007), hemorrhage management (p-value 0.0002), and overall skill (p-value 0.008). There were no differences in the other categories.
Participants trained with a combination of didactic education and task-trainers versus didactic education alone performed significantly better on all procedural aspects of a cesarean section and hemorrhage management on a high-fidelity simulator, demonstrating that simulation-based training allows trainees to gain procedural experience while decreasing patient risk.
我们评估了一种基于模拟的新型剖宫产培训项目，以教授剖宫产和出血管理的关键技术。方法：这是一项前瞻性教育干预研究。经机构审查委员会批准后，我们在三家医院招募了妇产科、家庭医学和普通外科住院医师。所有参与者都接受了理论教育。然后将参与者随机分为两组，一组接受基于任务训练器的培训，另一组不接受培训。之后，所有住院医师在高保真模拟器上接受完整剖宫产操作和产后出血管理的评估。评估人员对随机分组情况不知情。
2017年7月至2019年1月期间招募了33名参与者。对照组有19名学员，干预组有14名。干预组在剖宫产操作（p值0.007）、出血管理（p值0.0002）和整体技能（p值0.008）方面的得分显著更高。其他类别没有差异。
与仅接受理论教育相比，接受理论教育与任务训练器相结合培训的参与者在高保真模拟器上进行剖宫产和出血管理的所有操作方面表现明显更好，这表明基于模拟的培训使学员能够获得操作经验，同时降低患者风险。
