Rede D'Or São Luiz, Hospital São Rafael, Unidade de Cuidado Intensivo, Salvador BA, Brazil.
Universidade Federal da Bahia, Departamento de Neurociências e Saúde Mental, Salvador BA, Brazil.
Arq Neuropsiquiatr. 2021 Jan;79(1):2-7. doi: 10.1590/0004-282X-anp-2019-0369.
Simulations are becoming widely used in medical education, but there is little evidence of their effectiveness on neurocritical care. Because acute stroke is a neurological emergency demanding prompt attention, it is a promising candidate for simulation training.
To assess the impact of a stroke realistic simulation course on clinicians' self-perception of confidence in the management of acute stroke.
We conducted a controlled, before-after study. For our intervention, 17 healthcare professionals participated in a stroke realistic simulation course. As controls, participants were chosen from a convenience sample of attendees to the courses Emergency Neurologic Life Support (ENLS) (18 participants) and Neurosonology (20 participants). All participants responded pre- and post-test questionnaires evaluating their self-perception of confidence in acute stroke care, ranging from 10 to 50 points. We evaluated the variation between pre- and post-test results to assess the change on trainees' self-perception of confidence in the management of acute stroke. Multivariate analysis was performed to control for potential confounders.
Forty-six (83.63%) subjects completed both questionnaires. The post-test scores were higher than those from the pretests in the stroke realistic simulation course group [pretest median (interquartile range - IQR): 41.5 (36.7-46.5) and post-test median (IQR): 47 (44.7-48); p=0.033], but not in the neurosonology [pretest median (IQR): 46 (44-47) and post-test median (IQR): 46 (44-47); p=0.739] or the ENLS [pretest median (IQR): 46.5 (39-48.2), post-test median (IQR): 47 (40.2-49); p=0.317] groups. Results were maintained after adjustment for covariates.
This stroke realistic simulation course was associated with an improvement on trainees' self-perception of confidence in providing acute stroke care.
模拟教学在医学教育中应用广泛，但在神经危重症医学领域，其有效性的证据有限。由于急性脑卒中是一种需要立即关注的神经急症，因此它是模拟培训的一个很有前途的候选领域。
评估急性脑卒中真实模拟课程对临床医生管理急性脑卒中信心的自我认知的影响。
我们进行了一项对照前后研究。在我们的干预组中，17 名医疗保健专业人员参加了急性脑卒中真实模拟课程。作为对照组，从参加急诊神经生命支持（ENLS）课程（18 名参与者）和神经超声课程（20 名参与者）的便利样本中选择参与者。所有参与者在预测试和后测试问卷中回答了关于他们对急性脑卒中护理的自我认知的信心，范围从 10 到 50 分。我们评估了培训前后结果之间的变化，以评估受训者对急性脑卒中管理的自我认知的变化。进行了多变量分析以控制潜在的混杂因素。
46 名（83.63%）参与者完成了两份问卷。在急性脑卒中真实模拟课程组中，后测分数高于前测分数[前测中位数（四分位距-IQR）：41.5（36.7-46.5）和后测中位数（IQR）：47（44.7-48）；p=0.033]，但在神经超声[前测中位数（IQR）：46（44-47）和后测中位数（IQR）：46（44-47）；p=0.739]或 ENLS[前测中位数（IQR）：46.5（39-48.2），后测中位数（IQR）：47（40.2-49）；p=0.317]组中则不然。在调整协变量后，结果仍然成立。
这种急性脑卒中真实模拟课程与受训者对急性脑卒中护理的自我认知信心的提高有关。
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