Padhya Dipti, Tripathi Sandeep, Kashyap Rahul, Alsawas Mouaz, Murthy Srinivas, Arteaga Grace M, Dong Yue
Cedars-Sinai Medical Center, West Hollywood, CA, USA.
OSF HealthCare System, Peoria, IL, USA.
Glob Pediatr Health. 2021 Apr 23;8:2333794X211007473. doi: 10.1177/2333794X211007473. eCollection 2021.
Remote simulation training provides a unique opportunity to captivate providers despite language, distance, and cultural barriers. Previously we developed a novel electronic decision support and rounding tool, the Checklist for Early Recognition and Treatment of Acute Illness in Pediatrics (CERTAINp). This study was conducted to determine the feasibility and impact of remote simulation training of international PICU providers using CERTAINp. We conducted train-the-trainer sessions in 7 hospitals based in 5 countries (China, Congo, Croatia, India, and Turkey) between 11/2015 and 11/2016. Providers first took part in a base line simulation session to assess their clinical performance. They had structured hands-on training using CERTAINp, which was done remotely using video conference with recording capabilities. Performance in PICU "admission" and "rounding" scenarios was assessed by their adherence to standard of care guidelines using CERTAINp. After this training, the providers were re-evaluated for performance using a validated instrument by 2 independent trained reviewers. A total of 7 hospitals completed both baseline and post simulation sessions. We observed improved critical task (total 14) completion in the admission scenarios where pre training task completion was 8.2 ± 2.6, while after remote training was 11.2 ± 1.8, = .01. In rounding scenarios, compliance to standard of care guidelines improved overall from 45% to 95% ( < .01). We observed an improvement in compliance for measures determined as best practice guidelines in simulation rounding and overall improvement in critical tasks for simulated admission cases after remote training.
远程模拟培训提供了一个独特的机会，能够让医疗服务提供者不受语言、距离和文化障碍的影响。此前，我们开发了一种新颖的电子决策支持和查房工具——儿科急性疾病早期识别与治疗检查表（CERTAINp）。本研究旨在确定使用CERTAINp对国际儿科重症监护病房（PICU）医疗服务提供者进行远程模拟培训的可行性和影响。2015年11月至2016年11月期间，我们在5个国家（中国、刚果、克罗地亚、印度和土耳其）的7家医院开展了培训培训师课程。医疗服务提供者首先参加基线模拟课程，以评估他们的临床表现。他们使用CERTAINp进行了结构化的实践培训，培训通过具备录制功能的视频会议远程进行。通过他们在PICU“入院”和“查房”场景中对使用CERTAINp的护理标准指南的遵守情况来评估表现。培训结束后，由2名独立的经过培训的评审人员使用经过验证的工具对医疗服务提供者的表现进行重新评估。共有7家医院完成了基线和模拟后课程。我们观察到，在入院场景中，关键任务（共14项）的完成情况有所改善，培训前任务完成率为8.2±2.6，而远程培训后为11.2±1.8，P = 0.01。在查房场景中，对护理标准指南的遵守情况总体从45%提高到了95%（P<0.01）。我们观察到，在远程培训后，模拟查房中被确定为最佳实践指南的措施的遵守情况有所改善，模拟入院病例的关键任务总体也有所改善。
