Kabi Ankita, Dhar Mridul, Arora Poonam, Bhardwaj Bharat B, Chowdhury Nilotpal, Rao Shalinee
Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, IND.
Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, IND.
Cureus. 2021 Aug 20;13(8):e17323. doi: 10.7759/cureus.17323. eCollection 2021 Aug.
Background Coronavirus disease 2019 (COVID-19) has currently emerged as a global threat and a significant public health issue. The role of simulation-based training (SBT) during such a pandemic becomes more relevant for teaching a team approach and building capacity especially when there is a threat to health care workers due to aerosol generation and there is a huge demand for manpower during the pandemic. Objective To assess the effectiveness of a simulation-based training program in improving knowledge and concept of teamwork of health care workers involved in airway management of suspected or confirmed COVID-19 patients. Methods After institutional review committee approval, a prospective analytical study was conducted in the department of medical education on participants from various specialties undergoing COVID-19 airway training. The purpose of the study was to assess team dynamics during simulation scenarios and compare test scores at baseline, immediately post-training, and seven days post-training (using online forms). Scores were compared using the Friedman test followed by post-hoc testing. Sub-group comparison was done using an unpaired t-test. Results Median scores were significantly higher in the immediate post-training test and seven days post-training test (online) compared to baseline pretest scores in the overall participant group and in individual sub-groups. There was no significant difference in immediate versus seven-day post-training test scores overall and in all subgroups. In the sub-group comparisons, median improvement in score was significantly better in the non-anesthesia group and in the resident group. It was observed that team performance in terms of role clarity, closed-loop communication, and idea acceptance improved substantially during the subsequent scenarios. Conclusion Simulation-based training was effective in improving knowledge and team dynamics amongst health care workers regarding airway management in COVID-19 patients, with retention of up to one week. Similar future research can be planned for the affective and psychomotor domains.
背景 2019 冠状病毒病（COVID-19）目前已成为全球威胁和重大公共卫生问题。在这样的大流行期间，基于模拟的培训（SBT）对于传授团队协作方法和培养能力变得更加重要，尤其是当由于气溶胶产生对医护人员构成健康威胁且大流行期间对人力有巨大需求时。目的 评估基于模拟的培训计划对提高参与疑似或确诊 COVID-19 患者气道管理的医护人员的知识和团队协作概念的有效性。方法 经机构审查委员会批准后，在医学教育部门对来自各个专业的参与 COVID-19 气道培训的参与者进行了一项前瞻性分析研究。该研究的目的是评估模拟场景中的团队动态，并比较基线、培训后即刻和培训后七天（使用在线表格）的测试成绩。使用弗里德曼检验随后进行事后检验比较分数。亚组比较使用未配对 t 检验。结果 总体参与者组和各个亚组中，培训后即刻测试和培训后七天（在线）测试的中位数分数显著高于基线预测试分数。培训后即刻与七天后的测试成绩在总体和所有亚组中均无显著差异。在亚组比较中，非麻醉组和住院医师组的分数中位数改善明显更好。观察到在随后的场景中，团队在角色清晰度、闭环沟通和想法接受方面的表现有了显著改善。结论 基于模拟的培训有效地提高了医护人员在 COVID-19 患者气道管理方面的知识和团队动态，且能保持长达一周。未来可以针对情感和心理运动领域规划类似的研究。
