Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo.
Am J Perinatol. 2024 Jun;41(8):1094-1102. doi: 10.1055/a-1793-8024. Epub 2022 Mar 10.
Behavioral performance of health professionals is essential for adequate patient care. This study aimed to assess the behavioral skills of fellows in neonatology before and after a simulation training program on neonatal resuscitation.
From March 2019 to February 2020, a prospective cohort with 12 second-year fellows in neonatology were evaluated during three training cycles (16 hours each) in manikin-based simulation of neonatal resuscitation with standardized scenarios. Each cycle lasted 1 month, followed by a 3-month interval. One video-recorded scenario of approximately 10 minutes was performed for each fellow at the beginning and at the end of each training cycle. Therefore, each fellow was recorded six times, before and after each one of three training cycles. Anxiety of the fellows was assessed by the Beck Anxiety Inventory applied before the first training cycle. The videos were independently analyzed in a random order by three trained facilitators using the Behavioral Assessment Tool. The behavioral performance was evaluated by repeated measures of analysis of variance adjusted for anxiety and for previous experience in neonatal resuscitation.
Fellows' overall behavioral performance improved comparing the moment before the first training and after the second training. The specific skills, such as communication with the team, delegation of tasks, allocation of attention, use of information, use of resources, and professional posture, showed a significant improvement after the second month of training. No further gains were noted with the third training cycle. Anxiety was observed in 42% of the fellows and its presence worsened their behavioral performance.
An improvement in behavioral performance was observed, comparing the moment before the first training and after the second training, without further gains after the third training. It is worth noting the important role of anxiety as a modulator of acquisition and retention of behavioral skills in health professionals in training.
· Simulation training should improve technical and behavioral skills of providers. · Behavioral skills improve after a first cycle of training, but not after a repeat cycle. · Anxiety modulates trainees' behavioral performance.
卫生专业人员的行为表现对于提供充分的患者护理至关重要。本研究旨在评估新生儿科住院医师在接受新生儿复苏模拟培训计划前后的行为技能。
2019 年 3 月至 2020 年 2 月，对 12 名处于第二年培训阶段的新生儿科住院医师进行了前瞻性队列研究，他们在基于模型的新生儿复苏模拟培训中接受了三个培训周期（每个周期 16 小时），并采用了标准化场景。每个周期持续 1 个月，然后间隔 3 个月。每位住院医师在每个培训周期的开始和结束时都会进行大约 10 分钟的视频记录场景。因此，每位住院医师在三个培训周期之前和之后都进行了六次记录。在第一个培训周期之前，使用贝克焦虑量表评估住院医师的焦虑程度。视频由三名经过培训的主持人以随机顺序独立分析，使用行为评估工具进行分析。行为表现通过对焦虑和新生儿复苏先前经验进行调整的重复测量方差分析进行评估。
与第一次培训前相比，住院医师的整体行为表现在第二次培训后有所提高。沟通团队、任务分工、注意力分配、信息使用、资源利用和专业姿势等特定技能在培训第二个月后有显著提高。第三个培训周期没有进一步提高。42%的住院医师表现出焦虑，其存在会恶化他们的行为表现。
与第一次培训前相比，住院医师在第二次培训后行为表现有所提高，第三次培训后没有进一步提高。值得注意的是，焦虑作为培训中卫生专业人员行为技能获得和保留的调节因素的重要作用。
·模拟培训应提高提供者的技术和行为技能。·行为技能在第一轮培训后得到提高，但在重复培训后不会提高。·焦虑调节学员的行为表现。
