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产科硬膜外导管置入术:基于清单对免费可得视频资料的视频评估

Epidural Catheterization in Obstetrics: A Checklist-Based Video Assessment of Free Available Video Material.

作者信息

Flinspach Armin N, Raimann Florian J, Schalk Richard, Bepler Lena, Ruesseler Miriam, Flinspach Mairen H, Zacharowski Kai, Sterz Jasmina

机构信息

Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany.

Frankfurt Interdisciplinary Simulation Center FIneST, Medical Faculty, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt, Germany.

出版信息

J Clin Med. 2022 Mar 20;11(6):1726. doi: 10.3390/jcm11061726.

Abstract

Epidural catheterization has become an indispensable part of modern pain therapy, for example, in obstetrics. Learning how to master this skill is an important competency. Videos are among the information sources with the highest information content for learning such skills. The present study aims to analyze videos regarding epidural catheter placement provided on the YouTube platform based on a validated checklist. An expert workshop selected crucial items for learning epidural catheterization in obstetrics. Items were identified and optimized in a five-step testing process. Using this checklist, videos from YouTube were evaluated by eleven health care professionals. Sixteen videos were identified and analyzed. Concerning the catheterization-specific part of the checklist, only two videos showed satisfactory quality. In the didactic part, eleven out of 21 items reached a mean score >50% of the points. Regarding interrater reliability, the catheterization-specific checklist was shown to be substantial (Fleiss’ kappa = 0.610), and the didactic part was shown to be fair (Fleiss’ kappa = 0.401). Overall, standard monitoring and appropriate aseptic technique were followed in only 42% and 49% for the procedure. There was a significant correlation between the runtime and the content quality (p < 0.001). No correlation could be found in terms of platform rating parameters. The video quality varied highly in terms of the requirements of this practical skill. The majority appear unsuitable for self-study due to serious errors and deficiencies regarding patient safety. However, there is no quality control on free platforms. Accordingly, it is difficult to identify suitable videos for educational purposes.

摘要

硬膜外导管置入术已成为现代疼痛治疗中不可或缺的一部分,例如在产科领域。学习如何掌握这项技能是一项重要的能力。视频是学习此类技能的信息含量最高的信息来源之一。本研究旨在基于一份经过验证的检查表,分析YouTube平台上提供的有关硬膜外导管置入的视频。一个专家研讨会挑选了产科硬膜外导管置入术学习的关键项目。这些项目在一个五步测试过程中得以确定和优化。使用这份检查表,11名医疗保健专业人员对来自YouTube的视频进行了评估。共识别并分析了16个视频。关于检查表中特定于导管置入的部分,只有两个视频质量令人满意。在教学部分,21个项目中有11个项目的平均得分超过了总分的50%。关于评分者间信度,特定于导管置入的检查表显示为实质性的(Fleiss' kappa = 0.610),教学部分显示为尚可(Fleiss' kappa = 0.401)。总体而言,该操作中仅42%和49%的视频遵循了标准监测和适当的无菌技术。运行时长与内容质量之间存在显著相关性(p < 0.001)。在平台评分参数方面未发现相关性。就这项实践技能的要求而言,视频质量差异很大。由于在患者安全方面存在严重错误和缺陷,大多数视频似乎不适合自学。然而,免费平台上没有质量控制。因此,很难识别出适合教育目的的视频。

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