From the Departments of Pediatrics and Emergency Medicine, Yale University School of Medicine, New Haven, CT.
Warren Alpert School of Medicine of Brown University, Providence, RI.
Pediatr Emerg Care. 2022 Nov 1;38(11):e1655-e1659. doi: 10.1097/PEC.0000000000002678. Epub 2022 Mar 30.
SimBox simulations allow for high-frequency open-access health care education, overcoming cost and resource barriers. Prehospital paramedics and emergency medical technician (EMT) care for children infrequently. In this study, prehospital providers evaluated pediatric SimBox simulations.
This was a cross-sectional study of EMS professionals participating in a series of simulations conducted in a larger project assessing improvement of the quality of pediatric care in the prehospital setting. Participants were teams of two, which comprised a paramedic/paramedic, paramedic/EMT, or 2 EMTs. The simulations used facilitator resources, debriefing prompts, video depictions of patients and vital signs, and a low-fidelity manikin. Pediatric emergency care coordinators, EMS training officers, and/or emergency physicians facilitated simulations of seizure, sepsis with respiratory failure, and child abuse, followed by debriefings. Participants completed an online survey after the simulation and rated it in 4 domains: prebriefing, scenario content, debriefing, and overall. Ratings were trifold: "strongly agree," "somewhat agree," or "do not agree." Data were analyzed by case type, participant type, location, participant reaction to simulation elements, and the debriefing. Net Promoter Scores were calculated to assess participant endorsement of SimBox.
There were 121 participants: 103 (87%) were paramedics, and 18 (13%) were EMTs. Participant agreement of simulation benefit for clinical practice was high, for example, "I am more confident in my ability to prioritize care and interventions" (98.4% strongly or somewhat agree), and 99.2% of participants agreed the postsimulation debriefing with facilitators "provided opportunities to self-reflect on my performance during simulation." Overall, 97.5% strongly or somewhat agreed that the simulations "improved my comfort in pediatric acute care." Net Promoter Score showed 65.3% were promoters of and 24% were passive about SimBox.
SimBox simulations are associated with improved self-efficacy of prehospital care providers for care of acutely ill or injured children. The majority promotes SimBox as a learning tool.
SimBox 模拟可以实现高频次的开放医疗保健教育，克服成本和资源障碍。院前护理人员和急救医疗技术员（EMT）很少照顾儿童。在这项研究中，院前提供者评估了儿科 SimBox 模拟。
这是一项横断面研究，涉及参与一系列模拟的 EMS 专业人员，这些模拟是在一个更大的项目中进行的，该项目旨在提高院前环境中儿科护理的质量。参与者是由两名人员组成的团队，其中包括一名护理人员/护理人员、护理人员/EMT 或两名 EMT。模拟使用了协调员资源、辅导提示、患者和生命体征的视频描述以及低保真度模拟人。儿科急救护理协调员、EMS 培训官和/或急诊医师协助进行了癫痫发作、伴有呼吸衰竭的脓毒症和儿童虐待的模拟，随后进行了辅导。参与者在模拟后完成了在线调查，并在 4 个领域对其进行了评分：预简报、场景内容、辅导和总体。评分有三重：“强烈同意”、“有些同意”或“不同意”。按案例类型、参与者类型、地点、参与者对模拟元素的反应以及辅导进行数据分析。计算了净推荐值分数以评估参与者对 SimBox 的认可程度。
共有 121 名参与者：103 名（87%）是护理人员，18 名（13%）是 EMT。参与者对模拟对临床实践的益处的一致同意程度很高，例如，“我对自己优先考虑护理和干预的能力更有信心”（98.4%强烈或有些同意），并且 99.2%的参与者同意与协调员进行模拟后辅导“为我在模拟期间的表现提供了自我反思的机会”。总体而言，97.5%的参与者强烈或有些同意模拟“提高了我在儿科急症护理方面的舒适度”。净推荐值分数显示，65.3%的参与者是 SimBox 的积极推荐者，24%的参与者对 SimBox 持中立态度。
SimBox 模拟与院前护理人员对急性病或受伤儿童护理的自我效能感提高有关。大多数人认为 SimBox 是一种学习工具。
