Bican Rachel, Heathcock Jill C, Jedryszek Flora, Debarge Veronique, DeJonckheere Julien, Cybalski M C, Hanssens Sandy
Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.
Department of Obstetrics, Regional and University Hospital Centre Lille, Lille, France.
BMJ Simul Technol Enhanc Learn. 2020 Nov 13;7(5):323-328. doi: 10.1136/bmjstel-2020-000646. eCollection 2021.
Postpartum haemorrhage is the leading cause of maternal death. Healthcare simulations are an educational tool to prepare students for infrequent high-risk emergencies without risking patient safety. Efficiency of movement in the simulation environment is important to minimize the risk of medical error. The purpose of this study was to quantify the movement behaviours of the participants in the simulation and evaluate the relationship between perceived stress and movement.
N=30 students participated in 10 high-fidelity medical simulations using an adult patient simulator experiencing a postpartum haemorrhage. The participants completed the State-Trait Anxiety Inventory prior to the simulation to measure perceived stress. Physical movement behaviours included walking around the simulation, time spent at bedside, arm movements, movements without purpose, looking at charts/vitals and total movement.
Midwife (MW) students spent significantly more time walking (p=0.004) and looking at charts/vitals (p=<0.001) and significantly less time at bedside (p=<0.001) compared to obstetric (OB) students. The MW students demonstrated significantly more total movements compared to the OB students (p=<0.001). There was a significant, moderate, positive relationship between perceived stress and total movement during the simulation for the MW group (r=0.50, p=0.05). There was a trend for a moderate, positive relationship between perceived stress and total movement during the simulation for the OB group (r=0.46, p=0.10).
Physical movement during a simulation varies by job role and is influenced by perceived stress. Improved understanding of physical movement in the simulation environment can improve feedback, training and environmental set-up.
产后出血是孕产妇死亡的主要原因。医疗模拟是一种教育工具，用于让学生为罕见的高风险紧急情况做好准备，同时不危及患者安全。在模拟环境中的行动效率对于将医疗差错风险降至最低很重要。本研究的目的是量化模拟中参与者的行动行为，并评估感知压力与行动之间的关系。
30名学生使用一名经历产后出血的成年患者模拟器参与了10次高保真医疗模拟。参与者在模拟前完成了状态-特质焦虑量表以测量感知压力。身体行动行为包括在模拟区域走动、在床边停留的时间、手臂动作、无目的动作、查看图表/生命体征以及总行动量。
与产科（OB）专业学生相比，助产士（MW）专业学生在走动（p = 0.004）和查看图表/生命体征（p < 0.001）上花费的时间显著更多，而在床边停留的时间显著更少（p < 0.001）。与OB专业学生相比，MW专业学生的总行动量显著更多（p < 0.001）。在模拟过程中，MW组感知压力与总行动量之间存在显著、中等强度的正相关关系（r = 0.50，p = 0.05）。OB组在模拟过程中，感知压力与总行动量之间存在中等强度正相关关系的趋势（r = 0.46，p = 0.10）。
模拟过程中的身体行动因工作角色而异，并受感知压力影响。更好地理解模拟环境中的身体行动可以改善反馈、培训和环境设置。
