Young Ann L, Doughty Cara B, Williamson Kaitlin C, Won Sharon K, Rus Marideth C, Villarreal Nadia N, Camp Elizabeth A, Lemke Daniel S
Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
Section of Emergency Medicine, Baylor College of Medicine Department of Pediatrics, Houston, Texas, USA.
BMJ Simul Technol Enhanc Learn. 2020 Dec 2;7(5):338-344. doi: 10.1136/bmjstel-2020-000652. eCollection 2021.
Learner workload during simulated team-based resuscitations is not well understood. In this descriptive study, we measured the workload of learners in different team roles during simulated paediatric cardiopulmonary resuscitation.
Paediatric emergency nurses and paediatric and emergency medicine residents formed teams of four to eight and randomised into roles to participate in simulation-based, paediatric resuscitation. Participant workload was measured using the NASA Task Load Index, which provides an average workload score (from 0 to 100) across six subscores: mental demand, physical demand, temporal demand, performance, frustration and mental effort. Workload is considered low if less than 40, moderate if between 40 and 60 and high if greater than 60.
There were 210 participants representing 40 simulation teams. 138 residents (66%) and 72 nurses (34%) participated. Team lead reported the highest workload at 65.2±10.0 (p=0.001), while the airway reported the lowest at 53.9±10.8 (p=0.001); team lead had higher scores for all subscores except physical demand. Team lead reported the highest mental demand (p<0.001), while airway reported the lowest. Cardiopulmonary resuscitation coach and first responder reported the highest physical demands (p<0.001), while team lead and nurse recorder reported the lowest (p<0.001).
Workload for learners in paediatric simulated resuscitation teams was moderate to high and varied significantly based on team role. Composition of workload varied significantly by team role. Measuring learner workload during simulated resuscitations allows improved processes and choreography to optimise workload distribution.
在模拟团队复苏过程中学员的工作量尚未得到充分了解。在这项描述性研究中，我们测量了模拟儿科心肺复苏过程中不同团队角色学员的工作量。
儿科急诊护士以及儿科和急诊医学住院医师组成四至八人的团队，并随机分配角色以参与基于模拟的儿科复苏。使用美国国家航空航天局任务负荷指数（NASA Task Load Index）测量参与者的工作量，该指数在六个子分数上提供平均工作量得分（从0到100）：心理需求、体力需求、时间需求、绩效、挫折感和心理努力。如果得分低于40，则认为工作量低；如果在40至60之间，则为中等；如果大于60，则为高。
共有210名参与者，代表40个模拟团队。138名住院医师（66%）和72名护士（34%）参与。团队负责人报告的工作量最高，为65.2±10.0（p=0.001），而气道管理人员报告的工作量最低，为53.9±10.8（p=0.001）；除体力需求外，团队负责人在所有子分数上的得分都更高。团队负责人报告的心理需求最高（p<0.001），而气道管理人员报告的最低。心肺复苏教练和第一反应者报告的体力需求最高（p<0.001），而团队负责人和护士记录员报告的最低（p<0.001）。
儿科模拟复苏团队中学员的工作量为中等至高，并且根据团队角色有显著差异。工作量的构成因团队角色而异。在模拟复苏过程中测量学员工作量有助于改进流程和编排，以优化工作量分配。
