Sagalowsky Selin Tuysuzoglu, Prentiss Kimball A, Vinci Robert J
Departments of Emergency Medicine and Pediatrics, Columbia University College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York, USA.
Department of Emergency Medicine, Baystate Medical Center at Tufts University School of Medicine, Springfield, Massachusetts, USA.
BMJ Simul Technol Enhanc Learn. 2018 Oct 4;4(4):179-183. doi: 10.1136/bmjstel-2017-000282. eCollection 2018.
Repetitive paediatric simulation (scenario-debrief-scenario; RPS) is an instructional design that allows immediate application of learner-directed feedback, in contrast to standard simulation (scenario-debrief; STN). Our aim was to examine the impact of RPS embedded within a paediatric resident simulation curriculum, comparing it to STN.
In this prospective educational cohort study, paediatric residents were enrolled in STN (n=18) or RPS (n=15) groups from August 2012 through June 2013. Each group performed an initial high-fidelity simulation and another after 1-2 weeks. Attitudes, confidence and knowledge were assessed using anonymous surveys with each scenario and at 4-6 months. Skills were assessed in real time with a modified Tool for Resuscitation Assessment Using Computerised Simulation (TRACS). Two blinded reviewers assessed a subset of videotaped scenarios for TRACS inter-rater reliability.
Both STN and RPS designs were rated highly. The curriculum led to significant short-term and long-term improvements in confidence, knowledge and performance, with no significant differences between groups. All final respondents reported that they would prefer RPS to STN (n=6 STN, 4 RPS). TRACS intraclass correlation was 0.87 among all reviewers.
Paediatric residents reported preference for RPS over STN, with comparable impacts on confidence, knowledge and performance. The modified TRACS was a reliable tool to assess individual resident performance. Further research is needed to determine whether RPS is a more effective instructional design for teaching resuscitation skills to paediatric residents.
与标准模拟（情景 - 总结；STN）相比，重复性儿科模拟（情景 - 总结 - 情景；RPS）是一种教学设计，它允许立即应用以学习者为导向的反馈。我们的目的是研究嵌入儿科住院医师模拟课程中的RPS的影响，并将其与STN进行比较。
在这项前瞻性教育队列研究中，从2012年8月至2013年6月，儿科住院医师被纳入STN组（n = 18）或RPS组（n = 15）。每组进行一次初始高保真模拟，并在1 - 2周后再进行一次。在每个情景后以及4 - 6个月时，使用匿名调查问卷评估态度、信心和知识。使用改良的计算机模拟复苏评估工具（TRACS）实时评估技能。两名盲法评审员评估了一部分录像情景，以确定TRACS评分者间的可靠性。
STN和RPS设计的评分都很高。该课程在信心、知识和表现方面带来了显著的短期和长期改善，两组之间没有显著差异。所有最终受访者都表示，他们更喜欢RPS而非STN（STN组n = 6，RPS组n = 4）。所有评审员之间TRACS组内相关系数为0.87。
儿科住院医师表示更喜欢RPS而非STN，且对信心、知识和表现的影响相当。改良后的TRACS是评估住院医师个人表现的可靠工具。需要进一步研究以确定RPS是否是一种更有效的教学设计，用于向儿科住院医师教授复苏技能。
