Gross Isabel Theresia, Whitfill Travis, Auzina Luize, Auerbach Marc, Balmaks Reinis
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.
Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
BMJ Simul Technol Enhanc Learn. 2020 May 18;7(2):61-65. doi: 10.1136/bmjstel-2019-000512. eCollection 2021.
Simulation-based training is essential for high-quality medical care, but it requires access to equipment and expertise. Technology can facilitate connecting educators to training in simulation. We aimed to explore the use of remote simulation faculty development in Latvia using telesimulation and telementoring with an experienced debriefer located in the USA.
This was a prospective, simulation-based longitudinal study. Over the course of 16 months, a remote simulation instructor (RI) from the USA and a local instructor (LI) in Latvia cofacilitated with teleconferencing. Responsibility gradually transitioned from the RI to the LI. At the end of each session, students completed the Debriefing Assessment for Simulation in Healthcare (DASH) student version form (DASH-SV) and a general feedback form, and the LI completed the instructor version of the DASH form (DASH-IV). Outcome measures were the changes in DASH scores over time.
A total of eight simulation sessions were cofacilitated of 16 months. As the role of the LI increased over time, the debrief quality measured with the DASH-IV did not change significantly (from 89 to 87), although the DASH-SV score decreased from a total median score of 89 (IQR 86-98) to 80 (IQR 78-85) (p0.005).
In this study, telementoring with telesimulations resulted in high-quality debriefing. The quality-perceived by the students-was higher with the involvement of the remote instructor and declined during the transition to the LI. This concept requires further investigation and could potentially build local simulation expertise promoting sustainability of high-quality simulation.
基于模拟的培训对于高质量医疗至关重要,但需要使用设备并具备专业知识。技术有助于将教育工作者与模拟培训联系起来。我们旨在探索在拉脱维亚利用远程模拟和与美国一位经验丰富的总结汇报者进行远程指导开展远程模拟教员培训。
这是一项基于模拟的前瞻性纵向研究。在16个月的时间里,一名来自美国的远程模拟教员(RI)和拉脱维亚的一名本地教员(LI)通过电话会议共同进行指导。责任逐渐从RI转移到LI。在每次课程结束时,学生们填写医疗保健模拟总结汇报评估(DASH)学生版表格(DASH-SV)和一份通用反馈表格,LI填写DASH表格的教员版(DASH-IV)。结果指标是DASH分数随时间的变化。
在16个月内共共同开展了8次模拟课程。随着时间的推移LI的作用增加,用DASH-IV衡量的总结汇报质量没有显著变化(从89降至87),尽管DASH-SV分数从总中位数89(四分位间距86 - 98)降至80(四分位间距78 - 85)(p<0.005)。
在本研究中,远程模拟与远程指导带来了高质量的总结汇报。在远程教员参与的情况下,学生感知到的质量更高,并且在向LI过渡期间有所下降。这一概念需要进一步研究,并且有可能培养本地模拟专业知识,促进高质量模拟的可持续性。