Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
Faculty of Medicine, University College London, London, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2022 Sep;276:74-81. doi: 10.1016/j.ejogrb.2022.07.003. Epub 2022 Jul 8.
This review aims to systematically evaluate the currently available evidence investigating the effectiveness of simulation-based training (SBT) in emergency obstetrics care (EmOC) in Low- and Lower-Middle Income Countries (LMIC). Furthermore, based on the challenges identified we aim to provide a series of recommendations and a knowledge base for future research in the field.
A systematic database search was conducted of original articles that explored the use of simulation-based training for EmOC in LMIC in EMBASE, MEDLINE, Cochrane database and Google Scholar, from inception to January 2022.
The literature search identified 1,957 articles of which a total of 15 studies were included in this review, featuring 8,900 healthcare professionals from 18 countries. The SBT programmes varied in the reviewed studies. The most common training programme consisted of the PRONTO programme implemented by four studies, comprising of 970 participants across four different countries. In general, programmes consisted of lectures, workshops and simulations of emergency obstetric scenarios followed by a debrief of participants. There were thirteen studies, comprising of 8,332 participants, which tested for improvements in clinical knowledge in post-partum haemorrhage, neonatal resuscitation, pre-eclampsia, shoulder dystocia and sepsis. All the included studies reported improvements in clinical knowledge following the simulation of scenarios. Changes in teamwork, improvement in leadership and in communication skills were also widely reported.
The use of SBT programmes is not only sustainable, feasible and acceptable in LMIC, but could also improve clinical knowledge, communication, and teamwork among healthcare providers, thus directly addressing the UN Sustainable Development Goals.
本综述旨在系统评估当前关于在中低收入国家（LMIC）中利用模拟培训（SBT）进行紧急产科护理（EmOC）的有效性的证据。此外，基于确定的挑战，我们旨在为该领域的未来研究提供一系列建议和知识库。
我们对原始文章进行了系统的数据库搜索，这些文章探讨了在 LMIC 中使用基于模拟的培训进行 EmOC，检索范围从开始到 2022 年 1 月，涵盖了 EMBASE、MEDLINE、Cochrane 数据库和 Google Scholar。
文献搜索确定了 1957 篇文章，其中共有 15 项研究被纳入本综述，涉及来自 18 个国家的 8900 名医疗保健专业人员。在综述研究中，SBT 方案各不相同。最常见的培训方案是由四项研究实施的 PRONTO 方案，涵盖了四个不同国家的 970 名参与者。一般来说，方案包括讲座、研讨会和紧急产科情景模拟，随后对参与者进行反思。有 13 项研究，涉及 8332 名参与者，测试了产后出血、新生儿复苏、子痫前期、肩难产和败血症的临床知识的提高。所有纳入的研究都报告了模拟情景后临床知识的提高。团队合作的变化、领导能力的提高和沟通技巧的提高也得到了广泛的报道。
SBT 方案不仅在 LMIC 中具有可持续性、可行性和可接受性，而且可以提高医疗保健提供者的临床知识、沟通和团队合作能力，从而直接实现联合国可持续发展目标。
