From the SJOG Midland Public and Private Hospitals, Perth, Western AustraliaAustralia.
Curtin University, Perth, Western Australia, Australia.
Anesth Analg. 2023 Sep 1;137(3):551-558. doi: 10.1213/ANE.0000000000006468. Epub 2023 Apr 12.
Simulation-based education (SBE) is common in resource-rich locations, but barriers exist to widespread implementation in low-resource settings (LRSs). Vital Anesthesia Simulation Training (VAST) was developed to offer low-cost, immersive simulation to teach core clinical practices and nontechnical skills to perioperative health care teams. To promote sustainability, courses in new locations are preceded by the VAST Facilitator Course (VAST FC) to train local faculty. The purpose of this study was to explore the experiences of VAST FC graduates in translating postcourse knowledge and skills into their workplaces.
This qualitative study used focus group interviews with 24 VAST FC graduates (from 12 low- and middle-income and 12 high-income countries) to explore how they had applied new learning in the workplace. Focus groups were conducted by videoconferencing with data transcribed verbatim. Data were analyzed using inductive thematic analysis.
Enabler themes for knowledge and skill translation following facilitator training were (1) the structured debriefing framework, (2) the ability to create a supportive learning environment, and (3) being able to meaningfully discuss nontechnical skills. Two subthemes within the debriefing framework were (1.1) knowledge of conversational techniques and (1.2) having relevance to clinical debriefing. Barrier themes limiting skill application were (1) added time and effort required for comprehensive debriefing, (2) unsupportive workplaces, and (3) lack of opportunities for mentorship and practice postcourse.
Participants found parallels between SBE debriefing conversations, clinical event debriefing, and feedback conversations and were able to apply knowledge and skills in a variety of settings post course. This study supports the relevance of simulation facilitator training for SBE in LRSs.
基于模拟的教育（SBE）在资源丰富的地区很常见，但在资源匮乏的环境（LRS）中广泛实施存在障碍。Vital Anesthesia Simulation Training（VAST）旨在提供低成本、沉浸式模拟，以向围手术期医疗保健团队教授核心临床实践和非技术技能。为了促进可持续性，在新地点开设课程之前，先进行 VAST 培训师课程（VAST FC），以培训当地的教师。本研究的目的是探讨 VAST FC 毕业生将课程后的知识和技能转化为工作场所的经验。
本定性研究使用焦点小组访谈，对 24 名 VAST FC 毕业生（来自 12 个中低收入国家和 12 个高收入国家）进行访谈，探讨他们如何在工作场所应用新的学习成果。焦点小组通过视频会议进行，数据逐字转录。使用归纳主题分析对数据进行分析。
在培训师培训后，促进知识和技能转化的主题有：（1）结构化的讨论框架，（2）创建支持性学习环境的能力，（3）能够有意义地讨论非技术技能。讨论框架内的两个子主题是（1.1）对话技巧的知识和（1.2）与临床讨论的相关性。限制技能应用的障碍主题有：（1）全面讨论所需的额外时间和精力，（2）不支持的工作场所，（3）课程后缺乏指导和实践的机会。
参与者发现 SBE 讨论与临床事件讨论和反馈讨论之间存在相似之处，并且能够在课程结束后将知识和技能应用于各种环境中。这项研究支持在 LRS 中进行 SBE 的模拟培训师培训的相关性。
