Shrestha Rojina, Indrasena Buddhike Sri Harsha, Subedi Prakash, Lamsal Dayaram, Moulton Chris, Aylott Jill
Department of Emergency Medicine, Chitwan Medical College Teaching Hospital, Chitwan, Nepal.
Institute for Quality Improvement, World Academy of Medical Leadership, Sheffield, UK.
Resusc Plus. 2023 Aug 24;15:100448. doi: 10.1016/j.resplu.2023.100448. eCollection 2023 Sep.
To test junior doctors' abilities to retain advanced life support psychomotor skills and theoretical knowledge in management of shockable rhythm cardiac arrest.
A repeated measure pre-post study design was used with 43 junior doctors, recruited after notifying them with robust method of attraction through flyers, brochures, email and phone calls. Written and performance tests, initial pre-test, immediate post-training, 30-days post-training and 60-days post-training, using simulation-based scenarios with a low-fidelity manikin were used with recording performance of ALS.
Resuscitation Council UK ALS algorithms and guidelines were used in a simulated testing environment.
There was a highly significant improvement in knowledge immediately after training ( < 0.00), with a net gain of marks from a mean value of 63.2% before training to 87.7% after training by 24.5% (95% CI 19.4, 29.6).There was a gradual decline of retained knowledge with time from immediate post-training over, 30-days and 60-days post-training ( < 0.00). The simulation pre-training assessments and immediate post-training assessments results were statistically significant ( < .00). The mean difference was 44.1% (95% CI 50.11, 38.10). There was a statistically significant decline of the competency with time ( < .00). Unlike for the knowledge test, the drop was significant on the 30th day ( < .00) with a mean difference of -10.5% (95% CI -13.55, -7.40).
The training of junior doctors in shockable rhythm cardiac arrest in a low resource setting, improved knowledge and skills in the participants after training. However, retention of knowledge declined at 30 days and more significantly after 60 days and retention of skill was declined more significantly at 30 days.
测试初级医生在处理可电击心律心脏骤停时保持高级生命支持操作技能和理论知识的能力。
采用重复测量前后测研究设计，招募了43名初级医生，通过传单、宣传册、电子邮件和电话等强有力的吸引方法通知他们。使用基于模拟场景的低仿真人体模型进行书面和操作测试，包括初始预测试、培训后立即测试、培训后30天测试和培训后60天测试，并记录高级生命支持的表现。
在模拟测试环境中使用英国复苏委员会的高级生命支持算法和指南。
培训后知识立即有极显著提高（<0.00），分数净增益从培训前的平均值63.2%提高到培训后的87.7%，提高了24.5%（95%可信区间19.4, 29.6）。从培训后立即开始，随着时间推移，在培训后30天和60天，知识保留率逐渐下降（<0.00）。模拟预培训评估和培训后立即评估结果具有统计学显著性（<0.00）。平均差异为44.1%（95%可信区间50.11, 38.10）。能力随时间有统计学显著性下降（<0.00）。与知识测试不同，在第30天下降显著（<0.00），平均差异为-10.5%（95%可信区间-13.55, -7.40）。
在资源有限的环境中对初级医生进行可电击心律心脏骤停培训，培训后参与者的知识和技能得到提高。然而，知识保留率在30天下降，60天后更显著，技能保留率在30天下降更显著。
