Capogna Emanuele, Raccis Denise, Salvi Francesco, Velardo Matteo, Capogna Giorgio
EESOA Simulation Center.
MedEdPublish (2016). 2021 Jun 7;10:160. doi: 10.15694/mep.2021.000160.1. eCollection 2021.
This article was migrated. The article was marked as recommended. Introduction Evidence for self-assessment in medicine is controversialwith participants under-rating or overestimating their performance. It is also unclear whether this under or overestimation changes during the process of repeated simulation experience. In this study, the authors analyzed the evolution of the behavioral skills of anesthesia trainees during four consecutive standardized postpartum hemorrhages (PPH) high-fidelity simulation scenarios. They compared the self-assessment made by the leader himself and the assessment made by his teammates individually with the assessment made by two expert observers. Methods The authors enrolled forty anesthesia trainee volunteers and divided them into eight teams of five participants each. Each team enacted the same scenario of a patient with atonic PPH following vaginal delivery four times so that all the trainees, except the one assigned the leader's role, could rotate through the roles of anesthesia trainee, obstetrician, midwife, and nurse. The participants themselves and two expert observers, using standardized checklists and questionnaires, carried out an evaluation of the technical (diagnosis and treatment of atonic PPH) and behavioral (leadership, communication, situational awareness, and overall appraisal) skills evidenced in the scenarios. Results The authors noted a progressive improvement in the behavioral scores given to the leader by the examiners, his team, and himself, from the first to the fourth scenario. The scores given by the participants and by the leader himself were greater than those given by the independent observers in the first two scenarios but these differences were no longer significant during the last two scenarios. Discussion Participants overestimated their performances but this overestimation disappeared after the completion of the first two scenarios. The authors suggested that improving the skills of participants throughout the scenarios, most likely improved their metacognitive competence, helping them to better recognize their abilities.
本文已迁移。该文章被标记为推荐文章。引言 医学自我评估的证据存在争议，参与者会低估或高估自己的表现。在反复模拟体验过程中，这种低估或高估是否会发生变化也尚不清楚。在本研究中，作者分析了麻醉实习生在连续四个标准化产后出血（PPH）高保真模拟场景中的行为技能演变。他们将领导者自己的自我评估、队友的个人评估与两位专家观察员的评估进行了比较。方法 作者招募了40名麻醉实习生志愿者，并将他们分成8个团队，每个团队有5名参与者。每个团队对一名阴道分娩后出现宫缩乏力性PPH患者的相同场景进行了4次模拟，以便除被指定为领导者角色的实习生外，所有实习生都能轮流扮演麻醉实习生、产科医生、助产士和护士的角色。参与者本人和两位专家观察员使用标准化检查表和问卷，对模拟场景中展现的技术（宫缩乏力性PPH的诊断和治疗）和行为（领导力、沟通、情境意识和总体评估）技能进行了评估。结果 作者注意到，从第一个场景到第四个场景，考官、其团队和他自己给领导者的行为评分有逐步提高。在前两个场景中，参与者和领导者自己给出的分数高于独立观察员给出的分数，但在最后两个场景中，这些差异不再显著。讨论 参与者高估了自己的表现，但这种高估在完成前两个场景后消失了。作者认为，在整个场景中提高参与者的技能，很可能提高了他们的元认知能力，帮助他们更好地认识自己的能力。
