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复苏培训的快速循环刻意练习方法:一项系统综述。

Rapid cycle deliberate practice approach on resuscitation training: A systematic review.

作者信息

Abelairas-Gómez Cristian, Cortegiani Andrea, Sawyer Taylor, Greif Robert, Donoghue Aaron

机构信息

Faculty of Education Sciences and CLINURSID Research Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.

Simulation and Intensive Care Unit of Santiago (SICRUS) Research Group, Health Research Institute of Santiago, University Hospital of Santiago de Compostela-CHUS, Santiago de Compostela, Spain.

出版信息

Resusc Plus. 2024 May 6;18:100648. doi: 10.1016/j.resplu.2024.100648. eCollection 2024 Jun.

Abstract

AIM

To evaluate the effectiveness of Rapid Cycle Deliberate Practice (RCDP) compared to traditional instruction or other forms of learning on resuscitation training outcomes and on clinical and/or patient-related outcomes.

METHODS

As part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation it was conducted this review and searched Medline, Embase and Cochrane from inception to Feb 12th, 2024. Risk of bias assessment was performed with the Risk of Bias in Non-randomized Studies of Interventions assessment tool and the Revised Cochrane risk-of-bias tool for randomized trials. The GRADE approach was used to evaluate the overall certainty of evidence for each outcome.

RESULTS

4420 abstracts were retrieved by the initial search and 10 additional studies were identified through other resources. Sixty-five studies were selected for eligibility and nine simulated studies met the inclusion criteria. A -analysis was performed on three outcomes: time to chest compressions, time to defibrillation and time to first epinephrine given, which showed that RCDP had significantly shorter time to defibrillation and time to administration of epinephrine than controls. The overall certainty of evidence was very low across all outcomes due to risk of bias, inconsistency, indirectness, and imprecision.

CONCLUSION

It may be reasonable to include RCDP as an instructional design feature of basic and advanced life support training. However, substantial variations of delivering RCDP exist and there is no uniform use of RCDP. Further research is necessary on medium/long-term effects of RCDP training, and on the effects on different target groups of training.

摘要

目的

评估快速循环刻意练习(RCDP)与传统教学或其他学习形式相比,对复苏培训结果以及临床和/或患者相关结果的有效性。

方法

作为国际复苏联合委员会持续证据评估过程的一部分,进行了本次综述,并检索了从创刊至2024年2月12日的Medline、Embase和Cochrane数据库。使用干预性非随机研究的偏倚风险评估工具和随机试验的修订版Cochrane偏倚风险工具进行偏倚风险评估。采用GRADE方法评估每个结果的总体证据确定性。

结果

初步检索共获得4420篇摘要,通过其他资源又识别出10项研究。筛选出65项研究纳入资格评估,9项模拟研究符合纳入标准。对三个结果进行了分析:开始胸外按压的时间、除颤时间和首次给予肾上腺素的时间,结果显示RCDP组的除颤时间和给予肾上腺素的时间显著短于对照组。由于存在偏倚风险、不一致性、间接性和不精确性,所有结果的总体证据确定性都非常低。

结论

将RCDP纳入基础和高级生命支持培训的教学设计特征可能是合理的。然而,RCDP的实施存在很大差异,且没有统一的应用方式。有必要进一步研究RCDP培训的中长期效果,以及对不同目标培训群体的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f32/11096743/a3569451bac5/gr1.jpg

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