Yee Jennifer, Bambach Kimberly, Way David P, San Miguel Christopher E, Leung Cynthia G, Winfield Scott, Ahmed Rami A
The Ohio State University Wexner Medical Center, Columbus, USA.
Indiana University, Bloomington, USA.
Adv Simul (Lond). 2025 Jul 1;10(1):36. doi: 10.1186/s41077-025-00365-z.
Learners should ideally be taught low-frequency, high-acuity procedures in a simulated clinical environment to limit patient harm. Evidence supporting a simulation scenario with educational adjuncts to teach procedures versus a traditional procedure laboratory have not been previously demonstrated. To investigate the effects of simulation adjuncts on procedural skills attainment, we compared performances of learners who trained on a modified airway task trainer within the context of a simulation scenario with educational adjuncts for balloon tamponade placement to those who trained on the same task trainer in a typical procedure laboratory setting.
Fifty learners completed the curriculum: 37 emergency medicine residents, 8 emergency medicine/internal medicine residents, and 5 gastroenterology fellows. Learners were randomized into a simulation scenario with adjuncts (SA) or a control group using a modified task trainer in a procedure laboratory (PL) setting. We conducted baseline, approximately 1-month, and 5-month post-training assessments of self-identified competence, knowledge of the procedure, and observed procedural skills.
Learners from both groups demonstrated significant improvement on all three assessments from baseline to the first post-training session. Between the first and second follow-ups, both groups significantly improved on self-assessed competence. At the second follow-up, the PL-trained group scored significantly higher than the SA group on the performance assessment.
All learners demonstrated significant improvements in knowledge, skills performance, and feelings of competence. The PL group demonstrated significantly higher skills performance during the second follow-up after training. This finding suggests that structured practice alone is an effective learning strategy for balloon tamponade placement without needing the resources of accompanying adjuncts within a simulation scenario, and that education with additional adjuncts may contribute to skills decay over time.
理想情况下，应在模拟临床环境中教授学习者低频、高难度的操作，以减少对患者的伤害。此前尚未有证据表明，与传统操作实验室相比，带有教育辅助工具的模拟场景在教授操作方面的效果如何。为了研究模拟辅助工具对操作技能掌握的影响，我们比较了在带有球囊压迫放置教育辅助工具的模拟场景中，使用改良气道任务训练器进行训练的学习者与在典型操作实验室环境中使用相同任务训练器进行训练的学习者的表现。
50名学习者完成了该课程：37名急诊医学住院医师、8名急诊医学/内科住院医师和5名胃肠病学研究员。学习者被随机分为使用改良任务训练器在操作实验室（PL）环境中的模拟场景辅助组（SA）或对照组。我们在基线、训练后约1个月和5个月时，对自我认定的能力、操作知识和观察到的操作技能进行了评估。
两组学习者在从基线到第一次训练后评估的所有三项评估中均表现出显著改善。在第一次和第二次随访之间，两组在自我评估能力方面均有显著提高。在第二次随访时，PL训练组在表现评估中的得分显著高于SA组。
所有学习者在知识、技能表现和能力感受方面均有显著提高。PL组在训练后的第二次随访中表现出显著更高的技能表现。这一发现表明，仅结构化练习就是放置球囊压迫的有效学习策略，无需模拟场景中的辅助资源，并且额外辅助工具的教育可能会随着时间的推移导致技能衰退。
