Arnold Eric, Bulakali Patricial, Burner Elizabeth, Burkholder Taylor, Wendler Carlan
St. Mary Medical Center, United States.
Mbarara University of Science and Technology, Uganda.
Afr J Emerg Med. 2025 Dec;15(4):100893. doi: 10.1016/j.afjem.2025.100893. Epub 2025 Aug 28.
Emergency medicine simulation is an effective training modality in both high and low resource settings. We describe the authors' experiences conducting a four-week interdisciplinary, , simulation training series at an emergency centre in Burundi.
Training emphasized effective closed loop communication, early airway, breathing, and circulation assessment, as well as time to vital signs, IV placement, and oxygen administration when appropriate. Six doctor-nursing teams participated in four training sessions as well as pre- and post-test simulation cases which were graded by an independent evaluator.
The training resulted in a statistically significant improvement in closed loop communication as well as notable narrowing in standard deviation of times to critical actions after the training intervention. Although the small sample size and large variation of data limited their statistical significance, these results may indicate a short-term benefit towards early assessment, management and team communication when simulating management of critical patients. Additionally, we found that interdisciplinary, simulation was a safe and likely beneficial option for training and team building in a resource-limited emergency centre.
While this pilot study establishes feasibility of low-cost, interdisciplinary emergency simulation training in resource-limited settings, further research is needed to establish educational effectiveness on quality-of-care measures and its generalizability to other contexts prior to implementing similar trainings.
急诊医学模拟在资源丰富和匮乏的环境中都是一种有效的培训方式。我们描述了作者在布隆迪一个急救中心开展为期四周的跨学科模拟培训系列的经历。
培训强调有效的闭环沟通、早期气道、呼吸和循环评估,以及获取生命体征的时间、静脉置管和在适当情况下给予氧气。六个医生-护士团队参加了四次培训课程以及培训前和培训后的模拟病例,这些病例由独立评估员评分。
培训导致闭环沟通有统计学意义的改善,并且在培训干预后关键行动时间的标准差显著缩小。尽管样本量小和数据变化大限制了它们的统计学意义,但这些结果可能表明在模拟危重症患者管理时,对早期评估、管理和团队沟通有短期益处。此外,我们发现跨学科模拟对于资源有限的急救中心的培训和团队建设是一种安全且可能有益的选择。
虽然这项试点研究确定了在资源有限的环境中开展低成本、跨学科急诊模拟培训的可行性,但在实施类似培训之前,还需要进一步研究以确定其对医疗质量指标的教育效果及其在其他环境中的普遍性。